Klein N, Vignaud J M, Sadmi M, Plenat F, Borelly J, Duprez A, Martinet Y, Martinet N
INSERM U 14, Service d'Anatomo-pathologie A and Fédération Médicale et Chirurgicale de Pneumologie du Centre Hospitalier Régional de Nancy, France.
Lab Invest. 1993 Jan;68(1):26-32.
The question of whether bronchial squamous metaplasia is a true preneoplasia is important and demonstrated in animal for several carcinogens. We have now approached this problem in humans and in vivo.
Squamous metaplasia in the close vicinity of surgically resected lung tumors were evaluated for their mitotic index and screened for proto-oncogenes and P 53 protein expression by immunohistochemistry and/or in situ hybridization.
Among 16 patients, 4 had squamous metaplasia positive for either myc messages and/or for P 53 protein accumulation. In the same patients (3/4), the autologous bronchial tumors were also positive for the same markers. Squamous metaplasia positivity was observed essentially in patients with advanced diseases and only in squamous cell carcinomas. In addition, when evaluated with 5 iodo-2'-deoxyuridine systemic infusion, all patients presented hyperproliferative basal squamous metaplasic cells.
These results are reminiscent of the typical preneoplastic changes observed in familial colic adenomatosis, where genetic changes accumulate in hyperproliferative cells. They also suggest that bronchial squamous metaplasia could be an authentic preneoplasia in, at least, squamous cell carcinomas.
支气管鳞状化生是否为真正的癌前病变这一问题很重要，并且在动物实验中已通过多种致癌物得以证实。我们现在已在人体及体内研究了这一问题。
对手术切除的肺部肿瘤附近的鳞状化生进行有丝分裂指数评估，并通过免疫组织化学和/或原位杂交筛选原癌基因和P53蛋白表达。
在16例患者中，4例的鳞状化生对myc信息和/或P53蛋白积累呈阳性。在同一批患者中（3/4），其自身的支气管肿瘤对相同标志物也呈阳性。鳞状化生阳性主要见于晚期疾病患者，且仅见于鳞状细胞癌患者。此外，当通过5-碘-2'-脱氧尿苷全身输注进行评估时，所有患者均出现增生性基底鳞状化生细胞。
这些结果让人联想到在家族性结肠腺瘤病中观察到的典型癌前病变变化，即遗传改变在增生性细胞中积累。它们还表明，至少在鳞状细胞癌中，支气管鳞状化生可能是一种真正的癌前病变。
