J.Jpn. Surg. Soc.. 95(10): 763-774, 1994
Original article
MORPHOLOGICAL ATYPISM AND CLINICOPATHOLOGICAL FACTORS IN COLORECTAL ADENOMA AND CANCER USING NUCLEAR DNA CONTENT, p 53 AND PCNA
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1) Second Department of Surgery, Nippon Medical School, Tokyo, Japan Hideki Yamamoto1), Nobutaka Yamada2), Goro Asano3), Tasuku Shoji1) |
Nuclear DNA content revealed aneuploidy and polyploid cells in severely atypical adenomas and cancers.
Mutated p 53 protein was also observed in severely atypical adenomas, especially tortuous and villous lesions and cancers.
PCNA labeling index (P-I) was significantly increased in proportion to cell atypism and P-I over 50% was noted in half of severely atypical adenomas. Among infiltrating cancers, poorly differentiated adenocarcinoma showed high P-1. However, well differentiated adenocarcinoma infiltrating beyond the tunica muscularis propria showed various P-I values depending on the presence of metastasis to lymph node or blood vessel invasion. Furthermore, P-I in the metastatic lesion was significantly higher than that of primary lesion.
These results suggest that severely atypical adenomas showing morphological features such as an increased N/C ratio, loss of polarity, roundish nucleus, tortuous and villous change of gland have malignant potentiality. So severey atypical ademomas have the clinical indication for polypectomy.
In addition, poorly differentiated adenocarcinoma shows high proliferative ability and metastatic lesions or poorly differentiated components existing in infiltrating cancers may affect cancer development as productive clones.
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