CAJ | 학술논문

目的探讨大肠锯齿状腺瘤(SA)的内镜特征和癌胚抗原的表达情况.方法选择2005年6月-2008年7月在消化内镜室检出的SA患者27例(SA组),另选择同期检出的进展期结直肠腺癌(ACC)患者共26例(ACC组).结肠镜检查发现大肠息肉后用0.4%靛胭脂溶液进行喷洒染色并判断息肉的腺管开口,采用活检钳钳咬、高频电切除术、EMR等方法摘除息肉,对大肠癌等病灶则采用活检钳钳咬组织.上述标本进行病理组织学常规检查和腺体组织癌胚抗原(CEA)免疫组化染色.结果 SA组锯齿状腺瘤47枚,其它类型息肉27枚.SA形态以隆起亚蒂型多见,2枚最大径≥10 mm,45枚最大径在3～8mm.SA腺管开口较常见到Ⅱ型pit与ⅢL型pit的混合表现,Ⅱ型pit也占一定比例,好发部位均在左半结肠.SA的腺瘤性腺体CEA阳性表达明显强于其增生性腺体CEA阳性表达(P<0.01).结论 SA是一种独特的大肠腺瘤类型,其瘤细胞已有较强合成CEA能力,具备一定的恶变潜能,临床医师应予以高度重视.
목적 탐토대장거치상선류(SA)적내경특정화암배항원적표체정황.방법 선택2005년6월-2008년7월재소화내경실검출적SA환자27례(SA조),령선택동기검출적진전기결직장선암(ACC)환자공26례(ACC조).결장경검사발현대장식육후용0.4%전연지용액진행분쇄염색병판단식육적선관개구,채용활검겸겸교、고빈전절제술、EMR등방법 적제식육,대대장암등병조칙채용활검겸겸교조직.상술표본진행병리조직학상규검사화선체조직암배항원(CEA)면역조화염색.결과 SA조거치상선류47매,기타류형식육27매.SA형태이륭기아체형다견,2매최대경≥10 mm,45매최대경재3～8mm.SA선관개구교상견도Ⅱ형pit여ⅢL형pit적혼합표현,Ⅱ형pit야점일정비례,호발부위균재좌반결장.SA적선류성선체CEA양성표체명현강우기증생성선체CEA양성표체(P<0.01).결론 SA시일충독특적대장선류류형,기류세포이유교강합성CEA능력,구비일정적악변잠능,림상의사응여이고도중시.
Objective To explore the endoscopic features and careinoembryonic antigen (CEA) ex-pressions of colorectal serrated adenomas (SA). Methods From June 2005 to July 2008, 27 patients with colorectal polyps and 26 cases of advanced colorectal cancer (ACC) were enrolled in the study. The pit pat-tern of the suspected lesions were observed with 0. 4% indigo carmine sodium stain and classified according to Kudo classification. The polyps were removed by biopsy, high-frequency electrical excision or endoscopic mucosa resection and the samples of ACC were collected with biopsy forceps. All specimens underwent rou-tine pathological examination and CEA expression was detected by immunohistochemistry. Results There were 47 SAs and 27 other types of polyps in polyp group. Most SAs located in left-side colon and were char-acterized by the bulge semipedunculation. The diameters of 45 serrated adenomas ranged from 3 to 8ram, and the maximal diameter of other 2 were more than 10ram. The most common type of pit pattern in SA was mixed type Ⅱ and ⅢL, with type Ⅱ predominant in a certain percentage. Expression of CEA in SA glands was significantly higher than that in proliferative polyps (P < 0. O1). Candnsion SA is an unique type of colorectal adenoma, which is capable of expressing CEA, and displays malignant potential and deserves great attention.