Statistical analysis on colorectal adenomas. Role of the lymphocytic inflammatory infiltrate

<p>INTRODUCTION<br>The colon and rectum carcinoma is an heterogeneous disease. Clinical, biological, histopathological and experimental evidences back up the theory of the adenoma-carcinoma sequence evidences.<br>Among the histopathologlcal characteristics,the variables studied are subjective, although we have recently started. Using quantifying techniques in the morphological study (9), in order to obtain more objective parameters. As far as we know, these techniques have not yet been used in this pathobiology.<br>The present work aims to introduce the information of conventional histopathological techniques, AgNORs and morphometric (glandular and nuclear types) in order to put in relation these variables in the pathology of the adenoma-carcinoma sequence.<br>MATERIAL AND METHOD<br>We selected 100 consecutive patients, 50 with adenoma (33 with low-grade -LGA- dysplasia and 17 with high-grade -HGA- and 50 with adenocarcinoma-(ACA)- who were studied in the conventional way. From these patients we obtained representative surgical and endoscopic samples that we stained with H-E for histopathological diagnostic and morphometric study purposes (Zeiss-KontronMOP-Videoplan image analyzer) as well as for argentic techniques for the AgNORs quantifying.<br>We studied glandular and nuclear variables(area, perimeter, maximum diameter and shape factor) and the cellular proliferation (mitotic index, nuclear organising antigen -AgNORs-) in both neoplasia types and with regard to the nuclear atypia grade (dysplasia) in the adenomas (Kruskal-Wallis tests and by-steps discrimination).<br>RESULTS<br>In the one variant statistical and stepwise discriminant survey, the variables that showed significant differences (p<0.05), were as follows: mitotic index (LGA 10,8; HGA 11,0; ACA 22,5), nuclear perimeter (media) (LGA 10,6; HGA 11,3; ACA 14,4), nuclear area (standard deviation, DT) (LGA 6,9; HGA 9,4; ACA 10,0) maximum nuclear diameter (DT) (LGA 2,6; HGA 3,0; ACA 3,8), maximum glandular diameter (media) (LGA 0,2; HGA 0,1; ACA0,09), glandular shape factor (media) (LGA 0,7; HGA0,7; ACA 0,6), glandular shape factor (DT) (LGA 0,1; HGA0,1; ACA 0,2), luminal nucleus~edge distance (media) (LGA 17,1; HGA 16,1; ACA 12,0). We noticed a progressive increase of the area, maximum diameter and nuclear perimeter, mitotic index along with a gradual decrease of the glandular shape and luminal nucleus-edge distance.<br>CONCLUSION<br>Therefore, the development of adenocarcinomas in colon and rectum adenomas happens over increasing dysplasia grades: higher nuclear size and mitosis index, smaller and more abnormal glands together with loss of the nucleus basal polarity.</p>