Gastric Adenomas―Special Reference to Risk of Malignant Transformation in Association with Growth Patterns, Histologic Features and Phenotypic Expression Takashi Yao 1 , Masafumi Oya 1 , Toshihiko Nakamura 1 , Masazumi Tsuneyoshi 1 1Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University Keyword: 胃腺腫 , 形質発現 , Paneth細胞 , villous構造 , 陥凹型腺腫 pp.1367-1375
Published Date 2003/9/25
DOI https://doi.org/10.11477/mf.1403100754
  • Abstract
  • Look Inside
  • Reference
  • Cited by

 Most gastric adenomas used to be considered to express an intestinal phenotype, but recent advances in stain methods have revealed that some of them expressed not only an intestinal but also a gastric phenotype. Sixty-nine gastric adenomas(polypoid 37, depressed 32)and 72 intramucosal carcinomas(polypoid 46, depressed 26)were used for this study. According to the classification of intestinal metaplasia, their phenotypes were classified into four categories : complete intestinal type(C-type), incomplete intestinal type(I-type), gastric type(G-type)and unclassified type(U-type), based on the combination of the expression of CD10(small intestinal brush border),MUC2(intestinal goblet cell)and HGM(gastric foveolar epithelium).

 Adenomas were classified into 46% of C-type,48% of I-type,4% of G-type and 1% of U-type. Carcinomas were classified into 24% of C-type,51% of I-type,24% of G-type and 1% of U-type. Incidence of C-type was higher in adenomas than in carcinomas, and incidence of G-type was lower in adenomas than in carcinomas. There was no difference in phenotypic expression between polypoid and depressed ones. Paneth cells, which are associated with CD10 expression, are more frequently present in adenomas(36%)than in carcinomas(3%). Adenomas with a villous structure expressed a gastric phenotype, and 56% of them sporadically expressed p53 protein.

 Adenomas with a villous structure, which are associated with a gastric phenotype, are considered to have a higher risk of malignant transformation. Those of C-type, especially with Paneth cells, are considered to have a lower risk of malignant transformation. In addition, there seems to be no difference in risk of malignant transformation between polypoid and depressed adenomas.

Copyright © 2003, Igaku-Shoin Ltd. All rights reserved.


電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院