Department of Histopathology, Imperial College London, London, UK.
Int J Colorectal Dis. 2010 Oct;25(10):1193-200. doi: 10.1007/s00384-010-1007-5. Epub 2010 Jul 17.
Known collectively as serrated polyps, hyperplastic polyps (HP), sessile serrated adenomas (SSA/SSP) and traditional serrated adenoma (TSA) may represent a spectrum of increasing malignant potential with characteristic immunological markers. There is increasing evidence that HP, SSA/SSP and TSA are biologically different and are likely to represent a spectrum along the serrated polyp pathway. Although there is general consensus about the diagnostic features of serrated polyps, the morphological differences between the categories are often subtle. This study compares the expression of p53 and P504S among serrated polyps. Sixty seven randomly selected biopsies (n = 59) and resection specimens (n = 8) histologically diagnosed for SSA/SSP, TSA and HP (19, 30 and 18 specimens, respectively) were obtained.
There was a significant difference in p53 (P < 0.001) and P504S (P < 0.001) immunopositivity and distribution among the serrated polyps. In particular, there is diffuse expression p53 and P504S in TSA compared to HP and SSA/SSP where p53 and P504S expression was more frequently confined to the lower 1/3 of the crypts. In addition, percentage of cells expressing p53 and p504S expression was higher in TSA than those of HP and SSA/SSP.
Immunostains, p53 and P504S, may be useful adjuncts to morphological diagnosis of serrated polyps.
锯齿状息肉包括增生性息肉(HP)、无蒂锯齿状腺瘤(SSA/SSP)和传统锯齿状腺瘤(TSA),它们可能代表恶性潜能逐渐增加的一个谱系,具有特征性的免疫标志物。越来越多的证据表明,HP、SSA/SSP 和 TSA 在生物学上是不同的,它们可能代表锯齿状息肉途径中的一个谱系。尽管人们普遍认同锯齿状息肉的诊断特征,但这些类别的形态学差异通常很细微。本研究比较了锯齿状息肉中 p53 和 P504S 的表达。随机选择 67 例活检(n = 59)和切除标本(n = 8),组织学诊断为 SSA/SSP、TSA 和 HP(分别为 19、30 和 18 例标本)。
锯齿状息肉中 p53(P < 0.001)和 P504S(P < 0.001)免疫阳性率和分布存在显著差异。特别是 TSA 中 p53 和 P504S 的表达呈弥漫性,而 HP 和 SSA/SSP 中 p53 和 P504S 的表达更常局限于隐窝的下 1/3。此外,TSA 中表达 p53 和 p504S 的细胞百分比高于 HP 和 SSA/SSP。
免疫组化染色 p53 和 P504S 可能有助于锯齿状息肉的形态学诊断。