Goodman Z D, Yardley J H, Milligan F D
Cancer. 1979 May;43(5):1906-13. doi: 10.1002/1097-0142(197905)43:5<1906::aid-cncr2820430548>3.0.co;2-o.
The pathogenesis of juvenile polyps of the colon was studied in a patient with multiple juvenile polyposis who underwent proctocolectomy for rectal carcinoma and antrectomy for associated polyps of the stomach. Numerous polyps up to 3 cm in diameter were present predominantly in the cecum and rectum, and in addition there was an adenocarcinoma in the rectum. Microscopically there were five categories of lesions: 1) Hyperplastic epithelial foci and small hyperplastic polyps; 2) Typical Juvenile polyps; 3) Juvenile polyps with focal adenomatous epithelium; 4) Adenomas; and 5) and adenocarcinoma. The five categories could represent a pathogenetic sequence, beginning with epithelial hyperplasia, leading to small hyperplastic polyps which become inflamed and enlarge, forming juvenile polyps. Focal adenomatous areas which develop in some juvenile polyps might give rise to adenomas and in turn lead to carcinoma. Although juvenile polyps are generally not considered to be premalignant lesions, this case demonstrates that neoplastic changes may occur in juvenile polyps in certain individuals, and raises the possibility that these may on occasion give rise to carcinoma.
对一名患有多发性幼年性息肉病的患者进行了结肠幼年性息肉发病机制的研究，该患者因直肠癌接受了直肠结肠切除术，并因胃相关息肉接受了胃窦切除术。直径达3厘米的大量息肉主要存在于盲肠和直肠，此外直肠还有腺癌。显微镜下有五类病变：1）增生性上皮灶和小的增生性息肉；2）典型的幼年性息肉；3）有局灶性腺瘤样上皮的幼年性息肉；4）腺瘤；5）腺癌。这五类病变可能代表一种发病机制序列，始于上皮增生，导致小的增生性息肉，这些息肉发炎并增大，形成幼年性息肉。一些幼年性息肉中出现的局灶性腺瘤样区域可能发展为腺瘤，进而导致癌。虽然幼年性息肉一般不被认为是癌前病变，但该病例表明，在某些个体中幼年性息肉可能发生肿瘤性改变，并增加了这些息肉偶尔可能导致癌症的可能性。
