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PubMed1993

Gastric acid secretion, serum pepsinogen I, and serum gastrin in Japanese with gastric hyperplastic polyps or polypoid-type early gastric carcinoma.

We determined the maximum secretion of gastric acid and the fasting serum levels of pepsinogen I and gastrin in Japanese patients with gastric hyperplastic polyps or polypoid-type early gastric carcinoma, comparing those findings with observations in control subjects. Both the maximum acid secretion and fasting levels of serum pepsinogen I were significantly lower in the patients with gastric hyperplastic polyps or polypoid-type early gastric carcinoma than in the controls. Fasting serum gastrin levels were significantly higher in the patients with gastric hyperplastic polyps than in the other two groups of subjects. These data demonstrated that the combination of hypochlorhydria, a low level of pepsinogen I, and hypergastrinemia (type-A gastritis) was common in the patients with gastric hyperplastic polyps, whereas hypochlorhydria and a low pepsinogen I without hypergastrinemia (type-B gastritis) were common in those with polypoid-type early gastric carcinoma.

Aged↗
PubMed2006

BRAF, K-ras and BAT26 mutations in colorectal polyps and stool.

AIM: To assess the feasibility of using BRAF, K-ras and BAT26 genes as stool-based molecular markers for detection of colorectal adenomas and hyperplastic polyps (HPs). METHODS: We applied PCR-SSCP and direct sequencing to detect BRAF mutations of polyps and paired stool samples. Primer-mediated restriction fragment length polymorphism (RFLP) analysis and mutant-enriched PCR were used in detection of K-ras mutations of polyp tissues and paired stool samples respectively. BAT26, a microsatellite instability marker was examined by detection of small unstable alleles in a poly (A) repeat. RESULTS: No genetic alterations were detected in the 36 colonoscopically normal patients in either tissues or stools. BRAF, K-ras and BAT26 mutations were found in 4 (16%), 10 (40%) and 3 (12%) of 25 adenoma tissues and among them, 75%, 80% and 100% of patients were observed to contain the same mutations in their corresponding stool samples. In HPs, mutations of BRAF and K-ras were detected in the tumor DNA of 2 (11.1%) and 8 (33.3%) of 18 patients respectively, all of whom had identical alterations in their stools. Taken together, the three genetic markers detected 15 (60%) of 25 adenomas and 8 (44.4%) of 18 HPs. The sensitivity of stool detection was 80% for adenomas and 100% for HPs with an overall specificity of 92% for adenomas and 100% for HPs. CONCLUSION: BRAF, K-ras and BAT26 genes have the potential to be molecular markers for colorectal adenomas and HPs, and can be used as non-invasive screening markers for colorectal polyps.

Adult↗
PubMed2006

Endoscopic mucosal resection of large hyperplastic polyps in 3 patients with Barrett's esophagus.

AIM: To report the endoscopic treatment of large hyperplastic polyps of the esophagus and esophago-gastric junction (EGJ) associated with Barrett's esophagus (BE) with low-grade dysplasia (LGD), by endoscopic mucosal resection (EMR). METHODS: Cap fitted EMR (EMR-C) was performed in 3 patients with hyperplastic-inflammatory polyps (HIPs) and BE. RESULTS: The polyps were successfully removed in the 3 patients. In two patients, with short segment BE (SSBE) (<= 3 cm), the metaplastic tissue was completely excised. A 2 cm circumferential EMR was performed in one patient with a polyp involving the whole EGJ. A simultaneous EMR-C of a BE-associated polypoid dysplastic lesion measuring 1 cm multiply 10 cm, was also carried out. In the two patients, histologic assessment detected LGD in BE. No complications occurred. Complete neosquamous re-epithelialization occurred in the two patients with SSBE. An esophageal recurrence occurred in the remaining one and was successfully retreated by EMR. CONCLUSION: EMR-C appears to be a safe and effective method for treating benign esophageal mucosal lesions, allowing also the complete removal of SSBE.

Aged↗
PubMedDate not supplied

Conservative management of placental polyp with oral administration of methotrexate.

Surgical treatment is usually selected for placental polyp accompanied by massive bleeding but patients wishing to conserve their fecundity require conservative management. A 35-year old nullipara was diagnosed as having placental polyp on the basis of typical episodes, and detection of placental polypeptide hormones and blood flow by Doppler ultrasonography and dynamic magnetic resonance imaging. Oral administration of methotrexate (2.5 mg, three times a day for 5 days) was repeated for three cycles because surgical treatment was rejected. Serum human placental lactogen, blood flow and the polyp disappeared sequentially following chemotherapy. This report thus advocates considering conservative management for placental polyp.

Administration, Oral↗
PubMed1998

Hyperplastic gastric polyp causing progressive gastric outlet obstruction.

Hyperplastic polyps represent 75 to 90% of gastric polypoid lesions. The manifestations of these unique gastric neoplasms vary, including abdominal pain, nausea, and vomiting or gastrointestinal bleeding. The vast majority of these lesions are small, asymptomatic, and found incidentally on radiologic evaluation or endoscopic examination of the upper gastrointestinal tract. Herein we describe a large, benign, pedunculated hyperplastic polyp that led to progressive gastric outlet obstruction. In addition, we provide an overview of gastric polyps and a review of the literature. Excision of gastric polyps by endoscopic or surgical means is recommended as prudent treatment to eliminate occurrence of malignant foci.

Aged↗
PubMed2000

Benefits of laparoscopic-assisted colectomy for colon polyps: a case-matched series.

OBJECTIVE: To clarify the true benefits of laparoscopic-assisted colectomy by comparing clinical outcomes from a series of laparoscopic right colectomies with matched open colectomies, all performed for the singular indication of polyp not amenable to colonoscopic removal. PATIENTS AND METHODS: A retrospective case-matched study was performed of consecutive patients undergoing laparoscopic-assisted right hemicolectomy for polyps between January 1992 and July 1997. Each case was matched to a control undergoing the equivalent open procedure for the same indication during the same time period. RESULTS: Thirty-eight patients undergoing laparoscopic-assisted right hemicolectomy for polyps were identified, and matches were found. The conversion rate was 18.4% (7/38), 21.4% early in the series and 10% in later experience. Operative times were longer for laparoscopic-associated colectomy (median, 208 minutes vs 150 minutes, P < .001). Laparoscopic-assisted colectomy resulted in shorter postoperative ileus (time to flatus, 3.0 vs 4.0 days, P < .001; time to bowel movement, 3.5 vs 5.0 days, P < .001) and in earlier tolerance of regular diet (3.5 vs 6.0 days, P < .001). Fewer days of narcotic administration were required by the laparoscopic group (3.0 vs 4.5 days, P < .001). This resulted in a significantly shorter length of hospital stay (4.0 vs 7.0 days, P < .001). There was no significant difference in the incidence of postoperative complications. CONCLUSIONS: Laparoscopic right hemicolectomy has significant patient benefits. These benefits are apparent when procedures of equal complexity and equivalent indications are compared. Laparoscopic-assisted resection has become our preferred approach for polyps not amenable to colonoscopic polypectomy.

Aged↗
PubMed2003

Growth factors and receptors in juvenile nasopharyngeal angiofibroma and nasal polyps: an immunohistochemical study.

BACKGROUND: Juvenile nasopharyngeal angiofibroma is a rare nasopharyngeal tumor that occurs exclusively in adolescent boys. It is a histologically benign but locally persistent growth of stromal and vascular tissue. Although male hormones and some growth factors, such as transforming growth factor beta1 (TGF-beta1), insulin-like growth factor II (IGF-II), and, lately, the proto-oncogene beta-catenin, have been implicated in the histogenesis of the tumor, the biologic signaling pathways that drive this peculiar fibrovascular proliferation are still nuclear. OBJECTIVE: To evaluate immunoexpressions of beta-catenin, c-Kit, p130Cas, TGF-beta3, bone morphogenic protein 4, nerve growth factor (NGF), and the IGF receptor (IGF-1R) in a series of juvenile nasopharyngeal angiofibromas and to compare to that of a group of nasal polyps. DESIGN: A standard immunohistochemical technique was used on paraffin sections of 12 sporadic juvenile nasopharyngeal angiofibromas and 15 nasal polyps with microwave or steam antigen retrieval. Immunoreactivity was analyzed semiquantitatively in stromal cells and endothelial cells of each case. RESULTS: The expressions of beta-catenin (nuclear), c-Kit (cytoplasmic), and NGF (cytoplasmic) were higher and more frequent in stromal cells of juvenile nasopharyngeal angiofibromas than those of nasal polyps. Both juvenile nasopharyngeal angiofibromas and nasal polyps showed similarly frequent and strong immunoreactivity for p130Cas and TGF-beta3 and weak immunoreactivity for bone morphogenic protein 4 in both stromal cells and endothelial cells. No IGF-1R immunoreactivity was detected in any case of either group. CONCLUSIONS: Our results support the role of beta-catenin in juvenile nasopharyngeal angiofibromas and suggest a potential involvement of c-Kit and NGF signaling pathways in the juvenile nasopharyngeal angiofibromas. Although the biologic significance of c-Kit in juvenile nasopharyngeal angiofibromas has yet to be defined, the finding of frequent and high c-Kit expression might have therapeutic importance for patients with juvenile nasopharyngeal angiofibromas.

Adolescent↗
PubMed2005

Sessile serrated polyp mimicry in patients with solitary rectal ulcer syndrome: is there evidence of preneoplastic change?

CONTEXT: Solitary rectal ulcer syndrome (SRUS) is associated with erythema and ulceration of the rectal wall. Serrated lesions of the colon are divided into conventional hyperplastic polyps and a new set of lesions that are variably called sessile serrated polyps (SSPs) and sessile serrated adenomas. The SSPs are epithelial proliferative lesions that appear to act as a unique pathway to colorectal carcinogenesis. No association between SRUS and SSPs has been previously reported. OBJECTIVE: To assess a possible association between SRUS and morphologic features that mimic SSPs. DESIGN: Twenty-six patients with SRUS, who presented to our institution between January 1, 1999, and November 14, 2004, were retrospectively reviewed for SSP-type morphologic features by 3 pathologists. Ki-67 and hMLH1 immunohistochemical stains were used. Control tissues included 10 conventional left-sided hyperplastic polyps, 10 right-sided large SSPs, 7 adenocarcinomas with known loss of hMLH1 gene expression, and 4 normal human tonsil tissues. RESULTS: Ten (38%) of 26 SRUS specimens demonstrated histologic features consistent with SSPs. These features included exaggerated serration within the lower crypt compartments, crypt branching, hypermucinous appearance of epithelium, and horizontal extension of crypt bases along the muscularis mucosa. All 10 cases of SRUS had positive basal Ki-67 staining in 10% to 20% of cells. Two (20%) of the 10 cases demonstrated focal superficial loss of hMLH1 mismatch repair gene expression within areas of serrated morphologic features. One hyperplastic polyp superimposed on SRUS showed a reduced number of surface epithelial cells that express hMLH1 protein. CONCLUSIONS: Up to 38% of patients with SRUS have histologic changes that mimic SSPs. More importantly, 20% of these serrated lesions were found to have focal loss of hMLH1 gene expression, indicating a potential of preneoplastic change. This phenomenon may reflect an increased propensity for neoplastic progression in response to repeated trauma and repair process in certain cases of SRUS.

Adaptor Proteins, Signal Transducing↗
PubMed1994

[Fibroepithelial polyp of the prostatic urethra: report of two cases and review of the literature].

Two cases of Fibroepithelial polyp in 47-and 74-year-old males complaining of gross hematuria are described. In the foreign literature, this polyp most commonly occurs in infancy and childhood in the first decade of life, but rarely occurs in aged male. Ten cases of this disease could be accumulated in the Japanese literatures, in which this polyp more commonly occurs in older generation compared with younger one. Urethral polyp should be considered in the differential diagnosis of gross hematuria.

Aged↗
PubMed1998

[Inflammatory fibroid polyps of the colon].

Inflammatory fibroid polyp is an uncommon lesion involving the stomach, the small bowel and occasionally the colon. Inflammatory fibroid polyp is a large polypoid lesion arising from the submucosa. It has no malignant potential although extensive infiltration may occur. The main histological characteristics are diffuse inflammatory infiltrate with eosinophils and highly vascularized fibrocytic stroma. Immunohistochemistry is always positive for vimentine and negative for S 100 and desmin. We report four cases of inflammatory fibroid polyps, 3 of which mimicked carcinoma of the colon. Exploratory laparotomy and histopathological examination of the resected specimen were necessary to confirm definitive diagnosis. In the last case, diagnosis was established by histological examination of an endoscopically-removed colonic polyp.

Aged↗
PubMedDate not supplied

[Fibroepithelial polyps of the upper urinary tract: their diagnostic evaluation and treatment in pediatrics].

OBJECTIVE: To establish the diagnostic criteria, analyze the histological patterns of benign and malignant ureteral and renal pelvic polyps in pediatric patients and discuss the best treatment option based on the final diagnosis. METHODS/RESULTS: The literature is reviewed with special reference to the diagnostic and therapeutic aspects of fibroepithelial polyps of the upper urinary tract in pediatric patients. An additional case with benign cytological and radiological findings is described. The patient underwent partial pyeloureteral resection. Histological analysis of the surgical specimen confirmed a fibroepithelial polyp. CONCLUSIONS: We emphasize the importance of adequate preoperative evaluation, precise identification of the base of the lesion for a correct choice of the surgical approach, and the advantages of complete segmental resection and reanastomosis over simple excision of the polyp.

Child↗
PubMedDate not supplied

Cytotoxic intraepithelial lymphocytes in colorectal polyps and carcinomas.

The frequency of intraepithelial lymphocytes (IEL) was investigated in 255 colorectal lesions: in 18 metaplastic polyps, in 159 tubular, serrated and villous adenomas, in 28 incipient adenocarcinomas and in 50 overt adenocarcinomas. > or = 21 IELs were found in 13.6% (12/88) of the adenomas with high grade dysplasia (HGD) but in none of the 18 metaplastic polyps, the 71 adenomas with low grade dysplasia (LGD), or the 50 overt adenocarcinomas. CD3-T, MHCII and TIA1 cell antigens were positive in IELs from tubular adenomas, villous adenomas, incipient carcinomas and overt adenocarcinomas. In the normal colorectal mucosa and in metaplastic polyps, CD3-T was positive whereas MHCII and TIA 1 were not expressed. On the other hand, Fas cell antigen was expressed in the normal mucosa and in metaplastic polyps but it was downregulated in neoplastic lesions. The upregulation of CD3-T, MHC class II molecules, and TIA 1 in IELs of neoplastic colorectal lesions suggests that they are activated and cytotoxic; however, they undergo apoptosis due to the downregulation of the FAS molecules.

Colon↗
PubMedDate not supplied

BCL2 and BAX expression in hyperplastic and dysplastic rectal polyps.

BACKGROUND/AIMS: Members of the gene family that includes BCL2 and BAX are functionally antagonists in the apoptosis process and they have been observed in normal and neoplastic tissues. The aim of this study is to investigate the combined effects of BCL2 and BAX protein in normal mucosa, dysplastic and hyperplastic polyps of the rectum. METHODOLOGY: We studied BCL2 and BAX protein expression in 40 cases of adenomatous polyps all located in the rectum, with different dysplastic gradings, and the mean time in 10 cases of normal rectal mucosa. RESULTS: BCL2 expression was found more frequently in hyperplastic and in low dysplastic polyps with moderate and strong positivity compared to moderate and severe dysplasia. BAX expression was found in normal mucosa in hyperplastic and dysplastic polyps, the immunoreactivity was prevalently moderate and strong. CONCLUSIONS: These preliminary data suggest that BCL2 and BAX confirm a probably different role in apoptosis. Nevertheless, it is important to know the relation between the molecular pathways of apoptosis, the defective mismatch repair and the tumor suppressor genes associated with an increased mutation rate in cancerogenesis of the colorectum.

Adenoma↗
PubMed2000

Fundic gland polyps: a still elusive entity on the eve of the year 2000.

Fundic gland polyps (FGPs) are tiny multiple sessile polyps of the acid-secreting gastric mucosa. They have been described both in a sporadic form, mainly in middle-aged females, and in a syndromic form, associated with familial adenomatous polyposis (FAP)-Gardner's syndrome and attenuated variants (AFAP). They share the same histology, characterised by superficial and deep cystic dilatations, shortened gastric pits, with an inconspicuous lamina propria. They have been for a long time described as innocuous lesions, but some recent reports have shown that FGPs may harbour dysplastic foci and ultimately (particularly syndromic polyps) gastric cancer. Factors influencing their genesis are unknown. A circulating factor in FAP patients has been postulated and a role of female hormones has been suggested for sporadic FGPs. Whereas patients with sporadic FGPs have normal basal acid output, normal fast serum levels of gastrin and pepsinogen I, the role of gastrin seems crucial for the development of cystic changes in flat body-fundus mucosa, and for the appearance of FGPs in patients with Zollinger-Ellison syndrome. A role of H. pylori induced gastritis has been excluded. Actually, patients with both sporadic and syndromic FGPs appear consistently free from H. pylori colonisation, again for an unknown factor(s). Some recent reports have claimed a role for omeprazole in the genesis of FGPs, a highly controversial issue. Ultimately, the nature of FGPs is still debated: some have interpreted them as hamartomatous lesions, others as a peculiar form of hyperplastic polyp.

Adenomatous Polyposis Coli↗
PubMed1997

[Laparoscopy-assisted colonic polypectomy or how to be helped by laparoscopy to prevent colectomy in benign colonic polyps considered to be unresectable by colonoscopy].

The aim of this study was to prospectively evaluate the role of laparoscopic surgery in all patients presenting with colonic polyps. From April 1994 to April 1996, 16 consecutive patients were treated. The laparoscopy starts the procedure, then a colonoscopy easily and rapidly locates the colonic lesion. Under laparoscopic supervision a new snare polypectomy is often possible. If polypectomy remains impossible, a mini-laparotomy is performed above the polyp and allows polypectomy by extra-peritoneal colotomy. In one case, the polyp was not found on colonoscopy. Colonoscopic polypectomy was possible in 6 cases (40%), and 9 mini-laparotomies were necessary (60%). No colectomy was performed. The final histologic result showed two Dukes A carcinomas justifying secondary wide colectomy. Laparoscopy-assisted polypectomy is a safe and efficient procedure, allows complete excision of polyps and may avoid a colonic resection.

Aged↗
PubMed2000

Induction of segmentation in polyps of Aurelia aurita (Scyphozoa, Cnidaria) into medusae and formation of mirror-image medusa anlagen.

Polyps of Aurelia aurita can transform into several medusae (jellyfish) in a process of sequential subdivision. During this transformation, two processes take place which are well known to play a key role in the formation of various higher metazoa: segmentation and metamorphosis. In order to compare these processes in bilaterians and cnidarians we studied the control and the kinetics of these processes in Aurelia aurita. Segmentation and metamorphosis visibly start at the polyp's head and proceed down the body column but do not reach the basal disc. The small piece of polyp which remains will develop into a new polyp. The commitment to the medusa stage moves down the body column and precedes the visible onset of segmentation by about one day. Segmentation and metamorphosis can start at the cut surface of transversely cut body columns, leading to a mirror-image pattern of sequentially developing medusae.

Animals↗
PubMed2000

[Usefulness of the flexible fibroscope with working channel in the treatment of pedunculated polyps of the vocal cords].

INTRODUCTION: Suspension laryngoscopy by general anesthesia is the universally method of performing microlaryngeal surgery for the treatment of vocal cord polyps. Recently a new technique using a flexible endoscope with working channel has been introduced and popularized in Spain for treating these lesions. MATERIAL AND METHODS: A prospective study was undertaken to asses the efficacy of this technique, something modified, for removal either pedunculated vocal cord polyps or with minute implantation basis. RESULTS: Twenty-six consecutive patients with pedunculated cord polyps were surgically removed, at the ENT-Department of Sierrallana Hospital (Torrelavega, Cantabria) from January 1995 till September 1996. In 4 patients with strong gang reflexes the procedure could not be finished. Twenty-two patients improved their voice and were satisfied with the result. In 2 other cases, of the group, the voice regain was not complete, but owing to the feelings of the individuals no more surgical procedures were scheduled. No postoperative aftermath were observed. One year later all cases were checked and all proclaimed their well-being. CONCLUSIONS: We suggest that removal of pedunculated polyps of the vocal cord employing the fibroendoscope with working channel and local anesthetic should be the choix procedure for the lot of patients suffering this pathology, and the microsurgery with general anesthesia must be reserved for failure cases or for those patients using voice professionally.

Adult↗
PubMed2001

Accuracy of hysteroscopic diagnosis of endometrial polyps.

OBJECTIVE: To evaluate the diagnostic accuracy of endometrial polyps by hysteroscopy. MATERIAL AND METHOD: One hundred and sixty five women undergoing diagnostic hysteroscopy between January 1996 and December 1998 at the Gynecologic Endoscopy Unit, King Chulalongkorn Memorial Hospital were recruited in this study. The hysteroscopic diagnosis was compared with the histopathology by endometrial curettages performed after hysteroscopy. RESULTS: Endometrial polyps were diagnosed by hysteroscopy in 54 patients (32.73%). When compared to tissue pathology, we found an accuracy of 81.21 per cent, sensitivity of 92.59 per cent, specificity of 78.98 per cent, positive predictive value of 46.29 per cent, negative predictive value of 98.19 per cent, false positive of 17.57 per cent and false negative of 1.21 per cent. CONCLUSION: For endometrial polyps, diagnostic hysteroscopy yields a high accuracy but low positive predictive value. Therefore, endometrial biopsy is necessary to confirm diagnosis of endometrial polyps by hysteroscopy.

Adult↗

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