Albores-Saavedra J, Nadji M, Henson D E, Ziegels-Weissman J, Mones J M
Hum Pathol. 1986 Jun;17(6):614-20. doi: 10.1016/s0046-8177(86)80134-4.
The morphologic spectrum of intestinal metaplasia was studied in 49 gallbladders that had been excised because of cholelithiasis. Based on the absence or presence of endocrine cells, the cases of intestinal metaplasia were arbitrarily divided into two groups. The gallbladders from the first group (26 cases) contained isolated or small clusters of mature goblet cells, while those from the second group (23 cases), in addition to the goblet cells, contained argyrophil and argentaffin cells and, less frequently, Paneth cells and gland-like structures similar to colonic crypts. Pseudopyloric glands and superficial gastric-type epithelium were present in both groups. Argyrophil cells outnumbered argentaffin cells by a ratio of 4 to 1. By immunocytochemical methods serotonin-containing cells were found to be the most common endocrine cells. Other endocrine cells showed immunoreactivity for somatostatin, cholecystokinin, gastrin, and pancreatic polypeptide. The presence of gut endocrine cells and Paneth cells in the pseudopyloric glands suggests that these glands are also an integral component of intestinal metaplasia of the gallbladder. The findings support the hypothesis that cholelithiasis induces the appearance of a stem endodermal cell that, in turn, may differentiate into cells with mature intestinal or gastric phenotypes.
对49例因胆结石而切除的胆囊进行了肠化生的形态学谱研究。根据内分泌细胞的有无，将肠化生病例任意分为两组。第一组（26例）胆囊中含有孤立的或小簇的成熟杯状细胞，而第二组（23例）胆囊除杯状细胞外，还含有嗜银细胞和亲银细胞，较少见潘氏细胞和类似于结肠隐窝的腺样结构。两组均存在假幽门腺和浅表胃型上皮。嗜银细胞与亲银细胞的数量比为4∶1。通过免疫细胞化学方法发现含5-羟色胺的细胞是最常见的内分泌细胞。其他内分泌细胞对生长抑素、胆囊收缩素、胃泌素和胰多肽呈免疫反应。假幽门腺中存在肠道内分泌细胞和潘氏细胞提示这些腺体也是胆囊肠化生的一个组成部分。这些发现支持了胆结石诱导内胚层干细胞出现的假说，反过来，该干细胞可能分化为具有成熟肠或胃表型的细胞。
