The genetic changes in association with tumor progression and biological behavior

锯齿状腺瘤是结直肠腺瘤的一种亚型，呈息肉状和扁平状生长。为了分析早期扁平癌的进展，锯齿状腺瘤应纳入本研究。这些病变所产生的锯齿状腺瘤、化生性息肉和腺癌虽然都是结肠病变，但它们具有共同的组织学特征，并表现出相同的胃型表型。本文报道了其独特的细胞谱系，与一般管状腺瘤不同。另一方面，胃表型仅在3%的随机选择的结直肠癌中被识别。因此，这种锯齿状息肉癌序列被认为是一种独特的致癌途径。进一步对绒毛状腺瘤、溃疡性结肠炎癌和肝转移癌的表型研究，阐明了几种致癌途径，也揭示了CD 10表达的癌的高度恶性行为，提示p53在胃表型大肠癌的致癌途径中起重要作用，而在绒毛状肿瘤中则不起作用。免疫组化法检测p53蛋白的表达。需要进一步的遗传分析来精确评估生物学行为并阐明致癌途径。

The serrated adenoma, one of the subtype of colorectal adenoma, grows in polypoid and flat configurations. In order to analyze the progression of early flat carcinoma, the serrated adenoma should be included in this study. The serrated adenoma, metaplastic polyp and adenocarcinoma arising from these lesions had a common histological features and expressed the same phenotype of gastric-type, although they were colonic lesions. We reported the unique cell lineage of them, which was different from that of usual tubular adenoma. On the other hand, the gastric-phenotype was recognized only in 3 % of randomly selected colorectal carcinomas. Therefore, this serrated polyp-carcinoma sequence was considered o be a peculiar carcinogenic pathway. Further examination of phenotypes on the villous adenoma, carcinoma arising in ulcerative colitis and carcinoma with liver metastasis elucidated the several carcinogenic pathways, and also revealed the highly malignant behavior of carcinoma with CD10 expression.It was suggested that p53 played a important role in carcinogenic pathway of the colorectal carcinoma with gastric-phenotype, but it did not in villous tumor, by immunohistochemical study on p53 protein overexpression. Further genetic analysis will be needed for precisely evaluating the biological behavior and clarifying the carcinogenic pathway.