增生 (病理学)

此条目的主題是一种生物学现象。关于增生的其他含义，請見「增生」。
細胞增生
肥大源於細胞本身的大小增大，而細胞增生源於細胞個數的增多
类型前列腺良性增生或是乳房增生[1][2]
診斷方法切片[3]
治療依種類不同而有差異（參見種類）
分类和外部资源
醫學專科病理学
MedlinePlus003441
[编辑此条目的维基数据]
細胞發育（-plasia/-trophy）
-plasia：細胞、組織數量改變
-trophy：細胞、組織體積改變

細胞增生（英語：Hyperplasia），是指由於細胞數量增加（細胞增殖）而造成組織的體積質量增加[4]，並且有些情況下會導致器官變大。細胞增生有時會與良性的贅生物或是良性肿瘤混淆[5]。

細胞增生是細胞對外在刺激常見的腫瘤前期反應[6] ，在顯微鏡底下，增生細胞與正常細胞無異，但是數量變多，有時候增生細胞的體積也可能變大（細胞肥大）[7]。細胞增生與細胞肥大的主要差異在於細胞受到外在刺激之後的反應方式，細胞增生是受到刺激之後細胞數量增加，而細胞肥大則是細胞的體積變大[8]。

症狀

細胞增生是一種對特定刺激的正常生理反應，增生的細胞也仍然受到細胞生長週期調控[5]；然而，如果出現過多的荷爾蒙或是生長因子的刺激，細胞增生也會成為病理反應。異常的細胞增生和正常的細胞增生同樣受到生長因子控制，並且在移除刺激後停止生長[9]，這一點和癌症及良性腫瘤發展過程中的贅生物不同，不同點在於癌变細胞不但異常生長，而且對於正常生長因子刺激沒有反應[10] 。即使如此，異常的細胞增生可以是進一步發生癌變的起點[9]。

原因

許多原因都可能導致細胞增生，包括為了補償皮膚損傷而發生的表皮基底層增生、慢性發炎反應、荷爾蒙失調、或是因為創傷及其他疾病而發生的器官補償生長[11] 。細胞增生可能無害且發生在特定組織，例如乳腺的泌乳細胞在懷孕之後發生細胞增生，以因應分娩後的哺乳需求[12]。

胰岛素样生长因子1（IGF）在人體上最主要的功能是促進細胞增生，也就是細胞分裂[13]，相對地，細胞肥大則只是細胞體積增加，例如骨骼肌細胞在重量訓練及使用類固醇之後產生的變化[14]。使用IGF後，會導致細胞增生而真正地增加組織中肌肉細胞的數量[15]，之後施加重量訓練，無論是否使用類固醇，都可以使這些新產生的細胞在大小及力量上更成熟。有些理論認為某些運動的力量輸出訓練可以導致細胞增生，因此增加肌肉纖維的數量而不是僅增加單一肌肉纖維的體積[16]。

診斷

以子宮內膜細胞增生為例，通常是透過巴氏涂片检查來確認診斷，或是在子宮頸檢查時同時取得子宮內膜組織切片[3]。至於庫興氏病（英语：Cushing's disease）則可以檢查患者唾液的可體松濃度是否升高[17]。

種類

患者的右側上下肢發生偏側增生（英语：hemihyperplasia），從其骨盆傾斜的外觀可以發現長短腿症狀。

細胞增生有些更常見的臨床形式，或是有些情況導致細胞增生：

  • 子宮內膜增生症——子宮內膜發生細胞增生，是多囊卵巢綜合症的症狀之一，當雌激素長時間對子宮內膜刺激，且子宮內膜缺乏黃體素的保護時，就會導致子宮內膜增生。如果沒有接受適當的治療，可能會進一步發展成子宮內膜癌[20]。從子宮內膜增生症發展成子宮內膜癌是異常細胞增生可以導致癌變的典型範例[9] 。
  • 皮脂腺增生（英语：Sebaceous hyperplasia）——在這個種類中，患者的皮脂腺增生而變大，因此在皮膚上出現小而黃的突起，好發於臉部，這種疾病不具有傳染性也不危險[24]。
  • 肝臟代償性增生——肝臟受損之後，肝細胞大量分裂增殖，由新產生的細胞恢復肝臟功能到基本水準。肝臟即使有75%受損或是被切除，仍然可以在肝細胞分裂複製後恢復，這也是臨床上肝臟活體移植可行的原因[25]。

治療

細胞增生的治療會依據每種疾病的不同採用不同的治療方法。例如攝護腺肥大的患者可以合併使用甲型交感神經受體阻斷劑（英语：Alpha-1 blocker）以及5α還原酵素抑制劑（英语：5α-Reductase inhibitor）治療[26]。

參考資料

  1. ^ 1.0 1.1 Prostate Enlargement: Benign Prostatic Hyperplasia. www.niddk.nih.gov. [2015-05-30]. （原始内容存档于2015-06-11）. 
  2. ^ 2.0 2.1 Koerner, Frederick C. Diagnostic Problems in Breast Pathology. Elsevier Health Sciences. 2009. ISBN 1416026126. 
  3. ^ 3.0 3.1 Dunphy, Lynne M.; Winland-Brown, Jill E. Primary Care: The Art and Science of Advanced Practice Nursing. F.A. Davis. 2011-04-06. ISBN 9780803626478. 
  4. ^ Hyperplasia: MedlinePlus Medical Encyclopedia. www.nlm.nih.gov. [2015-05-30]. （原始内容存档于2016-07-05）. 
  5. ^ 5.0 5.1 Sembulingam, K.; Sembulingam, Prema. Essentials of Medical Physiology. JP Medical Ltd. 2012-09-01. ISBN 9789350259368. 
  6. ^ Zachary, James F.; McGavin, M. Donald. Pathologic Basis of Veterinary Disease. Elsevier Health Sciences. 2013-12-11. ISBN 9780323291729. 
  7. ^ Braun, Carie Ann; Anderson, Cindy Miller. Pathophysiology: Functional Alterations in Human Health. Lippincott Williams & Wilkins. 2007. ISBN 9780781762502. 
  8. ^ Rubin, Emanuel; Reisner, Howard M. Essentials of Rubin's Pathology. Lippincott Williams & Wilkins. 2009 [2018-04-16]. ISBN 9780781773249. （原始内容存档于2020-09-24）. 
  9. ^ 9.0 9.1 9.2 Kumar, V., Abbas, A., Aster, J. Robbins Basic Pathology. Philadelphia, USA: Elsevier. 2013: 4. ISBN 9780808924326. 
  10. ^ Hong, Waun Ki; Hait, William N. Holland Frei Cancer Medicine Eight. PMPH-USA. 2010. ISBN 9781607950141. 
  11. ^ Porth, Carol. Essentials of Pathophysiology: Concepts of Altered Health States. Lippincott Williams & Wilkins. 2011. ISBN 9781582557243. 
  12. ^ Dirbas, Frederick; Scott-Conner, Carol. Breast Surgical Techniques and Interdisciplinary Management. Springer Science & Business Media. 2011-01-15 [2018-04-18]. ISBN 9781441960764. （原始内容存档于2020-08-03）. 
  13. ^ Gardiner, Phillip. Advanced Neuromuscular Exercise Physiology. Human Kinetics. ISBN 9781450412278. 
  14. ^ Metzl, Jordan D.; Shookhoff, Carol. The Young Athlete: A Sports Doctor's Complete Guide for Parents. Little, Brown. 2009-10-31. ISBN 9780316086738. 
  15. ^ Publishing, Britannica Educational. The Endocrine System. Britannica Educational Publishing. 2011-11-01. ISBN 9781615307319. 
  16. ^ Kisner, Carolyn; Colby, Lynn Allen. Therapeutic Exercise: Foundations and Techniques. F.A. Davis. 2012-10-08. ISBN 9780803638976. 
  17. ^ Cushing's Syndrome: New Insights for the Healthcare Professional: 2013 Edition: ScholarlyBrief. ScholarlyEditions. 2013-07-22. ISBN 9781481651837. 
  18. ^ Cushing disease: MedlinePlus Medical Encyclopedia. www.nlm.nih.gov. [2015-05-30]. （原始内容存档于2016-07-05）. 
  19. ^ Congenital adrenal hyperplasia: MedlinePlus Medical Encyclopedia. www.nlm.nih.gov. [2015-05-30]. （原始内容存档于2016-07-05）. 
  20. ^ Endometrial Hyperplasia - ACOG. www.acog.org. [2015-05-30]. （原始内容存档于2019-10-30）. 
  21. ^ Hemihyperplasia - Glossary Entry. Genetics Home Reference. [2015-05-30]. （原始内容存档于2015-11-17）. 
  22. ^ Subbotin, Vladimir M. Analysis of arterial intimal hyperplasia: review and hypothesis. Theoretical Biology & Medical Modelling. 2007-10-31, 4: 41. ISSN 1742-4682. PMC 2169223 可免费查阅. PMID 17974015. doi:10.1186/1742-4682-4-41. 
  23. ^ Purkait, Swapan Kumar. Essentials of Oral Pathology. JP Medical Ltd. 2011. ISBN 9789350252147. 
  24. ^ Evans, Colby Craig; High, Whitney A. Skin Diseases in the Elderly: A Color Handbook. CRC Press. 2011-10-01 [2018-04-19]. ISBN 9781840766158. （原始内容存档于2020-08-03）. 
  25. ^ Kumar, Vinay; Abbas, Abul K.; Aster, Jon C. Robbins & Cotran Pathologic Basis of Disease. Elsevier Health Sciences. 2014-09-05. ISBN 9780323296359. 
  26. ^ Benign Prostatic Hypertrophy Treatment & Management: Approach Considerations, Combination Therapy, Minimally Invasive Treatment. Medscape. eMedicine. [3 September 2016]. （原始内容存档于2015-10-30）. 

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