Natural history of colorectal nonpolypoid adenomas: a prospective colonoscopic study and relation with cell kinetics and K-ras mutations
Natural history of colorectal nonpolypoid adenomas: a prospective colonoscopic study and relation with cell kinetics and K-ras mutations
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结直肠非息肉样腺瘤的自然史：前瞻性结肠镜研究及其与细胞动力学和 K-ras 突变的关系
DOI：
10.1111/j.1572-0241.2002.05931.x
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发表时间：
2002
影响因子：
9.8
通讯作者：
Y. Kohgo
中科院分区：
文献类型：
--
作者：
J. Watari;Y. Saitoh;T. Obara;M. Fujiya;A. Maemoto;T. Ayabe;T. Ashida;K. Yokota;Y. Orii;Y. Kohgo
目的：前瞻性地进行一系列结肠镜观察，以阐明非息肉样肿瘤的自然史。此外，以澄清是否细胞动力学状态影响肿瘤的发展，增殖指数，凋亡指数，和K-ras密码子12点突变的活检标本进行了investigated.METHODS：75大肠肿瘤，13息肉和62非息肉型（56平坦隆起型和6凹陷型）进行了研究。分别用抗Ki-67抗体和末端脱氧核苷酸转移酶介导的dUTP缺口末端标记法检测细胞增殖和凋亡。结果：随访1-50个月，平均22个月。息肉样型中，外生型占0%，形态不变型占92%，凹陷型占0%，消失型占33%，形态不变型占67%，凹陷型占39%，形态不变型占39%，凹陷型占13%，消失型占0%。初次结肠镜检查和随访结肠镜检查的肿瘤大小没有显著差异。非息肉样肿瘤在2年或更长时间内明显向外生性生长转变。外生性肿瘤的增殖指数/凋亡指数比值显著高于形态学无改变和消失/生长抑制的肿瘤（p < 0.05）。结论：细胞动力学状态在决定大肠癌微小发展中起重要作用，而K-ras基因第12密码子点突变与肿瘤发生无关。微小的非息肉样腺瘤往往生长缓慢，随着时间的推移，近40%的腺瘤变成外生性生长。大多数微小的非息肉样肿瘤似乎遵循腺瘤-癌序列。
OBJECTIVE:Serial colonoscopic observations were prospectively conducted to elucidate the natural history of nonpolypoid tumors. Furthermore, to clarify whether cell kinetic status affects the tumor development, proliferative indices, apoptotic indices, and K-ras codon 12 point mutations on biopsy specimens were investigated.METHODS:Seventy-five colorectal tumors, 13 polypoid and 62 nonpolypoid type (56 flat elevated and six depressed type) were studied. Proliferating and apoptotic cells were detected with anti-Ki-67 antibody and the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling method, respectively. Point mutations at K-ras codon 12 were examined by enriched polymerase chain reaction-based restriction fragment length polymorphism assay.RESULTS:The average follow-up period was 22 months (range 1–50). The lesions of subsequent exophytic growth, unchanged shape, depressed growth, and disappearance were observed in 0%, 92%, 0%, and 8% of polypoid type, in 39%, 39%, 13%, and 9% of flat elevated type, and in 33%, 67%, 0%, and 0% of depressed type, respectively. There was no significant difference in tumor size between initial and follow-up colonoscopy. Nonpolypoid tumors apparently changed to the exophytic growth during 2 yr or more. The tumors with exophytic growth had significantly higher proliferative indices/apoptotic indices ratios than those with unchanged morphology and disappearance/depressed growth (p < 0.05, respectively). K-ras codon 12 point mutations did not correlate with tumor development.CONCLUSIONS:Cell kinetic status plays an important role in determining minute colorectal tumor development, but not K-ras codon 12 mutations. Minute nonpolypoid adenomas frequently tend to grow slowly, and nearly 40% of those become the exophytic growth with time. Most of minute nonpolypoid tumors seem to follow the adenoma-carcinoma sequence.
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DOI：
--
发表时间：
1992-10
期刊：
The American journal of pathology
影响因子：
--
作者：
J. Mulder;G. Offerhaus;E. D. de Feyter;J. Floyd;S. Kern;B. Vogelstein;S. Hamilton
通讯作者：
J. Mulder;G. Offerhaus;E. D. de Feyter;J. Floyd;S. Kern;B. Vogelstein;S. Hamilton
影响因子：
29.4
作者：
Sandler, RS;Galanko, JC;Woosley, JT
通讯作者：
Woosley, JT
影响因子：
158.5
作者：
WINAWER, SJ;ZAUBER, AG;STEWART, ET
通讯作者：
STEWART, ET
影响因子：
158.5
作者：
VOGELSTEIN, B;FEARON, ER;BOS, JL
通讯作者：
BOS, JL