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At least 973 records · Page 54Linked to original sources
PubMed1984

Histopathology and prognosis of malignant colorectal polyps treated by endoscopic polypectomy.

The histopathological features and results of treatment of malignant polyps removed by endoscopic polypectomy from 60 patients are presented. The patients were followed for a minimum of five years. Forty six patients were treated by polypectomy alone as local excision was judged complete and the invasive carcinoma was well or moderately well differentiated. Thirty seven of these patients are alive and well after five years and the remaining nine have died of other causes up to four years later: there was no evidence of recurrence in any of these cases. Fourteen patients underwent a subsequent major surgical resection and residual tumour was found at the site of polypectomy in two cases but regional lymph nodes were not involved. Only one patient from this group with a high grade tumour developed metastases although the operative specimen was free of tumour. Malignant polyps can be successfully treated by polypectomy alone provided both the laboratory techniques of examination and the histopathological criteria are strictly applied.

Adenoma↗
PubMed1984

Radiological features of familial polyposis coli: grouping by polyp profusion.

The radiological features of familial polyposis coli (FPC) were studied in 60 patients by double-contrast barium enema examinations. When classified by profusion of polyps, cases fell into two groups: the profuse type and the sparse type. The radiologically determined boundary range distinguishing these types was 6-9 polyps/cm2 in adult patients and 3-6 in children. But on grouping the FPC patients by size of the polyps, one group of 34 cases had one or more polyps of more than 1 cm diameter, and in 16 of this group, one or more advanced cancers were histologically demonstrated; whereas in the group of 20 patients, in which the lesions were 5 mm or less, no malignancy was detected. In contrast to cases of the sparse type, in which the size of the polyps bore no relation to age, all cases of the profuse type who were 15 years old or more had polyps more than 1 cm in diameter.

Adolescent↗
PubMed1999

[A scanning method for detecting colorectal tumors].

OBJECTIVE: To develop a method for survey of colorectal tumors. METHODS: Mucus obtained by digital rectal examination was smeared on a slice to react with peanut agglutinin labeled by Horseradish-peroxidase. RESULTS: Brown color was noted in positive reaction. In detecting colorectal tumors, the sensitivity and specificity of the method was 88.2% and 92.5% respectively. CONCLUSION: The method is effective in detecting colorectal tumors in humans.

Adult↗
PubMed1992

Myb expression is higher in malignant human colonic carcinoma and premalignant adenomatous polyps than in normal mucosa.

Expression of the protooncogene c-Myb protein was assessed in normal mucosa and in tumor samples resected from six patients. We found that the tumor samples always expressed higher levels of full length Myb protein than the normal tissue. This contrasts with the situation in c-myb-associated hemopoietic malignancies of the mouse and chicken, in which Myb proteins are generally amino or carboxyl truncated. Tissues from five patients with colonic adenomatous polyps were also examined and found to express levels of Myb that were, in general, intermediate between those found in normal tissues and tumors. Of particular interest is that the more dysplastic polyps displayed higher Myb levels. In one patient with carcinoma and multiple colonic polyps, some polyps had intermediate levels of Myb, whereas one polyp with carcinoma in situ expressed tumor-like levels of Myb. To directly test the hypothesis that Myb expression may be important in determining the rate of colonic cell proliferation, we examined three colonic carcinoma cell lines and one polyp cell line. We found that the cell lines with the most rapid doubling times exhibited the highest Myb levels. In addition, we show that antisense myb oligonucleotides retard the proliferation of one of these colonic cell lines which expresses the highest level of Myb.

Base Sequence↗
PubMed1990

Induction of carcinoembryonic antigen and its crossreactive gene products in human colonic adenomas and carcinomas by transforming growth factor-beta.

The inducing effect of transforming growth factor-beta (TGF-B) on carcinoembryonic antigen (CEA) secretion and the cellular expression of CEA and CEA crossreactive glycoproteins (CEA-GLY) was examined from a panel of human colonic cell lines with different phenotypic classification. This panel included carcinomas with dissimilar differentiation characteristics and metastatic behavior, and premalignant adenomas derived from colonic polyps. A great degree of heterogeneity was observed in the endogenous levels of CEA secretion and the cellular expression of CEA and CEA-GLY species. The response profiles of the different cell lines to TGF-B treatment were also found to be heterogenous. However, TGF-B was able to induce CEA secretion and up-modulated the cellular expression of CEA and CEA-GLY from a majority of the cells tested. More importantly, TGF-B was able to exert these effects on carcinoma cells that secrete or express minimal or nondetectable amounts of these glycoproteins. These biologic modifying effects of TGF-B may have potential in augmenting the efficacy of CEA as a colon cancer marker, and in antibody-directed radioimaging and therapeutics. Further investigation in vivo in an experimental animal model system is warranted.

Adenoma↗
PubMed1985

[Carcinoembryonic antigen in intestinal lavage fluids and the tissue of colorectal tumors].

Determination of carcinoembryonic antigen (CEA) was carried out in 48 intestinal washing fluids (21 from healthy subjects, 15 from patients with polyps and 12 from patients with colorectal carcinoma). The histologic study of polyps and the histologic and immunohistochemical studies of tumors were realized. In the polyps's group, the mean of ACE is significantly higher than that of the volunteers's group, but 7 subjects have a CEA level below the mean and 8 subjects have a CEA level twice this mean. Furthermore, the CEA level seemed to be independent of histologic grade of polyps. The mean of CEA levels in the subjects with colorectal carcinoma is significantly higher than that of volunteers, but 4 of 12 patients have a CEA level below the mean of healthy subjects. The CEA levels are very variable for an identical stage of tumor's differentiation and is independent of Dukes stage (B-C or D). CEA determination in intestinal washing fluids allows neither the detection nor the appreciation of intestinal carcinoma's extend.

Adult↗
PubMedDate not supplied

[Colonoscopic follow up of rectocolonic cancer surgeries. Assessment of 64 examinations].

A collation of 64 colonoscopic examinations performed on 41 patients operated on for cancer of the colon or rectum is reported. Eleven patients (26.8 percent) had positive follow-up endoscopic findings. In 13 enumerated tumoral proliferations. 8 benign polyps and 5 malignant growths were found, one of the latter on the anastomosis, and the other 4 on the remaining colon. 80 percent of these tumoral growths and all malignant tumors were discovered in the two years following surgery. When colonic strictures present before operation prevent total colonoscopic exploration, such an endoscopic examination of the colon in its entirety must be made immediately following passage of three post-operative months. It is prudent not to wait for attendant alarming signs but rather to integrate total colonoscopy including excision of "overlooked" or newly-formed polyps into the follow-up protocol of all colon surgery cancer patients who have become high-risks for either a relapse or recurrence of polyps. In the initial two post-operative years, when there is a maximal risk. Colonoscopy should be performed every six months and thereafter at longer but regular intervals throughout survival.

Adenocarcinoma↗
PubMedDate not supplied

Rationalisation of colonoscopy surveillance services: the need for clearer guidelines.

Colonoscopic surveillance in premalignant conditions and after resection of colorectal cancer is necessary. However, it is expensive, time-consuming and patients find it unpleasant. Furthermore, limited resources exist. Cost-effectiveness will depend upon a rational approach. This article is stimulated by the need for clearer guidelines.

Adenomatous Polyps↗
PubMed1995

[Endoscopic treatment of colorectal cancer].

Endoscopic polypectomy should be applied only for early colorectal carcinomas. Intramucosal carcinoma do not have a risk of lymph node metastases. However, there is an about 10% risk of lymph node metastases among carcinomas showing submucosal invasion (sm carcinoma). When risk factors revealed to be positive after polypectomy, subsequent surgical resection of the large bowel with lymph nodes dissection is needed, because these sm carcinomas are considered to have a high risk of lymph node metastases. Therefore, accurate diagnosis of depth of invasion is essential to prevent subsequent surgical resection following endoscopic polypectomy. Endoscopy, barium enema and endoscopic ultrasonography (EUS) are all considered to be effective for an accurate diagnosis of depth of invasion. Endoscopic polypectomy includes hot biopsy, snare polypectomy and endoscopic mucosal resection (EMR). Appropriate maneuver must be chosen, considering the characteristics of the lesion. Major complications after endoscopic polypectomy are bleeding and perforation of the large bowel. Including an establishment of a new risk factors, further efforts must be made to prevent unnecessary additional surgical resection of the large bowel following endoscopic polypectomy.

Aged↗
PubMed1988

Impact of the barium enema on patient management.

The medical records of 214 consecutive inpatients who had a barium enema examination were reviewed, and the clinical indications, efficacy of the barium enema, and patient outcome were correlated to determine the impact of the barium enema on patient management. The most frequent indications were rectal bleeding (33%), abdominal pain (31%), anemia (17%), weight loss (12%), and previous lesions needing reevaluation (12%). Diverticular disease (30%), colonic polyps (10%), and primary or secondary malignancies (12%) were the most common abnormalities detected radiographically. The sensitivity of the barium enema for colonic neoplasms was 89%, with only 1 small cecal polyp being undetected. The effects of barium enema on patient management were serious pathology excluded (64%), diagnosis made that changed therapy (24%), existing therapy continued (10%), and a further study ordered (2%). No serious or life-threatening lesion was missed by barium enema.

Barium Sulfate↗
PubMed2001

Bidirectional endoscopy in patients with fecal occult blood.

BACKGROUND: Current screening protocols for colorectal cancer depend primarily on fecal occult blood testing (FOBT). However, positive test results do not always indicate the presence of a colonic neoplasm. METHODS: We reviewed the results of 100 consecutive bidirectional (upper and lower) endoscopic procedures performed to evaluate positive FOBT results. Patients were excluded if they presented with gross bleeding, a history of bowel lesions, or previous intestinal operations. There were 31 women and 69 men whose mean age was 51 years. RESULTS: Major abnormalities were found on esophagogastroduodenoscopy (n = 24), colonoscopy (n = 13), or both studies (n = 2). Active bleeding was manifested in two patients, (Barrett's ulcer, duodenal arteriovenous malformation). Two other patients had malignancy: One had a cecal adenocarcinoma and the other a gastric adenocarcinoma. Various benign lesions also were identified in the stomach including esophagitis (n = 8), ulcers/erosions (n = 8) varices (n = 5), and arteriovenous malformations (n = 2). Colonic pathology included polyps (n = 8), arteriovenous malformations (n = 3), and rectal varices (n = 1). Diverticulosis and hemorrhoidal disease were present in 29 and 16 patients, respectively, but were not considered to be likely sources of a positive FOBT. CONCLUSION: Positive FOBT results may indicate the presence of either upper or lower intestinal pathology, and bidirectional endoscopy is an efficient and accurate technique for the comprehensive evaluation of occult bleeding.

Adenocarcinoma↗
PubMedDate not supplied

[Diverticulosis and neoplasms of the colon].

About half of the carcinomas and polyps of the large intestine is placed in the descendent colon and in the sigma, where most frequently the diverticula are found. Literature refers to them as varying percentage of association diverticulosis-carcinoma between 2 to 8 percent. The increase of the frequency of neoplasms and diverticula in the same population classes may indicate common factors in their development. The study includes 1149 cases of colo-rectal neoplasms examined in the Department of Scienze Chirurgiche--University of Siena, from january 1981 to december 1993. The association of carcinomas and diverticula has been found in 8.96% of the cases (103 pts) and the tumours with stenosis in 59,2% of the cases. The colonoscopy is very important for a more precise differential diagnosis especially in occlusive forms, in which a multiple biopsy is indispensable. Referring to the data of literature, the authors consider that patients with symptomatic diverticular disease have a major general risk for cancer of the large intestine; the existence of certain common symptoms in either disease (especially the bleeding) may not exclude the presence of a tumor in patients with diverticular disease.

Adult↗
PubMed1988

Intraoperative colonoscopy in the detection of nonpalpable colonic lesions--how to identify the affected bowel segment.

The development and widespread use of the colonic fiberscope has led to the identification of early colonic cancers which, being small and flat, are not palpable by intraoperative examination of the exterior of the intestine. Standard operation for cancer is required when snare polypectomy is insufficient, or when it is considered that the lesions would be resected incompletely by electrocautery. We report on the use of intraoperative colonoscopy in 11 patients to identify small lesions and to maintain an adequate distance from the lesions. Intraoperative colonoscopy allows lesions to be detected rapidly, safe operations, and a decrease in operation time.

Adenoma↗