Hyperplastic-like mucosal change in Crohn's disease: An unusual form of dysplasia?
Hyperplastic-like mucosal change in Crohn's disease: An unusual form of dysplasia?
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DOI：
10.1038/modpathol.3880138
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发表时间：
2000-07-01
期刊：
影响因子：
7.5
通讯作者：
Goldblum, JR
中科院分区：
文献类型：
--
作者：
Kilgore, SP;Sigel, JE;Goldblum, JR
克罗恩病患者发生肠腺癌的风险增加。在这种情况下，异型增生既是腺癌的标志物，也是腺癌的前兆。回顾我们的克罗恩病相关腺癌病例，我们注意到在某些病例中，邻近和远离腺癌的粘膜都有一种特殊的增生样粘膜改变（HPC）。然而，这种变化的意义是unknow.We评估30例克罗恩病相关腺癌和30例年龄和部位匹配的克罗恩病切除标本无腺癌，以确定这种粘膜改变在这些群体中的患病率。HPC被认为是一个弥漫性的帽子粘膜扩张的架构类似于结直肠增生性息肉，并与细胞学平淡的基底核和顶端的细胞质粘蛋白扩张的细胞组成。在克罗恩病相关腺癌病例中观察到HPC与腺癌的关系。对两组中所有HPC病例进行p53免疫组化染色（抗体DO 7），30例克罗恩病相关腺癌中有10例（33%）发现HPC，而对照组30例中有3例（10%）发现HPC（P = 0.03）。在10例Crohn's相关腺癌中，3例在癌旁，5例在癌旁，2例在癌旁和癌旁均可见这种改变。在两个标本中，HPC被认为是直接毗邻腺癌的情况下，相邻的异型增生。5/10例（50%）克罗恩相关腺癌的HPC中p53免疫反应阳性。相比之下，p53免疫反应性没有看到在HPC中的三个控制情况下，这种粘膜alternation.In的结论，HPC是发现显着更常见于粘膜相邻和远离克罗恩氏相关腺癌相比，年龄和部位匹配的控制。此外，与对照组相比，p53免疫反应性在克罗恩病相关腺癌的HPC中更常见。这些数据表明，在某些情况下，这种粘膜改变可能代表了这种情况下不寻常的发育不良形式。
Patients with Crohn's disease are at increased risk of developing intestinal adenocarcinoma. Dysplasia is both a marker and a precursor of adenocarcinoma in this setting. In a review of our cases of Crohn's-related adenocarcinoma, we noted a peculiar hyperplastic-like mucosal change (HPC) in mucosa both adjacent to and distant from the adenocarcinoma in some cases. However, the significance of this change is unknown.We evaluated 30 cases of Crohn's-related adenocarcinoma and 30 age- and site-matched resection specimens with Crohn's disease without adenocarcinoma to determine the prevalence of this mucosal alteration in these groups. HPC was recognized by a diffuse expanse of hat mucosa with an architecture resembling that seen in colorectal hyperplastic polyps and composed of cells with cytologically bland basal nuclei and apical cytoplasmic mucin distention. The relationship of the HPC to the adenocarcinoma was noted in the Crohn's-related adenocarcinoma cases. An immunohistochemical stain for p53 (antibody DO7) was performed on all cases with HPC in both groups.HPC was identified in 10 of 30 (33%) cases of Crohn's-related adenocarcinoma compared with 3 of 30 (10%) cases in the control group (P = .03). In the 10 cases of Crohn's-related adenocarcinoma with HPC, this alteration was found adjacent to the adenocarcinoma in 3 cases, distant to the adenocarcinoma in 5 cases, and both adjacent to and distal from the adenocarcinoma in 2 cases. In two specimens, HPC was seen immediately adjacent to adenocarcinoma in the absence of adjacent dysplasia. p53 immunoreactivity was noted in HPC in 5 of 10 (50%) Crohn's-related adenocarcinomas. In contrast, p53 immunoreactivity was not seen in HPC in the three control cases with this mucosal alteration.In conclusion, HPC is found significantly more commonly in mucosa both adjacent to and distant from Crohn's-related adenocarcinoma when compared with age- and site-matched controls. In addition, p53 immunoreactivity is more commonly seen in HPC in cases of Crohn's-related adenocarcinoma compared with controls. These data suggest that this mucosal alteration may, in some cases, represent an unusual form of dysplasia in this setting.