摘要
目的探讨结直肠锯齿状病变中P16、MLH-1、Ki67、β-catenin的表达及临床病理意义。方法将我院在2012年3月至2015年3月收治诊断为结直肠锯齿状病变标本180例作为实验观察组，并将我院同期收治的管状腺瘤、结直肠癌及正常结直肠黏膜组织者139例作为对照组。使用免疫组织化学法检测两组病变标本中P16、MLH-1、Ki-67、β—catenin的表达水平。结果观察组中的广基锯齿状腺瘤（SSA／P）及传统型锯齿状腺瘤（TSA）在Ki-67、β-catenin、P16阳性表达率方面与对照组存在显著差异，P〈0．05；SSA／P与对照组的HP及正常粘膜在MLH-1阳性表达率上存在明显差异，有统计学意义，并且阳性表达率呈现出递增趋势，表明HP是SSA／P的一种前期病变；SSA／P镜下病理特征为：所有病例都能看见明显锯齿状结构，且常常处于隐窝基底部，紧邻黏膜肌；隐窝表现出“L”或倒“T”型，并扩张、膨大，呈现出水平分支状。TSA镜下病理特征为：锯齿状轮廓显著，存在典型的畸形隐窝，而且隐窝基底也不再“锚定”在黏膜肌上，形成“异位”样隐窝结构。结论SSA／P与TSA属于大肠癌（CRC）的癌前病变，并会经过锯齿状通路出现恶变，恶性潜能较高，应区分好其与HP的差别。
Objective to study the colorectal serrated lesions of P16, MLH 1, Ki-67, beta-catenin expression and clinical pathological significance. Methods our hospital in March 2012-march, 2015 were diagnosed with specimens of colorectal serrated lesions in 180 cases as experimental group, and will be of tubular adenoma admitted in our hospital during the same period, colorectal cancer and normal colorectal mucosa organizers 139 cases as control group. Immune histochemical method were used to detect P16 in the two groups of specimens of lesions, MLH 1, Ki-67, beta-catenin expression level. Results in the observation group wide base serrated adenoma （SSA/P） and conventional serrated adenoma （TSA） in Ki 67, beta catenin, P16 positive expression rate has significant differences with the control group, P〈0. 05; SSA/P with HP in the control group and normal mucosa in MLH 1 exist obvious differences in positive expression rate was statistically significant, and the positive expression rate presents the increasing trend, show that HP is SSA/P a precancerous lesion; SSA/P microscopically in pathological features： all the cases can see obvious jagged structure, and often in a crypt base, adjacent to mucosal muscle; Crypt show ＂L＂ or ＂T＂ type, and expand, enlargement, presents the level of branching. TSA microscopically pathological features as follows： the jagged outline, typical deformities fossae, and also no longer ＂anchor＂ crypt basement on mucosal muscle, form ＂ectopic＂ crypt structure. Conclusion SSA/P with the TSA belongs to the precancerous lesion of colorectal cancer （CRC）, and malignant change will appear after a jagged pathway, malignant potential is higher, should distinguish between its differences with HP.
出处
《检验医学》
CAS
2016年第B09期76-77,共2页
Laboratory Medicine
