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早期结直肠癌:CD10 表达、黏蛋白表型和黏膜下浸润。

Early colorectal carcinomas: CD10 expression, mucin phenotype and submucosal invasion.

机构信息

Departments of Pathology Gastroenterological Surgery, Fukuoka University, Fukuoka, Japan.

出版信息

Pathol Int. 2012 Sep;62(9):600-11. doi: 10.1111/j.1440-1827.2012.02850.x.

Abstract

We analyzed 170 tumors (polypoid, 98; non-polypoid, 72) of early colorectal carcinoma with or without submucosal invasions (Tis and T1 of TNM classification) from 161 patients to evaluate correlations between clinicopathological factors and immunohistochemical expressions of CD10, MUC2, and MUC5AC. The coexistence of adenomatous components was significantly less common in non-polypoid carcinomas (4.2%) than in polypoid carcinomas (66.3%) (P < 0.0001). Non-polypoid carcinomas were smaller in size and tended to infiltrate into the submucosa with higher incidence of lymphatic and venous permeations. CD10 was more frequently expressed in non-polypoid carcinomas (70.8%) than in polypoid carcinomas (51.0%) (P= 0.01). Total carcinomas with high grade atypia showed higher incidence of CD10 expression (60.6%) than those with low grade atypia (28.9%) (P < 0.0001). Carcinomas with low grade atypia exhibited a higher incidence of MUC2 and MUC5AC expression (91.1% and 57.8%, respectively), when compared with carcinomas with high grade atypia (41.6% and 20.0%, respectively) (both, P < 0.0001). In submucosal invasive carcinomas with residual intramucosal carcinoma component (IMCC), CD10 expression in IMCC and submucosal invasive carcinoma component (SMCC) simultaneously exhibited identical positive or negative results, regardless of the polypoid or non-polypoid growth pattern. The CD10 expression may occur in the early stage of carcinogenesis within the mucosa, and these neoplasms may retain CD10 in SMCC, possibly resulting in more advanced stages of stromal invasion and distant metastases. In conclusion, our data suggest that the CD10 expression and mucin phenotypes may be potentially useful markers for estimating biological properties of early colorectal carcinomas.

摘要

我们分析了 161 例患者的 170 个结直肠早期癌肿瘤(息肉样,98 个;非息肉样,72 个),这些肿瘤无论是否有黏膜下浸润(TNM 分类Tis 和 T1),以评估临床病理因素与 CD10、MUC2 和 MUC5AC 的免疫组化表达之间的相关性。非息肉样癌中腺瘤成分的共存明显少于息肉样癌(4.2%比 66.3%)(P<0.0001)。非息肉样癌的体积较小,且更倾向于浸润黏膜下层,淋巴和静脉渗透的发生率也更高。非息肉样癌中 CD10 的表达更为常见(70.8%比 51.0%)(P=0.01)。高级别异型的总癌中 CD10 表达的发生率更高(60.6%比 28.9%)(P<0.0001)。与高级别异型的癌相比,低级别异型的癌中 MUC2 和 MUC5AC 的表达率更高(分别为 91.1%和 57.8%)(均为 P<0.0001)。在残留黏膜内癌成分(IMCC)的黏膜下浸润性癌中,无论息肉样或非息肉样生长模式,IMCC 和黏膜下浸润性癌成分(SMCC)中 CD10 的表达同时表现出相同的阳性或阴性结果。CD10 的表达可能发生在黏膜内癌发生的早期阶段,这些肿瘤可能在 SMCC 中保留 CD10,从而导致更晚期的间质浸润和远处转移。总之,我们的数据表明 CD10 表达和黏蛋白表型可能是评估结直肠早期癌生物学特性的有用标志物。

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