结肠黑变病48例临床病理学分析

目的 研究结肠黑变病(Melanosis coli，MC)的，临床病理特点。方法 全部病例做了，临床资料分析及组织学观察，并做了脂褐素、黑色素，含铁血黄素，胆色素和PAS特殊染色，其中4例做免疫组化染色检查。结果 结肠黑变病粘膜固有层都有棕褐色色素沉着，该色素的脂褐素、含铁血黄素、黑色素和胆色素染色均为阴性，HMB45、S-100免疫组化染色该色素颗粒亦为阴性，但PAS染色阳性。结论结肠黑变病在很大程度上与慢性便秘服用泻药有关，色素可能系巨噬细胞吞噬蒽醌类泻剂后形成的脂褐素样物质，其能否导致结直肠肿瘤有待进一步探讨。

Clinicopathological analysis of 48 melanosis coli cases

Objective To investigate the clinic pathological features of melanosis coli and the nature of the pigment. Methods A clinical pathological study was made in all the cases.Special stains including lipofuscin, melamin, hemosiderin and bilirubin were performed in 48 cases and immunohistochemical staining of S-100 protein and HMB45 by APAAP and ultrastructural observation were made in 4 cases. Results Brown pigmentation was found in mucosa propria of melanosis coli in all cases. Stainaing fou lipofuscin, melanin, hemosiderin and billirubin were negative. The pigment had no reaction with S-100 protein and HMB45 antibodies. Ultratructurally the pigment was lipofucnsi-like material. Conclusion Melanosis coli is strongly related to the use of laxatives in the patients with constipation.The patholongic pigment may be formed by macrophages, which phagocytose anthraquinone laxatives. further study is needed to clarify the relationship between melanosis coli and colorectal neoplasm.