Tsukahara Y, Fukamatsu Y, Fukuta T
Nihon Sanka Fujinka Gakkai Zasshi. 1983 May;35(5):706-12.
Morphological investigations were carried out on 184 cases with GCH and related diseases, and the following results were obtained: 1. Pure GCH was observed in 112 cases (60.9%), GCH with ADH in 56 cases (30.4%), and GCH with ATH in 11 cases (6.0%). ECA related with GCH was found in 5 cases (2.7%). 2. It was suggested that GCH can serve as a remote precursor of ECA. Namely, GCH in some cases was found to develop into ECA apparently through the change from ADH to ATH. 3. It was morphologically observed that in GCH, both glandular epithelium and stromal cells were proliferated by being stimulated by estrogen, and such a proliferation was interrupted by an estrogen antagonist, progesterone. On the other hand, in the case of ATH, the growth of stroma was generally decreased and the proliferation of glandular epithelium became predominant. Moreover, the action of progesterone was minimum in ADH and ATH. These findings indicate that precancerous lesions such as ADH and ATH are those capable of developing easily into carcinoma.
对184例胃黏膜上皮内瘤变（GCH）及相关疾病进行了形态学研究，结果如下：1. 112例（60.9%）观察到单纯GCH，56例（30.4%）为GCH合并不典型增生（ADH），11例（6.0%）为GCH合并腺瘤样增生（ATH）。发现5例（2.7%）GCH与食管腺癌（ECA）相关。2. 提示GCH可作为ECA的远隔前驱病变。即，在某些病例中，GCH明显通过从ADH向ATH的转变发展为ECA。3. 形态学观察发现，在GCH中，腺上皮和基质细胞均受雌激素刺激而增殖，而这种增殖被雌激素拮抗剂孕酮所阻断。另一方面，在ATH病例中，基质生长通常减少，腺上皮增殖占主导。此外，孕酮在ADH和ATH中的作用最小。这些发现表明，ADH和ATH等癌前病变很容易发展为癌。
