EPITHELIAL MISPLACEMENT AFTER BIOPSY OF COLORECTAL ADENOMAS
EPITHELIAL MISPLACEMENT AFTER BIOPSY OF COLORECTAL ADENOMAS
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DOI：
10.1097/00000478-199312000-00007
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发表时间：
1993-12-01
影响因子：
5.6
通讯作者：
SCHOBEL, B
中科院分区：
文献类型：
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作者：
DIRSCHMID, K;KIESLER, J;SCHOBEL, B
有人提出这样一个问题，即从结直肠腺瘤中取出活检材料是否会导致肿瘤碎片错位进入肠壁更深的层。我们对21例患者的组织切片进行了分析，这些患者在腺瘤切除前2-21天进行了钳夹活检(n=18)或息肉切除术(n=3)。活检后几天的最初组织学图像是溃疡被化脓性渗出物和大量含有粘液的小的、自由分布的肿瘤细胞群所覆盖。平均7天后，我们发现这些细胞错位进入粘膜下层，在修复过程中，它们嵌入了富含毛细血管的肉芽组织。随后，粘膜下层纤维化发展为持续性粘液池。因此，我们的结果表明，从腺瘤中取出活检材料会导致肿瘤颗粒错位进入粘膜下层。这些变化在扁平或广泛的肿瘤中观察到，在活检后很短的一段时间内，似乎可以检测到上皮错位。对于鉴别诊断，重要的是要将这些改变与浸润性癌区分开来。
The question has been raised as to whether the removal of biopsy material from colorectal adenomas can lead to misplacement of tumour fragments into the deeper layers of the bowel wall. We carried out an analysis of histological sections obtained from 21 patients in whom, between 2 and 21 days before removal of their adenoma, forceps biopsy (n = 18), or polypectomy (n = 3) had been performed. The initial histological picture a few days after biopsy is of an ulcer covered by a suppurative exudate and abundant mucus-containing small, free-lying groups of tumour cells. After an average of 7 days, we found misplacement of these groups of cells into the submucosa where, during the course of reparative processes, they became embedded within a capillary-rich granulation tissue. Subsequently, fibrosis of the submucosa develops with persistent mucus pools. Our results thus show that removal of biopsy material from adenomas can result in misplacement of tumour particles into the submucosa. These changes were observed in flat or broad-based tumours, and epithelial misplacement appears to be detectable within only a short period after biopsy. For the differential diagnosis, it is important to distinguish these changes from invasive carcinoma.