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目的探讨结直肠锯齿状息肉的临床病理特征及MLH1、MGMT、RUNX3、CDX2、β-catenin、p16和Ki-67的表达。方法收集增生性息肉(HP)52例,其中微小泡状型增生性息肉(MVHP)38例,杯状细胞型增生性息肉(GCHP)12例,黏液缺乏型增生性息肉(MPHP)2例,观察其临床病理特征,同时进行免疫组化染色;并以广基锯齿状息肉(SSA)41例、传统锯齿状腺瘤(TSA)23例、正常结直肠黏膜组织24例及结直肠腺癌(CRC)24例作为对照。结果 HP多发生于左半结肠,可分为MVHP、GCHP和MPHP 3种亚型。主要表现为大部分腺腔有锯齿状结构,隐窝拉长,多呈管状,隐窝上部腔缘呈锯齿状,增生部分位于基底及下1/3,隐窝下1/3狭窄,间隔被覆未分化细胞及神经内分泌细胞。RUNX3、β-catenin、p16和Ki-67的表达阳性率,HP与其他各组比较差异显著(P<0.05)。结论 HP为最常见锯齿状病变,大部分腺腔呈锯齿状改变,伴/不伴杯状细胞。RUNX3、β-catenin与p16在HP的发生、发展过程中可能起重要作用。MPHP增殖活性较高可能有一定的恶性潜能。
Objective To investigate the clinicopathological features and the expressions of MLH1, MGMT, RUNX3, CDX2, β-catenin, p16 and Ki-67 in serrated polyps of colorectum. Methods Fifty - two cases of proliferative polyp (HP) were collected, including 38 cases of vesicular proliferative polyps (MVHP), 12 cases of goblet cell proliferative polyps (GCHP), 2 cases of mucinous hyponatremic polyps (MPHP) The clinicopathological features were observed and immunohistochemical staining was performed simultaneously. 41 cases of wide-base serrated polyps (SSA), 23 cases of traditional serrated adenomas (TSA), 24 cases of normal colorectal mucosa and 24 cases of colorectal adenocarcinoma CRC) 24 cases as a control. Results HP occurred in the left colon, can be divided into three subtypes of MVHP, GCHP and MPHP. Mainly manifested as most of the glandular cavity serrated structure, crypts elongated, mostly tubular, the upper edge of the crypt was jagged, hyperplasia located in the base and the next 1/3, 1/3 of the crypts, the interval is covered Undifferentiated cells and neuroendocrine cells. The positive rates of RUNX3, β-catenin, p16 and Ki-67 were significantly different from those of other groups (P <0.05). Conclusion HP is the most common serrated lesion with most of the glandular lumen serrated with / without goblet cells. RUNX3, β-catenin and p16 may play an important role in the pathogenesis and development of HP. MPHP higher proliferative activity may have some malignant potential.