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PubMedDate not supplied

Eradication of diminutive polyps: a prospective evaluation of bipolar coagulation versus conventional biopsy removal.

Bipolar probe coagulation (BICAP) was evaluated and compared with conventional cold biopsy (CBx) as a potential therapeutic modality for eradication of diminutive colonic polyps (DPs). Seventy-seven and 79 DPs were treated with BICAP and CBx, respectively. Twenty-one percent of the BICAP and 29% of the CBx (p greater than 0.05) group had residual polypoid tissue detected at flexible sigmoidoscopy 3 weeks after treatment. Because of incomplete polyp removal, CBx and BICAP coagulation cannot be recommended as definitive therapies for DPs. Neoplasia was present in 22% of DPs located less than 60 cm from the anus, 73% of proximally located small polyps, and 32% of all DPs. Despite apparent eradication at the time of treatment, the incidence of residual polypoid tissue would suggest the need for critical evaluation of other modalities used to eradicate or remove DPs.

Adult↗
PubMed1985

Unscheduled DNA synthesis in mononuclear leukocytes from patients with colorectal polyps.

The mononuclear leukocytes from peripheral blood samples of individuals with (n = 30) and without (n = 48) colonic polyps were examined for their abilities to carry out unscheduled DNA synthesis (UDS) induced by N-acetoxy-N-2-fluorenylacetamide (N-AcO-2-FAA). Individuals with polyps had significantly reduced UDS values compared to the nonpolyp group (P less than 0.01). Furthermore, in a more comprehensive study, patients with hyperplastic polyps had N-AcO-2-FAA-induced UDS values not significantly different from control individuals who were asymptomatic and free from colonic disease as judged by complete colonoscopy. However, patients who had had adenomatous polyps in their large bowel had significantly reduced levels of N-AcO-2-FAA-induced UDS in their mononuclear leukocytes (P less than 0.005). When N-AcO-2-FAA binding to DNA determinations were made in parallel and DNA repair proficiency indices were calculated (i.e., N-AcO-2-FAA-induced UDS/N-AcO-2-FAA binding to DNA), the patients with adenomatous polyps were still shown to be deficient in carrying out DNA repair synthesis. Since adenomatous polyps of the large bowel are considered the premalignant lesion for colorectal cancer, we postulate that reduced UDS may be a genetically sensitive marker that is useful in studying the mechanisms of genetic predisposition to colorectal cancer.

Acetoxyacetylaminofluorene↗
PubMed2006

Humoral immune response to MUC5AC in patients with colorectal polyps and colorectal carcinoma.

BACKGROUND: MUC5AC is a secreted mucin aberrantly expressed by colorectal polyps and carcinoma. It has been hypothesized that aberrant expression of MUC5AC in colorectal carcinoma tissues increased the overall survival of patients with colorectal carcinoma. The present study investigates the incidence of naturally occurring MUC5AC antibodies in the sera of normal individuals, patients with colonic polyps and patients with advanced colorectal carcinoma. A second aim was to determine the relationship of MUC5AC antibody with the prognosis of colorectal carcinoma. METHODS: Free circulating MUC5AC antibodies were measured using an enzyme-linked immunosorbent assay with a synthetic peptide corresponding to an 8 aa. segment of MUC5AC tandem repeat region. Immunohistochemical analysis was completed to demonstrate MUC5AC expression in the polyp specimens. RESULTS: MUC5AC antibodies were detected in 6 of 22 (27.3%) healthy subjects, 9 of 20 (45%) polyp patients, 18 of 30 (60%) patients with colorectal cancer. The presence of circulating free MUC5AC antibody levels was significantly correlated with expression of MUC5AC in polyp sections. Serum MUC5AC antibody positivity was higher in patients with colon located tumors, advanced stage and poorly differentiated tumors were found negatively affecting patient survival in our study. MUC5AC antibody positivity was higher in patients with poor prognostic parameters. Disease free survival and overall survival were shorter in this group of patients. In the multivariate analysis MUC5AC antibody positivity didn't find an independent prognostic factor on prognosis. CONCLUSION: Decreased survival in colorectal carcinoma patients with MUC5AC antibody positivity may be due to a decrease in the MUC5AC expression in tumor tissues of surviving carcinoma patients.

Adult↗
PubMed1982

[Surgical treatment of malignant polyps of the large intestine].

The report deals with the results of surgery in 1247 cases of colonic polyps. Malignant polyps were observed in 101 cases (8.1%). Eighty percent of polyps were up to 10 mm in size. Seventy five percent of malignant polyps were more than 10 mm in diameter. 94.4% of malignant polyps were in the rectum and sigmoid colon. Electro excision of malignant polyps via fibrocolonscope or rectoscope has been used on a large scale in recent years. Within five years after operation, newly-developed tumors were detected on the same sites in 11 cases (11.8%) (benign tumors--5, malignant polyps--4, carcinoma of large bowel--2). Newly-developed tumors were found at other sites in 26 patients (benign tumors--20, malignant polyps--5 and large bowel cancer--1).

Adult↗
PubMed1998

Colorectal cancer in women: an underappreciated but preventable risk.

Colorectal cancer is the third most common non-skin malignancy in women, after breast and lung cancer. Although approximately 40% of the 65,000 women diagnosed each year eventually die of the disease, colon cancer is highly curable when diagnosed at an early stage. Moreover, because the majority of colon cancers arise in previously benign colonic polyps, there is a substantial period, up to several years, in which removal of polyps can reduce the risk of colon cancer. Recently, the United States Preventive Task Force recommended universal screening for colon cancer after age 50. Strong evidence from randomized controlled trials and case-control studies supports use of annual testing for occult blood in stool and flexible sigmoidoscopy every 5-7 years. Although the risk of colon cancer is similar in men and women, women frequently have the perception that colorectal cancer is a man's disease. Partially in consequence, women are less likely than men to undergo screening sigmoidoscopy. Further barriers include primary care providers' lack of awareness of updated guidelines and patients' lack of compliance with multiple screening tests and their fear of discomfort. Because the risk of colorectal cancer can be reduced by up to 75% in those who undergo screening and subsequent surveillance to remove further polyps, it is crucial that women be targeted to undergo screening tests for colorectal cancer.

Age Distribution↗
PubMed1986

Colonoscopic polypectomy.

Colonoscopic polypectomy is well established as an outpatient procedure. In skilled hands it is essentially safe. The components of a satisfactory therapeutic outcome are good bowel preparation, adequate sedation analgesia, an experienced operator and the proper range of equipment. In this two year series of 71 patients (176 polyps) there were no fatalities, no perforations and only two minor bleeds. Eighty percent of the polyps were of the tubuloadenomatous or tubulovillus type. Carcinoma was present in 6% and their outcome is described in detail. The commonest presentation of colonic polyps was rectal bleeding or occult blood in the stools (56%). Two or more polyps were present in 60% of patients. Seventy percent were located distal to the splenic flexure and the rest proximally. Fifteen percent were over 2 cm in maximum diameter. Policies for the type and frequency of follow-up are a matter for ongoing discussion.

Adult↗
PubMed1992

Growth of colorectal polyps: design of a prospective, randomized, placebo-controlled intervention study in patients with colorectal polyps.

One hundred and sixteen patients were included, during 18 months, in a double-blind placebo-controlled intervention study, with calcium, vitamins A, C, E and selenium (in a cocktail) or placebo against growth of colonic polyps. Patients were randomized within three arms, according to diameter of the largest polyp, < 5 mm, 5-9 mm or > 9 mm. Polyps > 9 mm were resected, the others were left to be measured annually before resection after 3 years. The protocol (performed in all of the patients) included registration of demographic data, family and personal history, measurement of polyps, collection of blood specimens, stools and biopsy samples. Registration of nutritional status, diet history and 5-day prospective food consumption, was performed in 108 patients. The patient compliance was registered every third month by the hospital pharmacist, with concomitant delivery of new boxes of capsules. Additionally, stool collections were performed from all of the patients for the measurement of faecal calcium, bile salts and fat. Inclusion rate of 37, 41 and 38 patients in each of the three 6-month periods was uniform. The group with the largest polyps measuring 5-9 mm comprised 44% of the material. The sex ratio corresponded to that in overall referrals for colonoscopy. The age relationship of size and multiplicity of polyps and the distribution of polyps in the large bowel corresponded to previous experience in polyp-bearing individuals of the same age.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1985

Experience with 1000 colonoscopic polypectomies.

Experience with 1000 consecutive polypectomies in 591 patients, from December 1975 to October 1982, is reviewed. There were 633 adenomas, 292 hyperplastic, and 75 miscellaneous polyps. While eight minor bleeding episodes (0.8%) occurred, there were no major complications (perforations or bleeding requiring transfusion). The polyp retrieval rate was 97.9%. Of the 633 adenomas, seven (1.1%) had in situ carcinoma and ten (1.6%) invasive. Eight of the invasive group underwent colon resection with no positive nodes present. Anatomic location demonstrated a shift to the right side of the colon. Three hundred thirty-six (53.1%) were in the rectosigmoid; 134 (21.3%) were in the left colon; 79 (12.3%) were in the transverse colon; and 84 (13.3%) were in the right colon and cecum. Patients who have undergone benign polypectomy are colonoscoped again in 1 year, and, if negative, every 3 years thereafter. Postpolypectomy patients with malignant adenomas require closer observation. Endoscopic polypectomy, with its lower morbidity and mortality, has revolutionized the treatment of the colon polyp. It is also more cost-effective, with outpatient polypectomy being 29 times less expensive and inpatient polypectomy four times less expensive than transabdominal polypectomy.

Adenoma↗
PubMed1987

Synthetic antigens as immunogens: Part I. The combining site specificities of antibodies formed in rabbits to synthetic disaccharide alpha-L-Fuc-(1----3)-D-Gal.

Antibody to chemically synthesized Fuc alpha 1----3 Gal-1----OC6H4N = N bovine serum albumin was developed. Specificity analysis using related synthetic saccharides was performed. The antisera were shown to be specific for both sugars in the disaccharide, to the 1----3 positional linkage and to the alpha anomeric configuration. Immunohistochemical staining was performed on benign disease and adenocarcinoma tissue of the colon. 5/8 of the benign colon polyp tissue and 4/6 of the colonic adenocarcinoma tissue showed strong granular cytoplasmic staining of the epithelia cells lining the ducts. None of the six normal colon tissues tested showed any reactivity. Immunohistochemical staining was also performed on tissue from benign disease and from carcinoma of the mammary gland. 2/5 of the tissue from benign disease of the breast and 3/6 of the tissue from breast carcinoma showed strong granular cytoplasmic staining of the ductal epithelial cells.

Adenocarcinoma↗
PubMed1990

[Metastasis of a stomach carcinoma in a solitary adenomatous cecal polyp].

Gastric stump carcinoma with widely disseminated metastases and solitary coecal adenoma were recorded by postmortem investigation of a man who had died at the age of 69. The gastric carcinoma had spread metastases into the adenoma. This is the fourth case carcase of metastasis to a colonic polyp so far described in the literature.

Adenocarcinoma↗
PubMed1997

Perforated villous adenoma of the cecum: report of a case.

Villous adenomas are common neoplasms of the colon, often causing anemia or hemoccult positive stools. Less typically, these lesions may result in abdominal pain, melena, obstruction, or change in bowel habits. Intussusception may occur, but this complication is unusual in adults. Spontaneous bowel perforation attributable to colonic polyps has not been previously reported. We present here the first reported case of an adenomatous polyp with bowel perforation and bladder involvement.

Adenoma, Villous↗
PubMed2003

A method for detecting undisplayed regions in virtual colonoscopy and its application to quantitative evaluation of fly-through methods.

RATIONALE AND OBJECTIVES: When virtual endoscopy is used as a diagnostic tool, especially as a tool for detecting colon polyps, the user often performs automated fly-through based on automatically generated paths. In the case of automated fly-through in the colon, there are some blind areas at the backs of folds. The aim of this study is to detect undisplayed regions during fly-through and to perform quantitative evaluation. MATERIALS AND METHODS: Undisplayed regions are detected by marking displayed triangles for surface rendering or displayed voxels for volume rendering. The voxels or triangles not having displayed marks are considered to be undisplayed triangles or voxels. Various kinds of automated fly-through paths generated from medial axes of the colon and flattened views of the colon from the viewpoint of the rate of undisplayed regions are evaluated. RESULTS: The experiment results show that about 30% of colon regions are classified as undisplayed regions by the conventional automated fly-through along the medial axis and that the flattened view results in very few undisplayed regions. CONCLUSION: There is a possibility that the automated fly-through methods may cause many undisplayed regions.

Colonic Polyps↗
PubMed2003

An audit of familial juvenile polyposis at the Tel Aviv Medical Center: demographic, genetic and clinical features.

Familial juvenile polyposis (JP) is an uncommon genetic disorder that, if untreated, can lead to gastrointestinal cancer. To evaluate familial JP prevalence, phenotypic manifestations, causative mutations, treatment and compliance for diagnosis and follow-up in our registry. Since 1993 our familial JP patients were registered, followed-up before and/or after surgery and their families encouraged to have mutation analysis, endoscopic screening and treatment. Ten pedigrees were identified, all Jewish, but only one was Ashkenazi, six were Sepharadi and three were Oriental; the only mutation found was BMPR1A in two of six pedigrees examined. Of 139 first-degree relatives at risk for JP, 62 (45%) had JP or cancer; 56 (40.3%) were available for follow-up and 35 entered the registry. Of these, 71% reported rectal bleeding, 40% had <20 colonic polyps, 31% had 20-100 polyps; 2 had >100 gastric polyps. Cancer occurred in 22.9% (6 colonic, 2 gastric) before familial JP diagnosis or during follow-up elsewhere or non-compliance for follow-up; however, 1 gastric cancer developed during our treatment. In 46% the initial clinical-pathological diagnosis was incorrect. Compliance for evaluation and follow-up of pedigree members and individual familial JP patients was inadequate in 20% and 26%, respectively. Familial JP does not occur in the Israeli Ashkenazi Jewish population at the expected proportion; it is often misdiagnosed and is inadequately recognized in Israeli non-Jews. Mutations were identified in only a minority of pedigrees despite comprehensive screening. The inadequate compliance for screening and follow-up needs to be addressed by educating the public, health care workers and health insurances.

Adenomatous Polyposis Coli↗
PubMed1985

Hypomethylation of DNA from benign and malignant human colon neoplasms.

The methylation state of DNA from human colon tissue displaying neoplastic growth was determined by means of restriction endonuclease analysis. When compared to DNA from adjacent normal tissue, DNA from both benign colon polyps and malignant carcinomas was substantially hypomethylated. With the use of probes for growth hormone, gamma-globin, alpha-chorionic gonadotropin, and gamma-crystallin, methylation changes were detected in all 23 neoplastic growths examined. Benign polyps were hypomethylated to a degree similar to that in malignant tissue. These results indicate that hypomethylation is a consistent biochemical characteristic of human colonic tumors and is an alteration in the DNA that precedes malignancy.

Chorionic Gonadotropin↗
PubMed1988

In vitro mucus glycoprotein production by colonic tissue from patients with ulcerative colitis.

Colonic mucus production was measured in vitro by means of incorporation of tritiated glucosamine using biopsy material from patients with ulcerative colitis and compared with data from patients with Crohn's disease, colonic carcinoma, colonic polyps and patients with apparently normal colonic mucosae. Mucus production was significantly decreased (p less than 0.03) in all patients with ulcerative colitis, and in particular in patients with inactive disease when compared with normal subjects. In patients with active disease mucus production was not significantly different from normal subjects. The radiolabelled material was characterised by gel filtration and ion exchange liquid chromatography as mainly high molecular weight glycoproteins. These results indicate that the quantitative character of colonic mucus is abnormal in inactive ulcerative colitis.

Colitis, Ulcerative↗
PubMed2001

Biomarkers in colorectal cancer.

Epidemiological studies have revealed that the major dietary constituents implicated in colorectal carcinogenesis are fat/red meat (causative) and calcium/fibre (protective). Biomarkers have been used in both animal studies and clinical trials to investigate the effect of dietary factors and chemotherapeutic agents on colon carcinogenesis. They can be used as short-term end-points when investigations based on the development of cancer are not feasible. Although they can help in elucidating dietary or pharmacological effects, important results should be confirmed with longer-term studies. Colon cancer develops through an adenoma-carcinoma sequence. The appearance of colonic polyps in individuals at risk for colon cancer has been used as an end-point in clinical trials to assess diets and pharmacological agents for their effect on colon carcinogenesis. Normal-appearing mucosa can contain small foci of aberrant crypts, which can be dysplastic and thought of as microadenomas. The appearance and growth of such foci have been used to assess the effect of dietary factors and chemopreventive agents in experimental animals. Increased proliferation both increases the sensitivity of the colon to carcinogenesis and may represent an early step in colon carcinogenesis. Etheno-DNA adducts are an end-product of lipid peroxidation processes, and are strongly pro-mutagenic lesions. High dietary levels of n-6 fatty acids appear to be important here and may also increase eicosanoid or isoprostane exposure and provide a selective growth stimulus for tumour precursor cells. Low dietary calcium may lead to inhibition of apoptosis and possibly to an increase in cell proliferation. In three recently completed intervention trials, calcium moderately reduced the recurrence of adenomas, but in one study fibre increased recurrence dramatically.

Animals↗