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PubMed1995

Site of origin of nasal polyps. Transcranially removed naso-ethmoidal blocks as a screening method for nasal polyps in autopsy material.

In autopsy material naso-ethmoidal blocks were removed in 19 patients. None of the patients had a preceding rhinoscopy. Before removal, the maxillary and sphenoidal sinuses were opened and screened for polyps. After removal the total naso-ethmoidal complex was carefully examined for nasal polyps. The site of origin of the individual polyp was registered and documented photographically. Nine polyps were found in five patients, of which four had no history of asthma, allergy or sinusitis. Two patients had unilateral solitary polyps, three had polyps bilaterally. All polyps were found in the meatus. Eighty-nine per cent of the polyps were related to the clefts from the ethmoid. Polyps were not observed inside the ethmoidal and other paranasal sinuses.

Aged↗
PubMed2002

Adenomatous polyp recurrence and physical activity in the Polyp Prevention Trial (United States).

OBJECTIVE: To examine prospectively the association between physical activity and adenomatous polyp recurrence. METHODS: Information on past year total physical activity was collected annually through an interview-administered questionnaire from the 1905 men and women enrolled in a randomized dietary intervention study, the Polyp Prevention Trial. Multiple logistic regression analysis was used to examine the association between physical activity and polyp recurrence in up to three years of follow-up from baseline colonoscopy. RESULTS: There were no significant associations between moderate, vigorous, or total physical activity at the start of the trial and overall polyp recurrence in either men or women. Participants who reported consistent vigorous activity throughout the trial period had no significantly reduced risk of polyp recurrence compared to those who reported consistent sedentary activity (OR = 0.8, CI = 0.5-1.1). Consistent vigorous activity was also not significantly associated with either advanced or multiple polyps, nor with polyp recurrence at any specific anatomical location in the large bowel. CONCLUSIONS: These prospective data suggest that recent physical activity is not associated with polyp recurrence in a three-year period.

Adenomatous Polyps↗
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↗
PubMed1977

Nasal polyps, nasal polypectomy, asthma, and aspirin sensitivity. Their association in 445 cases of nasal polyps.

In a retrospective study of 445 patients with nasal polyps, 95 (21 per cent) had asthma. Forty-two (44 per cent) of the patients with asthma had been skin tested and 27 (60 per cent) had positive reactions. Nasal polyps were twice as common in men as women, though a woman with nasal polyps was twice as likely to have asthma as a man. The average age of onset of polyps was 39 years and of asthma was 38 years. No significant difference was found in the age of onset of polyps or asthma in various groups of patients. Two per cent of all the patients in the series had nasal polyps, asthma and hypersensitivity to aspirin (the ASA triad). Ten per cent of those with polyps and asthma were hypersensitive to aspirin and thus had the full triad. Overall, 6 per cent of all the patients in the series were recorded as being allergic to aspirin. Asthma developed more commonly before polypectomy than after in the ratio of 2.5:1. Around 1 per cent of first polypectomies and 0.5 per cent of all polypectomies were followed by the development of asthma within a few months. The onset of asthma was found to occur most frequently just before or just after the first polypectomy. Those who developed asthma after polypectomy had significantly more polypectomies than both non-asthmatics and those whose asthma preceded their polyps. Though it is possible polypectomy may on rare occasions precipitate asthma, it is felt that it does not cause it.

Adolescent↗
PubMed1994

Growth of colorectal polyps: recovery and evaluation of unresected polyps of less than 10 mm, 1 year after detection.

BACKGROUND AND METHODS: Colonoscopic 1-year control of polyps of less than 10 mm left in situ was carried out in 103 (89%) of 116 originally examined patients. RESULTS: Analysis showed an 85% recovery: 91% and 81% for polyps of 5-9 mm and < 5 mm, respectively. The recovery was significantly related to size and localization, whereas the growth rate was inversely correlated to the originally measured diameter. A linear relationship was demonstrated between anus-to-polyp distances 1 year apart, with a normalized agreement index of 0.70. In only 1 of 189 polyps, an increase of diameter to > 10 mm was demonstrated. The 79 new polyps in 52 (50%) of the patients were significantly smaller, more often right-sided, and related to multiplicity of polyps at the initial examination but not to growth of recovered polyps or cleansing status. CONCLUSION: An acceptable recovery and growth rate of polyps < 10 mm seems to justify the continuation of the study for the remaining 2 years.

Aged↗
PubMed1999

Colorectal polyps with extensive absorptive enterocyte differentiation: histologically distinct variant of hyperplastic polyps.

BACKGROUND: The histologic classification of colorectal polyps is well established. However, practicing pathologists may still occasionally encounter colorectal polyps that are difficult to classify. We studied 6 colorectal polyps that showed uncommon histologic features that have not been described in the English language literature. MATERIALS AND METHODS: The polyps were studied using standard hematoxylin-eosin stain, mucin histochemistry, and electron microscopy. RESULTS: The 6 polyps we studied showed extensive papillary and villous structures with alternating villi and crypts. The villi were lined by well-differentiated absorptive cells, whereas the crypts were lined by immature glandular cells, thus mimicking the histology of the small intestinal mucosa. CONCLUSIONS: These polyps appear to represent a variant of the hyperplastic polyp, in as much as cellular maturation (immature glandular cells differentiate into the mature surface absorptive cells) is the essential feature distinguishing hyperplastic polyps from adenomas.

Aged↗
PubMed2005

Aberrantly methylated CDKN2A, MGMT, and MLH1 in colon polyps and in fecal DNA from patients with colorectal polyps.

Colon cancer is the third leading cause of cancer-related death in the United States, affecting approximately 147,000 people each year. Most colon cancers arise from benign neoplasms and evolve into adenocarcinomas through a stepwise histologic progression sequence that starts from adenomas or hyperplastic polyps/serrated adenomas. Genetic alterations and, more recently, epigenetic alterations have been associated with specific steps in this polyp-adenocarcinoma sequence and likely drive the histologic progression of colon cancer. Consequently, we have assessed in colon adenomas and hyperplastic polyps the methylation status of MGMT, CDKN2A, and MLH1 to determine the timing and frequency of these events in the polyp-carcinoma progression sequence and subsequently to analyze the potential for these methylated genes to be molecular markers for adenomas and hyperplastic polyps. We have found that methylated MGMT, CDKN2A, and MLH1 occur in 49%, 34%, and 7% of adenomas and in 5%, 10%, and 7% of hyperplastic polyps, respectively, and that they are more common in histologically advanced adenomas. Furthermore, analysis of fecal DNA from persons who have undergone colonoscopic exams revealed methylated CDKN2A, MGMT, and MLH1 in fecal DNA from 31%, 48%, and 0% of individuals with adenomas and from 16%, 27%, and 10% of individuals with no detectable polyps, respectively. These results show that aberrant methylated genes can be detected frequently in sporadic colon polyps and that they can be detected in fecal DNA. Notably, improvements in the specificity and sensitivity of the fecal DNA-based assays will be needed to make them clinically useful diagnostic tests for polyps.

Adaptor Proteins, Signal Transducing↗
PubMed1987

[Are stomach polyps an indicator of colonic carcinoma and colonic polyps an indicator of stomach carcinoma?].

Over a period of six years a total of 407 patients with polyps of the gastrointestinal tract were examined by gastroscopy and coloscopy and the findings analysed retrospectively. Among patients with colon polyps 10.5% were found also to have polypoid gastric lesions, among those with adenoma of the colon the prevalence was 11.7%. Only 2.4% of simultaneously diagnosed gastric lesions were found to be malignant or premalignant, a figure similar to the population average. But in patients with more than ten polyps of the colon both the prevalence of polypoid gastric changes and the significance of polyps with respect to precancerous lesions were clearly increased. On the other hand, in patients with epithelial polyps and/or glandular cysts colon polyps were found in 45%, in 42% with precancerous changes (adenoma). Thus patients with epithelial gastric polyps and glandular cysts probably constitute a group with a real additional risk of colon carcinoma. Regular coloscopy will thus reveal precancerous changes (adenoma) in the colon of 42% of such patients; coloscopic polypectomy will be an effective prophylactic measure against carcinoma of the colon.

Adenomatous Polyposis Coli↗
PubMed2004

Carotenoids, vitamin A and risk of adenomatous polyp recurrence in the polyp prevention trial.

One trial reported beta-carotene supplementation was protective of adenomatous polyp recurrence in nonsmokers. We now examine the relation of serum and dietary carotenoids and vitamin A to adenomatous polyp recurrence in a subcohort of 834 participants in a low fat, high fiber, high fruit and vegetable dietary intervention, the Polyp Prevention Trial. Multivariate odds ratio (OR) and 95% confidence intervals (CI) of polyp recurrence were obtained using baseline or the average (first 3 years of the trial) carotenoid and vitamin A values after adjustment for covariates. Compared to the lowest quartile of baseline alpha-carotene concentrations, the OR of multiple polyp recurrence for the highest quartile was 0.55 (95% CI = 0.30-0.99) and the OR of right-sided recurrence was 0.60 (95% CI = 0.37-0.95). Baseline dietary intakes of alpha-carotene and vitamin A from food with/without supplements were inversely associated with any recurrence (p for linear trend = 0.03-alpha-carotene; p = 0.004 and p = 0.007 -intakes of vitamin A). Compared to the lowest quartile of averaged beta-carotene concentrations, the OR of multiple adenomas for the highest quartile was 0.40 (95% CI = 0.22-0.75) with an inverse trend (p = 0.02). The risk was inversely related to averaged: alpha-carotene concentrations and right-sided polyps; alpha-carotene intake and recurrence of any, multiple and right-sided polyps; beta-carotene intake and multiple adenoma recurrence; vitamin A from food (with supplements) and each adverse endpoint. Thus, alpha-carotene and vitamin A may protect against recurrence in nonsmokers and nondrinkers or be indicative of compliance or another healthy lifestyle factor that reduces risk.

Adenomatous Polyps↗
PubMed1998

Long pedunculated colonic polyp composed of mucosa and submucosa: proposal of a new entity, colonic muco-submucosal elongated polyp.

We encountered 15 patients with colonic polyps showing histologic features that did not belong to any of the known categories. All polyps were elongated and drumstick-shaped, with lengths of 12 to 160 (mean, 29 mm) mm. Histologically, the polyps were covered with normal mucosa and consisted of edematous, loose, fibrous, connective tissues and dense, fibrous submucosal layers, often showing dilation of blood vessels and lymphatics. Although the mechanism of generation of such polyps remains unknown, their elongation may be caused by intestinal motion. Because this kind of polyp has not been described previously outside Japan, we here introduce a new type of polyp, which we have proposed calling the colonic muco-submucosal elongated polyp.

Adult↗
PubMed1988

Review of recurrent polyps and cancer in 500 patients with initial colonoscopy for polyps.

Five hundred patients with 1240 polyps removed by colonoscopy and polypectomy over a 13-year period are the subject of ongoing follow-up study. Ninety-three percent of the patients have been followed an average of 53 months with a recurrence rate of polypoid disease in 26 percent, of which approximately 7 percent demonstrated malignant changes. This compares to a rate of 7 percent metachronous cancer in patients with a malignancy demonstrated at any time in the past. The highest risk group for recurrence are patients with more than four polyps at initial colonoscopy, with a 59 percent recurrence rate. The following recommendations for follow-up are made: 1) Flexible sigmoidoscopy is adequate yearly follow-up if the original polyps are confined to the rectum and sigmoid. 2) Colonoscopy should be carried out the first year if the original polyps are beyond the rectum and sigmoid, and yearly until the colon is cleared of recurring lesions. 3) Colonoscopy is indicated in patients with cancer before surgery if possible; if not, within six months after resection. 4) Interval six-month examinations are indicated in patients with colon cancer and multiple synchronous polyps until the colon is cleared. 5) Large, sessile polyps resected piecemeal require a three-month follow-up until gone. 6) When the above conditions are met, colonoscopy at three-year intervals is adequate for long-term follow-up of neoplastic polyps to detect and prevent early malignancy.

Adult↗
PubMed2006

Does tamoxifen therapy affect the hormone receptor expression and cell proliferation indices of endometrial polyps? An immunohistochemical comparison of endometrial polyps from postmenopausal women exposed and not exposed to tamoxifen.

OBJECTIVE: This study set out to test the null hypothesis that tamoxifen therapy would not affect the hormone receptor expression (oestrogen and progesterone receptors-ER and PR) or markers of cell proliferation/apoptosis (Ki67 and Bcl-2) of endometrial polyps from postmenopausal women exposed and not exposed to tamoxifen. METHODS: Endometrial polyps were prospectively obtained from women presenting with abnormal bleeding attending an out-patient hysteroscopy clinic who subsequently underwent endometrial polypectomy (16 from postmenopausal women not exposed to tamoxifen, 9 from women exposed to tamoxifen). Immunohistochemical staining for ER, PR, Ki67 and Bcl-2 was performed on polyps from both groups of women. Non-parametric statistical analysis was used (Mann-Whitney and Spearmans rank correlation). RESULTS: Endometrial polyps from tamoxifen users had significantly lower oestrogen receptor but increased progesterone receptor and Bcl-2 expression. There were no significant differences for proliferation markers (Ki67) between postmenopausal endometrial polyps exposed and not exposed to tamoxifen. CONCLUSIONS: Tamoxifen has a significant affect on hormone receptor expression and markers of apoptosis in endometrial polyps. The results support the hypothesis that tamoxifen promotes polyp growth by inhibiting apoptosis. The mechanism for this does not appear to be oestrogen receptor mediated.

Aged↗
PubMed2006

Are endometrial polyps from pre-menopausal women similar to post-menopausal women? An immunohistochemical comparison of endometrial polyps from pre- and post-menopausal women.

OBJECTIVE: Do endometrial polyps from pre- and post-menopausal women have similar immunohistochemical expression of oestrogen and progesterone receptors (ER, PR) and markers of cellular proliferation/apoptosis (Ki67 and Bcl-2). DESIGN: Prospective cohort study. Non-parametric statistical analysis was used. SETTING: Polyps recruited from women attending an out-patient hysteroscopy clinic in a UK district general hospital. PATIENTS: Fourteen pre-menopausal and 16 post-menopausal women who presented with abnormal bleeding with endometrial polyps. INTERVENTIONS: Immunohistochemical staining was performed on endometrial polyps. MAIN OUTCOME MEASURES: Significant differences or correlations between hormone receptor expression (oestrogen and progesterone) and cell growth indices (Ki67 and Bcl-2). RESULTS: Endometrial polyps from pre- and post-menopausal women had significant differences in their expression of hormone receptors and Ki67. However, polyps from both groups of women had similarly increased levels of Bcl-2, an inhibitor of apoptosis. CONCLUSIONS: Pre- and post-menopausal polyps exhibit differing hormone receptor and proliferation markers, presumably a result of their hormonal milieu. However, both groups appear to have lost the usual control mechanisms for apoptotic regulation, this appears to be responsible for their growth.

Adult↗
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↗
PubMed1985

Morphological range of hyperplastic polyps and carcinomas arising in hyperplastic polyps of the stomach.

A morphological range of 67 hyperplastic polyps was studied. They included polyps removed endoscopically and polyps found incidentally in resected stomachs with gastric ulcers and cancer. The hyperplastic polyps were essentially composed of cystic foveolae and pyloric type glands, lined by cells identical to those of the normal gastric mucosa. Thirty one polyps contained other cytological elements. In 18, intestinal metaplasia was seen; the tubules were mostly composed of columnar and goblet cells and lacked Paneth cells. In 11 polyps, nine cases of gastric dysplasia and two cases of intestinal dysplasia, dysplastic changes were found. The former consisted of a proliferation of irregularly shaped pits with pleomorphic cuboidal/columnar cells with relatively basophilic cytoplasm. They contained mucigen granules of a gastric type. The latter consisted of atypical pits composed of closely packed, tall columnar and small goblet cells, both resembling adenomatous cells of the colon. In three polyps carcinomas were seen, one of which was an intestinal type adenocarcinoma. In the other two, the cancer cells closely resembled the normal foveolar cells, containing gastric type mucigen granules. They were gastric type adenocarcinomas.

Adenocarcinoma↗
PubMed1992

Fibroepithelial polyps of the vagina: are they old granulation tissue polyps?

AIMS: To study the nature of fibroepithelial polyps of the vagina. METHODS: Sixty five fibroepithelial polyps of the vagina and 64 granulation tissue polyps diagnosed over 15 years were reviewed histologically. RESULTS: Cytologically benign multinucleated stromal cells were present in large numbers in 19 of the fibroepithelial polyps of the vagina (FEPV). Only one polyp contained atypical stromal cells, a high mitotic count, and abnormal mitoses and was indistinguishable from a malignant tumour. Immunostaining showed the presence of vimentin and desmin positive mono- and multinucleated stromal cells in FEPV and occasional oestrogen receptor positive nuclei. Desmin positive cells could not be shown in granulation tissue polyps. CONCLUSIONS: FEPV are common lesions with benign mono- and multinucleated fibroblastic stromal cells in which myoid differentiation is often present. FEPV may develop as a result of a granulation tissue reaction after some local injury of the vaginal mucosa. Hormonal factors may modulate the growth of FEPVs. Delayed differentiation of myofibroblastic cells may explain why granulation tissue sometimes does not contract properly but turns into polyps.

Adolescent↗