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At least 1,135 records · Page 63Linked to original sources
PubMed1985

Colon polyps and carcinomas: prospective comparison of the single- and double-contrast examination in the same patients.

Single-contrast (SC) and double-contrast (DC) colon examinations were compared in 425 consecutive patients for detection of polyps and stricturing carcinomas. Each patient was examined with both SC and DC during the same session. In patients with carcinoma, there was no significant difference between the two modalities. DC was far superior to SC for detection of rectal or colonic polyps (p less than 0.05); however, the techniques appeared to be complementary in the sigmoid and cecum. The authors conclude that DC is superior to SC as a means of screening for polyps of the rectum and colon, with SC being useful as an adjunct in problem areas such as the sigmoid and cecum.

Adolescent↗
PubMed2005

Sertoli cell tumor causing prepubertal gynecomastia in a boy with peutz-jeghers syndrome: the outcome of 1-year treatment with the aromatase inhibitor testolactone.

Peutz-Jeghers syndrome (PJS) is a rare disorder characterized by benign intestinal hamartomatous polyps and mucocutaneous pigmentation, and with an increased risk for intestinal and extra-intestinal neoplasms. Sertoli cell tumors in boys with PJS have been increasingly recognized as a cause of prepubertal gynecomastia. However, an association between nephrocalcinosis and PJS has not been reported before. We report on a 7.25-year-old boy with PJS, bilateral gynecomastia, Sertoli cell tumor and nephrocalcinosis, and present the outcome of 1-year treatment with the aromatase inhibitor testolactone. The patient presented with bilateral breast and testis enlargement, and mucocutaneous pigmentation. Testicular ultrasound revealed parenchymal multiple microcalcifications. Histopathological examination was consistent with Sertoli cell tumors. Nephrocalcinosis due to idiopathic renal hypercalciuria was also detected. The aromatase inhibitor testolactone was begun in an attempt to prevent acceleration in skeletal maturation. One-year treatment with testolactone reduced the breast base diameter from 7 to 3 cm, and bone age advanced 1.2 years during this period. Our case demonstrates that waiting for the effect of aromatase inhibitors on gynecomastia before making a decision for mastectomy may be a reasonable option. We also consider that the association between PJS and nephrocalcinosis may be a coincidence.

Aromatase Inhibitors↗
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↗
PubMed1990

Risk for colon adenomas in patients with rectosigmoid hyperplastic polyps.

OBJECTIVE: To determine whether hyperplastic polyps found in the rectosigmoid area of the colon are associated with proximal adenomas, and to judge whether patients with distal hyperplastic polyps found during sigmoidoscopy might benefit from full colonoscopy. DESIGN: Data on patients having colonoscopy collected prospectively according to a set protocol. The size and location of all polyps were noted, and all polyps were biopsied. SETTING: Two university hospitals. PATIENTS: One thousand eight hundred and thirty-six consecutive patients referred for colonoscopy between 31 December 1987 and 31 August 1989. RESULTS: Of the 970 patients who met eligibility requirements, 274 (28.3%) had adenomas and 108 (11.1%) had hyperplastic polyps. The proportion of patients with distal hyperplastic polyps and proximal adenomas (31.9%) was similar to the proportion of those without distal hyperplastic polyps (23.0%) (crude odds ratio, 1.57; 95% CI, 0.77 to 3.06). After adjusting for age and sex, the results were unchanged (adjusted odds ratio, 1.53; CI, 0.82 to 2.88). Patients with distal adenomas, on the other hand, were three times more likely to have proximal adenomas than those without distal adenomas (adjusted odds ratio, 3.42; CI, 1.99 to 5.88). CONCLUSIONS: Distal hyperplastic polyps are not strong predictors of risk for proximal adenomas. Based on the magnitude of the risk difference, we do not believe that finding a hyperplastic polyp during sigmoidoscopy justifies doing a full colonoscopy to search for proximal adenomas. Because rectosigmoid adenomas are associated with proximal adenomas, however, small polyps seen during sigmoidoscopy should be biopsied to determine their type. Colonoscopy should be reserved for patients who are proved to have adenomas.

Adenoma↗
PubMed1993

Dietary risk factors for the incidence and recurrence of colorectal adenomatous polyps. A case-control study.

OBJECTIVE: To investigate the association of dietary factors with the incidence and recurrence of colorectal adenomatous polyps. DESIGN: Two case-control studies. SETTING: Three university-based colonoscopy practices in New York City. PATIENTS: For the incidence study, 286 patients with pathologically confirmed incident adenomatous polyps (162 men and 124 women) were compared with 480 controls (210 men and 270 women) with no current or previous neoplasia. For the recurrence study, 186 patients with recurrent polyps (130 men and 56 women) were compared with 330 controls (187 men and 143 women). These patients had a history of polyps but no current neoplasia. MEASUREMENTS: Structured interviews using the Block food frequency questionnaire were conducted on all participants and were compared over quartiles of crude nutrient intake of total and saturated fat; fiber; protein; carbohydrates; carotene; vitamins A, C, and E; and various food groups. Data were adjusted for age, Quetelet index, and caloric intake by multiple logistic regression for men and women separately. RESULTS: For incident polyps, elevated adjusted odds ratios (high to low quartile) for women were found for saturated fat (odds ratio, 2.3; 95% CI, 0.9 to 5.8) and the ratio of red meat to chicken and fish intake (odds ratio, 1.9; CI, 1.0 to 3.6). Protective associations were observed for fish and chicken (odds ratio, 0.6; CI, 0.3 to 1.2) and vitamin A intake (odds ratio, 0.4; CI, 0.2 to 0.9). Among women, recurrent polyps showed an association with total dietary fat (odds ratio, 4.4; CI, 1.0 to 19.5), saturated fat (odds ratio, 3.8; CI, 1.0 to 14.9; P = 0.15 for the trend), and total fiber (odds ratio, 0.2; CI, 0.1 to 0.5; P = 0.01) and a borderline association with carbohydrates (odds ratio, 0.3; CI, 0.1 to 1.3; P = 0.10). No consistent relations were observed for men, although increased caloric intake increased the risk for incidence and recurrence in both men and women. CONCLUSIONS: These findings are consistent with previously described relations between diet and the incidence of colon cancer and suggest that, at least in women, dietary modification may be warranted in patients diagnosed with polyps.

Adult↗
PubMed2001

Polyposis syndromes: pediatric implications.

The diagnosis of a polyposis syndrome, such as juvenile polyposis, Peutz-Jeghers syndrome, and familial adenomatous polyposis, requires knowledge of the site, number, and histologic type of the polyps and an appreciation of relevant family history. Children and adolescents with polyposis syndromes are faced with not only the immediate complications of the polyps, such as intussusception or bleeding, but also the extraintestinal manifestations and the long-term risk for malignancy. This article reviews the diagnosis, clinical management, surveillance, and surgical options for children with polyposis syndromes and discusses genetics and appropriate screening programs.

Adenomatous Polyposis Coli↗
PubMed1988

The adenomatous polyp and the hereditary polyposis syndromes.

Adenomatous polyps are the benign precursors of colorectal adenocarcinoma. Colonic adenomas occur commonly in adults in Western countries. There is recent evidence that inheritance may play an important role in the etiology of these adenomatous polyps. Colonic adenomatous polyposis (numerous colonic adenomas) is the central feature of several rare inherited syndromes that give rise to colorectal cancer. There also appears to be a risk of gastrointestinal and other malignancies in the rare inherited syndromes of hamartomatous polyposis.

Adenomatous Polyposis Coli↗
PubMedDate not supplied

[Rectocolonic polyps in Senegal. Results of 1500 lower endoscopies carried out at the Dakar General Hospital].

57 polyps were discovered during 1,500 low endoscopies, and 24 of them were adenoma. In the same period of time, 26 proctocolitic adenocarcinomas were found. Adenomatous polyps appear to be 5 times less frequent in Senegal than in industrialized countries and frequency of colitic cancer should be of the same frequency, that is far less negligible. Even if proctocolitic cancer does not set up any Public Health problems one could envisage systematic screening of polyadenoma in every patient aged more than 40. Proctosigmoid being the seat of most adenoma, fibrosigmoidoscopy appears well adapted to this kind of screening because it does not require any preparation, it is easy to perform and well accepted.

Adolescent↗
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↗
PubMed1984

[Precancerous lesions of the colon and rectum].

We discussed significance of various kinds of precancerous lesions of the colon and rectum. Colonic adenoma was most important as a histogenetic background of colonic carcinoma, as it has been widely accepted. The first malignant transformation of adenoma seemed to occur at the relatively superficial layer of the central portion of adenoma in many cases. Growth rate of adenoma largely depended on cellular atypia. Six of twenty-seven patients with Peutz-Jeghers syndrome had advanced carcinoma and/or carcinoma in Peutz-Jeghers polyp. In general, malignant transformation in the polyp was higher in frequency in polyps more than 3.0 cm in the largest dimension. Significance of precancerous lesions in juvenile polyp, hyperplastic polyp, ulcerative colitis, Crohn's disease and radiation colitis was briefly presented.

Adenoma↗
PubMed1984

Genetics of rectal cancer.

Two operational subdivisions of hereditary colorectal cancer susceptibility are those with and those without premalignant adenomatous colonic polyp expression. In both of these subdivisions, reliable biomarkers of gene carriage would be of value in patient management as we have previously emphasized. Consideration must also be given to the familial (hereditary) occurrence of inflammatory bowel diseases associating with colorectal cancer susceptibility. The occurrence of rectal cancers should therefore alert the physician to investigate the possibility of a significant family medical history in order to fully elucidate the genetic heterogeneity of susceptibility to this disease. Clinicians should also be alert to the possibility of extracolonic malignancies where probable genetic colorectal cancer susceptibility is evident. Whenever possible, all potential biomarkers should be investigated to aid in definition of genetic heterogeneity.

Colitis↗
PubMedDate not supplied

[Gastrointestinal polyposis in Bourneville's tuberous sclerosis: an involvement often overlooked].

Ten patients (5 male, 5 female, mean age: 29.4 years) with tuberous sclerosis were investigated for gastrointestinal polyps. Three had adenomatous colonic polyps, one had a single duodenal hamartomatous polyp and the fifth a hyperplastic gastric polyp. This high prevalence (50%) should put the gastro-intestinal investigation as a useful test in the diagnosis of tuberous sclerosis, particularly in the incomplete varieties of disease. Conversely, tuberous sclerosis should be considered in the differential diagnosis of digestive polyposis.

Adolescent↗