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PubMed2006

MIB-1 and MCM-2 immunohistochemical analysis does not aid in identification of serrated colorectal polyps with abnormal proliferation.

We investigated the staining characteristics of serrated polyps with abnormal proliferation (SPAP) using MIB-1 and MCM-2 to determine if they could provide assistance in delineating SPAPs from traditional hyperplastic polyps (HPs). Using published morphologic criteria we reviewed H&E slides of 107 polyps from 80 patients. Thirty-nine (36.4%) polyps met the criteria for SPAP Within a given region, polyps in the transverse colon had the largest percentage of SPAPs (50.0%) followed by the right colon (40.9%). The majority of SPAPs (82.1%) and HPs (72.1%) showed MIB-1 staining confined to the basal third of the crypts. The majority of SPAPs (59.0%) and HPs (52.9%) showed MCM-2 staining extending into the apical third of the crypts. We do not recommend MIB-1 or MCM-2 staining to differentiate SPAPs from conventional HPs, since staining characteristics are not significantly different between the 2 groups, and frequent variable crypt staining within a given polyp is difficult to interpret.

Biomarkers, Tumor↗
PubMed2006

[Expression of transforming growth factor beta receptor I and II in chronic rhinosinusitis, nasal polyps and normal nasal mucosa tissues].

OBJECTIVE: To explore the expression of transforming growth factor beta receptor(TGFpR) I, II in the chronic rhinosinusitis, nasal polyps and normal nasal mucosa tissues. METHOD: The protein expression of the TGFbetaR I and TGFbetaR II were determined by means of immunohistochemistry in chronic rhinosinusitis tissues from 25 patients, nasal polyps tissues from 21 patients and inferior turbinate mucosa tissues from 17 patients with deviation of nasal septum. RESULT: (1) In chronic rhinosinusitis and nasal polyps tissues, compared with controls, the expression of TGFbetaR I and TGFbetaR II protein was increased significantly (P < 0.01). (2) The expression of TGFbetaR I and TGFbetaR II protein in nasal polyps tissues was significant increased than that in chronic rhinosinusitis tissues (P < 0.01). CONCLUSION: The different expression level and pattern of TGFbetaR I and TGFbetaR II in chronic rhinosinusitis and nasal polyps tissues indicates TGFbetaR may play a different role in the pathogenesis chronic rhinosinusitis and nasal polyps.

Adolescent↗
PubMed1991

[The morphogenesis of polyps of the large intestine].

The proportion of so-called hyperplastic polyps among other colon epithelial tumours remains unclear. Colon polyps are studied in 400 patients: hyperplastic polyps are found in 107, a combination of hyperplastic polyp with tubular adenoma in 143, tubular adenoma in 72, villous adenoma in 41 and tubulovillous adenoma in 37 cases. Hyperplastic structures and formation of adenomatous structures were, as a rule, observed in a polyp tip, this corresponding to the increase of nuclei volume and DNA amount in the tip colonocytes. The determination of karyometric coefficient (the ratio of the colonocyte nuclei volume in the polyp tip to colonocytes in the intact mucosa) is proposed as a quantitative criterion of proliferative and dysplastic processes.

Colon↗
PubMed2006

Comparison of virtual colonoscopy with conventional colonoscopy in detection of colorectal polyps.

BACKGROUND/AIMS: To determine the sensitivity and specificity of multidetector computed tomography-based virtual colonoscopy for colorectal polyp detection by using conventional colonoscopy as the reference standard. METHODS: 48 patients with high risk for colorectal cancer underwent virtual colonoscopy followed by conventional colonoscopy. Examination results were compared with conventional colonoscopy, which served as the gold standard. RESULTS: Virtual colonoscopy correctly depicted 19 of 22 polyps (sensitivity, 86%) that were detected in conventional colonoscopy. All 4 polyps that were greater than 10 mm in size (100%), 6 of 7 polyps 6-9 mm in size (85%), and 9 of 11 polyps 5 mm in size or smaller (81%) were correctly depicted with virtual colonoscopy. Virtual colonoscopy had an overall sensitivity of 86% and specificity of 98%. CONCLUSION: Multidetector computed tomography-based virtual colonoscopy has excellent sensitivity for the detection of clinically important colorectal polyps.

Adenoma↗
PubMed1975

[Endoscopic resection of colonic polyps. A propos of 45 polypectomies].

Endoscopic resection of polyps of the colon is, no doubt, a considerable therapeutic advance. It avoids surgical operation permits histological examination and makes simple biopsy unnecessary. It is indicated in the presence of pediculated polyps of a diameter or less than 3 cm, whatever the site of the polyp. Thus we were able to remove 45 polyps without complications. The method is not indicated in a large size polyp, sessile polyps or diffuse polyposis. The follow-up is still insufficient to assess : 1) the true risk of resection which can only be undertaken after long experience of colonoscopy ; 2) the frequency or recurrent adenomas. Endoscopic resection is at present the simplest method of detection and treatment of carcinoma in situ of the colon of which we observed four cases in our series. The problem of surgical reoperation is discussed.

Colonic Neoplasms↗
PubMed1991

Plasma protein-bound sialic acid in patients with colorectal polyps of known histology.

Protein-bound sialic acid (PBSA) was measured in serial plasma specimens from 62 healthy subjects, 48 patients with colorectal polyps, and 30 patients with colorectal adenocarcinomas. The mean plasma PBSA concentration in healthy smokers was significantly greater than that in healthy nonsmokers and healthy ex-smokers (P less than 0.0001). Villoglandular polyps were associated with higher plasma PBSA values than were the most benign hyperplastic polyps (P less than 0.025). Patients with the most neoplastic villoglandular and villous polyps had significantly greater (P less than 0.010-0.050) plasma PBSA values than healthy subjects. Polypectomy decreased the mean PBSA value significantly to the mean value for healthy subjects only for patients with villoglandular (P less than 0.010) or villous (P less than 0.050) polyps. Colorectal cancer patients had mean plasma PBSA concentrations significantly greater than those for the healthy subjects (P much less than 0.001) and the polyp patients (P much less than 0.001). Surgery significantly reduced (P less than 0.025) the mean PBSA value for the cancer patients to the mean PBSA value observed for the healthy subjects.

Adenocarcinoma↗
PubMedDate not supplied

[Gastric polyps: histogenetic considerations and therapeutic trends].

The Authors report their series of 86 patients with gastric polyps, observed from 1986 to 1989. Basing on the literature data the lesions were divided in A) inflammatory polyps, B) hyperplastic polyps, C) adenomatous polyps and 27, 49 and 10 lesions, were respectively found for each type. Particular attention was given to the association between intestinal metaplasia and gastric dysplasia for each type of polyp. A significant prognostic value as a precancerous lesion was recognized only to dysplasia. Therapeutic trend for each single polyp, based on the histologic type, is suggested.

Adenoma↗
PubMed1990

Natural history and current management of colorectal polyps.

There are numerous histological types of colon polyps. The neoplastic polyp, the precursor to colon cancer, is called an adenoma. Adenomas vary in frequency throughout the world and are particularly prevalent in Western countries. The belief that after several years of development some adenomas will become cancers is termed the adenoma-carcinoma sequence. These adenomas occur in both males and females and their incidence increases with age. While small polyps were once considered unimportant, it is now recognized that adenomas may be small. The clinical importance of other small polyps, most often hyperplastic polyps, is still being investigated. When adenomas are found in the colon a full colonoscopy with removal of all polyps and review of their pathology should be performed.

Adenoma↗
PubMed1990

[Colonoscopy in the diagnosis and follow-up of colonic polyps].

Out of 5000 patients examined endoscopically colon polyps were detected in 64%. The polyps were characterized by: higher incidence in 70-79-year-olds, high percentage of tubular adenomas (79%), large sizes of polyps with complex structure and their prevalence in the left colon, signs of malignancy in 0.64% of the removed polyps. The chance to develop cancer from tubular adenoma was 0.28%, tubular-villous, 1.4%, villous 3%. Recurrent polyps following polypectomy arose in 65% of cases. Tumor relapses emerging mainly within the first postoperative year occurred in 14% of cases. In 4 patients with cancer its onset was registered at the site of the removed large adenomas of complex histological structure. Colonoscopy proved an adequate method of diagnosis and follow-up of colon polyps. Endoscopic polypectomy can be considered as a measure to prevent colon cancer.

Aged↗
PubMed1990

Colocolic intussusception in a three-year-old child caused by a colonic polyp.

Colocolic intussusception is an uncommon cause of pediatric intestinal obstruction in North America; 95% of cases are ileocolic in location, with an equal percentage in which no pathologic lead point is evident on barium enema or laparotomy. In the last 20 years less than 3% of approximately 32,500 reported cases of intussusception originated in the colon. In a significant number of these cases juvenile polyps were identified as leading points. The majority of juvenile polyps occur in the rectosigmoid colon within the reach of a standard pediatric sigmoidoscope. These tumors most often cause painless hematochezia. Occasionally, juvenile polyps may grow large and serve as lead points for colocolic intussusception when located in the proximal colon. Pediatric patients presenting with documented colocolic intussusception should suggest the possibility of a colonic polyp or other mass lesion. Careful physical examination and barium studies should provide important diagnostic clues. Treatment is aimed at removing the lead point in patients presenting with intestinal obstruction. Colonoscopic polypectomy performed by an experienced endoscopist may serve as an alternative to surgical removal of the polyp. We report a case in a three-old-child of colocolic intussusception caused by a colonic polyp, and review some of the salient features of this clinical entity.

Child, Preschool↗
PubMedDate not supplied

[Prognosis of colorectal tumors in patients with synchronous polyps].

A retrospective study was carried out in 110 patients who underwent colon resection for cancer of the colon-rectum. Polypoid formation reappeared in 10 (21.5%) patients in whom synchronous polyps were found around carcinoma during initial staging; during the follow-up polyps were only found in 3% of patients in whom synchronous polyps had not been documented. A similar ratio was found in the incidence of neoplastic recurrences which was greater (14%) in patients with synchronous polyps. This incidence was higher in cases with multiple polyps and/or polyps larger than 2 cm in size, and in relation to their histological type. The authors suggest that a more comprehensive operation, for example subtotal colectomy, should be performed in patients at greater risk to develop a second primary carcinoma, and/or that a particularly careful post-operative follow-up should be carried out in these patients.

Aged↗
PubMed1990

[Bronchial reactivity in patients with nasal polyps].

Nasal polyposis is in 25-70% complicated by the development of bronchial asthma, its attribute being bronchial hyperreactivity (BH). The authors examined 101 patients (23 with polyps and asthma, 53 with polyps and 35 controls) using the standard bronchoconstriction test as described by Cockroft and Vondra). By inhalation of increasing concentrations of histamine solutions the provoking concentration, PC20, was assessed. In the group with polyps and asthma 56% patients suffered from spontaneous bronchial obstruction and 44% from high and medium BH (PC20 less than 1.0 mg/ml). In patients with nasal polyposis alone in 21% spontaneous obstruction was found or a high BH, similarly as in the group suffering from asthma (PC20 less than 0.5 mg/ml). A medium BH was recorded in 23% and a mild BH in 26% (PC20 less than 1-2 mg/ml). 30% of patients with polyps are normoreactive (PC20 greater than 2 mg/ml). In the control group all patients were normoreactive. Patients with polyps and a high or medium BH are a risk group (44% of patients) threatened by the development of asthma. They call for longitudinal follow up of the BH and frequent check-up examinations by an ENT specialist and allergologist. Many years' verification of this hypothesis and evaluation of other risk factors is necessary for a more detailed analysis of the risk group of patients with polyps.

Bronchial Provocation Tests↗
PubMed1990

The association of multiple colonic adenomatous polyps with cancer of the colon.

We reviewed our colonoscopy data for the past 10 yr for patients with five or more polyps to determine the association of multiple adenomatous polyps and colon cancer. During that period, 3,834 patients underwent colonoscopy. Fifty-two patients with five or more polyps at the initial colonoscopy were found. In 25 patients (group I) there were at least five synchronous adenomas, and in 27 patients (group II) a combination of adenomas and hyperplastic polyps totaling five or more. The number of polyps ranged from five to 30 (median, six). There was no significant difference in the location of polyps between groups I and II. Eight of 52 patients (15%) were found to have colon cancer at the initial colonoscopy. In group I, there were six cancers (24%), five of which were in the cecum. Two of 27 patients (7%) in group II had cancer, one of which was located in the cecum. Patients with five or more adenomas at the index colonoscopy are at high risk of having colon cancer that is particularly prone to arise from the right side of the colon.

Adenoma↗
PubMed1986

Immunological and non-immunological release of leukotrienes and histamine from human nasal polyps.

Nasal polyps were obtained from 22 patients undergoing polyp surgery. They were chopped into fragments of approximately 2 mm2, washed free of blood, and passively sensitized with serum from timothy allergen sensitive patients (RAST 30-40%), then, challenged with timothy allergen. Analysis of the incubation medium after a 30 min challenge as assessed by reversed phase high performance liquid chromatography and bioassay revealed the presence of leukotriene (LT) LTB4, LTC4, LTD4 and LTE4 (29 +/- 9, 6.6 +/- 3, 62 +/- 13 & 86 +/- 23 pmol/g tissue wet weight, respectively). The human nasal polyps also released histamine which reached a maximum after approximately 5 min (2.8 +/- 1.28 nmol/g tissue), as measured by radioenzymatic assay. A similar profile of leukotrienes and histamine release was observed when the nasal polyps were stimulated with ionophore A23187. However, the ionophore stimulated release was greater than that observed for the antigen challenge. When human polyps were stimulated with a mixture of the ionophore and arachidonic acid, all the above products as well as 5-hydroxy-eicosatetraenoic acid (5-HETE), 12-HETE, and 15-HETE were detected in the medium. These data, taken together, demonstrate that human nasal polyps are able to release significant amounts of leukotrienes and histamine upon both immunological and non-immunological stimulations and that these responses might significantly contribute to the symptoms of allergic rhinitis.

Allergens↗
PubMed1985

[Colonoscopy detection of polyps in patients operated on for colorectal cancer. Prospective study].

Subjects operated upon for colorectal carcinoma seem to constitute a population at high risk of a second colorectal malignancy and/or colonic adenoma (polyp). Ninety-four such patients were examined by colonoscopy. Their distribution by age and sex and the location of cancers in the colon were comparable to those reported in the literature. Colonoscopy was performed 12 +/- 6 months after surgery in 52 patients and was complete in 90% of them. Twenty-seven patients (52%) were found to have one or several polyps distributed throughout the colonic frame and varying in size from 2 to 75 mm (75% were less than 10 mm long). The larger the polyp, the more severe the dysplasia. Three malignant polyps were discovered; they were more than 10 mm in diameter. The colonoscopic examination was repeated annually over more than 3 years in 30 patients: at first repeat examination 54% had polyps which were still present in more than 30% at subsequent examinations. It is concluded that patients operated upon for colorectal carcinoma are at high risk of polyps and/or a second colorectal carcinoma and must therefore be followed-up by repeated colonoscopy.

Colonic Neoplasms↗
PubMed1988

In vitro models of human colonic adenomatous polyps.

In this report we describe methods which were used to cultivate cell lines from adenomatous polyps. Many of the techniques used have evolved from our past experience with the cultivation of colonic epithelial neoplastic cells (McBain et al., 1984) and the experience of others successful in the cultivation of benign and cancerous colon tissues. We feel that the preservation of cell-to-cell associations is a key to our successful cultivation of adenomas. Moyer (Moyer and Aust, 1984) has also pointed out the importance of preserving cell-to-cell associations in her successful studies to culture normal and neoplastic colonic tissues. Friedman's primary culture system for adenomatous polyps (Friedman et al., 1981) is further evidence supporting this point. Using the techniques described in this report, three cell lines, two small tubular polyps and one villous polyp, have been established and characterized. These cells can be expanded to numbers that will be sufficient for molecular and biochemical studies, and the cell number will be sufficient to conduct transfection experiments. Paraskeva (Paraskeva et al., 1984) has described two other cell lines derived from adenomatous polyps arising in patients with familial polyposis. The availability of cell lines from tubular and villous polyps make it possible to propose experiments to probe the biology of colonic adenomas.

Adenoma↗
PubMed1988

Pattern of epithelial cell proliferation in colorectal mucosa of normal subjects and of patients with adenomatous polyps or cancer of the large bowel.

Microautoradiography has been largely used to characterize the proliferative activity of colorectal mucosa. We used this technique in a large series of patients with polyps or cancer of the large bowel and in normal controls with the following objectives: (a) to define the normal pattern of cell replication in different tracts of the large bowel; (b) to compare the proliferative activity of colonic crypts in patients with colorectal cancer or polyps with that of controls; (c) to evaluate replicative activity of colorectal mucosa in the close vicinity and at distance from a neoplastic mass. Specimens of colorectal mucosa were taken during endoscopy (controls and polyps) or at surgery (cancer). During histological examination each intestinal hemicrypt was divided into five equal longitudinal compartments from the base to the surface and the labeled cells in each compartment were counted. In controls, total labeling index (ratio of labeled to total cells) and labeling index per crypt compartment showed only minor differences between the various large bowel tracts. Total labeling index tended to be higher in patients with polyps or cancer than in controls (13.5 +/- 0.4 and 12.5 +/- 0.4, respectively, versus 11.3 +/- 0.5). Labeling index per crypt compartment in the most superficial portions of the crypt (compartments 3 to 5) was significantly higher in the two groups of patients with tumors than in controls. This was particularly evident in the fifth compartment (the most superficial), in which labeled cells were observed in 15.8% (three subjects out of 19) of controls but in 71% (15 out of 21) and 87.5% (14 out of 16) of polyp and cancer patients, respectively. In patients with colorectal cancer there were not significant differences of cell proliferation between mucosal samples taken at various distances from the tumor margin; however, increased cell replication, especially in the most superficial portions of the crypt, has been observed. In conclusion, a significant upwards expansion of the proliferative zone of intestinal glands has been observed in patients with either polyps or cancer of the large bowel. In particular, labeling of the fifth compartment seems to possess the highest discriminatory power between subjects with or without intestinal neoplasms. Hyperproliferation of the entire colonic mucosa seems to be a common feature in patients with colorectal cancer.

Adenoma↗
PubMed1988

Lack of association between skin tags and colon polyps in a primary care setting.

Cutaneous skin tags (acrochordons) have recently been proposed as markers for adenomatous polyps of the colon among symptomatic patients referred for colonoscopy. To ascertain the utility of skin tags as a predictor of colonic polyps in a primary care setting, 492 patients, with a mean age of 58 +/- 13.3 years (241 with signs or symptoms and 251 for screening), were evaluated for the presence of skin tags and then examined using a 60-cm fiberoptic sigmoidoscope by an examiner "blinded" to the skin findings. Among patients with skin tags, 23 (10.2%) of 226 had polyps, whereas among patients without skin tags, 20 (7.5%) of 266 had polyps. The predictive value of the presence of a skin tag was 10.2%. Contrary to studies done in more selected populations with a higher prevalence of adenomatous polyps, the results using a 60-cm flexible sigmoidoscope in a primary care population suggest that cutaneous skin tags are not a marker for adenomatous polyps of the colon.

Adolescent↗