Sialosyl-Tn antigen is prevalent and precedes dysplasia in ulcerative colitis: A retrospective case-control study
Sialosyl-Tn antigen is prevalent and precedes dysplasia in ulcerative colitis: A retrospective case-control study
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DOI：
10.1053/gast.1996.v110.pm8608878
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发表时间：
1996-03-01
期刊：
影响因子：
29.4
通讯作者：
Sachar, DB
中科院分区：
文献类型：
--
作者：
Itzkowitz, SH;Young, E;Sachar, DB
背景和目标：糖相关唾液酸Tn（STn）抗原的表达与散发性结肠癌的发生相关。这项回顾性研究分析了监测结肠镜活检标本，以确定STn抗原是否可以作为长期溃疡性结肠炎患者肿瘤风险的标志物。研究方法：11例发生异型增生或癌症的患者，至少进行了3次监测结肠镜检查，与11例未发生肿瘤的对照组相匹配。用单克隆抗体TKH 2对969份监测活检标本的切片进行化学染色，并盲法判读。结果如下：与对照组相比，患者在其活检标本中更频繁地表达STn抗原（44%的患者活检标本vs. 11%的对照活检标本）。患者还可能接受结肠镜检查，其中两个或多个结肠段表达STn抗原（73% vs. 22%），在两个或多个连续结肠镜检查中重复STn抗原表达（91% vs. 27%），以及肝曲近端STn抗原表达（64% vs. 0%）。STn抗原的出现早于肿瘤的检测7年或更短时间，其在患者中的优先表达不受活动性炎症程度的影响。结论：STn抗原在非异型增生结肠粘膜中的重复表达可能预示着长期溃疡性结肠炎肿瘤的发展，并且可能是结肠镜监测期间异型增生的有用辅助手段。
Background & Aims: Expression of the carbohydrate-associated sialosyl-Tn (STn) antigen has been correlated with carcinogenesis in sporadic colon cancer. This retrospective study analyzed surveillance colonoscopy biopsy specimens to determine whether STn antigen could serve as a marker for neoplasia risk in patients with long-standing ulcerative colitis. Methods: Eleven patients who developed dysplasia or cancer and who had undergone at least three surveillance colonoscopies were matched with 11 controls who had not developed neoplasia. Sections from 969 available surveillance biopsy specimens were stained immunohistochemically with monoclonal antibody TKH2 and were interpreted blindly. Results: Compared with controls, patients expressed STn antigen more frequently in their biopsy specimens (44% patient biopsy specimens vs. 11% control biopsy specimens). Patients were also move likely to undergo colonoscopies with two or more colonic segments expressing STn antigen (73% vs. 22%), repeated STn antigen expression in two or more consecutive colonoscopies (91% vs. 27%), and STn antigen expression proximal to the hepatic flexure (64% vs. 0%). STn antigen appearance preceded the detection of neoplasia by 7 or fewer years, and its preferential expression in patients was not confounded by the degree of active inflammation. Conclusions: Repeated STn antigen expression in nondysplastic colonic mucosa may presage the development of neoplasia in long-standing ulcerative colitis and may be a useful adjunct to dysplasia during colonoscopic surveillance.