Department of Oncology and Pathology, Karolinska Institute, Stockholm, Sweden;
Institute of Pathology, Friedrich-Alexander-University Erlangen-Nuremberg, Klinikum Bayreuth, Bayreuth, Germany.
Anticancer Res. 2024 Oct;44(10):4371-4377. doi: 10.21873/anticanres.17266.
BACKGROUND/AIM: Tubular adenomas of the colon (TA) are neoplastic polyps composed of dysplastic tube-like crypts. Nondysplastic crypts, mostly in asymmetric branching have been previously reported, both beneath and bordering TA. In the present article, intercalated nondysplastic crypts (INDC) amidst dysplastic crypts in TA are showcased.
The occurrence of INDC was recorded in 139 TA.
Out of the 139 TA, 31% exhibited INDC; of these, 58% were in asymmetric branching (INDCAB), 35% were single intercalated crypts without branching (INDSNB), and 7% were in symmetric branching (INDCSB). Luminal dysplasia occurred in 53% out of the 43 TA: in 37% TA with INDCAB, in 16% TA with INDSNB, but in none of the TA with INDCSB. Thus, INDCAB predominated.
The finding of INDC in TA domain contrasts with the infrequency of INDCSB and with the absence of INDCAB in the normal colorectal mucosa. Hence, INDC emerge as integral components in TA. Since only 1 or 2 sections were available per TA, the total number of INDC in the entire TA is likely higher. INDC in TA may be remnants of acquired nondysplastic mucosal cores of abnormal cryptogenesis that were subsequently replaced by top-down growing dysplastic epithelium. The present and previous findings support the concept of field cancerization in the human colorectum.
背景/目的：结肠管状腺瘤（TA）是由异型管状隐窝组成的肿瘤性息肉。此前已有报道，在 TA 下方和边缘存在非异型隐窝，这些隐窝呈非对称分支状。本文展示了 TA 中异型隐窝之间的镶嵌非异型隐窝（INDC）。
记录了 139 例 TA 中 INDC 的发生情况。
在 139 例 TA 中，31%表现出 INDC；其中 58%呈非对称分支状（INDCAB），35%为无分支的单个镶嵌隐窝（INDSNB），7%为对称分支状（INDCSB）。在 43 例存在异型增生的 TA 中，53%出现管腔异型增生：在 37%的 TA 中存在 INDCAB，在 16%的 TA 中存在 INDSNB，但在无 INDCSB 的 TA 中不存在。因此，INDCAB 占优势。
TA 中 INDC 的发现与 INDCSB 的罕见性以及正常结直肠黏膜中不存在 INDCAB 形成对比。因此，INDC 成为 TA 的固有组成部分。由于每个 TA 仅提供 1 或 2 个切片，整个 TA 中 INDC 的总数可能更高。TA 中的 INDC 可能是异常隐窝发生后获得的非异型黏膜核心的残留物，随后被自上而下生长的异型上皮所取代。目前和以前的研究结果支持人类结直肠的肿瘤发生场概念。
