Sobhani I, Lehy T, Laurent-Puig P, Cadiot G, Ruszniewski P, Mignon M
INSERM U 10, Hôpital Bichat-Claude Bernard, Paris, France.
Gastroenterology. 1993 Jul;105(1):22-30. doi: 10.1016/0016-5085(93)90006-x.
Information concerning the influence that gastrin may exert on the colon is fragmentary and somewhat controversial. This study analyzed the effect of chronic endogenous hypergastrinemia on cell proliferation and tumor occurrence in the human colonic mucosa.
Twenty-three consecutive hypergastrinemic patients presenting with the Zollinger-Ellison syndrome and 18 normogastrinemic subjects were studied. All had fasting serum gastrin determination, colonoscopy, and cell kinetic measurement in two colonic sites using in vitro 5'-bromodeoxyuridine incorporation.
Macroscopic tumors, one endocrine and five adenomas, were found in 5 of 23 hypergastrinemic patients, without apparent relationship with the level of gastrin. The labeling indices were significantly higher in hypergastrinemic than in normogastrinemic individuals in the right and left colon, (P < 0.002 to P < 0.001) without resulting in colonic cell hyperplasia. There was no correlation between labeling indices and serum gastrin concentrations or duration of hypergastrinemia. The DNA labeling distribution along the crypt was normal in the two groups, without expansion of the proliferative zone towards the surface.
These results showed for the first time that long-lasting endogenous hypergastrinemia is accompanied by increased in vivo cell proliferation in the human colonic mucosa. However, the prevalence of adenomas (17.4%) in patients, all more than 50 years old, may not be different from that in the general population.
关于胃泌素对结肠可能产生的影响的信息不完整且存在一定争议。本研究分析了慢性内源性高胃泌素血症对人结肠黏膜细胞增殖和肿瘤发生的影响。
对连续就诊的23例患有卓艾综合征的高胃泌素血症患者和18例胃泌素水平正常的受试者进行了研究。所有患者均进行了空腹血清胃泌素测定、结肠镜检查，并使用体外5'-溴脱氧尿苷掺入法对两个结肠部位进行了细胞动力学测量。
在23例高胃泌素血症患者中，有5例发现了肉眼可见的肿瘤，其中1例为内分泌肿瘤，5例为腺瘤，这些肿瘤与胃泌素水平无明显关系。高胃泌素血症患者右半结肠和左半结肠的标记指数显著高于胃泌素水平正常的个体（P<0.002至P<图001），但未导致结肠细胞增生。标记指数与血清胃泌素浓度或高胃泌素血症持续时间之间无相关性。两组沿隐窝的DNA标记分布正常，增殖区未向表面扩展。
这些结果首次表明，长期的内源性高胃泌素血症伴随着人结肠黏膜体内细胞增殖增加。然而，所有年龄超过50岁的患者中腺瘤的患病率（17.4%）可能与普通人群无异。
