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PubMed1991

Clinical study of a new fecal occult blood test using a combination assay of hemoglobin and transferrin.

The applicability of a new immunological fecal occult blood test in which hemoglobin (Hb) and transferrin (Tf) are simultaneously assayed was evaluated. The mean absorbance and standard deviation (510/630 nm) obtained by this test was 0.840 +/- 0.805 in 51 fecal samples from patients with colon cancer, 0.248 +/- 0.305 in 95 samples from patients with colon polyps, and 0.104 +/- 0.053 in 110 samples from control patients; these values differed significantly (P less than 0.005). Hb and Tf concentrations were separately determined in the same fecal samples, and qualitative evaluation was performed with a cutoff value of 5.1 micrograms/g feces for Hb and 0.4 micrograms/g feces for Tf. Hb or Tf was positive in 41 of the 51 samples in the colon cancer group, 33 of the 95 in the colon polyp group, and 3 of the 110 in the control group. Qualitative analysis of the values obtained by the combination assay of Hb and Tf with a cutoff value of 0.200 revealed positive rates of 41/51 in the colon cancer group, 33/95 in the colon polyp group, and 4/110 in the control group. These results suggest the usefulness of a combination assay of Hb and Tf as a fecal occult blood test.

Aged↗
PubMed2005

Angiogenesis in colon hyperplastic polyp.

Despite the significance of tumor angiogenesis and the extensive knowledge on the molecular basis of blood vessel formation in carcinoma of colorectum, no data exist in hyperplastic polyp. This prompted us to examine angiogenesis in hyperplastic polyp. Eleven small hyperplastic polyps, 13 large hyperplastic polyps and their adjacent normal mucosas were included in this study. Angiogenesis was assessed by immunohistochemistry using monoclonal antibody against CD34. Angiogenic factor, thymidine phosphorylase was also examined by immunohistochemistry. Intra-tumoral microvessel density (IMD) in large hyperplastic polyp was significantly higher than that in small hyperplastic polyp (P<0.01) and that in normal mucosa (P<0.01). DAD in small hyperplastic polyp was also significantly higher than that in normal mucosa (P<0.01). Expression of dThdPase was almost observed in stromal cells in normal, small and large hyperplastic polyp. In addition, the proportion of the stromal cells expressing dThdPase in large hyperplastic polyp was significantly higher than that in small hyperplastic polyp and normal tissue (P<0.01, respectively). The proportion of the stromal cells expressing dThdPase in small hyperplastic polyp was significantly higher than that in normal tissue (P<0.01). The present study provides that angiogenesis may have an important role(s) in the development of hyperplastic polyp and dThdPase in stromal cells may support angiogenesis in hyperplastic polyp. Anti-angiogenic therapy might be available for suppression of hyperplastic polyp.

Antigens, CD34↗
PubMed1990

Colon cancer and polyps in acromegaly: increased risk associated with family history of colon cancer.

A cohort of 52 subjects diagnosed with acromegaly in southeastern Michigan and northern Ohio between 1935 and 1985 were followed to determine the incidence of colon cancer and polyps. Medical records were reviewed, subjects or their next-of-kin were interviewed, and screening examinations of the colon were offered to the living patients who were located. Data on demographics, personal histories of cancer and colon polyps, family history of colon cancer, and cure from acromegaly were obtained for both living and deceased subjects. The risk for colon cancer compared to the general population was estimated using standardized incidence ratios (SIRs). The expected number of cases was determined utilizing age, sex and race-specific rates provided by the cancer registry in southeastern Michigan. Among the 52 subjects, one could not be located and nine were deceased, none from colon cancer, with one known to have a history of colon polyps. Of 13 (31%) who declined the screening physical, one had a history of polyps and none reported a history of colon cancer. Two of 29 screened patients were found to have right-sided adenocarcinoma of the colon. Of the entire cohort, eight people (including one deceased) had a current or previous diagnosis of polyps, with five known to be histologically adenomatous. The SIR for colon cancer was 4.7 (95% confidence interval 0.6-17.1). Seven subjects, including the two with detected adenocarcinoma and four of the six living subjects with polyps only, reported a family history of colon cancer. The SIR for the subset of subjects with a family history of colon cancer was 29.1 (95% confidence interval of 3.5-104.6).(ABSTRACT TRUNCATED AT 250 WORDS)

Acromegaly↗
PubMed1989

Gastrointestinal polyposis syndromes.

Well recognized cutaneointestinal syndromes in which colonic polyps are a constant and defining feature include Gardner's syndrome (familial adenomatous polyposis), Peutz-Jeghers syndrome, and Cronkhite-Canada syndrome. Colonic polyps are also found with increased frequency in Cowden's disease, the Muir-Torre syndrome, and neurofibromatosis. The Ruvalcaba-Myhre-Smith syndrome is a newly defined entity in this category. The relationship between acrochordons and colonic polyps remains a controversial issue, awaiting additional studies.

Humans↗
PubMed2000

Endoscopic resection of small inflammatory fibroid polyp of the colon.

Inflammatory fibroid polyp (IFP) is a solitary intestinal lesion of unknown etiology. Although IFP is benign, laparotomy for the resection of colonic IFP is performed in most cases because the polyp is usually large. We report a successful endoscopic resection of cecal IFP. It is considered that colonic IFP should be resected endoscopically if the polyp is small and is located submucosally.

Colonic Polyps↗
PubMed1979

[Colonoscopic polypectomy. Histopathological features and course (author's transl)].

A study of 424 colonic polyps resected electrically via colonic fibroscopy in 343 patients, in several Parisian centers between september 1972 and august 1976. The topography, shape, diameter and histological type of the polyps were analysed, and 14.3% were malignant. Study of the prevalence of the different histological types in subjects of the both sexes, by ten year age groups, revealed the large number of villous and adenocarcinomatous forms in the young woman. The preponderance and increase with age of villous forms in the male explain the marked shift in histological forms towards malignancy seen after the age of 60. The average time taken for transformation of a benign polyp already accessible to endoscopic resection into a killing recto-colic carcinoma may be 13 years. Initial results of the follow-up, of 83 patients undergoing 101 colonoscopic polypectomies, and despite inadequate follow-up, indicated that 9% of polyps recurred (above all, villous and adenovillous polyps), and the absence of local recurrence or metastases detectable after electrical resection of 17 colonic polyps with invasive adenocarcinoma must be taken with great reserve.

Adenocarcinoma↗
PubMed1984

Sebaceous gland tumors and systemic disease: a clinicopathologic analysis.

The association of sebaceous gland neoplasms with visceral carcinomas, first described by Muir and Torre, has become widely recognized. The purpose of our study was to determine the prevalence of malignancy, other associated diseases, and familial carcinoma in patients who had one or more cutaneous lesions within the spectrum of sebaceous adenoma, epithelioma, or carcinoma. Our histopathology files contained tissue from 59 such cases. Overlap between the categories was common, often precluding precise histologic classification. Of the 59 patients, 25 (42%) had one or more primary visceral malignancies. These totaled at least 49, of which 25 were colonic, 9 urogenital, 5 hematologic, 4 breast, and 6 miscellaneous. Fifteen patients (25%) had colonic polyps, most often multiple; and at least one primary carcinoma of the colon appeared in 10 of these, initially or later. Other less common findings included uterine fibroids, thyroid adenomas, and benign renal cysts. A family history of carcinoma was found in 72% of cases with visceral malignancy, most often of the colon and stomach. We conclude that sebaceous neoplasms form a histologic continuum, and strong associations with colonic polyps, internal malignancy, and a family history of carcinoma are apparent.

Adenocarcinoma↗
PubMed2001

[Morphometry in the diagnosis of colon villous polyps].

Endoscopic biopsies were carried out in 62 patients with colon villous adenomas and 28 patients with colon adenocarcinomas. Differential-diagnostic schemes of evaluation different morphological versions of colon villous adenomas were used for processing results of hystological investigations. These schemes were offered by G.G. Avtandilov et all. Multifactorial analysis of diagnostic features showed a possibility of transition from villous adenoma to adenocarcinoma.

Adenocarcinoma↗
PubMed2001

[Hydrocolonic sonography--potentials and limitations of ultrasonographic diagnosis of colon diseases].

Hydrocolonic sonography - potentials and limitations of ultrasonographic diagnosis of colon diseases. Ultrasonic examination has become increasingly important in the diagnosis of diseases of the gastrointestinal tract. In neoplastic diseases of the large intestine, however, the diagnostic value of conventional transabdominal sonography is limited. The sonographic evaluation of the colon could be improved by the retrograde instillation of water into the colon in a procedure called hydrocolonic sonography. This technique allows the visualization of the colon sonographically from the rectosigmoid transition to the cecum. Hydrocolonic sonography enables a detailed sonographic examination of the hypoechoic colonic lumen, the five individual layers of the colon wall and the surrounding connective tissue, thus providing additional information and allowing a more precise diagnosis of many diseases of the colon. Colonic polyps and carcinomas appear sonographically as echogenic structures projecting from the intestinal wall into the lumen. Colonic polyps larger than 7 mm in diameter and carcinomas of the colon can be detected with great sensitivity. In addition, detailed evaluation of the structure of the bowel wall permits more precise staging of tumors of the colon. Aside from such localized changes, hydrocolonic sonography can also demonstrate changes in the wall structure in chronic inflammatory large bowel diseases such as Crohn's disease and ulcerative colitis. In addition hydrocolonic sonography has been proven to be of great value for the ultrasonographically-guided hydrostatic reduction of intussusception in children. On the other hand virtual colonoscopy is another promising new imaging method for the diagnosis of colon diseases. The differences between hydrcolonic sonography and virtual colonoscopy and their potential for screening purposes of colon cancer will be discussed.

Colon↗
PubMedDate not supplied

Leiden mutation (as genetic) and environmental (retinoids) sequences in the acute and chronic inflammatory and premalignant colon disease in human gastrointestinal tract.

BACKGROUND: Tumor, calor, dolor, pallor and functio laesa are together involved in the different acute and chronic inflammatory processes. The processes involved in the inflammation are determined by differently acquired and hereditary factors. Recently the presence of a new genetic marker (Leiden point mutation) was found in Crohn's disease and ulcerative colitis. On the other hand, the GI mucosal integrity was proven on gastrointestinal mucosal damage to be produced by different chemicals, xenobiotics, drugs. In human observations, the serum level of retinoids (vitamin A, lutein, zeaxanthin, alpha-, beta-carotene) was proven in patients with chronic gastrointestinal inflammatory bowel disease. The aims of this study were (1) to measure the prevalence of Leiden mutation; (2) to identify the changes in the serum retinoid level in patients with Helicobacter pylori infection of the stomach (n=24), hepatitis C infection (n=75), ileitis terminalis (Crohn's disease; n=49), ulcerative colitis (n=35), colon polyposis (n=59) and adenocarcinoma in colon polyps (n=9), and 57 healthy persons were used in the control group; (3) to compare the directions of the changes in the measured parameters in the acute (H. pylori and hepatitis C infections), chronic (ileitis terminalis, ulcerative colitis) GI inflammatory diseases and in colon polyposis without and with malignisation. METHODS: The Leiden mutation was measured by the method of polymerase chain reaction, the retinoid level in the patient's serum was measured by high liquid cromathografic method (HPCL). RESULTS: (1) It has been found that the prevalence of Leiden mutation increased significantly in patients with ileitis terminalis (P<0.001), ulcerative colitis (P<0.001), colon polyposis (P<0.001) and with colon polyps with malignisation (P<0.01). (2) Serum level of vitamin A and zeaxantin were decreased significantly in all group of patients except for the group with H. pylori infections. (3) alpha- and beta-carotenes were found to be practically at the same level as those in the control groups, except in patients of colon polyps with malignisation. (4) The vitamin A, lutein, zeaxantin, alpha- and beta-carotenes were decreased in patients with ileitis terminalis. CONCLUSIONS: (1) The essential role of retinoids (carotenoids) as environmental factors are suggested for keeping GI mucosal integrity in human healthy subjects and patients. (2) Leiden mutation, as a genetic marker, can be used in the screening of patients with ileitis terminalis, ulcerative colitis and colon polyposis (without and with malignisation). (3) An opposite direction can be found between the increased prevalence of Leiden mutation and decrease of serum levels of retinoids in group of patients with ileitis terminalis, ulcerative colitis and colon polyposis (without and with malignisation).

Acute Disease↗
PubMed1997

Lack of spontaneous regression of tubular adenomas in two years of follow-up.

OBJECTIVE: Change in colon polyp size over time has not been well characterized. It has been inferred that some polyps will increase in size, leading to an increased risk of progressing to cancer, whereas other polyps may spontaneously regress. To develop a better understanding of the natural history of colon polyps, we prospectively investigated change in polyp size over a 2-yr period. METHODS: Patients were enrolled if they had an endoscopically detected proximal rectal or sigmoid polyp measuring 3-9 mm. The index polyp site was then permanently marked with an adjacent India ink tattoo to allow definitive future localization of the polyp. Patients underwent flexible sigmoidoscopy at 6-month intervals, and at each examination, the polyp size was carefully measured with open biopsy forceps. After a maximum of 2 yr, each polyp was removed and the histology determined. RESULTS: Thirty polyps were followed in 26 patients who completed the study. Twelve polyps were tubular adenomas (TA), one was tubulovillous, 14 were hyperplastic polyps (HP), two had no pathological diagnosis, and one was a leiomyoma. HP were more likely to decrease in size than were TA. Three polyps demonstrated fast growth rates (2-4 mm/yr), and all were TA. Two polyps were removed early because their size had reached 1 cm or more. Both of those polyps were TA. No polyps regressed completely during the 2 yr of the study; neither did we find consistent linear growth rates. CONCLUSIONS: In contrast to prior reports, in this study, after polyps had been definitively localized with India ink, we observed no complete polyp regressions.

Adenoma↗
PubMed1989

Skin tags are not a risk factor for colorectal polyps.

To ascertain whether acrochordons (simple skin tags) are associated with a higher risk for colon polyps, we prospectively studied 218 male and female patients, age 40 or older without history of colon cancer, polyps, ulcerative colitis, familial polyposis, or recent lower intestinal symptoms. Each patient was assessed for the presence of skin tags. A screening flexible sigmoidoscopy was then performed without knowledge of the dermatologic findings. All polypoid lesions were recorded, and patients with polyps greater than or equal to 3 mm in diameter underwent full colonoscopy and polypectomy. Twenty patients (9.2%) had documented adenomatous polyps on colonoscopy. Nineteen other patients had hyperplastic polyps and mamillations. There was no significant difference in the prevalence of polypoid lesions in those with skin tags compared with those without skin tags, either analyzed as group totals or stratified by age, sex, or type of polyp. We conclude that skin tags are not associated with a higher than usual risk for colonic polyps and should not be used as a marker for more intensive screening.

Adult↗
PubMedDate not supplied

[Complex recto-colic adenomatous and hamartomatous polyposis with hyperplastic gastric polyps in a 13-year-old girl].

We report the case of a 13-year-old girl who presented mixed polyposis coli and gastric polyps. The rectal and colonic polyps were of the adenomatous and hamartomatous type (i. e. juvenile and Peutz-Jeghers polyps) without any intermediate features; in the stomach, the polyps were of the hyperplastic type. Microadenomas of the appendix and lymphoid hyperplasia of the ileum were also found. The karyotype was normal and the HLA group was A2 B12. No family history of polyps was discovered. To our knowledge no such case (complex polyposis) has been previously described. The present findings suggest that the usual pathological classification of polyposis may be arbitrary and that various pathological types may represent different aspects of the same spectrum of disease. Absence of "intermediate" polyps rule out the hypothesis of the sequence "hyperplastic polyp-juvenile polyp-adenoma".

Adolescent↗
PubMed2005

Helicobacter pylori infection is associated with colon adenomatous polyps detected by high-resolution colonoscopy.

Helicobacter pylori (H. pylori) is associated with the development of cancer in the stomach, but both positive and negative associations were reported with colorectal neoplasia. We sought to determine whether H. pylori is associated with colon neoplasia in Japanese population. We examined 332 patients who underwent routine high-resolution total colonoscopy and serologic testing for IgG antibodies agonist H. pylori. Subjects who received cyclooxygenase-2 inhibitors or previous eradication therapy and those with borderline titer levels were excluded from data analysis (n = 27). Seronegative control subjects were from the same study population to maximize the representativeness. There were no significant differences in age and gender between the 2 patient groups. A significant increase in the incidence of adenomatous polyps (p < 0.0001) and decrease in normal colonoscopic findings (p < 0.0005) were observed in seropositive patients than those seronegative. Our study indicates an etiological link of H. pylori infection to colorectal neoplasia and the need of routine colonoscopy in seropositive patients.

Adenomatous Polyps↗
PubMedDate not supplied

Computer-aided detection of polyps in a colon phantom: effect of scan orientation, polyp size, collimation, and dose.

PURPOSE: To determine the importance of polyp size, orientation to the scan plane, collimation, scanner type (single or multislice helical), and radiation dose on computed tomography (CT) colonography computer-aided detection. MATERIALS AND METHODS: Eight tissue-equivalent simulated polyps were placed into the interior of an air-filled acrylic tube placed within a water-filled box. Their sizes, expressed by diameter and height in millimeters, were 10 x 10, 10 x 7, 10 x 5, 10 x 3, 7 x 7, 7 x 5, 7 x 3, and 5 x 5. Detection of the polyps was performed by applying our prototype automated polyp detector software to 48 CT colonography data sets of the phantom acquired with different CT scanner settings. RESULTS: We detected at least six of the eight polyps in 47 of 48 experiments. The two most frequently undetected polyps (7 x 7 and 5 x 5) had extreme eccentricity (their height was twice the radius of the base) and were most commonly missed for 90 degrees tube orientation, 5-mm collimation, and high table speed. False-positive detections occurred in only 5 of 48 experiments. CONCLUSION: Clinically significant 10-mm polyps can be detected with 100% sensitivity in all orientations, doses, collimations, and modes that we examined.

Artifacts↗
PubMed2000

Non familial juvenile polyposis presenting as chronic intestinal obstruction.

Juvenile polyps are the commonest colonic polyps seen in children and present most often with rectal bleed. Intussusception is an extremely rare presentation in juvenile polyposis (JP) syndrome. This case highlights the rare association of ileo-colic intussusception with non-familial Juvenile Polyposis.

Biopsy, Needle↗
PubMed1975

Large-bowel polypectomy via the colonoscope: experience with 80 polyps.

The experience of two colonoscopy units in managing 88 patients referred with 114 suspected colonic polyps are presented. Almost a quarter of the suspected polyps were artefacts, while some actual polyps were not visualized at the initial colonoscopy. All but 10 of the confirmed polyps were successfully snared. Morbidity was low. Five of the polyps were malignant. The technical aspect of snaring and of setting up colonoscopy units are discussed. It is considered that colonoscopic polypectomy is the optimum management of colonic polyps.

Adult↗