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目的:分析结直肠腺癌中差分化细胞群 (poorly differentiated clusters, PDC) 与肿瘤出芽 (tumor buddings, TB) 之间的关系, 以及MUC1在PDC和TB中的表达, 探讨结直肠腺癌中PDC和TB的相关性, 阐明两者的生物学特征.方法:183例结直肠腺癌中PDC的识别和分级采用HE染色下观察, TB的识别和分级采用CK免疫组化染色, MUC1在PDC与TB中的表达采用免疫组化EnVision方法检测.结果:183例结直肠腺癌中, PDC的检出率为56.8％ (104/183), 肿瘤内出芽 (intratumoural budding, ITB) 的检出率为54.1％ (99/183), 肿瘤浸润前沿出芽 (peritumoural budding, PTB) 检出率为62.3％ (114/183) .结直肠腺癌中PDC与ITB、PDC与PTB的检出率均呈正相关 (P ＜0.001);结直肠腺癌中PDC分级与PTB分级呈正相关 (P ＜0.05), 而与ITB的级别无关 (P＞ 0.05);在瘤体主体MUC1主要呈腔缘和 (或) 胞质表达, 而在PDC和TB中MUC1呈反向表达模式即 (inside-out, I/O) 模式, MUC1在PDC、ITB和PTB中反向表达率分别为55.8％、58.6％和54.4％.结论:结直肠腺癌中PDC和TB密切相关, 特别是与PTB有关, 提示两者生物学行为具有密切相关性;MUC1在PDC和TB中的反向表达模式提示两者具有微乳头状癌特征, 可能是微乳头状癌发生过程中的不同形成阶段.“,”Objective:To analysis the relationship of poorly differentiated clusters (PDC) and tumor buddings (TB) in colorectal adenocarcinoma and MUC1 expression in PDC and TB. To explore the correlation and biologic characteristic of PDC and TB in colorectal carcinoma. Methods:The identification and grading of PDC in 183 cases of colorectal adenocarcinoma were observed by HE staining. The identification and grading of TB were examined by CK immunohistochemical staining. MUC1 expression of PDC and TB was detected by EnVision immunohistochemical method. Results:Among 183 cases of colorectal adenocarcinoma, the detection rate of PDC was 56.8％ (104/183), intratumoural budding (ITB) was 54.1％ (99/183), and peritumoural budding (PTB) was 62.3％ (114/183).There was a positive correlation between PDC and ITB, PDC and PTB in colorectal adenocarcinoma (P ＜ 0.001). PDC grade was positively correlated with PTB grade (P ＜ 0.05), but not with ITB grade (P＞ 0.05). MUC1 was mainly expressed in the lumen margin and/or cytoplasm in the main body of the tumors, while in PDC and TB, MUC1 was expressed in the reverse mode, i.e. I/O mode. The reverse expression rates of MUC1 in PDC, ITB and PTB were 55.8％, 58.6％ and 54.4％, respectively. Conclusion:PDC and TB, especially PTB, were closely related in colorectal adenocarcinoma which suggested that their biological behaviors were closely related.Reverse expression patterns of MUC1 in PDC and TB suggested that they may have the characteristics of micropapillary carcinoma, which may be different stages of micropapillary carcinogenesis.