摘要
Background and aims:We previously demonstrated a significant colorectal neoplasia risk in inflammatory bowel disease(IBD)patients with mucosal changes indefinite for dysplasia(IND)and the potential diagnostic utility of p53 and cytokeratin 7 immunohistochemistry in IBD-associated neoplasia.The primary aim of this exploratory study was to determine the predictive value of the two markers for neoplasia risk in the IBD-IND population.Methods:We identified 44 eligible cases with IBD and IND in colon biopsy from our pathology database.We semi-quantified the expression of p53 and cytokeratin 7 in the colon biopsies by immunohistochemistry and correlated their expression,demographic information,and clinical features with colorectal neoplasia outcome.Results:The mean age of the cohort was 46.6615.1 years,with 25(56.8%)being male.The median follow-up was 101 months(range:6–247)after IND diagnosis.Among these 44 patients,11(25%)progressed to neoplasia(low-grade dysplasia¼6;high-grade dysplasia¼2;cancer 3)at a median follow-up of 66 months(range:19–145).Univariate analysis demonstrated that age and p53 overexpression were associated with progression to neoplasia.Conclusions:Twenty-five percent of patients with IBD and IND developed colorectal dysplasia or cancer.Overexpression of p53 and age are associated with neoplastic progression.
背景和目的:我们之前研究发现,具有不典型增生不确定型黏膜改变(IND)的炎性肠病(IBD)患者具有较高的瘤变风险,同时发现,p53和细胞角蛋白7免疫组化检测对于IBD相关的瘤变具有潜在的诊断价值。本研究旨在初步论证这两种标记物对于IBD-IND患者瘤变风险的预测价值。方法:我们从病理数据库中筛选出了44例符合研究纳入标准且经组织学证实的IBD-IND患者。采用免疫组化方法对所有结肠标本进行p53和细胞角蛋白7的半定量检测,分析这两种标记物的表达、人口统计学特征及临床资料与结直肠瘤变的相关性。结果:本组病例平均年龄(46.6–15.1)岁,男性患者25例(56.8%)。在IND诊断后,中位随访101(6–247)月。11例(25%)患者在随访期间发生瘤变,其中低级别上皮内瘤变6例,高级别上皮内瘤变3例,癌变3例。这11例患者的中位随访时间为66(19–145)月。单因素分析显示,年龄和p53过表达与瘤变相关。结论:有25%的IBD-IND患者会进展为不典型增生或癌。p53过表达和年龄与IND-IBD的瘤变相关。
