Role of proliferation and apoptosis in superficial tumor in the colon

为了确定浅表病变和息肉样病变的遗传差异，我们对不同形态的结直肠病变进行了增殖、凋亡状态和微卫星不稳定状态的检测。采用抗bc12和抗ki67抗体免疫组化检测37例不同形态结直肠腺瘤细胞的增殖和凋亡情况。材料包括11例息肉样腺瘤、16例扁平升高腺瘤和10例浅表性腺瘤，息肉样腺瘤、扁平升高腺瘤和浅表性腺瘤的增殖情况相似。然而，关于细胞凋亡状态与腺瘤形态的关系，浅表腺瘤比息肉样腺瘤更倾向于携带活跃的细胞凋亡状态。微卫星不稳定性（MSI）最初是在遗传性非息肉病性结直肠癌中发现的。近年来，MSI被认为是一种反映DNA错配修复状态的标记物，并可能进一步影响生物学行为。对103例晚期散发性结直肠癌进行了MSI检查。在本研究中，15.7%的散发性结直肠癌检测到MSI。结肠癌近端和远端MSI阳性率分别为33%和6%。MSI多见于近端结肠。对44例无结直肠癌家族史的早期结直肠癌患者进行MSI状态检测。材料包括28个息肉样病变和16个浅表病变，近端结肠19个病变，远端结肠25个病变。11.4%的早期结直肠癌患者MSI呈阳性。在结肠近端，浅表腺瘤比息肉样腺瘤更常显示MSI阳性（44% vs 0%, p0）。O4)，这可能提示浅表病变和息肉样病变的不同癌变机制。本研究结果提示，结直肠癌近端与远端癌变不同。通过增殖-凋亡状态和MSI状态，也可以认为浅表病变和近端结肠息肉样病变的肿瘤发生是不同的。少

In order to determine the genetic difference between superficial lesion and polypoid lesion, proliferation and apoptosis status and microsatellite instability status were examined using colorectal lesions with differing morphology. Proliferation and apoptosis status were examined in 37 colorectal adenomas with differing morphology by immunohistochmistry using anti-bc12 and anti-Ki67 antibodies. Materials were consisted of 11 polypoid adenomas, 16 flat elevated adenomas and 10 superficial adenomas, Proliferation status was similar among polypoid adenomas, flat elevated adenomas and superficial adenomas. However, concerning the relation between apoptosis status and morphology of the adenomas, superficial adenomas were tended to carry more active apoptosis status than polypoid adenomas.Microsatellite instability(MSI) was initially reported to be found in hereditary non polyposis colorectal cancer. Recently MSI is considered to be a marker to reflect DNA mismatch repair status and may refl … More ect the biological behavior. MSI were examined in 103 sporadic colorectal cancer in advanced stages. In this series, MSI was detected in 15.7% of sporadic colorectal cancers. Positive rate of MSI in colorectal cancers in the proximal colon and in the distal colon were 33% and 6%, respectively. MSI was found more in the proximal colon.Forty-four early colorectal cancers without family history of colorectal cancers were assayed for MSI status. Materials were consisted of 28 polypoid and 16 superficial lesions, and 19 lesions cited in the proximal colon and 25 lesions in the distal colon. MSI was positive in 11.4% of early colorectal cancers. In the proximal colon, superficial adenomas showed positive MSI more frequently than polypoid adenomas(44% vs 0%, p0.O4), which may suggest the different carcinogenesis between superficial lesions and polypoid lesions.The result in the present studies suggested that the carcinogenesis was different between in the proximal colon cancer and in the distal colorectal cancer. The tumorigenesis was also considered to be different between in the superficial lesions and in the polypoid lesions in the proximal colon by means of proliferation-apoptosis status and MSI status. Less