潰よう性大腸炎に伴うＤｙｓｐｌａｓｉａおよび癌化についての臨床病理学的，組織化学的，免疫組織化学的検討

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  • Clinicopathological, Histochemical and Immunohistochemical Study of Dysplasia and Carcinoma Complicating Ulcerative Colitis.

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Long-standing ulcerative colitis has been noticed as an increased risk factor of colorectal carcinoma. Dysplasia is believed to constitute a premalignant state of carcinoma. However, natural history of dysplasia has not been well understood. In attempt to clarify morphological characteristics and biological behavior of colitic carcinoma associated with dysplasia, 13 cases of colorectal carcinoma complicating ulcerative colitis were analyzed.<BR>From clinicopathological point of view, carcinoma usually occurred in younger age patients, and multiple occurrence of carcinomatous lesions were detected more frequently than non-colitic carcinoma. Histologically poorly differentiated and mucin producing adenocarcinomas were also prominent in colitic carcinoma patients. Dysplastic lesions showed an abnormal cellular surface glycoantigen, which was similar to that of high-grade dysplasia and carcinoma by the use of lectin histochemistry. An increase of cellular proliferation was detected in high-grade dysplasia by histochemical analysis of PCNA. According to an analysis of nuclear DNA content by cytofluorometry, dysplasia was considered to be neoplastic condition, and high-grade dysplasia could be included in intramucosal carcinoma.<BR>These results suggest that dysplasia-carcinoma sequence might be the main route in the cases with carcinoma occurring from ulcerative colitis.

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