Loss of Hes1 Differentiates Sessile Serrated Adenoma/Polyp From Hyperplastic Polyp.
Loss of Hes1 Differentiates Sessile Serrated Adenoma/Polyp From Hyperplastic Polyp.
复制标题
DOI：
10.1097/pas.0000000000000531
复制
发表时间：
2016-01
期刊：
影响因子：
--
通讯作者：
Xin W
中科院分区：
文献类型：
--
作者：
Cui M;Awadallah A;Liu W;Zhou L;Xin W
无蒂锯齿状腺瘤/息肉（SSA/p）是一种癌前病变，在某些情况下，仅根据形态学将其与增生性息肉（HP）鉴别诊断可能具有挑战性。Hes 1是Notch信号通路的下游靶点，通过调节肠上皮细胞的分化在肠道发育中发挥重要作用。在这项研究中，我们评估了Hes 1在SSA/p和增生性息肉（HP）中的表达模式，并确定Hes 1免疫染色是否有助于区分这两种实体。锯齿状息肉伴细胞学异常增生（无蒂锯齿状腺瘤伴细胞学异常增生、管状腺瘤和传统锯齿状腺瘤）也进行了研究。Hes 1在正常结肠上皮细胞的细胞核中广泛表达。与HP中Hes 1的正常表达（35/35，100%）相比，在研究中的大多数SSA/p中观察到Hes 1的完全丢失或非常弱的表达（58/63，92%）。在SSA/p与细胞发育不良，发育不良的地区表现出细胞质和/或核染色的Hes 1。管状腺瘤和传统的锯齿状腺瘤显示息肉内Hes 1染色的变异性，具有混合阳性和阴性染色模式。我们的研究表明，Hes 1的缺失可以作为一个敏感和特异性的标志物，以区分SSA/p和HP，这有助于诊断形态学上的挑战性病例。
Sessile serrated adenoma/polyp (SSA/p) is a precancerous lesion, and its differential diagnosis from hyperplastic polyp (HP) could be challenging in certain circumstances based on morphology alone. Hes1 is a downstream target of Notch signaling pathway and plays an important role in intestinal development by regulating differentiation of enterocytes. In this study, we evaluated the expression patterns of Hes1 in SSA/p and hyperplastic polyp (HP), and determine whether Hes1 immunostaining can help differentiate between these two entities. Serrated polyps with cytological dysplasia (sessile serrated adenoma with cytological dysplasia, tubular adenoma, and traditional serrated adenoma) were also studied. Hes1 is ubiquitously expressed in the nuclei of normal colon epithelial cells. The complete loss or a very weak expression of Hes1 is observed in the majority of the SSA/p in the study (58/63, 92%) compared to the normal expression of Hes1 in HP (35/35,100%). In SSA/p with cytological dysplasia, dysplastic area demonstrated cytoplasmic and/or nuclear staining for Hes1. Tubular adenoma and traditional serrated adenoma showed variability of Hes1 staining within the polyp with a mixed positive and negative staining pattern. Our study suggests that loss of Hes1 could be used as a sensitive and specific marker to differentiate SSA/p from HP, which helps the diagnosis in morphologically challenging cases.