Histogenesis of human colorectal adenomas and hyperplastic polyps: the role of cell proliferation and crypt fission
Histogenesis of human colorectal adenomas and hyperplastic polyps: the role of cell proliferation and crypt fission
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DOI：
10.1136/gut.50.2.212
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发表时间：
2002-02
期刊：
影响因子：
24.5
通讯作者：
W. Wong;N. Mandir;R. Goodlad;B. Wong;S. Garcia;S. Lam;N. Wright
中科院分区：
文献类型：
--
作者：
W. Wong;N. Mandir;R. Goodlad;B. Wong;S. Garcia;S. Lam;N. Wright
背景：人类大肠增生性息肉和大肠腺瘤的组织发生至今仍知之甚少。方法：在结肠镜检查过程中获得人类结直肠腺瘤、增生性息肉和正常结直肠粘膜（排除家族性腺瘤性息肉病和遗传性非息肉病性结直肠癌患者），并将其显微解剖成单个隐窝。然后研究了从这些病变中分离的隐窝的形态学、细胞增殖特征和分裂指数。结果如下：从结直肠腺瘤和结直肠增生性息肉中分离的隐窝明显大于从正常结直肠粘膜中分离的隐窝（p<0.001）。隐窝分裂在正常结肠粘膜中是一种罕见的事件，但在腺瘤和增生性息肉中的隐窝分裂是常见的（p<0.001）。有丝分裂分布的分析表明，腺瘤中的增殖区室向上扩展到隐窝表面，而增殖细胞分布没有逆转，如前所述。结论：散发性结直肠腺瘤和增生性息肉的生长是通过隐窝分裂过程进行的。增殖区室的扩张在腺瘤的隐窝中得到证实，与细胞周期控制的失调一致。
Background: The histogenesis of human colorectal hyperplastic polyps and colorectal adenomas is poorly understood even now. Method: Human colorectal adenomas, hyperplastic polyps, and normal colorectal mucosae (patients with familial adenomatous polyposis and hereditary non-polyposis colorectal carcinoma were excluded) were obtained during colonoscopy and microdissected into individual crypts. Morphology, cell proliferation characteristics, and fission indices of crypts isolated from these lesions were then studied. Results: Crypts isolated from colorectal adenomas and colorectal hyperplastic polyps were significantly larger (p<0.001) than crypts from normal colorectal mucosae. Crypt fission was an uncommon event in normal colonic mucosae but common in crypts isolated from adenomas and hyperplastic polyps (p<0.001). Analysis of the distribution of mitoses suggested an upward expansion of the proliferation compartment in adenomas to the surface of the crypt with no reversal of proliferating cell distribution, as has previously been described. Conclusions: Sporadic human colorectal adenomas and hyperplastic polyps grow by the process of crypt fission. Expansion of the proliferative compartment was demonstrated in crypts from adenomas, consistent with deregulation of cell cycle control.