Deschner E E, Raicht R F
Cancer. 1981 May 15;47(10):2440-5. doi: 10.1002/1097-0142(19810515)47:10<2440::aid-cncr2820471022>3.0.co;2-f.
The histologic and proliferative characteristics of 16 colonic biopsies taken from an operative specimen of a 38-year-old female patient with multiple polyposis are presented. Kinetic measurements are based on 3HTdR incorporation accomplished in vitro, using both single and double labelling techniques. Epithelial cells in adenomatous tissue were more actively engaged in DNA synthesis than those normal-appearing mucosa (L.I.13.0 +/- 6.9 versus 9.3 +/- 1.6); however, because of extreme variability between biopsies, the difference was not significant. No difference in S phase duration was found, but a faster turnover time (Tg) than that in the normal appearing colonic mucosa was estimated (Tg 52.6 hours versus 74.2 hours). Only two of ten biopsies containing normal-appearing mucosa had a completely normal incorporation pattern with proliferative cells located only in the lower two thirds of crypts. Eight biopsies showed extension of the proliferative compartment to the luminal surface. One of these eight also expressed an additional proliferative defect, namely, a shift of the major zone of DNA synthesis to the middle and upper regions of the crypts. This specimen had been located adjacent to an area of microscopic adenoma. Subpopulations of labelled epithelial cells showing transition from normal to hyperplastic or to adenomatous appearance were in the otherwise normal-appearing crypts. The majority of labelled hyperplastic-appearing cells occupied the lower thirds of the crypts, whereas 68% of labelled adenomatous-appearing cells were located in the middle and upper zones of the glands. Based on these observations, the development of an adenoma is believed forecast by the redistribution of the proliferative compartment toward the surface. A further stage in tumorogenesis before the appearance of a focus of neoplasia is the emergence of actively proliferating cells transforming to a more adenomatous appearance primarily in that same location, that is, the middle and upper third of the colonic crypts.
本文呈现了取自一名38岁患有多发性息肉病女性患者手术标本的16份结肠活检组织的组织学和增殖特征。动力学测量基于体外3HTdR掺入实验，采用单标记和双标记技术。腺瘤组织中的上皮细胞比外观正常的黏膜上皮细胞更活跃地参与DNA合成（标记指数分别为13.0±6.9和9.3±1.6）；然而，由于活检样本之间差异极大，差异并不显著。未发现S期持续时间有差异，但估计其周转时间（Tg）比外观正常的结肠黏膜更快（Tg为52.6小时对74.2小时）。在10份含有外观正常黏膜的活检样本中，只有2份具有完全正常的掺入模式，增殖细胞仅位于隐窝的下三分之二处。8份活检样本显示增殖区延伸至腔面。这8份样本中的1份还表现出另一种增殖缺陷，即DNA合成的主要区域转移至隐窝的中上部。该样本位于微小腺瘤区域附近。在外观正常的隐窝中存在显示从正常向增生或腺瘤样外观转变的标记上皮细胞亚群。大多数标记的增生样细胞占据隐窝的下三分之一，而68%标记的腺瘤样细胞位于腺管的中上部区域。基于这些观察结果，认为腺瘤的发生是由增殖区向表面重新分布所预示的。在肿瘤形成灶出现之前，肿瘤发生的进一步阶段是主要在同一位置（即结肠隐窝的中上部三分之一）出现活跃增殖并转变为更具腺瘤样外观的细胞。
