[Three-dimensional analysis of colonic adenoma and of carcinoma in adenoma with scanning electron microscope and...

Three-dimensional structures were analyzed on 32 human colonic adenomas, 5 hyperplastic polyps, 4 normal colonic mucosa and 5 advanced colonic carcinomas with Scanning Electron Microscope (SEM) and with sequential serial sectioning. After SEM observation, the samples were softened with 2% NaHCO3 and observed with histological serial sectioning. By combining both techniques, that is combined analysis of outer structures for SEM and inner structures for serial sectioning, three dimensional analysis of the colonic adenoma and carcinoma in adenoma were successfully completed. The colonic adenomas were classified into 6 types based on the surface structure observed by SEM as Type I (circular type), Type II (long-elliptical type), Type III (branched type), Type IV (gyral type), Type V (wrinkle type) and Type VI (complicated type). Classified Types I, II, III and IV were observed in tubular adenoma, and grades of atypia seemed to be increased as increasing type numbers. Type V, in tubulo-villous adenoma and villous adenoma, were found out and showed severer atypia than observed in Type IV. Among 32 adenomas, 3 portions of focal cancers were detected, and the surface structures of them had highly complicated patterns as shown with Type VI.