Mitomi H, Uesugi H, Nishiyama Y, Ohida M, Arai N, Kobayashi N, Okayasu I
Department of Pathology, School of Medicine, Kitasato University, Sagamihara, Kanagawa, Japan.
Am J Gastroenterol. 1997 Aug;92(8):1374-7.
To assess cell proliferation and analyze oncogenetic abnormalities in cases of juvenile polyposis of the stomach (JPs), with or without coexisting tumors.
The Ki-67 labeling indices (KLI) were compared for juvenile polyps and coexisting tumors in three cases of JPs along with values for gastritis, foveolar epithelial hyperplastic polyps, adenomas, and carcinomas. Expression of p53, Bcl-2, and c-ErbB-2 in tumors was examined immunohistochemically, and a search for c-Ki-ras mutations was made by DNA direct sequencing.
The KLI for JPs did not significantly differ between cases, being consistently lower than the values for both hyperplastic polyps and gastritis. The KLI for the papillary tumors and a signet ring cell carcinoma found in association with JPs tended to be lower than those for their conventional counterparts. P53, but not Bcl-2 and c-ErbB-2, was focally expressed in the papillary tumors, whereas all three were absent in the signet ring cell carcinoma, in the JPs. No c-Ki-ras mutations were detected in the papillary tumors.
The cell proliferation of JPs is relatively low and the polyps can be considered hamartomatous. However, neoplastic change clearly can occur in association with a relative increase in proliferative activity being observed in coexisting tumors. Low cellular proliferative activity and absence of oncogenetic abnormalities in tumors of JPs, compared with their conventional counterpart tumors, suggest that pathways of tumorigenesis and genetic alteration in JPs may be different from those in their conventional counterparts.
评估胃幼年性息肉病（JPs）病例中的细胞增殖情况，并分析有无并存肿瘤时的肿瘤发生异常。
比较3例JPs患者幼年性息肉和并存肿瘤的Ki-67标记指数（KLI），并与胃炎、胃小凹上皮增生性息肉、腺瘤和癌的相应数值进行比较。采用免疫组织化学方法检测肿瘤中p53、Bcl-2和c-ErbB-2的表达，并通过DNA直接测序寻找c-Ki-ras突变。
JPs病例的KLI在各病例之间无显著差异，始终低于增生性息肉和胃炎的数值。与JPs相关的乳头状肿瘤和印戒细胞癌的KLI往往低于其传统对应肿瘤。p53在乳头状肿瘤中有局灶性表达，而Bcl-2和c-ErbB-2无表达，在JPs的印戒细胞癌中三者均无表达。在乳头状肿瘤中未检测到c-Ki-ras突变。
JPs的细胞增殖相对较低，息肉可被认为是错构瘤性的。然而，在并存肿瘤中观察到增殖活性相对增加时，明显可发生肿瘤性改变。与传统对应肿瘤相比，JPs肿瘤的细胞增殖活性低且无肿瘤发生异常，提示JPs的肿瘤发生途径和基因改变可能与其传统对应肿瘤不同。
