Lee Y S
Department of Pathology, National University of Singapore, Republic of Singapore.
Dis Colon Rectum. 1988 Apr;31(4):291-7. doi: 10.1007/BF02554363.
Examination of 1014 consecutive autopsies revealed four early malignant lesions, comprising: 1) a carcinoma in situ arising from a large (2.5 cm) pedunculated adenomatous polyp; 2) a carcinoma in situ arising from a small (0.8 cm) flat adenoma; 3) an early invasive carcinoma arising from a flat (2.5 cm) adenoma, and 4) an early invasive polypoid adenocarcinoma (0.7 cm) with no identifiable remnants of adenoma. The early malignant lesions encountered in this study reaffirm the importance of the adenoma-cancer sequence in the pathogenesis of colorectal cancers in man. The malignant potential of flat adenomas is emphasized. The occurrence of small carcinomas without evidence of adenomatous elements raises the possibility of de novo origin as an alternative pathway. In the present study, one of four early colorectal cancers may have a de novo origin.
对1014例连续尸检的检查发现了4例早期恶性病变，包括：1）起源于一个大的（2.5厘米）带蒂腺瘤性息肉的原位癌；2）起源于一个小的（0.8厘米）扁平腺瘤的原位癌；3）起源于一个扁平的（2.5厘米）腺瘤的早期浸润癌；以及4）一个早期浸润性息肉状腺癌（0.7厘米），未发现腺瘤的残余成分。本研究中遇到的早期恶性病变再次证实了腺瘤-癌序列在人类结直肠癌发病机制中的重要性。强调了扁平腺瘤的恶性潜能。无腺瘤成分证据的小癌的出现增加了作为另一种途径的从头起源的可能性。在本研究中，四例早期结直肠癌中有一例可能是从头起源。
