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At least 631 records · Page 35Linked to original sources
PubMed2004

Colon cancer specific nuclear matrix protein alterations in human colonic adenomatous polyps.

Most colon cancers arise within preexisting adenomatous polyps or adenomas. The slow evolution from the non-invasive premalignant lesion, the adenomatous polyp, to invasive cancer supports a strategy of early detection. Recently, we identified unique nuclear matrix proteins (NMPs) specific for colon cancer (CC2, CC3, CC4, CC5). Most of the NMPs identified are common to all cell types, but several identified NMPs are tissue and cell line specific. The objective of this study is to describe and characterize the NMP profile of premalignant adenomatous colon polyps. Specifically when in the adenoma-carcinoma sequence four specific colon cancer NMPs, previously described, appear. Using two-dimensional (2-D) gel analysis 20 colon polyps (one juvenile polyp, six tubular adenoma (TA), seven tubulovillous adenoma (TVA), six TVA with focal high-grade dysplasia (HGD), were analyzed for the presence of four (CC2, CC3, CC4, CC5) specific NMPs. CC2 was not seen in any of the premalignant polyps. CC5 was present in only two premalignant TVA with HGD and in one TA. CC3 and CC4 were present in most adenomas. None of the NMPs were seen in the juvenile polyp, which is not considered to be a precursor of colon cancer. CC2 and CC5 are NMPs expressed at the junction of an advanced adenoma and invasive colorectal cancer. CC3 and CC4 are expressed earlier in the evolution of adenomatous polyps. Development of an assay to these proteins may serve as a new method for early detection of colorectal cancer.

Adenomatous Polyps↗
PubMed1986

[Importance of the dimensions and histologic nature of polyps of the colon in a comparison between double contrast enema and colonoscopy].

In 244 patients the results obtained by double contrast barium enema and endoscopy in the detection of small colonic polyps were compared. The results were evaluated by subdividing the polyps according to size. In order to define the endoscopic false positives percentage, controversial cases were re-examined with a second double contrast barium enema. The authors put forward a few considerations on the suitability of diagnosing small colonic polyps on the basis of their histologic nature.

Barium Sulfate↗
PubMed1988

Beta-endorphin-like immunoreactivity in normal mucosa, muscle layer, adenocarcinoma, and polyp of the colon.

beta-Endorphin-like immunoreactivity was detected in the mucosa and muscle layer of normal colon, adenocarcinomas derived from the colon mucosa, and colon polyps which were histologically confirmed to be adenoma without a focus of carcinoma or with in situ carcinoma. The contents of beta-endorphin-like immunoreactivity in adenocarcinomatous tissue (11.94 +/- 1.77 pmol/g wet wt) and colon polyps without focus of carcinoma (10.71 +/- 1.50 pmol/g wet wt) were found to be significantly higher than those in the mucosal layer (6.86 +/- 0.64 pmol/g wet wt) and muscle layer (8.30 +/- 0.68 pmol/g wet wt) of normal colon. These data suggest that the production of beta-endorphin-like immunoreactivity is specifically increased in some adenocarcinomas and adenomatous polyps and may be related to the alteration of bowel habits. Gel exclusion chromatography of beta-endorphin-like immunoreactivity revealed three peaks corresponding to beta-endorphin, beta-lipotropin, and an immunoreactive form between the two. In the mucosal layer and muscle layer of the colon, a broad major peak was eluted at the position of beta-endorphin, and minor peaks were eluted at the position of beta-lipotropin and between beta-endorphin and beta-lipotropin. In adenocarcinoma and polyp, the peak size corresponding to authentic beta-lipotropin was greater than that of beta-endorphin. This study demonstrated that beta-endorphin-like immunoreactivity existed at a high concentration in some colon adenocarcinomas and polyps whose elution patterns were different from those of normal colon tissue.

Adenocarcinoma↗
PubMed2003

Avoiding surgery in patients with colorectal polyps.

PURPOSE: Colonic polyps are sometimes difficult to remove endoscopically and are referred for surgical resection. This study was performed to determine how many polyps referred for surgery could actually be managed endoscopically. METHODS: An endoscopic database with data entered prospectively and consecutively was used to identify patients referred for surgery for a colonic polyp. Rectal polyps were excluded. All patients underwent colonoscopy before surgery to see if the polyp could be managed endoscopically. Cases were reviewed to see the method and outcome of treatment. RESULTS: The study population consists of 58 patients referred for surgical resection of a colorectal polyp. Endoscopic polypectomy was initially successful in 48. Five of the 48 needed surgery later for a final success rate of 43/58 avoiding surgery. There were no deaths, four complications of endoscopic polypectomy (three bleeds, one post-polypectomy syndrome) and two patients had complications of surgery (one splenic injury, one ventral hernia). Polyps ranged in size from 1.5 cm to 8.0 cm. Seven polyps contained invasive cancer (three needing surgical resection), eight contained intramucosal cancer (one operated) and 11 had severe dysplasia (three operated). Rate of persistent polyp was 16/37 at first follow up, 7/23 at second, 1/14 at third and 0/8 at fourth. CONCLUSION: Most polyps referred for surgical resection were successfully managed endoscopically. Patients with colonic polyps that are difficult or potentially dangerous to remove endoscopically should be sent for a second opinion before surgery is performed.

Aged↗
PubMedDate not supplied

Laparoscopic colectomy in the management of large, sessile, transformed colorectal polyps.

BACKGROUND: Colonic polyps are usually removed endoscopically. Surgical intervention is reserved for large, inaccessible colorectal polyps that have underdone malignant transformation. Laparoscopic management of colonic polyps has gained a well-defined role. METHODS: Since 1993, 650 laparoscopic colectomies have been performed in our department. Twenty-eight patients with large, sessile, polyps that have undergone malignant transformation underwent elective laparoscopic colectomy. Operative procedures included 14 sigmoidectomies, 10 low anterior recto-sigmoid resections, 3 right colectomies, and 1 left colectomy. Central ligation of vessels and lymph node dissection were preformed in all patients. RESULTS: The main outcome measures include conversion rate (11%), morbidity (11%), and mortality (3.5%). The mean return of bowel function was 3.1 days, liquid intake 1.4 days, solid food intake 2.5 days, and mean hospital stay 8 days. The mean specimen length was 23 cm, and the mean number of retrieved lymph nodes was 15. Malignancy according to Dukes classification was in situ, n=4; A, n=15; B, n=4; C, n=4; and D, n=1. During follow-up, 2 patients developed liver metastases. CONCLUSION: Laparoscopic colectomy is a technically feasible and effective method for treating large colorectal polyps that have undergone malignant transformation.

Aged↗
PubMed1995

Intestinal protein loss and bleeding assessed by fecal hemoglobin, transferrin, albumin, and alpha-1-antitrypsin levels in patients with colorectal diseases.

Four fecal proteins (hemoglobin, transferrin, albumin, and alpha 1-antitrypsin) were measured by enzyme-linked immunosorbent assay (ELISA) in patients with colorectal diseases. Levels of all 4 proteins were significantly increased in patients with colonic cancer and ulcerative colitis (UC) compared to levels in control subjects, while fecal alpha 1-antitrypsin was particularly elevated in colonic Crohn's disease (CD). That is, the fecal protein pattern of CD was distinct from those of colonic polyps, colonic cancer, and UC. To investigate whether levels of these fecal proteins reflect disease activity in UC and CD, comparative evaluation of fecal proteins in the active and inactive phases was performed. In UC, differences in the fecal concentrations of all 4 proteins were significant between the active and inactive phases of the disease. In CD, however, the difference in alpha 1-antitrypsin concentration was significant. Our results suggest that measurements of these 4 fecal proteins would be useful in the screening of colorectal diseases. In addition, these markers can also be used as indicators of disease activity in inflammatory bowel diseases.

Adult↗
PubMed1987

Polyps of the colon in juvenile and young patients: histological type and C.E.A. content in relation to follow-up.

31 colonic polyps in 21 patients between 2 and 30 years of age removed by endoscopy were studied. The site, size, cytohistological characteristic and tissue CEA content of these polyps were evaluated. 58% of the polyps were located in the rectum and sigmoid, the remaining 42% were in the descending colon. At histological examination 13 polyps proved to be neoplastic, 3 of which had severe dysplasia. In 3 cases of juvenile hyperplastic hamartomatous polyps and in 5 cases of inflammatory polyps the tissue C.E.A. was low; in 13 neoplastic polyps it was in direct correlation with the degree of dysplasia. Moreover in 10 patients with neoplastic polyps, 5 presented further adenomas at follow-up, and in 3 of them the C.E.A. tissue content of the first polyps obtained was medium to high. The occurrence in young patients of polyps of the colon with C.E.A. content medium to high must be followed by endoscopic examination at close intervals.

Adolescent↗
PubMedDate not supplied

[Non-neoplastic polyps of the colon].

Non-neoplastic colon polyps are benign lesions with normal histology components, we present our experience with colonoscopy polypectomy in 10 years. We resected 187 polyps in 96 patients (50 males) with medium age of 49.3 years and range 2-82. Most common indication was hemorrhage (37%) taking out the hyperplastic polyps who were found in asymptomatic patients with the highest frequency (41%). Juvenile polyps follows with 25%. 71% polyps were unique but hamaetomatous polyps of Peutz-Jeghers syndrome were multiple (39%). Juvenile (retention) polyps were found among the youngest patients (average 13.2 years) and frequently had hemorrhage (21-25). Lipomas were found in elder patients (range 52.5 years). We had no major complications with hemorrhage or mortality, minor complications were found in 3.09%.

Adolescent↗
PubMed1986

Mixed hyperplastic and neoplastic polyp of the colon. An immunohistological study.

A small colonic polyp which was composed of equal parts of hyperplastic and adenomatous tissue sharing a common basement membrane, displayed a paradoxical distribution of immunohistological markers: In contrast with the neoplastic component, the hyperplastic tissue lacked signs of functional maturity (IgA, secretory component) and displayed markers associated with carcinoma (carcinoembryonic antigen, peanut-agglutinin binding).

Adenoma↗
PubMed1993

Effects of oral calcium supplementation on intestinal bile acids and cytolytic activity of fecal water in patients with adenomatous polyps of the colon.

Calcium has been proposed to prevent colon cancer in subjects at risk for this tumour. This effect is supposed to be due at least in part to binding the bile acids to calcium, making them insoluble and harmless. To evaluate the effects of oral calcium supplementation on intestinal bile acids, 19 patients with adenomatous colonic polyps were supplemented with 35.5 mmol Ca2+ daily for 12 weeks. Duodenal bile, 24-h feces and 24-h urine were collected before and at the end of the 12-week period. In duodenal bile proportional concentration of cholic acid increased (38 +/- 4 vs. 51 +/- 3%, P < 0.001), whereas that of chenodeoxycholic acid decreased (35 +/- 3 vs. 25 +/- 2%, P < 0.01). Total fecal bile acid excretion increased (950 +/- 126 vs. 1218 +/- 137 mumol 24 h-1, P < 0.01), with proportional concentrations of the main primary and secondary bile acids remaining the same. Cytolytic activity of fecal water, measured by the degree of lysis of erythrocytes by the water, decreased (45 +/- 8 vs. 30 +/- 7%, P < 0.05). Total excretion of calcium increased as expected from the supplementary dose. It is concluded that calcium supplementation markedly affects intestinal bile acids and lytic activity of fecal water and that, in view of similar results during 1-week calcium supplementation in young healthy subjects, these effects remain constant over at least 3 months and occur both in healthy persons and in patients at increased risk for colon cancer.

Bile Acids and Salts↗
PubMed1993

[Endoscopic resection of 49 polyps of the colon and rectum larger than 2 cm].

The management of rectal and colonic polyps has changed since the advent of endoscopic polypectomy, that interrupts the adenoma-carcinoma sequence. We assessed the effectiveness, limitations, morbidity and mortality of endoscopic polypectomy in 49 polyps larger than 2 cm in diameter. Polypectomy was successful in 94% of polyps, which were predominantly located in left colon (92%) and were pedunculated (87%). A malignant component was found in 28.3% of polyps, that was observed with higher frequency in larger and sessile polyps and in male patients. There was no mortality and scarce morbidity related to the procedure. It is concluded that polypectomy is a low risk procedure that can be frequently performed in ambulatory patients and that endoscopists must suspect malignancy in polyps larger than 2 cm in diameter.

Adolescent↗
PubMed1990

The association of multiple colonic adenomatous polyps with cancer of the colon.

We reviewed our colonoscopy data for the past 10 yr for patients with five or more polyps to determine the association of multiple adenomatous polyps and colon cancer. During that period, 3,834 patients underwent colonoscopy. Fifty-two patients with five or more polyps at the initial colonoscopy were found. In 25 patients (group I) there were at least five synchronous adenomas, and in 27 patients (group II) a combination of adenomas and hyperplastic polyps totaling five or more. The number of polyps ranged from five to 30 (median, six). There was no significant difference in the location of polyps between groups I and II. Eight of 52 patients (15%) were found to have colon cancer at the initial colonoscopy. In group I, there were six cancers (24%), five of which were in the cecum. Two of 27 patients (7%) in group II had cancer, one of which was located in the cecum. Patients with five or more adenomas at the index colonoscopy are at high risk of having colon cancer that is particularly prone to arise from the right side of the colon.

Adenoma↗
PubMed2001

NF-kappaB, p38 MAPK and JNK are highly expressed and active in the stroma of human colonic adenomatous polyps.

The factors that govern the progression from colonic adenomatous polyp to colon cancer are poorly understood. The observation that NSAIDs act as chemopreventative agents and reduce the size of colonic polyps suggests the involvement of inflammatory signalling, but inflammatory signalling in colonic polyps has not been studied. We investigated the expression of the active forms of NF-kappaB, JNK and p38 MAPK using immunohistochemistry with activation specific antibodies in human colonic adenomas. We show that active NF-kappaB is seen in stromal macrophages that also express COX-2 and TNF-alpha, active JNK is seen in stromal and intraepithelial T-lymphocytes and periendothelial cells of new blood vessels, and active p38 MAPK is most highly expressed in macrophages and other stromal cells. These results demonstrate the presence of active inflammatory signal transduction in colonic polyps and that these are predominantly in the stroma. In the case of NF-kappaB this coincides with the cellular localisation of COX-2. These results support evidence that NSAIDs may act through effects on stromal cells rather than epithelial cells.

Adenomatous Polyps↗
PubMed1993

Delayed presentation of an inflammatory polyp following colonic ischemia.

Inflammatory polyps are usually associated with inflammatory bowel disease. The majority of these lesions are asymptomatic, however, they may be a source of obstruction or hemorrhage. These polyps represent re-epithelialization of the damaged colonic mucosa. Although inflammatory polyps have been associated with the acute phase of ischemic colitis, there has been only one report of delayed presentation of a symptomatic inflammatory polyp following ischemic injury to the colon. We present the second such report and a review of the literature.

Aged↗
PubMed1976

Multiple dermal perifollicular fibromas with polyps of the colon -- report of a peculiar clinical syndrome.

In the present study, a peculiar fibromatosis cutis in two siblings has been reported, the dermatosis being characterized by innumerable perifollicular fibromas on face, neck and trunk as well as multiple fibromata pendulantia. Since the father allegedly had skin lesions resembling those of his two affected children, an inherited condition is assumed for the disease which manifests itself rather late in age. In the female patient, several adenomatous colon polyps were found, one transformed into an incipient carcinoma. Since the clinical and dermatohistological features are anything but typical of Gardner's syndrome and, in particular, hamartomalike fibromas of the perifollicular hair sheath are not constituents of its well-known skin tumour complex, we have discussed in detail the possibility of a peculiar cutaneo-intestinal syndrome hitherto unknown.

Adult↗
PubMedDate not supplied

Gastrointestinal endoscopic polypectomy.

Recent advances in the field of gastroenterological endoscopy have now embraced endoscopic polypectomy. Experiences at the Royal North Shore Hospital over a period of one year include 42 colonic and three gastric polypectomies. Rectal bleeding was the main presenting feature in the patients with colonic polyps. All colonic polyps were situated between the sigmoid and transverse colon. Eighteen polyps were under 1 cm in size, 15 between 1 and 2 cm and nine over 2 cm. There was one carcinoma detected in each of these groups. No significant complications were encountered with any of these patients. The high yield of malignancy, none of which could be suspected on clinical or radiological grounds, more than justifies the introduction of this endoscopic procedure which will offer considerable saving from both the point of view of economic factors and personal discomfort.

Adenocarcinoma↗
PubMed1976

Generalized dermal perifollicular fibromas with polyps of the colon.

The cases of 2 siblings with a rare, generalized genodermatosis have been reported, the most conspicuous feature being multiple perifollicular fibromas. In this type of dermal hamartomas, an apparent autosomal dominant trait was noted as well as the association with a small number of colon polyps in one of the patients. The author assumes a distinct dermo-intestinal syndrome not reported hitherto, which can be differentiated from Gardner's syndrome.

Adult↗