Nakamura S, Kino I, Baba S
Department of Pathology, Okayama University Medical School, Japan.
Gut. 1988 Jul;29(7):997-1002. doi: 10.1136/gut.29.7.997.
Studies of the cell kinetics of the colonic crypts could explain the morphogenesis of colonic adenomas and results suggest that a derangement of the proliferative zone of the colonic crypts takes place before adenoma development. This study was conducted to determine whether this is the case or not. The labelling distribution and labelling index (LI) of the colonic crypts was examined with ex vivo autoradiography. Eight patients with intestinal neoplasms, three with familial polyposis coli, four with ordinary colon cancer, and one with two colonic adenomas. Similar labelling distributions and absent upward shift of the active proliferative zone in crypts were observed in patients with familial polyposis and in those with non-polyposis cancer, or adenomas. The non-proliferative zone of the crypts was well preserved in all eight patients. The mean of the labelling index of the three patients with familial polyposis coli was 8.35% (3.17), values expressed as means (SD) and that of the five patients with non-polyposis cancer, or adenomas was 8.55% (3.20). None of the eight patients showed derangement of the proliferative zone of colonic crypts. This result is compatible with the hypothesis that adenomas are detected first as 'buds of adenomas', which sprout into the lamina propria mucosae in the middle part of normal crypts.
对结肠隐窝细胞动力学的研究可以解释结肠腺瘤的形态发生，结果表明在腺瘤发生之前结肠隐窝增殖区就发生了紊乱。本研究旨在确定情况是否如此。采用离体放射自显影法检测结肠隐窝的标记分布和标记指数（LI）。8例肠道肿瘤患者，3例患有家族性结肠息肉病，4例患有普通结肠癌，1例患有两个结肠腺瘤。在家族性结肠息肉病患者以及非息肉病性癌症或腺瘤患者中，观察到类似的标记分布，并且隐窝中活跃增殖区没有向上移位。所有8例患者隐窝的非增殖区均保存良好。3例家族性结肠息肉病患者的标记指数平均值为8.35%（3.17），以均值（标准差）表示，5例非息肉病性癌症或腺瘤患者的标记指数平均值为8.55%（3.20）。8例患者均未出现结肠隐窝增殖区紊乱。这一结果与腺瘤首先以“腺瘤芽”形式被检测到的假说相符，这些“腺瘤芽”在正常隐窝中部向黏膜固有层发芽。
