[Morphological atypism and clinicopathological factors in colorectal adenoma and cancer using nuclear DNA content, p53 and PCNA].
Cytofluorometric analysis of DNA content and immunohistochemical examination of p53 and PCNA were performed in colorectal adenomas, mainly borderline lesions, and cancers. Nuclear DNA content revealed aneuploidy and polyploid cells in severely atypical adenomas and cancers. Mutated p53 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-I. 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 severely atypical adenomas 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.
Yamamoto
H
H
Second Department of Surgery, Nippon Medical School, Tokyo, Japan.
Yamada
N
N
Asano
G
G
Shoji
T
T
D000230:Adenocarcinoma / Q000737:chemistry / Q000235:genetics / Q000473:pathology; D000236:Adenoma / Q000737:chemistry / Q000235:genetics / Q000473:pathology*; D000782:Aneuploidy; D002467:Cell Nucleus / Q000737:chemistry; D015179:Colorectal Neoplasms / Q000737:chemistry / Q000235:genetics / Q000473:pathology*; D004273:DNA, Neoplasm / Q000032:analysis*; D005434:Flow Cytometry; D006801:Humans; D007150:Immunohistochemistry; D009154:Mutation; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis*; D016159:Tumor Suppressor Protein p53 / Q000032:analysis* / Q000235:genetics
D004273:DNA, Neoplasm; D018809:Proliferating Cell Nuclear Antigen; D016159:Tumor Suppressor Protein p53