大肠小扁平腺瘤内镜和组织学特征及p53、p21表达研究  

Colonoscopic and Histological Features of Colorectal Small Flat Adenoma and Its Expression of p53 and p21

作　　者：童淑兰 黄熙源 陈维香[1] 丁珺[1] 费绍华 杨玲芳[1] 叶龙珍[1] 孙宏夫[1] 

机构地区：[1]上海市浦东新区公利医院,上海200135

出　　处：《肿瘤学杂志》2005年第4期270-272,共3页Journal of Chinese Oncology

摘　　要：[目的]探讨大肠小扁平腺瘤的形态学特征及p53、p21表达的生物学意义。[方法]①用电子结肠镜及光学显微镜观察50例大肠小扁平腺瘤形态学特征。②用免疫组化二步法检测50例小扁平腺瘤及对照组26例大肠癌、15例正常人大肠黏膜中p53、p21表达率。[结果]①小扁平腺瘤发生于大肠任何部位,其发病率依次以横结肠、乙状结肠、直肠为多见;肠镜下见病灶呈圆形或椭圆形,扁平状,基底宽,体积<1cm。②光镜下小扁平腺瘤呈管状腺瘤样图像,上皮具有不同程度的异型增生。③小扁平腺瘤中p53、p21的表达率分别为58%(29/50)、56%(28/50)。随着小扁平腺瘤异型增生程度的增高,p53、p21的表达率也逐渐升高(P<0.05)。p53、p21在正常肠黏膜、小扁平腺瘤及大肠癌组中阳性表达率均逐渐升高,三组间差异有显著性(P<0.05)。[结论]大肠小扁平腺瘤有其独特的形态学特征,p53、p21的表达与大肠小扁平腺瘤的癌变发生发展有密切关系。[Purpose] To investigate the morphology and the expression of p53, p21 in colorectal small flat adenoma. [Methods] ①Colonoscopy and microscopy were performed in 50 cases with colorectal small flat adenomas features. ②The expression of p53, p21 was detected by the two-step of immunohistochemistry method in 50 cases with small flat adenomas, 26 cases with colorectal carcinomas and 15 cases with the normal colorectal mucosa（control group）. [Results] Small flat adenoma can occur in any site of the large bowel, although the most site was transverse colon sigmoid and rectum. The lesion was round, flat shape, sessile and small size（〈10mm in diameter）. Small flat adenoma were tubular adenomas with varing degrees of dysplasia. The expression ratio of p53, p21 in small flat adenomas was 58%（29/50）, 56%（28/50） respectively. With the increasing of the degree of dysplasia, the expression ratio of p53, p21 incresed in small flat adenomas significantly. The expression rate of p53, p21 in small flat adenoma was higher than that in control group, but lower than that in colorectal carcinomas（P〈0.05）. [Conclusion] Small flat adenomas show their distinct characteristics in colonoscopy and histology. The expression of p53, p21 was associated with carcinogenesis of small flat adenomas.

关 键 词：肠肿瘤 基因 p53 基因 p21 内窥镜检查 胃肠道 组织学 

分 类 号：R574.6[医药卫生—消化系统]