Immunohistochemical Study of Villous Type Adenomas of Colon and Rectum.

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Villous adenoma has been considered to have high malignant potential. To elucidate the clinical and pathological features of villous and tubovillous ademoma, 26 specimens in formalin-fixed and paraffin-embedded tissues were obtained from polypectomy or surgery and were investigated by immunohistochemical techniques.<BR>The more epithelial atypia increased in the lesion, the smaller amounts of mucin, and O-acylated sialomucin without vicinal diols and DBA reactivity. In villous adenoma, sialomucin was predominantly observed by HID-AB staining, and so was O-acylated sialomucin without vicinal diols by PAT/KOH/PAS staining. And the reactivity on DBA staining was stronger in villous adenoma than tubovillous and tubular adenoma. There was no difference between histological type by UEAI and CEA staining. Of 6 cases of villous lesions with carcinoma, 2 cases (33%) was mucinous carcinoma, whose mucin substance was similar to that in adenomatous lesions.<BR>These results suggest that villous and tubovillous adenoma contains various type of mucin and does not have higher malignant potential than tubular adenoma, so it could be concluded that the lesion is adequately treated with a local excision except for those which is recognized malignant transformation macroscopically.
日本大腸肛門病学会の論文