Motoyoshi H
First Department of Surgery, Osaka City University School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1990 Nov;91(11):1691-9.
The presence of Lewis blood group antigens (Lewis(a), Lewis(b)) was determined immunohistochemically in 75 carcinomas and 58 adenomas of the sigmoid colon and rectum. 1. The rate of positive Lewis(b) staining of adult normal mucosa was 100% in the ascending colon, 100% in the transverse colon, 25% in the sigmoid colon and 30% in the rectum, respectively. The incidence of Lewis(b) was high in the proximal colon but low in the sigmoid colon and rectum. 2. The rate of positive Lewis(b) staining was 97% in cancer, 57% in adenoma and 26% in normal mucosa, respectively. The difference between the incidence of positive Lewis(b) staining in normal mucosa, and those in cancer and adenoma was significant (p less than 0.01). 3. The rate of positive Lewis(b) staining was 42% in mild and moderate dysplastic adenoma and 68% in severe dysplastic adenoma. There was a significant difference between the percentage of Lewis(b) staining in mild or moderate dysplastic adenoma and that of severe dysplastic adenoma (p less than 0.05). The expression of Lewis(b) antigen correlated with the size of adenoma. These results suggest that Lewis(b) antigen has a cancer-associated nature and Lewis(b) staining might be useful as an indicator of malignant potential of adenoma of the sigmoid colon and rectum.
采用免疫组织化学方法检测了75例乙状结肠和直肠癌以及58例乙状结肠和直肠腺瘤中Lewis血型抗原(Lewis(a)、Lewis(b))的表达情况。1. 成人正常黏膜中Lewis(b)染色阳性率在升结肠为100%,横结肠为100%,乙状结肠为25%,直肠为30%。Lewis(b)在近端结肠的发生率较高,而在乙状结肠和直肠中较低。2. Lewis(b)染色阳性率在癌组织中为97%,腺瘤中为57%,正常黏膜中为26%。正常黏膜、癌组织和腺瘤中Lewis(b)染色阳性率之间的差异具有统计学意义(p<0.01)。3. 轻度和中度发育异常腺瘤中Lewis(b)染色阳性率为42%,重度发育异常腺瘤中为68%。轻度或中度发育异常腺瘤与重度发育异常腺瘤中Lewis(b)染色阳性率百分比之间存在显著差异(p<0.05)。Lewis(b)抗原的表达与腺瘤大小相关。这些结果表明,Lewis(b)抗原具有与癌症相关的特性,Lewis(b)染色可能作为乙状结肠和直肠腺瘤恶性潜能的一个指标。