Franzin G, Grigioni W F, Dina R, Scarpa A, Zamboni G
Histopathology. 1983 Sep;7(5):707-18. doi: 10.1111/j.1365-2559.1983.tb02283.x.
Changes in mucin secretion and increase in height of the colonic mucosa adjacent to colorectal carcinoma (transitional mucosa) have been considered pre-malignant. In this study similar changes (both morphological and histochemical) have been found in some cases of ulcerative colitis and ischaemic colitis, as well as in juvenile, inflammatory and hyperplastic (metaplastic) polyps. 'Transitional' patterns of mucin secretion also occur in some other cases of ulcerative colitis, colostomies and Crohn's disease of the colon in which the mucosa has a normal height, suggesting the changes in mucin secretion are independent of mucosal morphology. In all these pathological conditions, hyperplastic (metaplastic) mucosa also coexisted. These findings seem to suggest that: (1) 'transitional' changes more likely represent a secondary regenerative phenomenon rather than a premalignant one; (2) the pattern of mucin secretion is not selective enough to serve as a premalignant marker; therefore is not a valid prognostic indicator in colonic biopsies; (3) hyperplastic (metaplastic) changes might derive from 'transitional' mucosa as a result of a more mature phase of this exaggerated regenerative phenomenon. However, in some patients longstanding 'transitional' mucosa may lead to dysplasia under the influence of environmental and genetic factors.
结直肠癌旁结肠黏膜（移行黏膜）的黏蛋白分泌变化及高度增加被认为是癌前病变。在本研究中，溃疡性结肠炎、缺血性结肠炎以及幼年性、炎性和增生性（化生）息肉的某些病例中也发现了类似变化（形态学和组织化学方面）。在溃疡性结肠炎、结肠造口术及结肠克罗恩病的其他一些病例中，黏膜高度正常，但也出现了黏蛋白分泌的“移行”模式，这表明黏蛋白分泌变化与黏膜形态无关。在所有这些病理状况下，增生性（化生）黏膜也同时存在。这些发现似乎表明：（1）“移行”变化更可能代表一种继发性再生现象而非癌前病变；（2）黏蛋白分泌模式的选择性不足以作为癌前标志物；因此在结肠活检中不是有效的预后指标；（3）增生性（化生）变化可能源于“移行”黏膜，是这种过度再生现象更成熟阶段的结果。然而，在一些患者中，长期存在的“移行”黏膜在环境和遗传因素影响下可能导致发育异常。
