中间丝蛋白CK7和CK20的微形态学特征及表达在结直肠锯齿状病变鉴别诊断中的意义

IF 1.5 Q3 GASTROENTEROLOGY & HEPATOLOGY Gastroenterology Insights Pub Date : 2023-02-26 DOI:10.3390/gastroent14010008
I. Ilić, Pavle J. Ranđelović, Ž. Mijović, Maja Jovičić Milentijević, Biljana Radovanović Dinić, Jana Cvetković
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引用次数: 0

摘要

结直肠的锯齿状病变包括所有上皮肿瘤病变,其上皮隐窝呈锯齿状形态。分类系统在病理学上将结肠锯齿状息肉分为三种不同的类型,主要强调其微形态生长模式和细胞分化:(1)增生性息肉,(2)无柄锯齿状腺瘤/息肉和(3)传统锯齿状腺瘤。总的来说,在四年的时间里,109例结肠锯齿状病变患者在一次或多次内镜或手术干预期间接受了内镜或手术息肉切除术/肿瘤切除术。患者平均年龄62.8±11.6岁。男性患者出现结肠锯齿状病变的频率是女性的2.4倍(70.6% vs. 29.4%)。所有无发育不良的无柄锯齿状病变CK7阳性,与其他锯齿状病变相比具有统计学意义,如果这种阳性存在于完全隐窝中(p = 0.005)。CK20阳性是增生性息肉相对于其他锯齿状病变的特殊特征,且仅限于隐窝上半部分,具有统计学意义(p = 0.0078)。而CK20阳性的完全隐窝是传统锯齿状腺瘤的显著特征(p < 0.01)。不同锯齿状病变中细胞角蛋白7和20表达模式的差异可能提示结直肠癌的不同发生途径,并具有诊断和预后价值。
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Significance of Micromorphological Characteristics and Expression of Intermediate Filament Proteins CK7 and CK20 in the Differential Diagnosis of Serrated Lesions of the Colorectum
Serrated lesions in the colorectum include all epithelial neoplastic lesions, which show a sawtooth-like morphology in the epithelial crypts. Classification systems nosologically divide colon serrated polyps into three different categories, primarily emphasizing their micromorphological growth pattern and cytodifferentiation: (1) hyperplastic polyps, (2) sessile serrated adenomas/polyps and (3) traditional serrated adenomas. Overall, 109 patients with serrated lesions of the colon, who underwent endoscopic or surgical polypectomy/tumorectomy during one or multiple endoscopic or surgical interventions, over a four-year period, were analyzed. The average age of patients was 62.8 ± 11.6 years. The frequency of serrated lesions of the colon in male patients was 2.4 times higher than in females (70.6% vs. 29.4%). All sessile serrated lesions without dysplasia were positive for CK7 and statistically significant compared to other serrated lesions, if this positivity was present in the complete crypt (p = 0.005). CK20 positivity, which is limited to the upper half of the crypt, is a special feature of hyperplastic polyps compared to other serrated lesions, which is statistically significant (p = 0.0078). Whereas, CK20 positivity of complete crypts is a statistically significant feature of traditional serrated adenomas (p < 0.01). Differences in the expression pattern of cytokeratin 7 and 20 in different serrated lesions may indicate different pathways of colorectal carcinogenesis, and be diagnostically and prognostically useful.
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来源期刊
Gastroenterology Insights
Gastroenterology Insights GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
2.80
自引率
3.40%
发文量
35
审稿时长
10 weeks
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