Histopathological Characteristics of Laterally Spreading Tumor（LST） Type Early Colorectal Cancer
Histopathological Characteristics of Laterally Spreading Tumor（LST） Type Early Colorectal Cancer
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横向扩散肿瘤（LST）型早期结直肠癌的组织病理学特征
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发表时间：
2014
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通讯作者：
H. Kijima
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作者：
Kaori Takasugi;S. Morohashi;Toshihiro Haga;Takahito Toba;H. Seino;Yunyan Wu;Takahiro Suzuki;N. Hanabata;Y. Sasaki;S. Fukuda;H. Kijima
近年来，早期结直肠癌的侧向扩散性肿瘤(LST)越来越多地采用内窥镜下黏膜下剥离术(ESD)治疗。许多早期结直肠癌被诊断为高分化腺癌，但组织学和/或免疫史上的异质性常见于LST。本研究采用组织学和免疫组织化学方法，分析了61个LST型早期结直肠癌病变的形态特征。高级别异型性成分的存在与粘膜下侵犯深度显著相关(P=0.0102)，且主要位于粘膜下层癌的浸润性前沿(深部)。高度不典型组P53和Ki-67的ALLRED评分均升高，与肿瘤的侵袭深度无关。CDX2和CD10的表达随肿瘤侵袭深度的增加而显著上调，且在高度不典型增生中呈高表达趋势。综上所述，本研究表明大多数LST在组织学上是异质性的。高度非典型性LST的成分上调了细胞的增殖，这可能导致LST侵袭黏膜下层的恶性潜能增加。广阪医学部：158-169,2014
Recently, laterally spreading tumor (LST) of early colorectal carcinoma has been treated by endoscopic submucosal dissection (ESD) more frequently. Many cases of early colorectal carcinomas are diagnosed as well differentiated adenocarcinomas, but histological and/or immunohistorogical heterogeneity is often seen in LSTs. In this study, we analyzed morphological characteristics of 61 lesions of LST-type early colorectal carcinoma by using histolosical and immunohistochemical procedures. Presence of high grade atypia components was significantly correlated with depth of submucosal invasion (P=0.0102), and these were predominantly located to the invasive front (deep part) of the submucosal carcinoma. Allred scores of p53 and Ki-67 labeling indices were increased in the component of high grade atypia regardless of depth of invasion. Expressions of CDX2 and CD10 were significantly upregulated in a depth-of-invasion dependent manner, and these tended to be highly expressed in the high grade atypias. In conclusion, the present study indicates that the majority of LST is histologically heterogeneic. The component of high grade atypia of LST upregulates cell proliferation, which may leed to increase the malignant potential of LST for invading the submucosa. Hirosaki Med.J. 64:158―169,2014