Griffioen G, Bosman F T, Verspaget H W, De Bruin P A, Biemond I, Lamers C B
Department of Gastroenterology and Hepatology, University Hospital, Leiden, The Netherlands.
Histopathology. 1990 Dec;17(6):529-35. doi: 10.1111/j.1365-2559.1990.tb00792.x.
The histological, mucin histochemical and immunohistochemical features were evaluated of 74 solitary and 73 synchronous colorectal adenomas which were endoscopically removed from 124 patients. Of the patients, 60% had a single adenoma, whereas 40% had at least two adenomas in their colorectum. Comparing the incidence of synchronous adenomas in both sexes revealed a statistically significant higher incidence (P less than 0.005) in males. The localization of the solitary and synchronous adenomas in the large bowel was similar. Moreover, parameters of malignant change within the adenomas (size, predominant type of mucosal growth and degree of dysplasia-with the exception of severe dysplasia) as well as signs of dedifferentiation (relative proportions of goblet and columnar cells) were also similar. Mucin staining intensities (periodic acid-Schiff, high iron diamine and alcian blue) and the immunoreactivity patterns of secretory component and carcinoembryonic antigen, both cytoplasmic and on the surface of the epithelial cells, were also identical in both groups of adenomas. Thus, neither the routine histological nor the mucin- and immunohistochemical features differed between the groups, except for severe dysplasia. It is concluded that there is no inherent difference in malignant potential between solitary and synchronous adenomas, with the possible exception of the degree of dysplasia.
对从124例患者内镜切除的74个单发和73个同时性结直肠腺瘤的组织学、黏液组织化学和免疫组织化学特征进行了评估。这些患者中，60%有单个腺瘤，而40%的患者在其结直肠中有至少两个腺瘤。比较两性同时性腺瘤的发生率发现，男性的发生率在统计学上显著更高（P小于0.005）。单发和同时性腺瘤在大肠中的定位相似。此外，腺瘤内的恶变参数（大小、黏膜生长的主要类型和发育异常程度——严重发育异常除外）以及去分化迹象（杯状细胞和柱状细胞的相对比例）也相似。两组腺瘤的黏液染色强度（过碘酸-希夫反应、高铁二胺和阿尔辛蓝）以及分泌成分和癌胚抗原在上皮细胞胞质和表面的免疫反应模式也相同。因此，除了严重发育异常外，两组之间的常规组织学、黏液和免疫组织化学特征均无差异。结论是，单发和同时性腺瘤之间在恶变潜能上没有内在差异，严重发育异常程度可能除外。
