幼年性息肉和幼年性息肉病回顾性病理分析

Pathologic analysis of dysplastic changes in juvenile polyps and juvenile polyposis syndrome

目的 了解我国幼年性息肉病(JPS)不典型增生改变的存在,比较单发结、直肠幼年性息肉(JP)和JPS的不同病理特点。方法32例单发结、直肠JP标本和5例JPS(共35枚息肉)标本经常规切片,HE染色后进行病理检查,观察不典型增生改变情况并进行分级。结果 32枚单发结、直肠JP未见不典型增生改变。5例JPS的35枚息肉中4例共24枚息肉(68.6％)局部有不典型增生改变,其中轻度16枚,中度7枚,重度1枚。结论JPS和单发结、直肠JP病理改变不完全相同。前者由于息肉是多发的,个别息肉局部可出现不典型增生改变,因而多认为是癌前病变,后者多为良性病变。

Objective To investigate the dysplastic changes in juvenile polyposis syndrome (JPS)and to compare different morphologic characteristics between solitary colorectal juvenile polyps(JP) and JPS. Methods A total of 32 routine specimens from 32 cases with JP and 35 specimens from 5 cases with JPS were included in this research . Hematoxylin and eosin (HE) stained sections were used to evaluate the presence and grades of dysplasia. Results There was no dysplastic changes shown in 32 cases of solitary colorectal JP , but in 24 out of 35 JPS(68.6%), there were dysplastic changes from 4 out of 5 cases (16 mild grade, 7 moderate grade and 1 severe grade). Conclusions The pathological changes of polyps in JPS were different from those of polyps in JP. In the former the polyps was generally multiple, occasionally with non-typical dysplastic changes , which was considered to be a potentially precancerous condition; while those in the latter were benign lesions.