Mizuguchi Yasuhiro, Takei Kazuo, Matsubayashi Jun, Kojima Tatsuya, Nisinakagawa Shuuta, Oba Nobuyuki, Kawai Takashi, Moriyasu Fuminori
Department of Gastroenterology, Tokyo Rosai Hospital, Tokyo, Japan.
Hepatogastroenterology. 2012 Mar-Apr;59(114):659-63. doi: 10.5754/hge10365.
The patient was a 57-year-old Japanese woman who had been identified as having anemia and hypoproteinemia by a local group medical check-up. Esophagogastroduodenoscopy revealed an elevated lesion of 35mm in diameter on the posterior wall of the gastric antrum, surrounded by multiple polyps. The elevated lesion was diagnosed as an adenocarcinoma on the basis of biopsy, and total gastrectomy was performed. Histological examination of entire resected stomach revealed two lesions of intramucosal carcinoma together with multiple hyperplastic polyps. To investigate the mucin phenotypes and carcinogenesis of these lesions, immunohistochemical analyses of MUC2, MUC5AC, MUC6, CD10, Ki-67 and p53 protein expressions were performed in 17 hyperplastic polyps and two cancerous lesions. Expression of the MUC6 positive glands beneath the surface foveolar epithelium of hyperplastic polyps caused a morphological change from sessile to pedunculated, suggesting that this was also involved with cancerous changes. The case reported herein seems to be extremely interesting in terms of elucidating the process whereby gastric cancer arises from hyperplastic polyps.
该患者为一名57岁的日本女性，在当地团体体检中被诊断为贫血和低蛋白血症。食管胃十二指肠镜检查发现胃窦后壁有一个直径35mm的隆起性病变，周围有多个息肉。经活检，该隆起性病变被诊断为腺癌，并进行了全胃切除术。对整个切除胃的组织学检查发现了两个黏膜内癌病灶以及多个增生性息肉。为研究这些病变的黏液表型和致癌机制，对17个增生性息肉和两个癌性病灶进行了MUC2、MUC5AC、MUC6、CD10、Ki-67和p53蛋白表达的免疫组化分析。增生性息肉表面小凹上皮下方MUC6阳性腺体的表达导致息肉形态从无蒂变为有蒂，提示这也与癌变有关。就阐明胃癌从增生性息肉发生的过程而言，本文报道的病例似乎极其有趣。
