Biomedical subjects

E Harju

Publications and source records attributed to E Harju.

At least 19 recordsLinked to original sources

PubMed1992

Independent clinical, histological and quantitative prognostic factors in transitional-cell bladder tumours, with special reference to mitotic frequency.

A cohort of 537 transitional-cell bladder cancers (TCC) was followed up for a mean of 9 years. Clinical stage, WHO grade, papillary status, 6 nuclear factors and volume-corrected mitotic index (M/V index) were related to progression and survival. Classic and quantitative prognostic factors were significantly interrelated (p less than 0.001). In Ta-Tl tumours M/V index predicted progression independently (p less than 0.001) and in the entire cohort progression was related independently to the M/V index (p = 0.0001) and to the WHO grade (p = 0.0022). In survival analysis, clinical stage (p less than 0.0001), M/V index (p less than 0.0001), WHO grade (p less than 0.0001), papillary status (p less than 0.0001) and nuclear factors (p less than 0.0001) were significant predictors. In papillary tumours, clinical stage (p less than 0.0001), M/V index (p less than 0.0001), WHO grade (p less than 0.0001) and nuclear factors (p = 0.0001-0.0133) were related to survival. In a multivariate analysis T-category (p less than 0.001), WHO grade (p less than 0.001), M/V index (p = 0.002) and papillary status (p = 0.034) predicted survival independently in the entire cohort whereas in papillary tumours T-category (p less than 0.001) and M/V index (p less than 0.001) were independent predictors. If tumours with pelvic lymph-node metastases or distant metastases at diagnosis were excluded from the analysis, T-category (p less than 0.001), M/V index (p less than 0.001) and WHO grade (p less than 0.001) were independent predictors. In papillary tumours T-category (p less than 0.001), M/V index (p less than 0.001) and WHO grade (p = 0.048) predicted survival. The results emphasize the importance of mitotic activity as a most important histological prognostic factor in TCC, second only to clinical stage. In Ta-TI tumours quantitative mitotic frequency analysis includes all the available independent prognostic information. Accordingly, TCC can be graded by mitotic frequency analysis in place of subjective grading systems.

Carcinoma, Transitional Cell↗

PubMed1992

Prognostic factors in WHO grade 2 transitional-cell bladder cancer (TCC); a novel two-grade classification system for TCC based on mitotic index.

A retrospective histological analysis has been carried out on 537 cases of transitional-cell bladder carcinoma, followed-up over a period of 9 years. In the first part of the study WHO grade 2 tumours were analysed and a number of independent factors predictive for survival identified. In a multivariate analysis the T category and M/V index (number of mitotic figures/mm2 neoplastic epithelium) were the most important prognostic factors. In a subsequent analysis of the whole series of 537 cases, overall the M/V index was not as important in predicting survival as the stage of the tumour. However, in superficial tumours (Ta-T1) subsequent analysis showed that the M/V index alone could be used to predict survival.

Aged↗

PubMed1992

Prediction of superficial bladder cancer by nuclear image analysis.

A cohort of 270 superficial transitional cell bladder tumours (Ta-T1) was followed-up for over 8 years. WHO grade, papillary status and six nuclear factors were related to progression, recurrence-free survival (RFS) and bladder cancer-related survival (BS) during the follow-up period. Mean nuclear area (NA), standard deviation of nuclear area (SDNA), nuclear perimetry (PE), standard deviation of nuclear perimetry (SDPE), shortest nuclear axis (Dmin) and longest nuclear axis (Dmax) were significantly related to WHO grade and papillary status (P < 0.0001). All the nuclear factors were related significantly to progression in univariate analysis (P < 0.01) whereas in a multivariate analysis WHO grade (P < 0.0001) and papillary status (P = 0.048) included independent prognostic information. RFS was related to PE (P = 0.009), SDPE (P = 0.013), Dmin (P = 0.021), Dmax (P = 0.028) and SDNA (P = 0.029). In papillary tumours SDPE (P = 0.007) and Dmin (P = 0.024) predicted RFS. BS was related to WHO grade, papillary status, NA, SDNA, PE, Dmax, Dmin (all P < 0.0001) and to SDPE (P = 0.003). In papillary tumours PE (P < 0.0001), Dmax (P = 0.0022), Dmin (P = 0.0027), WHO grade (P = 0.0036), NA (P = 0.0005), SDNA (P = 0.0355) and SDPE (P = 0.0718) predicted BS. In multivariate analysis SDPE (P = 0.029) predicted RFS and survival was related to WHO grade (P < 0.001) and PE (P = 0.014) independently. In papillary tumours only Dmax (P = 0.001) predicted survival independently. The results show that superficial papillary transitional cell bladder tumours can be efficiently categorised into prognostic groups by nuclear image analysis and the results provide a new classification system for superficial papillary bladder tumours. Tumours with high nuclear factor values should be considered for radical primary therapy and adjuvant therapy after transurethral resections.

Aged↗

PubMed1992

Tumour infiltrating lymphocytes as an independent prognostic factor in transitional cell bladder cancer.

The prognostic value of tumour infiltrating lymphocytes (TIL) was assessed in a cohort of 514 patients with a transitional cell bladder cancer (TCC) during a follow up period of over 9 years. The density of TIL were positively correlated to WHO grade (P < 0.0001), non-papillary growth architecture (P < 0.0001), morphometric nuclear factors (P < 0.007) and volume corrected mitotic index (M/V index) (P < 0.0001). Dense TIL predicted progression in Ta-T1 tumours (P < 0.0006) whereas in a multivariate analysis they had no independent predictive value. Dense TIL were related to short recurrence-free survival in Ta-T1 tumours in a univariate analysis (P = 0.06) as well as in a multivariate analysis (P = 0.005). Dense TIL predicted unfavourable prognosis in the entire cohort (P = 0.0316) and in papillary tumours (P = 0.062) whereas in nodular tumours TIL were a sign of good prognosis (P = 0.0141). Also in T3-T4 tumours TIL were related to less aggressive behaviour of TCC (P = 0.0259). In a multivariate analysis including clinical stage (T-category), WHO grade, papillary status, six morphometric nuclear factors and M/V index dense TIL were a highly significant indicator of a favourable prognosis (P = 0.007). Particularly TIL categorized rapidly proliferating TCC into prognostic groups (P = 0.001). The results show that TIL are a sign of efficient host defence mechanisms in TCC and TIL predict a favourable prognosis in invasive TCC.

Aged↗

PubMed1991

Patient satisfaction among day surgery patients in a central hospital.

Satisfaction among patients treated one year before day surgery in a central hospital was studied by questionnaires, sent to 100 and returned by 70 patients. The satisfaction before surgery was positive in 74% and negative in 6% of the patients. Based on their experiences from surgery, patients satisfaction improved in 59%, and did not decline. The preferred waiting times to the out-patients examination and also between this and the operation day was 8-10 weeks. Except for patients unable to work (mostly orthopedic patients) very short waiting times were difficult. Hospital arrangements during the treatment day (before, during and after the operation) were considered very good by 56 to 62%, good by 31-40%, satisfactory by 1-6%, and weak by 0-1% of the patients. In all, 96% of the patients would be ready to return to day surgery. The two patients who would refuse had difficulties at discharge. Thus day surgery has had a positive effect on surgical patient satisfaction. The most important improvement was increased surgical availability. In order to improve satisfaction further, patients unable to work as a result of their surgical problem should be treated almost immediately.

Adolescent↗

PubMed1991

Immediate effect of vagotomy on pancreatic insulin secretion.

The effect of vagotomy and gastric resection on insulin secretion was examined by the glucagon stimulated C-peptide test in gastrectomy patients (n = 11) without truncal vagotomy and in total gastrectomy patients (n = 10) with truncal vagotomy. The test was performed twice in each patient: 10 minutes after the midline incision was made and then 60 to 90 minutes later when gastric resection or total gastrectomy was completed, during the reconstructive phase of the operation. Gastric resection without truncal vagotomy was followed by a higher increase (48%) in serum C-peptide concentration caused by glucagon stimulation than total gastrectomy with truncal vagotomy (13%). There was a significant (p less than 0.05) increase in the glucagon stimulated glucose-related C-peptide concentration in patients without truncal vagotomy, whereas truncal vagotomy inhibited this increase. These results suggest that truncal vagotomy will produce a reduction in stimulated insulin secretion in humans.

Adult↗

PubMed1991

Postprandial blood concentrations of insulin-independent carbohydrate, galactose, in oral test after gastric surgery.

In order to examine the postprandial blood concentrations of insulin-independent carbohydrates after gastric surgery oral galactose test (1.65 g/kg body weight in water, 33%, w/v) was performed in 55 symptomatic patients and in 5 healthy subjects. There were patients after total gastrectomy (TG) (n = 17), gastric resection with (GRS, n = 17) or without (GR; n = 12) selective vagotomy, and after proximal selective vagotomy (PSV, n = 9). The patients had immediately after drinking the test solution a 2- to 5-fold higher blood galactose concentration than the healthy subjects. The TG patients had the most rapid, the healthy subjects the slowest and the GR and GRS patients an intermediate rapid, immediate increase of blood galactose concentration. The TG patients showed a plateau 40-60 min and a decrease 60-90 min after the start of the test. The PSV patients showed a plateau 60-90 min after the commencement of the test. The GR and GRS patients and the healthy subjects had a continuous increase in blood galactose concentration during the whole test period, but the maximal point 90 min after the drinking of the solution was lower in the GRS than in the GR patients and lowest in the healthy subjects. The PSV patients had a lower blood galactose curve than the TG, GRS and GR patients but higher than the healthy subjects except the plateau 60-90 min postprandially.(ABSTRACT TRUNCATED AT 250 WORDS)

Carbohydrate Metabolism↗

PubMed1990

The effect of elective surgery on serum N-acetyl-beta-D-glucosaminidase activity.

N-acetyl-beta-D-glucosaminidase (NAG; EC 3.2.1.30) activity was measured in sera of 23 patients admitted for elective surgery. Cholecystectomy increased serum NAG activity (by 62%) (p less than 0.004), whereas other types of operations (minor or major abdominal surgery, inguinal hernias and leg varices) had no regular effect. In cholecystectomy patients, the increase of serum NAG activity was associated with parallel changes in liver enzymes suggesting that manipulation of liver may liberate NAG into the circulation. Surgical trauma per se does not provoke any significant liberation of NAG.

Acetylglucosaminidase↗

PubMed1989

Late carotid restenosis: aetiologic factors for recurrent carotid artery stenosis during long-term follow-up.

During a fourteen-year-period 257 patients underwent carotid endarterectomy in an unselected population of 700,000 inhabitants. The incidence of haemodynamically significant restenosis was 13.5% in 133 vessels in 116 patients studied by duplex scanning 28 to 209 months following carotid endarterectomy. The most striking differences between patent and restenosed cases were in serum cholesterol, triglyceride and HDL-cholesterol levels. The patients with a long-term low cholesterol (less than 6.5 mmol/l), low triglyceride (less than 1.42 mmol/l) and high HDL cholesterol (greater than 1.0 mmol/l) levels had significantly less high grade restenosis (P less than 0.05). Apolipoprotein A-I and B had no significant effect, but if the lowest limit of normal apolipoprotein A-I level was considered as 1.27 g/l the difference was significant. The frequency of a high-grade restenosis in patients with diabetes mellitus and coronary heart disease was not significantly increased, but supports the view that these are risk factors in the development of atherosclerotic changes in an operated carotid artery. The incidence of recurrent stenosis appears to be unrelated to hypertension, claudication, obesity, smoking, operative factors or to the indication for surgery. Men were more prone than women to get a high-grade restenosis. Postoperative treatment with acetylsalicylic acid was most effective, the incidence was only half of that expected, whereas the anticoagulants or a combination of acetylsalicylic acid and dipyridamole were of no benefit. Haematocrit, RBC, platelet count and thrombocrit were contradictory.

Adult↗

PubMed1989

Clinical pharmacokinetics of iron preparations.

The principle of iron conservation is the basis of iron metabolism; the normal basal loss of iron from the body is about 1 mg daily in a 70 kg man and 0.8 mg in a 55 kg woman. Iron is lost mainly by the menstrual and gastrointestinal routes. The total iron requirement during pregnancy is 800 mg; in the last month the requirement may amount to 7 to 8 mg/day. Supplementary iron is recommended for many menstruating women, and during the latter part of pregnancy. Correct fetal iron metabolism is ensured by proper maternal iron status, although there are contradictory opinions and findings about the relationship between maternal and fetal iron metabolism. Preterm infants fed on breast milk have a negative iron balance, and require an iron intake of about 0.6 mg/kg/day, and 3.4 mg/1 g haemoglobin, to compensate for intestinal and venesection iron losses, respectively. The absorption of supplementary iron by the preterm infant is a linear function of intake. Preterm infants do not require iron supplements when given repeated blood transfusions. During lactation the total iron losses of the mother are 1 mg/day, and thus no supplementary iron is needed if the iron metabolism has been in balance during the pregnancy. Serum ferritin concentration decreases continuously when iron stores in the body are reduced, and totally empty iron stores are the only known reasons for low serum ferritin concentration. Despite depleted iron stores, serum ferritin concentration can be normal or higher than normal in protein-energy malnutrition, up to 3 months after major surgery, in acute liver damage, in some patients with prolonged hyperglycaemia due to diabetes mellitus, in acute lobar pneumonia, active pulmonary tuberculosis and rheumatoid arthritis on gold therapy, in sepsis secondary to marrow hypoplasia induced by chemotherapy, in heavy drinkers and for a few days after myocardial infarction. In haemochromatosis, iron is deposited in liver (producing fibrosis), pancreas, endocrine glands and heart. The rise in the level of iron in the body is due to increased absorption and/or increased intake. This pathology may occur in transfusions, in alcoholism (especially when alcoholic beverages are contaminated with iron and the diet is low-protein), in several liver diseases, in congenital transferrin deficiency and in idiopathic disease. Patients susceptible to haemochromatosis should receive a low-iron diet. Serum ferritin determination may be helpful in early identification of susceptible members of a family with idiopathic familial haemochromatosis, but transferrin saturation is not a good indicator of either iron depletion or iron overload.(ABSTRACT TRUNCATED AT 400 WORDS)

Biological Availability↗

PubMed1988

Body iron stores in patients subjected to surgery of the large bowel.

Iron stores as estimated by serum ferritin concentration were studied in 40 patients subjected to colon surgery in reference to postoperative complications and restoration of iron stores, as well as to dietary and supplementary iron. The results showed that empty iron stores are common in patients subjected to colon surgery; 40 percent of the patients had a total loss before the operation. Preoperatively empty iron stores were associated (P less than .01) with an increased risk of postoperative complications that were not explained by other nutritional parameters. Surgery of the colon did not affect serum ferritin concentration or iron stores acutely or long-term. Intake of dietary iron was determined by food recording for seven days in all patients and was compared to 40 controls. The preoperative hemorrhagia and lower daily intake of dietary iron (8 +/- 3 mg) in the patients than in the controls (14 +/- 4 mg) may explain the empty iron stores. However, patients with normal iron stores also had low amounts of dietary iron (9 +/- 3 mg). In 12 patients with empty iron stores the effects of ferrous sulfate (80 mg Fe++) three times daily for six weeks were studied. The patients responded well to the therapy. It is concluded that preoperatively empty iron stores are common in patients subjected to colon surgery, and that this raises the risk of postoperative complications. Colon operations are not followed by acute or long-term changes in serum ferritin concentration or iron stores. The restoration of iron is achieved by oral iron therapy.

Bone Marrow↗

PubMed1988

Serum electrolyte concentrations during two days post-laparotomy infusion of saline, glucose or amino acids in rabbit.

The changes in serum sodium, potassium, chloride, calcium, and phosphorus concentrations during 48 hours post-laparotomy infusion of saline, 10 percent glucose alone, and in combination with two different amino acid solutions were investigated in the rabbit. Most of the changes occur 24-hours after the laparotomy. The changes of serum potassium concentration are different from those of chloride, sodium, calcium, and phosphorus. The quality of infusion does not change the direction of the post-laparotomy change of the serum chloride (increase) and calcium (decrease) concentration. The serum potassium concentration increases and phosphorus remains constant when saline is infused, whereas potassium remains constant and phosphorus decreases when the other solutions are given. The responses to the different infusions are most diversed in the case of sodium. The serum electrolyte concentrations remain at the level of the 24-hours post-laparotomy state also after the 48-hours infusion, with the exception the decrease of potassium during saline, increase of sodium during glucose and amino acid and increase of calcium during glucose infusion.

Amino Acids↗

PubMed1988

Inflammation parameters in the diagnosis of acute appendicitis.

The role of the common parameters of inflammation in the diagnosis of acute appendicitis was studied by measuring axillary temperature (Tax), blood leukocyte (Leuk) and lymphocyte fraction (Lymph), serum C-reactive protein (CRP) and ESR in 354 patients with clinical diagnosis of acute appendicitis. Laparotomy showed normal appendix in 97 cases, but deduction of 14 with other surgically correctable disorders gave the negative appendectomy rate 83/354 (23.4%). The appendix had perforated in 9.9%. Tax, Leuk, Lymph and CRP could significantly differentiate acute appendicitis from the other cases, with respective sensitivity (and false positive) percentages 88.7 (66.0), 78.5 (24.7), 84.4 (48.5) and 52.7 (24.7). Although such statistical differences are not particularly helpful in preoperative diagnosis of individual cases, none of the 37 patients with simultaneously normal Leuk, Lymph and CRP had obvious appendicitis (2 probably had incipient inflammation). If laparotomy had not been performed in these 37 cases, almost half of the unnecessary operations could have been avoided, thereby reducing the negative appendectomy rate to 15.2%, with 11.7% perforation rate.

Abdomen, Acute↗

PubMed1988

Nutritional state after colon interposition for benign oesophageal disease.

The nutritional state of 32 patients after (mean 66 months) colon interposition due to benign oesophageal disease was examined. Forty-four per cent of the patients had depleted iron stores (low serum ferritin concentration). Serum iron and blood haemoglobin concentrations were lower (P less than 0.001) in those with low than in those with normal serum ferritin concentration (115 +/- 12 g/l and 15 +/- 5 mumol/l vs 135 +/- 12 g/l and 23 +/- 9 mumol/l). Most very low blood haemoglobin concentrations (less than 110 g/l) were found in patients with depleted iron stores. Eighteen patients had serum albumin concentrations slightly below (35-39 g/l) the normal range, and two other patients had values less than 35 g/l. The patients had less dietary iron (13 +/- 6 mg/d) than age- and sex-matched controls (19 +/- 7 mg/d), but the intake of patients with depleted iron stores (12 +/- 5 mg/d) was similar to that of patients with normal iron stores (14 +/- 6 mg/d). Symptoms and/or the replacement of colon graft anti- or isoperistaltically did not have any significant association with the nutritional status, only slightly reduced blood haemoglobin and serum albumin concentration were found among the symptomatic patients and the patients with an antiperistaltic graft. Iron therapy and protein supplements, eg, from milk, egg, soy and meat, are recommended as the dietary treatment. To improve the nutritional status a short intra-abdominal colon graft loop anastomosed to the proximal stomach instead of long loop with an antral anastomosis of the present patients is suggested.

Adolescent↗

PubMed1987

Dietary habits of patients with regurgitation after colon interposition.

The dietary habits after colon interposition following oesophagectomy in patients without symptoms (n = 8), with regurgitation (n = 22) and in sex- and age-matched healthy controls (n = 20) were studied by a 7-day diary method. The patients ate smaller meals (1080 +/- 90 kJ versus 1810 +/- 151 for the controls, P less than 0.01), more frequently during the day (eight versus five in the controls). Solid and sour foods were preferred, especially by those with regurgitation, compared with controls. The asymptomatic patients consumed more milk and coffee and less cheese, sour milk, meat, fish, eggs, tea and orange juice than the patients with regurgitation. Vegetable fats and medium chain triglycerides were consumed in negligible amounts. The patients with regurgitation had more fluids separately from meals than the asymptomatic patients. The results suggest that intake of vitamin supplements and replacement of animal fats by vegetable fats may be useful in these patients. Much of the dietary difficulties after colon interposition might be the result of the intra-abdominal colon graft loop anastomosed to the antrum; a short graft with a more proximal anastomosis to the lesser curvature merits study in this context.

Body Weight↗

PubMed1987

The protective effect of nutrients against stress induced gastric ulcers in the rat.

The first part of the study consisted of 110 rats in 11 groups with ten rats in each. Nine of the groups were fed nutrient solutions of different compositions, antacid and sucralfate through orogastric tube during induction of stress ulcer by restraint and a cold ambient temperature. One group served as a control group and received no feeding and the 11th group was given cimetidine intraperitoneally. The extensiveness of the stress effect was estimated in each group by the number of rats with ulcer as percentage, the mean number of ulcers in each rat, the mean distribution of ulcers of different sizes, the mean total of mucosal damage in each rat and the contribution of ulcers of a different size to the total mucosal damage. The results showed that cimetidine is an effective protector against stress ulcer. Guar gum, Intralipid (fat emulsion), egg protein and 30 per cent glucose are slightly weaker protectors than cimetidine but much stronger than 10 per cent glucose wheat flour and distilled water. Sucralfate increased the susceptibility to stress ulcer. The second part of the study consisted of 86 rats. It showed, that guar gum increased the healing rate of stress ulcers. During a 30 hour treatment period after four hours of stress, the rats fed guar gum (n = 30) showed a lower (p less than 0.001) number of ulcers than the control rats fed normal rat food (n = 26) or immediately after the four hours of stress (n = 30). The mechanisms suggested for ulcer prevention and increased ulcer healing rate found herein may be due to reduced acidity, increased local mucosal supply of energy and mechanical protection.

Animal Nutritional Physiological Phenomena↗

PubMed1987

Postprandial hyperglycemia after different carbohydrates in patients with total gastrectomy.

Eating related difficulties and symptoms and postprandial serum glucose levels were studied in 11 patients (44 to 70 years old) five to 48 months after total gastrectomy and Roux-en-Y reconstruction for carcinoma of the stomach with no signs of metastasis or residual tumor. Three tests were used. The first contained 150 milliliters of 50 per cent glucose alone, the second had 150 milliliters of 50 per cent glucose with 5 grams of guar gum (viscose dietary fiber) and the third was a vegetable meal containing 75 grams of glucose. All of the patients with total gastrectomy had eating related symptoms, such as dumping and difficulties with the large volume of a meal. They had to eat small meals and the most usually experienced postprandial symptoms were abdominal pain, nausea and faintness. The postprandial serum glucose level was highest after drinking glucose alone and the lowest after eating the vegetable meal (as the highest 9.4 +/- 2.0 and 6.2 +/- 1.6 millimole per liter, respectively, 50 minutes postprandially, p less than 0.01). Hyperglycemia was associated with nausea, sweating, faintness, reduction of blood pressure and increase of pulse rate. The large volume of the vegetable meal produced difficulties (dysphagia and abdominal distension) in eating for everyone except one patient. Guar gum eaten with glucose reduced the postprandial hyperglycemia near to the level found after the vegetable meal. Also, the symptoms experienced after glucose with guar gum reduced from that after glucose alone, five patients became symptomless. Four of these five patients have supplemented guar gum regularly for several months into their daily meals with the result of reduction of the postprandial subjective symptoms. The dose has been adjusted individually from 2 to 7 grams of guar gum three times daily. Loose stools and diarrhea may occur at the beginning. These are avoided by a gradual increase of the dose during an adaptation period of two weeks. Sometimes glucose with guar gum may result in hypoglycemia with prolonged symptoms after immediate hyperglycemia. It is concluded that guar gum gives a possibility to avoid the symptoms related to a large volume of a meal and to reduce those produced by a high glucose content of a meal in patients after total gastrectomy. Guar gum also works in practical prolonged use when the dose is estimated from postprandial symptoms.

Adult↗

PubMed1986

Gastric polyposis and malignancy.

Gastric malignancies developed in 15 patients with gastric polyps (seven men, eight women; mean age 66 +/- 8.8 years) during a 14-year follow-up of 170 patients (8.8 per cent). The polyps were hyperplastic in 90 per cent of the patients, adenomas in 8.2 per cent and leiomyomas in 1.8 per cent. During follow-up 4.7 per cent of the patients had both adenomas and hyperplastic polyps. Ten patients developed adenocarcinoma, two lymphoma, one lymphoid sarcoma, one carcinoid tumour and one severe dysplasia. The incidence of malignancy was sevenfold higher than expected (P less than 0.01). There is an associated but lower risk of malignancy in stomachs with hyperplastic polyps than with adenomas; 2 of the 15 stomachs with adenomas and 3 of the 142 hyperplastic polyps showed later malignancy (P less than 0.001). Before the diagnosis of malignancy 1.1 +/- 1.4 (0-4) gastroscopies were done and 12 +/- 19 (0-48) months had elapsed since the first examination and detection of polyps, whereas the mean number of gastroscopies and length of follow-up period in all patients with polyps was 1.9 +/- 0.9 (0-10) and 68 +/- 35 (0-156) months, respectively. Eleven patients had a stage I malignancy and four had a stage IV tumour. The survival rate of the eight patients with malignancy found at the first examination was better (6/8) than for those diagnosed during the follow-up period (3/7) (P less than 0.01; chi2 test). The results show the high risk of malignancy in stomach polyps, adenomas or hyperplasia, and stress the importance of careful and repeated examination of these patients.

Adenoma↗