王仰坤 1高春芳 1吴英超 1吕学霞 1蒙念龙 1原旭涛1
作者信息
- 1. 471031,河南洛阳,解放军第一五○中心医院病理科
- 折叠
摘要
Abstract
Objective To study the gastric mucosal biopsy clinical and pathological features of adenoma,phenotype, biological behavior. Methods Fifty-two patients with pathological diagnosis of gastric biopsy specimens of adenomas were studied by light microscopy, immunohistochemical staining and follow-up methods. Results Gastric adenoma histopathological characteristics: the nuclear inter-change, reflected increases in size and shape of nuclear irregularity, and the emergence of one or more of the nucleolus, nuclear fission ≤ 2/10HPF. Glands structural change: a tubular adenoma over more consistent, occasional glands of irregular size and contour, may be associated with intestinal metaplasia. When the core volume increased significantly, mitotic＞2/10HPF, glands appeared irregular distortions, branching-like structure, suggesting that adenomas and development. Immunophenotype: Different molecular weight keratin and tumor-associated carbohydrate antigens have a higher expression. CDX-2, APC, PTEN, and high expression of CEA is closely related to the formation of adenomas. Mucin Muc-2 high expression of mucin Muc-1 was negatively correlated with low expression, two kinds of combination can help determine the progress of gastric adenoma. survivin, bcl-2 and p53 protein positive expression rate is low, the three pairs of gastric adenomas with malignant transformation of the discriminant of great significance. Ki-67 positive cells 20％～40％, and can be used as degree of cell proliferation, the evaluation a useful indicator of prognosis. 37～45 months follow-up found that cured 42. 3％ (22/52), there are still adenomatous hyperplasia 38. 5％ (20/52), with the development of the opposite sex hyperplasia showed 15.4％ (8/52), development of mucosal carcinoma in situ were 3. 8％ (2/52). Conclusion The emergence of a nuclear volume of gastric adenoma increased significantly, mitotic＞2/10HPF, irregular gland distortion and branch-like structure; APC, CDX-2, PTEN, Muc-2 were expression decreased, survivin, bcl-2 and p53 positive expression rates appeared increased, Ki-67 index was increased about 40％, suggesting that there are cancerous tendencies and endoscopic mucosal resection should be required.关键词
胃黏膜活检/腺瘤/病理学/免疫组织化学分类
医药卫生
