Structural and cellular changes of the uninvolved colonic mucosa from patients with colorectal adenocarcinoma

U novije vreme sve češći predmet istraživanja su interakcije između tumorskih ćelija i vezivno-tkivnih elemenata koji čine stromu tumora. Pored istraživanja interakcija tumorskih ćelija i stromalnih elemenata samog tumora u progresiji maligne bolesti, pokazano je da postoje promene u nezahvaćenoj sluznici u neposrednoj okolini tumora (tzv. prelaznoj sluznici). Međutim, zanemareno je proučavanje nezahvaćene sluznice na većoj udaljenosti od tumora. U literaturi izostaju jasni podaci o tome da li su promene opisane u prelaznoj sluznici ograničene samo na neposrednu blizinu tumora ili postoje u nezahvaćenoj sluznici i na većoj udaljenosti od malignog tumora. Uprkos ovome, pojedini istraživači ovu sluznicu koriste kao normalno, nepromenjeno tkivo. Za proučavanje udaljene nezahvaćene sluznice u okolini tumora odabrali smo debelo crevo, pošto je ovaj organ često zahvaćen malignom bolešću, a primarna tumorska lezija i nezahvaćeni deo organa su relativno lako dostupni. Ciljevi istraživanja. Detektovanje i kvantifikovanje promena epitelnih ćelija debelog creva (promene u sekreciji sulfomucina i sijalomucina, proliferaciji i fraktalnoj dimenziji jedara epitelnih ćelija) i strukturnih (krvni i limfni sudovi, kolagena, retikularna vlakana, periostin i hijaluronska kiselina) i celularnih elemenata (fibroblasti, miofibroblasti, makrofazi, T-limfociti, B-limfociti, plazma ćelije i dendritske ćelije) lamine proprije sluznice debelog creva na udaljenosti 10 cm i 20 cm od tumora i poređenje sa laminom proprijom sluznice debelog creva uzetom sa iste lokacije kod pacijenata bez malignog tumora. Materijal i metode. Uzorci sluznice debelog creva, na udaljenosti 10 cm i 20 cm kaudalno od primarne tumorske lezije, dobijeni su biopsijom u Centru za gastroenterologiju i hepatologiju Kliničko-bolničkog cenra „Zvezdara“ u Beogradu prilikom dijagnostičkog pregleda osoba sa malignim tumorom ovog organa (n=40). Kao kontrola korišćeni su uzorci sluznice debelog creva 50 zdravih osoba sa familijarnim opterećenjem za malignitet creva...Recently, increasingly frequent subjects of research are interplays between tumor cells and tumor-associated stromal elements. In addition to investigating the interaction of tumor cells and tumor-associated stromal elements in the progression of malignant disease, it has been shown that there are changes in uninvolved mucosa in the close vicinity of the tumor (so-called transitional mucosa). However, no attention has been devoted to the studies of uninvolved tissue in the remote surrounding of the tumor. In the literature, there is no clear indication whether the changes in the transitional mucosa are limited only to the immediate proximity of the tumor, or they also exist in the uninvolved mucosa at a greater distance from the malignant tumor. Despite this, some researchers use this remote mucosa as normal, unchanged tissue. To study the uninvolved mucosa at a greater distance from the malignant tumor, we selected colon, as this organ is often affected by malignant disease, and both the primary tumor and the uninvolved mucosa are relatively easy to access. Aims. Determination and quantification of changes of colonic epithelial cells (changes in sulfomucin and sialomucin secretion, proliferation and fractal dimension of nuclei) and structural (blood and lymphatic vessels, collagen, reticular fibers, periostin and hyaluronic acid) and cellular elements (fibroblasts, myofibroblasts, macrophages, Tlymphocytes, B-lymphocytes, plasma cells and dendritic cells) of colonic lamina propria at a distance 10 cm and 20 cm away from the tumor, and comparison with mucosa taken from the same location from patients without malignant tumor. Materials and methods. Tissue samples of colonic mucosa 10 cm and 20 cm away in caudal direction from the tumor, were endoscopically collected at the Center for Gastroenterology and Hepatology, Zvezdara Clinical Center, Belgarde, during diagnostic examination of patients with colorectal adenocarcinoma (n=40). As control, the samples of colonic mucosa taken from 50 healthy persons, with a family history of intestinal malgnancy, were used..