Biomedical subjects

Inge T Bernstein

Publications and source records attributed to Inge T Bernstein.

5 recordsLinked to original sources

PubMed2006

[Serrated, hyperplastic and hyperplasia-like colorectal polyps].

The colorectal hyperplastic polyp has generally been considered a finding of no clinical significance. Recent research has, however, called attention to the existence of some variants of hyperplastic polyp which are potentially malignant. The term "advanced serrated polyp" has been coined for such cases, which comprise mixed hyperplastic/adenomatous tissue, serrated adenoma, and sessile serrated polyp, in contrast to the traditional hyperplastic polyp. Since epithelial dysplasia is an integrated component of mixed hyperplastic/adenomatous polyp and of the serrated adenoma, such a diagnosis would dictate control colonoscopy comparable to the guidelines for subjects with conventional adenomas. The cytology of the sessile serrated polyp is, however, closer to that of the traditional hyperplastic polyp, whereas the architecture mimics that of the serrated adenoma. For this reason, a consensus regarding the optimal management of such patients has not been obtained, but if the polyp is sizeable and located in the right colon, control should be considered. The small, usually left-sided traditional polyp as a rule needs no follow-up, but the context in which such a lesion is found and its morphology may influence the clinical decision. Future large-scale investigations of serrated colorectal polyps, including interobserver studies, will be required to identify histological details of clinical utility which can be adopted in daily routine practice.

Adenoma↗

PubMed2006

[Hyperplastic colorectal polyposis].

Two cases of hyperplastic polyposis are presented, a 59-year-old female with >50 colorectal serrated polyps in a pancolic distribution and a 69-year-old female with four mucinous colorectal carcinomas and seven serrated polyps, three of which >10 mm. The pathological tissue of the latter patient was confined to the right colon and the neoplastic areas displayed loss of MLH1 expression. Three first degree relatives of this patient had carcinoma of the large bowel, breast and ovary, respectively. A first degree relative of the former patient succumbed to a colorectal carcinoma.

Adenoma↗

PubMed2006

[Familial colorectal cancer].

The most frequent monogenic predisposition to CRC is hereditary non-polyposis colorectal cancer (HNPCC). Less frequent are syndromes with polyposis. In some families the occurrence of CRC indicates a familial risk of CRC without the diagnostic criteria for the above syndromes being fulfilled. In families where causative mutations are identified, predictive genetic testing is offered. When no mutation is identified in a family, the risk of individual members of the family is evaluated according to the family history. Individuals with a high risk of CRC are offered surveillance.

Adenomatous Polyposis Coli↗

PubMed2005

[Hereditary colorectal cancer].

HNPCC and FAP are inherited diseases with a lifetime risk of colorectal cancer (CRC) of 80-100% in gene carriers. Disease-causing mutations have been identified in the APC gene at FAP and in MMR genes at HNPCC. In FAP-patients, screening has reduced the prevalence of CRC by 55%, and the survival rate has improved considerably. For HNPCC-patients, 77% of CRCs found by screening were Duke' A or B, and survival after CRC has improved significantly since 1990. Continuous central registration in the HNPCC and Polyposis registers is recommended to ensure identification of high-risk families and evaluate the effect of screening.

Adolescent↗

PubMed2003

[Prevention of colorectal cancer in families with hereditary nonpolyposis colorectal cancer].

INTRODUCTION: Hereditary non-polyposis colorectal cancer (HNPCC) is a dominant inherited colorectal cancer syndrome, with lifetime risk up to 90% of developing colorectal cancer (CRC) for carriers of the genes. Screening with colonoscopy can reduce the CRC-rate by 62% and prevent CRC-deaths. The HNPCC-Register was established with the aim of identification and registration of Danish HNPCC-families and coordination of surveillance. MATERIALS AND METHODS: The results of 703 colonic screenings in 396 asymptomatic individuals from 150 HNPCC-families were analysed and related to the family diagnosis. RESULTS: In 112 asymptomatic individuals, 31, colorectal cancers and 140 adenomas were diagnosed. Neoplasia was found in one fifth of the examinations and almost one third of the individuals developed an asymptomatic neoplasia which was detected by screening. At the time of the diagnosis, 77% of the colorectal cancers were localized (Dukes stage A or B). DISCUSSION: In Finland, screening for colorectal cancers in HNPCC-families prevents 25-45-fold more CRC-deaths compared to general population screening for colorectal cancer. The results of the Danish colonic HNPCC-screening reveal neoplasia in 21% of the examinations and the colorectal cancers found by screening were at a more favourable Dukes stage compared to sporadic CRC, and probably also CRC found by general population screening. The HNPCC-Register initiates surveillance together with the clinical genetic departments, but the results of the recommended colonic examinations are not automatically reported to the HNPCC-Register. To enable an in-depth investigation of the effect of CRC-screening in all Danish HNPCC-families, further financial resources should be allocated to the HNPCC-Register to collect the results.

Adenocarcinoma↗