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PubMed1990

A prospective study of the prevalence of colonic neoplasms in asymptomatic patients with an age-related risk.

This study was designed to determine the prevalence of colorectal neoplasia in healthy, asymptomatic adults with an age-related risk for colorectal neoplasia. Ninety patients were studied with air contrast barium enema and colonoscopy. The study population included 61 males and 21 females, with an age range of 51-82 yr (65 +/- 2 yr). Adenomatous polyps were found in 27% of males and 14% of females or 24% of patients overall. Sixty-six percent of these neoplasms were above the rectosigmoid junction and the mean size of the polyps was 6.5 +/- 1.2 mm. In two patients, carcinoma was discovered. A linear association between age and the prevalence of colonic neoplasia was not demonstrated. This study demonstrates a relatively high prevalence of colonic neoplasia in patients with an age-related risk.

Adenoma↗
PubMedDate not supplied

[Appendiceal mucocele associated with colonic neoplasm. Report of 2 cases and review of the literature].

Appendiceal mucocele is a rare entity frequently associated with colorectal cancer. We report two cases of mucocele associated with colorectal tumours. The first case (male, 64 yrs) is an appendiceal mucinous cystadenoma found incidentally during surgery for colon cancer. There is no evidence of disease after a 4-year follow-up. The second case (male, 66 yrs) is a mucocele associated with mucosal hyperplasia that was found during surgery for acute appendicitis with a periappendicular abscess. Endoscopic follow-up showed a rectal adenocarcinoma that was initially treated with local excision with T.E.M.. Examination of the pathology specimen documented vascular invasion and the patient underwent curative colorectal resection. The preoperative radiological and endoscopic diagnostic procedures and the current therapeutic approaches described in the literature are reviewed. The relevance of the association between appendiceal mucocele and colorectal cancer is emphasized. Thorough investigation of the colorectal tract is recommended after diagnosing an appendiceal mucocele.

Aged↗
PubMed1994

[Does intake of antihypertensive agents and sedatives explain the increasing incidence of colonic neoplasms?].

Not much attention has been given to drug use and risk of colorectal cancer. We investigated the issue in an 18-year prospective cohort study of 5249 Copenhagen males aged 40-59 years. Potential confounders included were tobacco smoking, alcohol consumption, coffee drinking, physical activity, and social class. Colon cancer was diagnosed in 51 men, rectal cancer in 42 (all adenocarcinomas). Estimated from a Cox proportional hazards regression equation, use of antihypertensive medicine was highly significantly associated with risk of colon cancer, relative risk (95% confidence limits) was 3.5 (1.6-7.5), p = 0.001. Frequent use of minor tranquillizers or sleeping pills was also associated with a highly significantly increased risk of colon cancer, relative risk was 3.2 (1.6-6.6), p = 0.002. By contrast, there was no such association with rectum cancer. We suggest that use of antihypertensive medicine and use of minor tranquillizers or sleeping pills may be strong risk factors for colon cancer, and that their use may contribute substantially to explaining the increased incidence of colon cancer since 1945.

Adenocarcinoma↗
PubMed1991

[Emergencies in the surgery of colonic neoplasms. A review of the literature and the authors' cases].

The paper reports the personal experience of the 2nd Division of General Surgery of the Martini Hospital in Turin and compares it to the results of the most recently published studies. Of 123 patients who underwent emergency surgery, 101 were suffering from tumors of the colon complicated by intestinal occlusion and 22 by perforation. Only right hemicolectomy was performed in cases of perforation or resection with ileostomy and colic mucous fistula was used for neoplasms located in the right colon; Hartmann's operation or dual ostomy was performed in the event of neoplasms in the left colon. Surgical treatment of occlusive tumors of the left colon is still the subject of continued debate. The elective surgical technique is an amblée resection using colo-colic anastomosis with a protective ostomy. This is followed by Hartmann's operation, whereas decompressive colostomy should only be used in patients who are admitted to hospital in generally precarious conditions.

Aged↗
PubMed1976

Synthesis of secretory component by colonic neoplasms.

The secretory component (SC) polypeptide chain of secretory immunoglobulin A can be considered as a differentiation marker in that it is normally synthesized in the non-mucus-containing columnar epithelial cells, but not goblet cells, of the large intestine. With this in mind, we have studied the expression of SC in 36 colonic adenocarcinomas and 15 polyps (adenomatous and villous) by the fluorescent antibody technique. As in the normal mucosa, the synthesis of SC in tumors found in non-mucus-containing columnar cells and was absent from goblet cells. However, in several well-differentiated carcinomas it appeared that columnar cells contained both SC and mucin; these cells could be analogous to the normal mucosal precursor of both cell types. SC was synthesized throughout all adenomatous polyps and villous adenomas with the exception of some atypical nonmucinous areas of adenomatous polyps. Secretory component synthesis by carcinomas was associated with mucus production, although goblet cells did not contain SC. The presence of SC also correlated with the degree of differentiation. Secretory component was absent from half of the carcinomas as well as from atypical nonmucinous areas of polyps, and this could represent one of the earliest changes associated with the development of malignancy.

Adenocarcinoma↗
PubMedDate not supplied

Pharmacologic prevention of colonic neoplasms. Effects of calcium, vitamins, omega fatty acids, and nonsteroidal anti-inflammatory drugs.

Dietary supplements of calcium, vitamins A, C, and E, carotenoids, and omega-3 fatty acids can reduce the yield of experimental cancers in animals and reverse the pattern of abnormal epithelial proliferation in animals and humans. Epidemiological studies indicate that diets containing high amounts of these agents convey a protective effect against the development of colon cancer. Moreover, regular aspirin use in humans appears to reduce the risk of colon cancer and sulindac causes regression of polyps in patients with familial polyposis. These agents are promising for the prevention of human colorectal cancer, but their efficacy has not yet been shown in prospective, controlled trials. Thus, although it is tempting to speculate that in the future we may treat our patients who have a predisposition to colon polyps and cancer, or even healthy people at average risk, with such ordinary supplements as calcium, vitamins, fish oil, or aspirin, such advice at this time is premature.

Animals↗
PubMed1976

Secretory immunoglobulins in colonic neoplasms.

Secretory immunoglobulins are found in nongoblet columnar cells of normal intestinal epithelium. These molecules consist of a secretory component portion, which is synthesized in the columnar cells, and an immunoglobulin portion which enters the columnar cells from plasma cells in the adjacent lamina propria. In the present work, the synthesis and transport of these various subunits have been studied by immunofluorescence in benign polyps and cancers of the colon. In both the epithelium and plasma cells of benign and malignant tumors, as well as in normal tissue, IgA is the principal immunoglobulin, followed by IgM. However, when compared to normal tissue, neoplastic epithelium contains less immunoglobulin and also less secretory component; the decrement usually inversely parallels the degree of differentiation. Thus, benign polyps closely resemble normal colonic mucosa in so far as the secretory immunoglobulin system is concerned. In contrast, atypical areas of benign polyps and carcinomas exhibit greatly decreased or absent synthesis and transport of secretory IgA. Plasma cells tend to be markedly decreased in the stroma of carcinomas, suggestive of an alteration in the normal mechanism for attracting the circulating precursors of local IgA plasma cells. Whenever neoplastic epithelium contained IgA, plasma cells with IgA could be observed in the vicinity; this is in keeping with the concept of local synthesis of secretory IgA. In some instances in which local plasma cells were plentiful, neoplastic cells were deficient in secretory component and IgA, which suggested impairment of the mechanisms for transporting IgA across epithelium. The possible role of secretory component in such transport and in attracting lymphoblasts to mucous membranes is dicussed.

Colonic Neoplasms↗
PubMed1984

Distribution of histocompatibility and leucocyte differentiation antigens in normal human colon and in benign and malignant colonic neoplasms.

Monoclonal antibodies (McAbs) directed against the framework determinants of Class I and Class II products of the major histocompatibility complex (MHC) and against leucocyte differentiation antigens were used in an indirect immunoperoxidase technique to study their expression in normal, benign (adenomatous polyps) and malignant disease of the colon. Class I products (detected by the McAb 2A1) were strongly expressed on all cell types in normal and benign tissues but some carcinomas exhibited a heterogenous pattern of epithelial cell staining and 4/15 were completely negative. Class II products (detected by TDR31.1) were strongly expressed on cells (mainly B lymphocytes) within the lamina propria. In carcinomas TDR31.1 staining was mainly interstitial, but in 2/15, DR + epithelial cells were also detected. In normal and benign tissues, leucocytes (reactive with 2D1) found predominantly in the lamina propria, comprised T cells mainly of the helper/inducer (OKT4) subset, DR + cells in approx. equivalent proportion and a few OKM1+ cells mostly of macrophage morphology. Occasional intraepithelial lymphocytes were of cytotoxic/suppressor (OKT8) phenotype. In malignant neoplasms, there was wide inter and intra-tumour variation in the proportion of leucocytes which were heterogeneous with respect to cell type and confined mainly to the stroma. T cells were consistently predominant, but B cells and macrophages were also present. Two neoplasms showed unequivocal evidence of a shift (relative to peripheral blood) in favour of the OKT8+ subset, but in the majority of tumours OKT4+; and OKT8+ cells were present in roughly similar proportions. Natural killer cells (monitored with Leu7, HNK1) were virtually undetectable in both normal and malignant tissues. There were no apparent correlations between the extent and type of leucocyte infiltration, tumour differentiation or expression of MHC products. Some implications for the extrapolation of in vitro data on leucocyte function to the in vivo situation are discussed.

Adenocarcinoma↗
PubMed2002

Tattoo of colonic neoplasms in 113 patients with a new sterile carbon compound.

BACKGROUND: Endoscopic marking of intestinal lesions is essential when difficulty is anticipated with subsequent localization during surgical resection or postpolypectomy surveillance. The most commonly used indelible marker has been India ink, which must be diluted and sterilized, a cumbersome process. SPOT, a prepackaged, sterile Food and Drug Administration-approved formulation of pure carbon particles in suspension, eliminates the need for preinjection preparation. METHODS: Ten patients with colonic polyps deemed endoscopically unresectable or malignant-appearing had the area surrounding the lesions injected with SPOT and subsequently underwent surgical resection. An additional 103 patients underwent colonoscopic injection with SPOT and were followed endoscopically or underwent surgery at another hospital. RESULTS: The SPOT injection sites were visible to the surgeons in all 10 cases. On histopathologic evaluation, none of the resection specimens exhibited necrosis or abscess formation. In total, there were 118 SPOT injections in 113 patients; none had fever, abdominal pain, or any other signs or symptoms of inflammation develop. In the nonoperated group, 42 patients subsequently underwent colonoscopies at our institution, and in all cases stains were readily identifiable at the injection sites. CONCLUSIONS: SPOT is a safe and effective marker for use at colonoscopy when surgical resection is anticipated. It is also useful for endoscopic follow-up of patients who have not undergone surgery.

Adult↗