Kubota O, Kino I
First Department of Pathology, Hamamatus University School of Medicine, Japan.
Am J Surg Pathol. 1995 Mar;19(3):318-27. doi: 10.1097/00000478-199503000-00010.
Depressed adenomas of the colon have been reported more often during the past several years, but there are few reports on the details of their characteristics or behavior. In this study, depressed and ordinary polypoid adenomas, especially those in an early stage, in the large intestine of 28 patients with familial adenomatous polyposis (FAP) were examined macroscopically, by dissecting microscope, and histologically. Proliferating cell nuclear antigen (PCNA) and the density of crypts in the background mucosa around depressed and polypoid adenomas were also compared. Depressed adenomas of < 1.0 mm in diameter showed horizontal growth between the normal adjacent crypts, which often left the normal crypts as islands, whereas polypoid adenomas grow expansively without including remnants of normal crypts. In depressed adenomas, PCNA shifted to the upper part of the crypts, and the background mucosa in their vicinity showed a low density of crypts. These findings indicate that a unique characteristic of growth of depressed adenomas at an early stage is superficial proliferation.
在过去几年中，结肠凹陷性腺瘤的报道更为常见，但关于其特征或行为细节的报道却很少。在本研究中，对28例家族性腺瘤性息肉病（FAP）患者大肠中的凹陷性和普通息肉样腺瘤，特别是早期腺瘤，进行了大体、解剖显微镜及组织学检查。还比较了凹陷性腺瘤和息肉样腺瘤周围背景黏膜中增殖细胞核抗原（PCNA）和隐窝密度。直径<1.0 mm的凹陷性腺瘤在相邻正常隐窝之间呈水平生长，常使正常隐窝呈岛屿状残留，而息肉样腺瘤则呈膨胀性生长，不包含正常隐窝残余。在凹陷性腺瘤中，PCNA转移至隐窝上部，其附近的背景黏膜隐窝密度较低。这些发现表明，凹陷性腺瘤早期生长的一个独特特征是表面增殖。
