Fucci L, Valentini A M, Caruso M L
Servizio di Anatomia Patologica, Istituto di Ricovero e Cura a Carattere Scientifico, Castellana Grotte (Bari), Italy.
Eur J Histochem. 1993;37(4):335-44.
We verified the binding of peanut agglutinin (PNA) in 28 pedunculated adenomas (10 with pseudo and 18 with true invasion, respectively) of the large bowel. The distribution of glycoproteins was assessed in the normal mucosa of the stalk, in the surface dysplastic mucosa and in the mucosa of the pseudo-invasion or cancerization areas. The aims of the study were to verify: the PNA role in the differential diagnosis between pseudo and true invasion; the changes in PNA binding during transformation of mucosa from the normal to dysplastic and neoplastic status; the PNA ability as a predictive marker in the neoplastic transformation. The total percentage of PNA positivity in our samples was not significatively higher in carcinomatous than in pseudoinvasive areas (83.3% vs 50%). But the analysis of semiquantitative expression of PNA binding showed that an analogous, or reduced expression of marker in the epithelium in the submucosa compared to the dysplastic surface was consistent with the diagnosis of pseudoinvasion, while its increase strengthened the diagnosis of true invasion. In addition, we found a progressive increase of expression of PNA from the normal to dysplastic and neoplastic mucosa; therefore our data confirmed the quantitative relationship of this marker with malignant transformation. Finally, when we compared the expression of the PNA binding in solely superficial adenomatous tissue of benign and malignant polyps, we found an equal percentage of positive cases (66.6% in the carcinomatous vs 70% in the benign adenomas). Therefore, PNA does not recognize the risk of actual malignant evolution in an adenoma but is indicative of carcinomatous transformation when it is strongly positive.
我们检测了28例大肠带蒂腺瘤（分别有10例伴假浸润和18例伴真浸润）中花生凝集素（PNA）的结合情况。评估了在蒂部正常黏膜、表面发育异常黏膜以及假浸润或癌变区域黏膜中糖蛋白的分布。本研究的目的是验证：PNA在假浸润和真浸润鉴别诊断中的作用；黏膜从正常状态转变为发育异常和肿瘤状态过程中PNA结合的变化；PNA作为肿瘤转化预测标志物的能力。我们样本中PNA阳性的总百分比在癌组织中并不显著高于假浸润区域（83.3%对50%）。但对PNA结合的半定量表达分析显示，与发育异常表面相比，黏膜下层上皮中标志物表达类似或降低与假浸润的诊断一致，而其增加则强化了真浸润的诊断。此外，我们发现从正常黏膜到发育异常和肿瘤性黏膜，PNA的表达逐渐增加；因此我们的数据证实了该标志物与恶性转化的定量关系。最后，当我们比较良性和恶性息肉仅表面腺瘤组织中PNA结合的表达时，发现阳性病例的百分比相同（癌组织中为66.6%，良性腺瘤中为70%）。因此，PNA不能识别腺瘤实际恶性进展的风险，但当其强阳性时提示癌变。
