PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Colonic Polyps”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 55 records · Page 3Linked to original sources
PubMed2005

A retrospective study of colonic polyps in King Chulalongkorn Memorial Hospital.

To evaluate and classify polyps from colon in Thai patients, the authors retrospectively analyzed the 776 polyps from 696 subjects in King Chulalongkorn Memorial Hospital during the past five-year period from 1999 to 2003. All colonic polyps were included in the study. There were 461 (59%) male and 315 (410%) female with the mean age of 51 years. Non-neoplastic and neoplastic polyps were documented 50% each. Hyperplastic polyp was the most frequent diagnosis (39%), followed by tubular adenoma (36%). According to neoplastic polyp, 8%, 3%, and 14% cases were identified as high-grade dysplastic change, intramucosal carcinoma, and invasive carcinoma, respectively.

Adenomatous Polyps↗
PubMed1998

Risk factors for self-reported colon polyps.

OBJECTIVE: Investigate risk factors for colon polyp using multivariate analyses. DESIGN: In a group responding to a 1992 mail survey, we assessed the association between physician-diagnosed colon polyp and possible risk factors reported primarily 10 years earlier. SETTING: Survey respondents within the Cancer Prevention Study II. PARTICIPANTS: Respondents, 72,868 men and 81,356 women, who reported no polyp diagnosis when questioned in 1982 at ages 40 to 64 years. MEASUREMENTS AND MAIN RESULTS: The characteristics of 7,504 men (10.3%) and 5,111 women (6.3%) reporting a first colon polyp were compared with those of participants who did not report a polyp. After adjustments for age, family history of colorectal cancer, and other potential risk factors, polyp occurrence was associated with 1982 histories of smoking, former smoking, alcohol use of at least two drinks per day (odds ratios [ORs] from 1.5 to 1.1; all p < .005), and a body mass index > or = 28 kg/m2 (men's OR 1.06; 95% confidence interval [CI] 1.00, 1.13; women's OR 1.08; 95% CI 0.99, 1.17). Polyps were also associated with a diagnosis of gallbladder disease or gallstone at any time and with gallbladder surgery up to 1982 (OR from 2.7 to 1.3; all p < .001). Polyp occurrence was inversely associated with 1982 histories of high exercise level (men's OR 0.83; 95% CI 0.76, 0.91; women's OR 0.90; 95% CI 0.78, 1.03), frequent aspirin use in women (OR 0.85; 95% CI 0.77, 0.95), and high parity in women (OR 0.84; 95% CI 0.75, 0.94). Among participants lacking a clinically normal gallbladder, the polyp risks associated with smoking and high body mass index were reduced (p < .04 for interactions). CONCLUSIONS: Despite the limitations and potential biases in these self-reported data, the risk factors described here may be useful for identifying persons at modestly increased risk of having a colon polyp. The effect-modifying role of gallbladder status deserves further investigation.

Adult↗
PubMed1988

Lack of association between skin tags and colon polyps in a primary care setting.

Cutaneous skin tags (acrochordons) have recently been proposed as markers for adenomatous polyps of the colon among symptomatic patients referred for colonoscopy. To ascertain the utility of skin tags as a predictor of colonic polyps in a primary care setting, 492 patients, with a mean age of 58 +/- 13.3 years (241 with signs or symptoms and 251 for screening), were evaluated for the presence of skin tags and then examined using a 60-cm fiberoptic sigmoidoscope by an examiner "blinded" to the skin findings. Among patients with skin tags, 23 (10.2%) of 226 had polyps, whereas among patients without skin tags, 20 (7.5%) of 266 had polyps. The predictive value of the presence of a skin tag was 10.2%. Contrary to studies done in more selected populations with a higher prevalence of adenomatous polyps, the results using a 60-cm flexible sigmoidoscope in a primary care population suggest that cutaneous skin tags are not a marker for adenomatous polyps of the colon.

Adolescent↗
PubMed1997

Increased prevalence of colonic polyps and altered lymphocyte subset pattern in the colonic lamina propria in acromegaly.

OBJECTIVE: The balance of evidence suggests that acromegaly is a risk factor for colonic neoplasia. We have evaluated the prevalence of colonic polyps in acromegalics from Southern Italy and characterized the lymphocyte subsets in the colonic lamina propria in order to analyze differences in the colonic immunological environment. DESIGN: All the patients and controls were submitted to pancolonoscopy. Ten per-endoscopic biopsies of the intestinal mucosa surrounding polyps were carried out to evaluate lymphocyte subsets. PATIENTS: Fifty acromegalics and 318 sex- and age-matched controls entered this study. Colonic lamina propria lymphocyte subsets were studied in 34 patients and 34 controls. RESULTS: Colonic polyps were resected in 23 acromegalics (46%) and 42 controls (13.2%; P < 0.0001); hyperplastic polyps were found in 24% and 6.3%, adenomatous polyps in 22 and 6.9%, (P < 0.01), adenocarcinoma in 2 and 1.2% while synchronous polyps occurred in 18% and 2.5% (P < 0.01), respectively. The number of polyps was significantly correlated with age both in acromegalics (r = 0.422, P < 0.005) and in controls (r = 0.865, P < 0.001). However, polyp prevalence was greater in patients aged below 40 yrs (r.r = 1.9) and in patients with two or more skin tags (r.r = 1.2). A significant decrease of CD20, CD19, CD16, gamma/delta, CD4@leu8- and increase of CD3 and CD4+/leu8+ was found in the lamina propria lymphocyte subsets. CONCLUSIONS: The results of this study confirm that acromegalics are at increased risk of colonic polyps compared to the healthy population. The increased prevalence of premalignant polyps, namely the adenomatous type, suggests that acromegalics should undergo a careful screening and follow-up by pancolonoscopy. An impairment of mucosal immune surveillance seems to exist in acromegaly although a causal effect in the polyp formation cannot be ruled out.

Acromegaly↗
PubMed1995

A multicenter, multiyear, case-controlled study of the risk of colonic polyps in patients with gastric polyps. Are gastric adenomas a new indication for surveillance colonoscopy?

A multicenter, multiyear, case-controlled colonoscopic study of 41 patients with gastric polyps undergoing colonoscopy analyzed whether patients with gastric polyps, particularly adenomas, run an increased risk of having colonic polyps. The primary controls were 109 patients undergoing colonoscopy matched for age and colonoscopy indications. A secondary control group was 69 of these 109 patients who, in addition to matching for age and colonoscopy indications with study patients, had no gastric polyps demonstrated by upper gastrointestinal examination. Patients with nonmalignant mucosal gastric polyps had a significantly greater incidence than primary controls of colonic polyps [odds ratio (OR) = 3.19, OR confidence interval = 1.46 - 6.99, p < 0.004, chi(2)], colonic neoplasms (OR = 3.58, OR confidence interval = 1.56 - 8.23, p < 0.006, chi(2)), and colonic cancer (OR = 4.5, OR confidence interval = 1.05 - 19.4, p < 0.04, Fisher's exact test). Moreover, patients with gastric adenomas had a significantly greater incidence than did primary controls of colonic polyps (OR = 7.6, OR confidence interval = 1.29 - 44.7, p < 0.02, Fisher's exact test). The association between gastric and colonic polyps did not arise as an artifact of the significantly higher frequency of females in the study group because this association remained after patient stratification by sex. The higher risk of colonic polyps in study patients did not arise as an artifact of unappreciated gastric polyps in the primary controls because study patients also had a significantly higher risk of colonic polyps than the secondary controls (OR = 3.21, OR confidence interval = 1.35 - 7.63, p , 0.01, chi(2). Our retrospective case-controlled study suggests that gastric adenomas may be a new, significant risk factor for colonic polyps. A strong association would require that patients with gastric adenomas undergo surveillance colonoscopy to diagnose and remove colonic polyps. However, before we apply this finding to clinical practice, the apparent association should be confirmed by another, preferably prospective study.

Aged↗
PubMed2005

Intraoperative ultrasonography: a tool for localizing small colonic polyps.

BACKGROUND AND AIMS: Small colonic polyps are difficult to palpate and thus difficult to localize during surgery. Preoperative injection of dyes and "on-the-table colonoscopy" are some of the methods used to allow the surgeon to find the polyps. The aim of the present study was to evaluate the value of intraoperative ultrasound as a tool that may allow detection of small colonic polyps during surgery. RESULTS: The study population consisted of nine consecutive patients referred to surgery for polyps of the large bowel that were not amenable to endoscopic removal. At surgery, the colon was filled with saline and than scanned by linear ultrasound probe. In 8 out of 9 patients, intraoperative ultrasound successfully detected all polyps, even those smaller than 0.5 cm. In one patient with two polyps, one in the right colon was easily localized, but a second flat, 0.4-cm tubular adenoma at the splenic flexure was missed. In three patients, intraoperative ultrasound showed penetration into the muscular coat. These polyps were found on pathology to be invasive cancer. CONCLUSION: Intraoperative ultrasound makes it possible for surgeons to easily localize small nonpalpable polyps of the large bowel. Furthermore, it can determine the aggressive potential of these lesions with great accuracy.

Adult↗
PubMedDate not supplied

[Colonic polyps in children. Experience with polypectomy].

BACKGROUND: Colonic polyp, the most common gastrointestinal tumor in children, is considered a cause of rectal bleeding in the pediatric population. Colonoscopy is the "gold standard" procedure in diagnosis and therapeutic. OBJECTIVE: To know the incidence and symptomatology of colonic polyps in children to remark on the usefulness of the endoscopic examination. PATIENTS-METHODS AND RESULTS: Between 1985 and 1996, over 1,000 colonoscopies were performed on 50 children between 8 months and 14 years old. The patients had colonic polyps and lower gastrointestinal bleeding. In 40 cases polyps were solitary, 82% were located in rectum sigmoid, and 80% of polyps were found to be juvenile (retention). There were no complications associated with diagnostic and therapeutic endoscopy. CONCLUSIONS: The endoscopic method was shown to be very useful for diagnosis as well as treatment of the colonic polyps in children.

Adolescent↗
PubMed1987

Natural history of untreated colonic polyps.

The natural history of untreated colonic polyps is uncertain. A retrospective review of Mayo Clinic records from a 6-yr period just before the advent of colonoscopy identified 226 patients with colonic polyps greater than or equal to 10 mm in diameter in whom periodic radiographic examination of the colon was elected over excisional therapy. In all patients, follow-up of polyps spanned at least 12 mo (mean, 68 mo; range, 12-229 mo) and included at least two barium enema examinations (mean, 5.2; range, 2-17). During the follow-up period, 83 polyps (37%) enlarged. Twenty-one invasive carcinomas were identified at the site of the index polyp at a mean follow-up of 108 mo (range, 24-225 mo). Actuarial analysis revealed that the cumulative risk of diagnosis of cancer at the polyp site at 5, 10, and 20 yr was 2.5%, 8%, and 24%, respectively. In addition, 11 invasive cancers were found at a site remote from the index polyp during the same follow-up period. These data further support the recommendation for excision of all colonic polyps greater than or equal to 10 mm in diameter. Periodic examination of the entire colon is recommended in this group of patients to identify neoplasms arising at a site remote from the index polyp. Although this study has limitations inherent to any retrospective analysis, comparable prospective data are unlikely to be available in the future because of the current widespread availability of colonoscopy.

Actuarial Analysis↗
PubMed1986

[Endoscopic diagnosis and management of colonic polyps].

Colonoscopic diagnosis of colonic polyps is a rather easy task, although some small polyps might be missed when they are situated around the steep angulation or behind the fold. A correct diagnosis of mucosal carcinoma is difficult not only by colonoscopy but also by biopsy because the cancer focus may be small or not exposed on the polyp surface. Therefore, colonoscopic polypectomy is the best procedure of choice for correct histologic diagnosis of mucosal and invasive carcinoma. Only by polypectomy can correct diagnosis of invasive carcinoma be made, although there are various endoscopic signs such as irregularity of the surface configuration and white spots on the surrounding mucosa suggesting invasive carcinoma. Over the course of several years experience of colonoscopy we have encountered small flat elevations under 1 cm in diameter of which 58% were benign adenomas and 42% contained minute foci of carcinoma. These small flat lesions might have been missed quite easily during routine examination in the past and they might play an important role in the pathogenesis of colonic carcinoma. Benign polyp and mucosal carcinoma can be adequately treated by polypectomy only, whereas invasive carcinoma needs further treatment as it has a risk of node metastasis. Risk factors influencing metastasis are lymphatic permeation, poorly differentiated carcinoma, massive invasion close to the cut end. Only when one of these findings is seen in the removed polyp, further surgical treatment must be considered. However, the patient's general condition, age and site of the polyp should be carefully taken into account in order to choose the appropriate treatment in each individual case as the risk of metastasis under such situations mentioned above is not so high. Management of invasive carcinoma is still a controversial issue and a long-term, clinicopathologic study will be needed to solve this question.

Biopsy↗
PubMed1987

Multiparameter flow cytometric analysis of colon polyps.

Sixty-eight colonic polyps of various histologic types were studied using retrospective flow cytometric (FCM) DNA analysis to determine the prevalence of aneuploid cell populations and whether they were associated with any particular histologic features. Overall, 13 of 68 polyps (19%) contained DNA-aneuploid cells, including 3 of 9 villous and 4 of 10 villoglandular polyps with histologic features of carcinoma in situ (CIS), 4 of 11 villous and 1 of 18 villoglandular polyps without CIS, and 1 of 12 adenomatous polyps. Eight hyperplastic polyps were diploid. These results show retrospective FCM analysis can detect DNA aneuploidy in polyps; DNA aneuploidy may occur before histologic evidence of invasive carcinoma; and this change is more frequent in types of polyps thought to have increased malignant potential (i.e., those with villous morphology and/or CIS).

Adenoma↗
PubMed2004

[The recurrence rate of colon polyp after polypectomy and the interval of surveillance colonoscopy: predictors of early development of advanced polyp].

BACKGROUND/AIMS: Surveillance of individuals with colon polyps is important for the prevention of colon cancer, and its interval is based on the clinical status. Our aims were to determine the recurrence rate of advanced polyp after polypectomy and estimate the adequate interval of surveillance colonoscopy as well as the risk factors of recurrence in Korea. METHODS: Ninety-seven patients who underwent follow-up colonoscopy after initial colonoscopic polypectomy were retrospectively studied. All polyps were endoscopically removed with electrocautery. RESULTS: Mean number of initial polyps were 2.2 and advanced polyps were observed in 40% of the patients. The cumulative recurrence rate of colon polyp was 13.8% within 1 year, and 60% within 3 years, while that of advanced polyps was 2.5% and 31% within 1 and 3 years, respectively. The significant difference was noted according to the initial polyp number in both overall and advanced polyp recurrence rate. The age at the diagnosis of colon polyps was a significant factor only in overall polyp recurrence rate. Patients who initially had one polyp showed 15% of advanced polyp recurrence within 3 years. CONCLUSIONS: Recurrence of advanced polyp is very rare within one year after polypectomy. Patients with single polyp have low risk and thus, their surveillance may be delayed beyond the standard 3 years. When surveillance colonoscopy is to be performed for the patients with 2 or more polyps, initial polyp number and age should be considered.

Aged↗
PubMed2006

[Application of CT colonography in diagnosis of colonic polyps].

OBJECTIVE: To assess the clinical values of CT colonography (CTC) in the diagnosis of colonic polyps. METHODS: Forty-two patients who were clinically suspicious of colonic polyps or underwent colonic polyps screening received both CTC and conventional colonoscopy. Sixteen or 64-slice spiral CT and professional imaging processing techniques were used for evaluation. Per-polyp and per-patient results were analyzed. Those by per-polyp were subsequently divided into > or = 10 mm group, 5-10 mm group, and < or = 5 mm group. Sensitivity, positive predictive value (PPV), specificity, negative predictive value (NPV), and accuracy were calculated using statistical method for diagnostic studies, with conventional colonoscopy as a gold standard. RESULTS: Ninety and 61 polyps were found by CTC and conventional colonoscopy, respectively. Sensitivity and PPV were 80.3%/55.6% by per-polyp and 100%/92.9%, 93.8%/65.2%, and 68.8%/ 41.5% in the > or = 10 mm group, 5-10 mm group, and < or = 5 mm group, respectively. Sensitivity, PPV, specificity, NPV, and accuracy by per-patient were 97.1%, 89.5%, 42.9%, 75.0%, and 88.1%, respectively. CONCLUSION: CTC can clearly reveal the morphology of colonic polyps and can be used as a routine monitoring method for the clinical diagnosis of polyps.

Adult↗
PubMed1985

Increased activities of thymidine kinase isozymes in human colon polyp and carcinoma.

Thymidine kinase (TK), the enzyme in the pyrimidine salvage pathway, and its isozymes were examined in 15 specimens of normal mucosa, 14 polyps and 14 carcinomas in human colon. The average TK activities in colon polyps and carcinomas were about 1.6 and 2.9 times that in normal colon mucosa, respectively. The colon TK isozymes were separated into 2 types by DEAE-cellulose column chromatography. The activity of the TK isozyme eluted with 0.1 M NaCl in buffer was 1.6-fold higher in colon polyp and 1.5-fold higher in colon carcinoma than that in normal colon mucosa. In colon carcinoma, but not colon polyp, the activity of the other isozyme eluted with buffer alone was increased to 5.1-fold that in normal tissues. As the activity of the latter isozyme was not affected by deoxycytidine triphosphate, it may be involved in DNA replication. The results suggest that increases in the activities in the former and latter TK isozymes may indicate tumorigenesis and carcinogenesis, respectively, in the human colon.

Adult↗
PubMed1994

The effect of sulindac on colon polyps: circumvention of a transformed phenotype--a hypothesis.

Sulindac suppresses the growth of colon polyps in Gardner syndrome and familial adenomatous polyposis. The mechanism of action is not known. The problems are to ascertain the significance of high prostaglandin concentrations in transformed cells, colon polyps and cancers and to explain how sulindac restores normal growth patterns. A few clinical observations and an abundance of experimental data can be integrated to produce a reasonable model based on current biochemical and physiologic concepts. A fundamental defect in the formation of colon polyps is mutation of the APC (adenomatous polyposis coli) gene that leads to inadequate suppression of proliferation. There is high PGE2 content in colon polyps and cancers, presumably the result of stimulation by protein kinase C (PKC). In small quantities it stimulates cyclic AMP production but with persistent high concentrations it desensitizes and down-regulates specific PG receptors and inactivates adenylate cyclase, cAMP synthesis, and the cAMP-dependent mechanism for control of proliferation. The PKC pathway is thereby unopposed. It is hypothesized that restriction of PG synthesis by sulindac is accompanied by resensitization of PG receptors, and reactivation of the cAMP-dependent pathway for control of cell growth. It is further postulated that restoration of cAMP synthesis and protein kinase A activity converts a functionally inadequate mutant APC suppressor gene to one sufficient to inhibit colon polyp formation.

Colonic Neoplasms↗
PubMed1999

Symptomatic colonic polyps in childhood: not so benign.

BACKGROUND: The clinical spectrum of symptomatic polyps and the frequency of familial polyposis is not well defined in children. In the present study, a series of children with juvenile polyposis coli (JPC) and non-JPC polyps were studied. METHODS: Children with symptomatic colonic polyps and negative family history of polyps were ascertained by review of endoscopic records. Juvenile polyposis coli was defined as 10 or more juvenile polyps or any juvenile polyp in a relative of an index case of JPC. Polyps were tested for Ki-ras mutations, p53 overexpression, and aneuploidy. RESULTS: Seventy-eight children (age range, 0.4-18 years) were identified, all evaluated for lower gastrointestinal bleeding. Nine (12%) had JPC, 66 (84%) had isolated juvenile polyps, and 3 (4%) had other types of polyps. The JPC and non-JPC groups were similar in age (p = 0.4) and symptom duration (p = 0.3). The JPC group had more polyps (p = 0.0001), and greater likelihood of anemia (p = 0.01), polyps with adenomatous change (p = 0.03), and right-colon polyps (p = 0.001). In three of eight JPC families, polyps were identified in asymptomatic first-degree relatives. No abnormalities in Ki-ras, p53, or aneuploidy were identified. CONCLUSIONS: Juvenile polyposis coli is common in children with symptomatic polyps, and is associated with anemia, right-colon polyps, and adenomas. The risk of polyps and of colorectal cancer in relatives of persons with JPC requires further study.

Abdominal Pain↗