Hattori T
Pathol Res Pract. 1985 Jul;180(1):36-44. doi: 10.1016/S0344-0338(85)80072-8.
In order to elucidate the biological behaviour of the Group III lesion of the stomach, morphogenesis of the lesion was studied from cell kinetic point of view. In most Group III lesions, the proliferative cell zones were found at the upper third level of the mucosa, whereas they were confined to the middle third and to the lower third level in the normal pyloric and in the intestinalized mucosa, respectively. The smallest Group III lesion was a single gland dysplasia, in which the Group III cells were confined to the middle level of the mucosa. These findings suggested that the Group III lesion must be a change initiated in the neck stem cells of the pyloric mucosa as is the case in the intestinal metaplasia. The Group III cells arising at the neck region surge upwards and then accumulate in the upper part of the foveola to form an aberrant proliferative focus from which a lesion develops by budding. This morphogenesis manifests an adenomatous nature of the lesion. However, there was apparently a spectrum of cytological and histological abnormalities which varied from the lesions which might be considered to be a kind of intestinalized tubule, to the typical Group III lesion. Some Group III lesions imitating the intestinal metaplasia contained the proliferative cell zones at the middle level of the mucosa, indicating that a group of the dysplastic tubules arose zonally, not from a single gland. This morphogenesis reflects a metaplastic nature of the lesion. (ABSTRACT TRUNCATED AT 250 WORDS)
为阐明胃Ⅲ型病变的生物学行为,从细胞动力学角度研究了该病变的形态发生。在大多数Ⅲ型病变中,增殖细胞区位于黏膜上三分之一处,而在正常幽门黏膜和肠化生黏膜中,增殖细胞区分别局限于中三分之一和下三分之一处。最小的Ⅲ型病变为单个腺体发育异常,其中Ⅲ型细胞局限于黏膜中层。这些发现提示,Ⅲ型病变必定是幽门黏膜颈部干细胞起始的一种改变,如同肠化生的情况一样。在颈部区域产生的Ⅲ型细胞向上涌动,然后积聚在胃小凹上部,形成异常增殖灶,病变由此通过出芽发展而来。这种形态发生表明病变具有腺瘤性质。然而,显然存在一系列细胞学和组织学异常,从可能被视为一种肠化生小管的病变,到典型的Ⅲ型病变不等。一些类似肠化生的Ⅲ型病变在黏膜中层含有增殖细胞区,这表明一组发育异常的小管是区域性发生的,而非起源于单个腺体。这种形态发生反映了病变的化生性质。(摘要截选至250词)