Matsuda K, Watanabe H, Ajioka Y, Kobayashi M, Saito H, Sasaki M, Yasuda K, Kuwabara A, Nishikura K, Muto T
First Department of Pathology, Niigata University School of Medicine, Japan.
J Gastroenterol. 1996 Dec;31(6):860-7. doi: 10.1007/BF02358616.
A 53-year-old man with a 22-year history of ulcerative colitis(UC) (pancolitis), had an ulcerating rectal tumor. Resection of the rectum and sigmoid colon was performed. Pathology showed an expansive ulcerating adenocarcinoma tumor (type 2) invading the adventitia against a background of UC in a resolving phase. Dysplasia was also found in granular and flat mucosa adjacent to the invading carcinoma. Immunostaining for p53 showed diffuse positivity in both the carcinoma and dysplasia, and also in the mucosa with indefinite dysplasia or no dysplasia neighboring the dysplasia and carcinoma. Mapping of neoplasms and the area with p53 protein overexpression showed that the grade of dysplasia increased as the lesion approached the invasive carcinoma and that the mucosa with dysplasia was surrounded by mucosa without dysplasia or indefinite for dysplasia, but with p53 protein overexpression. In some areas without dysplasia showing p53 overexpression, there was significant morphometric enlargement of the area and diameter of the nucleus p53 Immunostaining is a good marker for assessing the genetic alterations that precede histological abnormalities and for diagnosing carcinoma in UC. Objective findings such as p53-protein overexpression and morphometric values should be used to evaluate cytological abnormalities in UC, as well as in common colorectal cancer.
一名患有22年溃疡性结肠炎（UC）（全结肠炎）病史的53岁男性，患有溃疡性直肠肿瘤。进行了直肠和乙状结肠切除术。病理显示为膨胀性溃疡性腺癌肿瘤（2型），在处于缓解期的UC背景下侵犯外膜。在侵袭性癌附近的颗粒状和平坦黏膜中也发现了发育异常。p53免疫染色显示癌组织和发育异常组织均呈弥漫性阳性，在发育异常和癌组织相邻的具有不确定发育异常或无发育异常的黏膜中也呈阳性。肿瘤和p53蛋白过表达区域的定位显示，随着病变接近侵袭性癌，发育异常的程度增加，且发育异常的黏膜被无发育异常或发育异常不确定但有p53蛋白过表达的黏膜所包围。在一些无发育异常但显示p53过表达的区域，细胞核的面积和直径有明显的形态计量学增大。p53免疫染色是评估UC组织学异常之前的基因改变以及诊断UC中癌的良好标志物。应使用p53蛋白过表达和形态计量学值等客观发现来评估UC以及常见结直肠癌中的细胞学异常。
