Ciliated Cells in the Cardiac Gland of the Human Stomach Evidence of Metaplastic Change

In a study on 12 Japanese patients, many ciliated cells were found in the human cardiac mucosa in association with intestinal metaplasia. Two cases were studied by electron microscopy, which revealed the presence of cilia and basal bodies in the apical portion of the mucosal cells. The ciliated cells sometimes contained prominent auto-phagosomes in the supranuclear region and abundant filaments in the cytoplasm, but neither mucus nor neuroendocrine granules were evident. Ciliated cells have commonly been found in human pyloric mucosa showing intestinal metaplastic changes in aged Japanese patients. In the cardiac mucosa, the incidence of ciliated cells was relatively low. Ultrastructural study revealed that the metaplastic gastric cilia were almost the same as those of respiratory cilia. The presence of ciliated cells in the adult human gastric mucosa was always associated with intestinal metaplasia; therefore our interpretation is that this is a type of metaplasia, for which we propose a new term, "ciliated metaplasia" of the stomach. Acta Pathol Jpn 39: 388 392, 1989.     

Ultrastructure of metaplastic ciliated cells in human stomach

Summary Intestinal metaplasia of the gastric mucosa occurs commonly in aged Japanese patients and has been discussed in relation to the high incidence of gastric cancer in Japanese. Ciliated cells in the gastric mucosa have frequently been found in association with intestinal metaplasia in the pyloric gland and rarely in the cardiac gland in many Japanese patients, and exceptionally in one Chinese and in one Swedish patient. Electron microscopic examination of 12 Japanese patients has revealed that these structures are not metaplastic stereocilia, but true cilia. Ciliated cells have been found in the basal part of the gastric glands and never in the surface epithelium. The fine structure of the gastric cilia was almost the same as that of normal respiratory cilia. However, in the gastric cilia, most dynein arms were inconspicuous even after tannic acid fixation, indicating that ciliary beating of the gastric cilia is problematic. Abnormal cilia and basal bodies also were found. Ciliated cells have always occurred in association with intestinal metaplasia, therefore this phenomenon might be a type of metaplasia and is named ciliated metaplasia of the gastric mucosa.     

Ki-67在胃癌及癌旁组织中的表达

目的:探讨Ki-67在胃癌和癌旁黏膜上皮中的表达、分布特征及其在胃癌组织发生学上的意义。方法:采用免疫组化方法对36例胃癌及癌旁组织进行检测。结果:胃腺癌与癌旁伴异型增生慢性萎缩性胃炎Ki-67阳性率无显著性差异;胃腺癌与癌旁伴高、中增殖型肠上皮化生慢性萎缩性胃炎Ki-67阳性率无显著性差异(P>0.05)。结论:Ki-67是一种较好的癌前标志物,胃黏膜上皮异型增生和高、中增殖型肠上皮化生萎缩性胃炎与胃癌的发生密切相关。     

Small mucus-granule-containing ciliated cells in the human gastric mucosa: a transitional form to metaplastic ciliated cells

Summary Ciliated cells were found in the gastric mucosa in close association with intestinal metaplasia, mainly in the pyloric mucosa, of Japanese patients. The occurrence of ciliated cells is believed to be an acquired phenomenon and is considered to be a type of metaplasia; the term ciliated metaplasia is used to describe this phenomenon. Ciliated cells are found in the basal part of the glands among normal-looking mucous cells, mucous neck cells and neuroendocrine cells, but never on the surface or in foveolar epithelium. In ciliated cellcontaining glands, mitoses were noted in the neck region and the ultrastructural features of these cells were identical to those of undifferentiated neck cells. However, cell metaplasia from undifferentiated cells to metaplastic ciliated cells has never been demonstrated previously. The small mucus-granule-containing ciliated cells found in our present study may arise subsequent to division of undifferentiated neck cells into mucous cells with some daughter cells then exhibiting differentiation characteristics specific to ciliated cells. Thus they contain a mixture of both small mucus granules and numerous basal bodies and cilia, at the same time as a transitional form.     

Atypical Cilia in Hyperplastic, Metaplastic, and Dysplastic Human Bronchial Mucosa

Twenty-two cases displaying potentially precancerous epithelial changes of the bronchial mucosa—including basal and goblet cell hyperplasia, epidermoid metaplasia, and dysplasia—showed a wide variety of cilial abnormalities on the ultrastructural level. The changes comprised abnormal configurations of the ciliary plasma membrane, variations in the amount of ciliary matrix, disorganization of basal bodies, and diverse alterations of the axonemal microtubular pattern. More than one such alteration was observed in one and the same case, and there was no correlation with the actual type of epithelial lesion nor the degree of dysplasia. These changes, interpreted as abnormal ciliary regeneration in severely damaged ciliated cells, are potentially reversible and seem to represent a nonspecific response of the affected cells to an ample spectrum of noxes. Their diagnostic significance is poor, especially with regard to the modification of the axonemal microtubular pattern, unless the entire clinical picture suggests an immotile cilia syndrome.     

Gastric and Intestinal Phenotypic Expression of Human Stomach Cancers as Revealed by Pepsinogen lmmunohistochemistry and Mucin Histochemistry

Gastric and intestinal phenotypic expression in 223 surgically obtained primary gastric cancers and their histogenetic relationship to intestinal metaplasia in the surrounding gastric mucosa were studied by mucin histochemistry and pepsinogen (Pg) immunohistochemistry. Histochemical differentiation of mucins (paradoxical concanavalin A, the galactose oxidase-Schiff sequence and sialidase galactose oxidase Schiff) and immunohisto chemical staining of Pgs I and II, allowed differentiation of gastric cancer cells from different histological categories into gastric elements including mucous neck cells, pyloric gland cells and surface mucous cells or intestinal elements including goblet cell and intestinal absorptive cell types. Of 122 papillary and tubular adenocarcinomas, 33 (27.1%) consisted mainly of gastric type cells and 42 (34.4%) predominantly of intestinal type cells. The remainder (38.5%) consisted of mixtures of gastric- and intestinal-type cells. Of 101 poorly differentiated adenocarcinomas, signet ring cell carcinomas and mucinous adenocarcinomas, 59 (58.4%) consisted mainly of gastric-type cells and 20 (19.8%) mainly of intestinal-type cells. Seven out of 35 papillary and tubular adenocarcinomas consisting mainly of gastric type cancer cells were surrounded by mucosa with intestinal metaplasia. Conversely, 10 out of 40 papillary and tubular adenocarcinomas consisting mainly of intestinal-type cancer cells were observed in non metaplastic gastric mucosa. Thus no relationship as regards intestinal phenotypic expression was found between gastric cancers and surrounding gastric mucosa.     

Metaplastic lipid-rich carcinoma of the breast

A case of lipld-rich mammary carcinoma identified in a lumpectomy specimen from a 56year-old female is presented. The tumor showed features of poorly differentiated invasive ductal carcinoma of clearcell phenotype. Cytoplasmic lucency was mainly accounted for by the accumulation of neutral fat and, to a lesser degree, glyco-gen. Tlnctorial properties Included positivity of tumor cells with Sudan iii dye and diastasesensitive periodic acid-Schiff staining. Ultrastructural examination confirmed the presence of abundant cytoplasmic lipid droplets and some glycogen rosettes. On immunohistochemistty, most tumor cells reacted for cytokeratin, vimentin and S-100 protein, and there was focal expression of carclnoembryogenic antigen. A minority of tumor cell nuclei expressed progesterone receptors. As an additional feature, part of the leslon exhibited chondroid metaplasia. Lipid-rich carcinoma of the breast is exceedlngly rare and, to our knowledge, no such example harboring metaplastic elements has been described previously.     

Intestinal phenotypes in pediatric gallbladder epithelium

The aim of this study was to characterize the physiologic expression of “intestinal” features in gallbladders of infants and children. The study group consisted of 56 pediatric (age, 2 weeks to 7 years) and 15 adult (15-25 years) patients who underwent incidental cholecystectomy during surgery for other lesions. All gallbladders examined were histologically unremarkable without inflammation, gallstones, or neoplasia. The presence of goblet cells and the expression of cytokeratin 7, cytokeratin 20, mucin core protein 2, and caudal-related homeobox protein 2 were examined. Intestinal features were frequently detected in the pediatric gallbladders: goblet cells in 34 cases (61%), cytokeratin 20 expression in 25 (45%), mucin core protein 2 expression in 32 (57%), and caudal-related homeobox protein 2 expression in 16 (29%). In contrast, none of these features was identified in adult gallbladders. The expression of mucin core protein 2 was mostly restricted to goblet cells in pediatric gallbladders, whereas cytokeratin 20 and caudal-related homeobox protein 2 were expressed in both goblet and nongoblet cells. Cytokeratin 7 was diffusely and consistently expressed in both pediatric and adult gallbladder epithelium including goblet cells. Intestinal features became less frequent with age and were scarce in children aged 6 to 7 years. Thus, goblet cells were identified in 14 (93%) of 15 children aged <1 year, together with the common expression of cytokeratin 20 (73%), mucin core protein 2 (93%), and caudal-related homeobox protein 2 (53%). In conclusion, intestinal features are physiologically present in gallbladder epithelium of children, particularly those aged <6 years. Intestinal metaplasia, as associated with cholangiopathy or carcinogenesis in adult patients, may represent an immature phenotype of biliary epithelium.     

胃粘膜肠上皮化生CEA的免疫组织化学研究

用PAP法对84例胃粘膜肠化上皮癌胚抗原(CEA)作了光镜和免疫电镜观察。癌旁肠化CEA阳性率(80.60%)和硫酸粘液阳性率(97.01%)均明显高于胃良性病变伴肠化(47.06%,29.41%);硫酸粘液(+)组肠化CEA阳性率(81.43%)明显高于硫酸粘液(一)组(35.71%)。产生CEA胃癌的粘液与结肠粘液类似,而不产生CEA胃癌的粘液与胃粘液类似。文中还对肠化与胃癌的关系及胃癌的组织发生进行了讨论。     

Loss of differentiation in intestinal metaplasia in cancerous stomachs. A comparative morphologic study.

229 stomachs resected for duodenal and gastric ulcer and carcinoma were examined with special regard to the morphological and histochemical pattern of intestinal metaplasia (IM). The results of qualitative and semiquantitative studies were analysed statistically. Whereas duodenal and gastric ulcer cases are best discriminated by the presence or absence of IM, the strongest discriminating factor between carcinoma and gastric ulcer is the content of goblet cells in metaplastic crypts. Metaplastic crypts lined exclusively with goblet cells producing sulfated acid glycoproteins could be identified in more than one third of the cancer cases. The increase in goblet cells coincides with a loss of the more differentiated cells in the metaplastic glands, such as enterocytes, APUD cells, or Paneth cells. This "enterocoli metaplasia" seems to be specific for cancer bearing mucosa and occurs more often in cancer of intestinal type; it may represent a form of a derepressive dedifferentiation. The significance of enterocoli metaplasia as a premalignant lesion remains to be elucidated.     

Placental Alkaline Phosphatase-like Isoenzymes Produced by Human Gastric Cancer Cells

The human gastric cancer cell lines, MKN1 and SCH, were biochemically and biologically characterized according to the monophenotypic expression of placental alkaline phosphatase (PLAP)- like enzymes. The MKN1 cell line, derived from adenosquamous carcinoma, showed the same enzyme properties as the Regan isoenzyme, whereas the SCH cell line, derived from primary gastric choriocarcinoma, had properties identical with the Nagao isoenzyme. Regan isoenzyme activity expressed by MKN1 cells was stimulated by glucocorticoid and suppressed by retinoic acid. Both agents had no significant effect on SCH cells. On the other hand, Nagao isoenzyme activity expressed by SCH cells was stimulated by sodium butyrate, which had no stimulatory effect on MKN1 cells. Moreover, the PLAP like activity of MKN1 cells showed no observable relationship to human chorionic gonadotropin (hCG) producibility. Whereas expression of the Nagao isoenzyme by the SCH cell line is presumably a result of functional differentiation in the trophoblastic direction, that of the Regan isoenzyme by the MKN1 cell line is probably not. Perhaps the Regan isoenzyme is related to carcinogenesis. Acta Pathol Jpn 39: 630 637, 1989.     

Neoplastic Argentaffin Cells with Intracytoplasmic Eosinophilic Granules in a Gastric Adenocarcinoma

A case of poorly differentiated adenocarcinoma of the stomach with unique histological features is reported: in addition to characteristic adenocarcinoma cells, a large number of tumor cells contained bright eosinophilic and argentaffin granules in their cytoplasm. On routine histologic examination, the latter cells closely resembled the endocrine cells present in the normal human gastrointestinal tract, although the granules were distributed throughout the cytoplasm and did not show any polarity, which is usually subnuclear in normal endocrine cells. Imuunohis-tochemical studies demonstrated positive staining for lysozyme, CEA, gastrin and HCG. Electron microscopic examination revealed cytoplasmic neurosecretory granules, and some tumor cells were found to contain both secretory granules and mucinous material within the same cytoplasm. These neoplastic endocrine cells presumably originated from primitive digestive system elements capable of differentiating towards both endocrine and mucus-secreting varieties. Acta Pathol Jpn 41: 905-910, 1991.     

Concurrent tubulovillous adenoma and transitional cell carcinoma associated with diffuse gastric and intestinal metaplasia of the defunctioned ureter

Villous adenoma is a common lesion of the gastrointestinal tract, but it is rare in the ureter. Thus, as far as we know, only one case limited to this location has been described. Intestinal metaplasia of the urothelium is not rare. However, only one case of gastric metaplasia with pseudopyloric glands has been described in the literature. We here report in detail on a tubulovillous adenoma of the ureter associated with diffuse gastric and intestinal metaplasia and a concurrent primary, solid, high grade transitional cell carcinoma, with extensive clear cell change, in a 56-year-old male patient. He had undergone a left nephrectomy for renal tuberculosis twenty years earlier, and the lesions developed in the ureteric stump. To the best of our knowledge, such a combination of lesions has not been reported previously either in the ureter or in the rest of the urinary tract. The coexistence of diverse lesions in our case might represent the pluripotentiality of the urothelium in association with chronic inflammation and neoplastic induction. The present report also emphasizes the metaplastic and malignant potential of a defunctioned urothelial structure. This case is of particular interest, because these coexistent lesions arose simultaneously with an anatomically separate adenocarcinoma of the rectum (Dukes' B). The patient died 76 days after admission. The dismal prognosis of our case was determined by the advanced anatomical stage and the histological high grade of the transitional cell carcinoma of the ureter.     

Occurrence of the parathyroid cyst in golden hamsters

Parathyroid cyst is a rare lesion, but has clinical significance because of it's ability to mimic a thyroid mass and it's association with hyperparathyroidism. The occurrence and morphology of parathyroid cysts in golden hamsters from neonatal to senile periods were investigated using light and electron microscopy. The results demonstrate the presence of chief cell cysts in the parathyroid glands of 5-day-old hamsters. Some chief cells lining the cyst wall showed mitosis and apoptosis. The existence of chief cell cysts may represent the rapid proliferation of the parathyroid chief cells in 5-day-old hamsters. Ciliated cysts were observed in the parathyroid glands of 5-day-, 1- and 3-month-old hamsters. Three cell types were distinguished in the wall of the ciliated cyst: Ciliated, mucous and basal cells. Ciliated cysts possessed the features of the pharyngeal epithelia without endocrine cells and may arise from embryological remnants of pharyngeal pouches in the neck undergoing cystic degeneration and entrapping portions of parathyroid tissue. The frequency of parathyroid cysts decreased with age.     

流行性出血热患者胃粘膜内病毒抗原定位的研究

１９８６～１９８９年在对１２０例流行性出血热（ＥＨＦ）患者进行胃镜诊治中发现，胃粘膜具有明显的形态学和病理学变化。为研究其发病机制，应用免疫组化酶染法对２０例ＥＨＦ患者的胃粘膜进行ＥＨＦ病毒抗原定位检测，１７／２０例获得阳性结果，初步阐明了上消化道出血／胃粘膜损害与ＥＨＦ病毒抗原的亲嗜及侵袭有关。     

大黄对胃粘膜保护作用与胃粘膜屏障和前列腺素E_2的关系

本工作研究大黄对胃粘膜的保护作用与粘膜屏障和粘膜前列腺素E_2的关系。实验结果表明;(1)胃饲大黄(0.5g/100g体重)能显著抑制乙醇造成的大量K~ 离子外流;(2)胃饲大黄能有效提高胃粘膜前列腺素E_2含量,还可明显减弱消炎痛对胃粘膜前列腺素E_2合成的抑制作用。(3)预先注射消炎痛(5mg/kg)能抑制大黄对前列腺素E_2合成的促进作用,但不能阻断大黄对胃粘膜的保护作用。结果提示:大黄保护胃粘膜作用与促进粘膜前列腺素E_2合成和加强胃粘膜屏障有关。     

胃癌和胃正常黏膜拉曼光谱检测

采用共焦显微拉曼光谱仪检测 2 0例胃癌和胃正常黏膜组织切片的拉曼光谱。结果表明 ,两种病理组织学形态胃组织的光谱数据具有较好的一致性 ,正常胃黏膜组织拉曼光谱存在 16 4 2 (cm-1)、16 6 2 (cm -1)蛋白质的酰氨I振动双峰 ,而胃癌组织中仅存在位于 16 6 8(cm-1)处的酰氨I振动单峰 ,与临床病理检测结果对照相符 ,因此 ,胃癌和胃正常黏膜拉曼光谱检测有望成为诊断胃癌的一种有效方法。     

应用RNA干扰技术抑制人胃癌细胞环氧合酶-2基因的表达研究

目的 研究应用RNA干扰技术进行抑制胃癌SGC-7901细胞COX-2的表达研究。方法 依据siRNA设计原则,针对人COX-2的mRNA序列,设计并合成3条21bp的双链RNA,瞬时转染人胃癌细胞SGC-7901,Western blot验证基因沉默效率以筛选合适的siRNA序列;根据筛选出的有效序列,合成编码短发卡RNA的双链寡核苷酸,定向克隆到含有U6 RNA聚合酶Ⅲ启动子的pSilencer? 2.1-U6 neo 真核表达载体,稳定转染胃癌细胞SGC-7901中,经G418筛选,获得克隆细胞。 结果 筛选出一条有效的干扰序列,位于291-311bp,成功构建表达载体,COX-2在蛋白水平的表达明显被抑制。结论：利用化学合成siRNA进行初筛,再构建shRNA表达载体,可快速实现目的基因的表达抑制。     

Changes in Morphology and Cellular Replacement of Surface Epithelia in Human Gastric Mucosa Affected by Different Pathological Changes: A Scanning Electron Microscopical Study of Human Gastric Biopsy Material

The surface epithelium of normal gastric mucosa shows a constant turnover, migrating from the proliferation zone at the neck of the gastric glands to the mucosal surface. The cytologic changes associated with the concomitant cellular differentiation were so far studied in sections by light and electron microscopy only. With these methods neither the changes of surface morphology associated with cellular maturation nor the shedding of surface epithelia can be recorded. With the scanning electron microscope it is possible to study especially these changes of the mucosal surface plus those of the single surface epithelia over a wide range of magnification and with a sufficient depth of focus.In this study therefore an attempt was made to correlate some scanning electron microscopic findings concerning these changes of mucosal and cellular surface with the results of parallel light microscopic examinations. For this purpose double biopsies of human gastric mucosa were taken during routine endoscopic examination. One of these biopsies was processed for light microscopic examination after formaldehyde fixation. The other was fixed in buffered glutaraldehyde solution and 1 % OS04 solution and thereafter the material was processed for scanning electron microscopic study by dehydration against an increasing acetone gradient, critical point drying and sputter coating of the dry specimens which were mounted on metal stubs with conductive silver.Some aspects of surface morphology of the mucosa and the single cells in correlation to different types of gastritis are demonstrated and the morphological expressions of cytological degeneration and shedding from the mucosal surface are commented on.