Department of Pathology, Shizuoka City Shimizu Hospital, Miyakami 1231 Shimizu-Ku, Shizuoka, 424-8636, Japan.
Med Oncol. 2011 Dec;28(4):941-4. doi: 10.1007/s12032-010-9556-6. Epub 2010 May 11.
The author investigated histopathology of malignant changes of gastric foveolar hyperplastic polyps (GFHP). A total of 497 GFHP from 412 patients were retrospectively examined. Malignant changes were present in 11 GHP (2.2%). They were focal malignancies and well-differentiated adenocarcinoma without apparent invasion. In all the 11 GFHP, dysplastic glands were present in the vicinity of carcinomatous foci. Focal intestinal metaplasia was recognized in one case and was absent in the remaining 10 GFHP. Focal dysplastic glands were recognized in 51 GFHP (10%). Of these, four GFHP were associated with focal intestinal metaplasia, but the remaining 47 GFHP were not associated with intestinal metaplasia. Intestinal metaplasia alone was recognized in 23 GFHP (5%). Immunohistochemically, all carcinomatous foci within the 11 GFHP with malignant transformation showed positive p53 expression and high Ki-67 labeling. Of the 51 GFHP with dysplasia, 42 GFHP were positive for p53 protein, and the remaining 9 GFHP were negative for p53 protein. The dysplastic lesions of the 51 GFHP showed relatively high Ki-67 index. Intestinal metaplasia within GFHP was negative for p53 protein and showed low Ki-67 labeling. These results suggest that malignant transformation of GFHP may occur in 2.2% of cases, and that malignant changes develop via hyperplasia-dysplasia-carcinoma sequence in GFHP. Intestinal metaplasia within GFHP was not associated with carcinogenesis of GFHP.
作者研究了胃窝状增生性息肉（GFHP）恶性变化的组织病理学。回顾性检查了 412 例患者的 497 个 GFHP。11 个 GFHP 存在恶性变化（2.2%）。它们是局灶性恶性肿瘤和分化良好的腺癌，没有明显的浸润。在所有的 11 个 GFHP 中，癌灶附近存在发育不良的腺体。在 1 例中发现局灶性肠上皮化生，其余 10 例 GFHP 中未见肠上皮化生。在 51 个 GFHP 中发现局灶性发育不良腺体（10%）。其中，4 个 GFHP 与局灶性肠上皮化生有关，但其余 47 个 GFHP 与肠上皮化生无关。单纯肠上皮化生在 23 个 GFHP（5%）中被发现。免疫组织化学显示，11 个有恶性转化的 GFHP 中所有癌灶均表达阳性的 p53，Ki-67 标记物高表达。在 51 个有发育不良的 GFHP 中，有 42 个 GFHP 的 p53 蛋白阳性，其余 9 个 GFHP 的 p53 蛋白阴性。51 个有发育不良的 GFHP 的病变显示出相对较高的 Ki-67 指数。GFHP 内的肠上皮化生不表达 p53 蛋白，Ki-67 标记物低表达。这些结果表明，GFHP 的恶性转化可能发生在 2.2%的病例中，并且 GFHP 的恶性变化是通过增生-发育不良-癌序列发展的。GFHP 内的肠上皮化生与 GFHP 的癌变无关。
