Department of Pathology, Karolinska Institute, University Hospital, Stockholm, Sweden.
Institute of Pathology, Friedrich-Alexander-University Erlangen-Nuremberg, Bayreuth, Germany.
Int J Exp Pathol. 2023 Jun;104(3):100-106. doi: 10.1111/iep.12466. Epub 2023 Feb 3.
Dysplastic crypt branching (DCB) was recently found in ulcerative colitis-associated dysplasia. The aim was to assess the frequency and the branching phenotype of DCB in polypoid colorectal tubular adenomas (TA). A total of 3956 DCB were found in the 139 TA: 98% were in asymmetric branching (DCAB) and the remaining 2% in symmetric branching (DCSB). A linear correlation was found between DCB frequency and the increasing digital size in TA (p < .05). Using a digital ruler, adenomas were divided into small TA (<5 mm) and larger TA (≥5 mm). The difference between the frequency of DCB in small TA (n = 75) vs. larger TA (n = 64), was significant (p < .05). DCB frequency was not influenced by age, gender or TA localization. In the normal colorectal mucosa (≈2 m ), only occasional CSB is found and no CAB. And yet, multiple DCB (mean 16.7 DCB), mostly DCAB, was found in small TA, occupying <5 mm of the mucosal area. In larger TA, as many as 42.1 DCB (mean), mostly DCAB, occurred in merely 7.8 mm (mean) of the colon mucosa. Thus it is suggested that DCB is a standard histologic element of TA. The natural expansion of the adenomatous tissue in larger TA appears to be follow on from newly produced, mostly DCAB, by DCSB and by the accumulation of their dysplastic offspring's progenies. The findings strongly suggest that DCB is a central microstructure in the histological events unfolding in polypoid colorectal TA.
锯齿状隐窝分支（DCB）最近在溃疡性结肠炎相关异型增生中被发现。目的是评估息肉状结直肠管状腺瘤（TA）中 DCB 的频率和分支表型。在 139 个 TA 中发现了 3956 个 DCB：98%为不对称分支（DCAB），其余 2%为对称分支（DCSB）。在 TA 中，DCB 频率与数字大小的增加呈线性相关（p < .05）。使用数字标尺，将腺瘤分为小 TA（<5 mm）和较大 TA（≥5 mm）。小 TA（n = 75）与较大 TA（n = 64）中 DCB 频率的差异具有统计学意义（p < .05）。DCB 频率不受年龄、性别或 TA 定位的影响。在正常结直肠黏膜（≈2 m）中，仅偶尔发现 CSB，而无 CAB。然而，在小 TA 中发现了多个 DCB（平均 16.7 个 DCB），主要为 DCAB，占据黏膜面积<5 mm。在较大的 TA 中，多达 42.1 个 DCB（平均），主要为 DCAB，仅发生在结肠黏膜 7.8 mm（平均）的范围内。因此，建议 DCB 是 TA 的标准组织学特征。较大 TA 中腺瘤组织的自然扩张似乎是由新产生的、主要是 DCAB 的 DCSB 以及它们的异型后代的后代的积累所导致的。这些发现强烈表明，DCB 是息肉状结直肠 TA 中展开的组织学事件的核心微观结构。
