Histopathological Analysis of Ulcerative Colitis-related Cancers(Colitic Cancers)with Reference to Their Histogenesis Shinichi Ban 1 , Michio Shimizu 2 , Hidetsugu Yamagishi 3 , Yoshihiko Ueda 4 , Kuriko Kanagaki 5 , Hideaki Takasugi 5 , Yoshinari Oyanagi 5 , Yoshiyuki Hirata 5 , Chuichi Sekine 5 , Hiroyuki Hayashi 6 , Akira Sugita 7 , Hisashi Horiguchi 8 , Hideaki Sato 1 1Department of Pathology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan 2Department of Pathology, Saitama Medical University Saitama International Medical Center, Hidaka, Japan 3Anatomic and Diagnostic Pathology, Dokkyo Medical University, Mibu, Japan 4Department of Pathology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan 5Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan 6Department of Pathology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan 7Department of Surgery, Yokohama Municipal Citizen's Hospital, Yokohama, Japan 8Department of Pathology, Hitachi, Ltd. Hitachinaka General Hospital, Hitachinaka, Japan Keyword: 潰瘍性大腸炎 , colitic cancer , dysplasia , 低異型度癌 pp.1407-1422
Published Date 2014/9/25
DOI https://doi.org/10.11477/mf.1403114265
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 To investigate the histogenesis of colitic cancers, we performed histopathological analysis of surgically resected ulcerative colitis-related cancers from 10 ulcerative colitis patients, with particular focus on the associated surrounding mucosal changes of the 13 main cancer lesions. In seven patients, with 10 of the main cancer lesions, the surrounding mucosal changes included eosinophilic and/or goblet cell-rich irregular glands with dystrophic goblet cells, and a partly serrated appearance, generally showing and low-grade atypia. Given that some of the main invasive cancers comprised low-grade neoplastic epithelia similar to those in the associated surrounding mucosa, and that some minute invasive cancers arose from the bases of glands with low-grade atypia as mentioned above, the presence of these glands showing low-grade atypia is an important stage in the development of colitic cancers. These glands showed abnormal proliferation and maturation through the crypt axis, some were strongly positive for p53, and many were positive for human gastric mucin(45M1). In the other three patients, the main cancer lesions showed proliferation of glands with high-grade atypia in the atrophic flat mucosa, which in one case included an area of mucin-rich villous epithelium with low-grade atypia strongly positive for p53, indicating another significant lesion related to colitic cancers. In contrast, the above-mentioned lesions were not observed in nine non-operative ulcerative colitis cases with sporadic adenoma-like polypoid lesions during a mean follow-up period of 5.8 years. The identification of low-grade atypia in mucosal glands could be a vital step in the early diagnosis of colitic cancers.

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