-
摘要:
目的 异常隐窝病灶（aberrant crypt foci，ACF）目前被广泛认为是光镜下可视最早期的大肠癌癌前病变。本研究在2年时间通过结肠镜下动态观察ACF的变化来初步探讨ACF与结直肠癌的关系。 方法 选取2013年1月至2014年12月在山西医科大学第二医院接受结肠镜检查并排除常见致癌及抑癌因素的100例患者，常规在退镜时进行直肠靛胭脂染色，观察并记录初次结肠镜检查、1年及2年复查肠镜时直肠ACF的数目及单个ACF的自然发展变化过程。 结果 初次检查及1年和2年后的ACF阳性率比较，差异无统计学意义。ACF随时间的变化大部分继续存在或自行消失，少数发展为息肉、腺瘤，ACF < 6枚的病例，以及腺管开口为椭圆形的ACF自行消失率更大，而腺管开口为非椭圆形者更易发展为息肉或腺瘤。 结论 ACF变化呈异质性，其中部分可能为大肠癌癌前病变。 Abstract:Objective To investigate the relationship between aberrant crypt foci (ACF) and colorectal cancer through a 2-year followup colonoscopy observation of patients with ACF. Methods We enrolled 100 patients who accepted colonoscopies from January 2013 to December 2014 in The Second Hospital of Shanxi Medical University. The patients did not have common carcinogenic or cancer-suppressing factors and agreed to participate in the study. Routine rectal indigo carmine staining was carried out, and we observed and recorded the number of ACFs and the natural development process of single ACFs at the baseline, the 1st year, the 2nd year using colonoscopies. Results There was no statistical difference in ACF positive incidence among baseline, 1st year, and 2nd year exams. During the 2-year observation, most ACFs remained or disappeared, and only a few developed into polyps or adenomas, which were common in subjects with ≥6 ACFs; while those with oval crypt openings mostly died away. Conclusions ACFs are heterogeneous, and only a subset of ACFs may be biomarkers for colorectal cancer. -
Key words:
- aberrant crypt foci (ACF) /
- colorectal cancer /
- precancerous lesions
-
图 2 同一例患者初次结肠镜检查时2枚相邻的ACF的图片（A）及其在1年（B）和2年（C）后复查肠镜时的图片（黑色箭头所示），在2年复查肠镜时其旁可见新发ACF（白色箭头所示）
表 1 ACF病变分别于0、1、2年的阳性率比较
表 2 0、1、2年ACF阳性病例存在ACF的平均数目
表 3 初次检查的66枚ACF两年后的变化情况
-
[1] Bird RP. Observation and quantification of aberrant crypts in the murine colon treated with a colon carcinogen: preliminary findings[J]. Cancer Lett, 1987, 37(2):147-151. doi: 10.1016/0304-3835(87)90157-1 [2] Prêtlow TP, Barrow BJ, Ashton WS, et al. Aberrant crypts: putative preneoplastic foci in human colonic mucosa[J]. Cancer Res, 1991, 51 (5):1564-1567. http://cn.bing.com/academic/profile?id=6fc6456c1fcd286e8c7f78f7d85c6284&encoded=0&v=paper_preview&mkt=zh-cn [3] Sugihara Y, Zuo X, Takata T, et al. Inhibition of DMH-DSS-induced colorectal cancer by liposomal bovine lactoferrin in rats[J]. Oncol Lett, 2017, 14(5):5688-5694. http://cn.bing.com/academic/profile?id=e059407627d64dd9bf42153da60964cb&encoded=0&v=paper_preview&mkt=zh-cn [4] Qi G, Zeng S, Takashima T, et al. Inhibitory effect of various breads on DMH -induced aberrant crypt foci and colorectal tumours in rats[J]. Biomed Res Int, 2015, (2015):8290-8296. http://cn.bing.com/academic/profile?id=c9cbf3b79e0df67fb54178a40110d0a2&encoded=0&v=paper_preview&mkt=zh-cn [5] Shwter AN, Abdullah NA, Alshawsh MA, et al. Chemoprevention of colonic aberrant crypt foci by Gynura procumbens in rats[J]. J Ethnopharmacol, 2014, 151(3):1194-1201. doi: 10.1016/j.jep.2013.12.044 [6] Shpitz B, Klein E, Buklan G, et al. Suppressive effect of aspirin on aberrant crypt foci in patients with colorectal cancer[J]. Gut, 2003, 52 (11):1598-1601. doi: 10.1136/gut.52.11.1598 [7] Anderson JC, Swede H, Rustagi T, et al. Aberrant crypt foci as predictors of colorectal neoplasia on repeat colonoscopy[J]. Cancer Causes Control, 2012, 23(2):355-361. doi: 10.1007/s10552-011-9884-7 [8] Takayama T, Katsuki S, Takahashi Y, et al. Aberrant crypt foci of the colon as precursors of adenoma and cancer[J]. N Engl J Med, 1998, 339 (18):1277-1284. doi: 10.1056/NEJM199810293391803 [9] Roncucci L, Pedroni M, Vaccina F, et al. Aberrant crypt foci in colorectal carcinogenesis. Cell and crypt dynamics[J]. Cell Prolif, 2000, 33(1):1-18. doi: 10.1046/j.1365-2184.2000.00159.x [10] McLellan EA, Medline A, Bird RP. Sequential analyses of the growth and morphological characteristics of aberrant crypt foci: putative preneoplastic lesions[J]. Cancer Res, 1991, 51(19):5270-5274. http://cn.bing.com/academic/profile?id=4c7c0f308aea526b0a43780b04d6c658&encoded=0&v=paper_preview&mkt=zh-cn [11] Pinsky PF, Fleshman J, Mutch M, et al. One year recurrence of aberrant crypt foci[J]. Cancer Prev Res (Phila), 2010, 3(7):839-843. doi: 10.1158/1940-6207.CAPR-09-0257 [12] 卢青, 陶珊, 陈楚第, 等.Wistar鼠大肠癌模型中肿瘤与异常腺窝病灶关系的初步研究[J].中国现代医学杂志, 2007, 17(24):3004-3006. doi: 10.3969/j.issn.1005-8982.2007.24.016 [13] Raju J. Azoxymethane-induced rat aberrant crypt foci: relevance in studying chemoprevention of colon cancer[J]. World J Gastroenterol, 2008, 14(43):6632-6635. doi: 10.3748/wjg.14.6632 [14] Preston SL, Wong WM, Chan AO, et al. Bottom-up histogenesis of colorectal adenomas: origin in the monocryptal adenoma and initial expansion by crypt fission[J]. Cancer Res, 2003, 63(13):3819-3825. http://cn.bing.com/academic/profile?id=c244f78871978afc61a469659349964f&encoded=0&v=paper_preview&mkt=zh-cn [15] Kristt D, Bryan K, Gal R. Colonic aberrant crypts may originate from impaired fissioning: relevance to increased risk of neoplasia[J]. Human Pathology, 1999, 30(12):1449-1458. doi: 10.1016/S0046-8177(99)90167-3 -
下载:
点击查看大图
图(3) / 表(3)
计量
- 文章访问数: 120
- HTML全文浏览量: 12
- PDF下载量: 1
- 被引次数: 0
