Gastrointestinal Research Laboratory, Department of Pathology, Karolinska Institute and University Hospital, Stockholm, Sweden;
Department of Medicine (Solna), Karolinska Institute and Ersta Hospital, Stockholm, Sweden.
Anticancer Res. 2021 Mar;41(3):1515-1521. doi: 10.21873/anticanres.14910.
BACKGROUND/AIM: We recently noticed in nonpolypoid adenomas (NPA) and the adjacent normal mucosa, nondysplastic crypts in symmetric and asymmetric fission (NDCSAF).
All NDCSAF found in 80 small NPA and in the adjacent mucosa were registered.
A total of 178 NDCSAF (mean, 2.2) were found: 12 (6.7%) interspersed between adenomatous glands, 36 (20.2%) partially replaced by dysplastic epithelium, and 130 (73%) underneath the adenomatous tissue. Of the 61 cases with normal mucosa adjacent to NPA, 40 (65.6%) disclosed NDCSAF, and the remaining 21 (34.4%) normal crypts, exclusively.
The accruing of NDCSAF within NPA and surrounding mucosa, are outstanding findings. Given that colonic crypts may undergo only one fission every 30-40 years, the accruing of NDCSAF in and about small NPA reveals mucosal hubs with pathological aberrations of cryptogenesis, probably conveyed by somatic mutations. The findings support the existence of field cancerization in the colonic mucosa.
背景/目的：我们最近在非息肉性腺瘤（NPA）及其相邻的正常黏膜中发现了非发育性隐窝的对称和不对称分裂（NDCSAF）。
登记了在 80 个小 NPA 及其相邻黏膜中发现的所有 NDCSAF。
共发现 178 个 NDCSAF（平均 2.2 个）：12 个（6.7%）散布在腺瘤性腺体之间，36 个（20.2%）部分被异型上皮取代，130 个（73%）位于腺瘤组织下方。在 61 例 NPA 相邻的正常黏膜中，40 例（65.6%）显示有 NDCSAF，其余 21 例（34.4%）仅有正常隐窝。
在 NPA 及其周围黏膜中出现 NDCSAF 是突出的发现。鉴于结肠隐窝每 30-40 年才发生一次分裂，在小 NPA 中及周围出现的 NDCSAF 表明黏膜中有发生病理性隐窝发生异常的部位，可能是由体细胞突变引起的。这些发现支持结直肠黏膜存在癌前病变的观点。
