Immunohistochemical demonstration of IgA and secretory component in relation to epithelial cell differentiation in normal colorectal mucosa and metaplastic polyp: a semiquantitative study.

The metaplastic polyp is a non-neoplastic epithelial lesion found within the human colorectum. Although not regarded as precancerous, recent studies have demonstrated the expression of multiple cancer-associated phenotypes. This might indicate a possible indirect relationship between metaplastic polyps and colorectal cancer. Epithelial secretory component and IgA were demonstrated by the immunoperoxidase technique and staining intensities were assessed semiquantitatively. The findings were related to cellular differentiation in normal colorectal epithelium as compared to the metaplastic polyp. The crypt base cells and also the surface epithelial cells stained with similar intensity in both types of epithelium. However, the expected increase in staining characterizing normal lower and upper crypt columnar cells and reduction in staining associated with the switch from crypt to surface columnar cell was not observed in the metaplastic polyp. Metaplastic crypt columnar cells showed significantly reduced staining for both IgA and secretory component as compared to their normal counterparts. There was also a significant reduction in the number of IgA-secreting plasma cells in the lamina propria of the metaplastic polyp. These findings are consistent with the concept of a premature switch to mature surface cell characteristics within the metaplastic polyp. They are discussed in the light of other changes in phenotype associated with this lesion.