Colarian J, Arlow F L, Calzada R, Luk G D, Majumdar A P
Department of Internal Medicine, Veterans Administration Medical Center, Detroit, Michigan.
Gastroenterology. 1991 Jun;100(6):1528-32. doi: 10.1016/0016-5085(91)90649-6.
Hyperplastic polyps are considered to be benign colonic lesions with almost no potential for malignant transformation. Recent reports have shown an increased association of hyperplastic polyps with adenomatous polyps and have advocated a full colonoscopy in patients who harbor hyperplastic polyps. Hyperproliferative mucosa is known to be associated with adenomatous polyps, but its relationship to hyperplastic polyps is unknown. In the present pilot study, it is determined whether a change in mucosal proliferative patterns is observed in patients who harbor only hyperplastic polyps or a history of hyperplastic polyps relative to those who harbor both hyperplastic polyps and adenomatous polyps by measuring ornithine decarboxylase and tyrosine kinase activity in macroscopically normal rectal mucosa. Fifteen patients had either adenomatous polyps proximally or harbored adenomatous polyps and hyperplastic polyps. Seven patients had hyperplastic polyps and 15 patients had a prior history of hyperplastic polyps with no polyps found during the current examination. The ornithine decarboxylase activity of the rectal mucosa with proximal adenomatous polyps or both polyp types was significantly higher than that of hyperplastic polyps, the history of hyperplastic polyps, or controls, and values for hyperplastic polyps and the history of hyperplastic polyps were similar to controls. On the other hand, tyrosine kinase activity in the rectal mucosa of patients with both or either polyp type was elevated without any significant difference between hyperplastic and adenomatous polyps. Thus, it is concluded that although increased ornithine decarboxylase activity in rectal mucosa suggests the presence of adenomatous polyps or a combination of adenomatous with hyperplastic polyps, increased tyrosine kinase activity suggests the presence of any type of polyp.
增生性息肉被认为是良性结肠病变,几乎没有恶变潜能。最近的报告显示增生性息肉与腺瘤性息肉的关联增加,并主张对患有增生性息肉的患者进行全结肠镜检查。已知增生性黏膜与腺瘤性息肉有关,但其与增生性息肉的关系尚不清楚。在本初步研究中,通过测量宏观正常直肠黏膜中的鸟氨酸脱羧酶和酪氨酸激酶活性,确定相对于同时患有增生性息肉和腺瘤性息肉的患者,仅患有增生性息肉或有增生性息肉病史的患者是否观察到黏膜增殖模式的变化。15名患者近端有腺瘤性息肉,或同时患有腺瘤性息肉和增生性息肉。7名患者有增生性息肉,15名患者有增生性息肉病史,本次检查未发现息肉。近端有腺瘤性息肉或两种息肉类型的患者直肠黏膜的鸟氨酸脱羧酶活性显著高于增生性息肉、增生性息肉病史或对照组患者,增生性息肉和增生性息肉病史患者的值与对照组相似。另一方面,患有两种息肉类型或其中一种息肉类型的患者直肠黏膜中的酪氨酸激酶活性升高,增生性息肉和腺瘤性息肉之间无显著差异。因此,得出的结论是,虽然直肠黏膜中鸟氨酸脱羧酶活性增加提示存在腺瘤性息肉或腺瘤性息肉与增生性息肉的组合,但酪氨酸激酶活性增加提示存在任何类型的息肉。