Bonato M, Piantanida R, Riva C, Cis C, Capella C
Acta Otorhinolaryngol Ital. 1989 May-Jun;9(3):297-310.
Fourteen cases of intestinal-type adenocarcinomas (IADC) of the nasal cavity and paranasal sinuses were studied at the Regional Hospital of Varese during the period from 1973 to 1988. They were 13 males and 1 female, mean age 57.5 years; the five year survival was 25% and tumors were preferentially located in the ethmoidal sinus. Morphological study and the use of monoclonal and polyclonal antibodies made it possible to define the structural features of IADC and to detect specific antigenic markers such as CAR-5 (a glycoprotein contained within intestinal goblet-cells) and M1 (a glycoprotein contained within gastric foveolar cells). For comparison 10 cases of colonic adenocarcinomas and 14 cases of non-AIDC carcinomas of the nose and paranasal sinuses were also examined. The parallel morphological and immuno-histochemical investigations based on specific markers demonstrated that it was impossible to differentiate IADC from large bowel adenocarcinoma for both the structural pattern and antigenic expression. Moreover, AIDC also showed a CAR-5 and M1 immunoreactivity (IR) different from that displayed by the nasal carcinomas of different histotypes. From a histopathological standpoint IADC appears to be a distinctive entity even when compared to salivary gland tumors. In addition, the present immunohistochemical investigation demonstrates that gastric and intestinal glycoproteic antigens (M1 and CAR-5 respectively) occur in the normal nasosinusal mucosa. Both CAR-5 and M1 were observed in the mucous produced by nasal goblet cells with a distribution pattern resembling that of colonic goblet cells. Therefore, the present data confirm the similarity between nasal and colonic goblet cells which has already been pinpointed in previous morphological and ultrastructural studies. The common antigenic expression shared by the naso-sinusal and colonic mucosa might suggest a histogenetic hypothesis alternative to those of the malformative or metaplastic origin of naso-sinusal IADC.
1973年至1988年期间，在瓦雷泽地区医院对14例鼻腔和鼻窦肠型腺癌（IADC）进行了研究。患者为13名男性和1名女性，平均年龄57.5岁；五年生存率为25%，肿瘤多位于筛窦。形态学研究以及单克隆和多克隆抗体的使用使得确定IADC的结构特征并检测特定抗原标志物成为可能，如CAR-5（肠杯状细胞内所含的一种糖蛋白）和M1（胃小凹细胞内所含的一种糖蛋白）。作为对照，还检查了10例结肠腺癌以及14例鼻腔和鼻窦非IADC癌。基于特定标志物的平行形态学和免疫组织化学研究表明，无论是结构模式还是抗原表达，都无法将IADC与大肠腺癌区分开来。此外，IADC的CAR-5和M1免疫反应性（IR）也与不同组织学类型的鼻腔癌不同。从组织病理学角度来看，即使与涎腺肿瘤相比，IADC似乎也是一种独特的实体。此外，目前的免疫组织化学研究表明，胃和肠糖蛋白抗原（分别为M1和CAR-5）存在于正常鼻窦黏膜中。在鼻杯状细胞产生的黏液中观察到了CAR-5和M1，其分布模式类似于结肠杯状细胞。因此，目前的数据证实了鼻杯状细胞与结肠杯状细胞之间的相似性，这在之前的形态学和超微结构研究中已经得到明确。鼻窦和结肠黏膜共有的抗原表达可能提示了一种组织发生学假说，不同于鼻窦IADC的畸形或化生起源假说。
