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At least 1,225 records · Page 68Linked to original sources
PubMed2005

Frequency of colorectal polyps in patients with sporadic adenomas or adenocarcinomas of the papilla of vater--an age-matched, controlled study.

BACKGROUND: Epithelial tumors of the papilla of Vater are rare neoplasms of the gastrointestinal tract. The carcinogenesis of these tumors seems to be fairly analogous to the genetic mechanisms which have been described for colorectal carcinoma. Patients with familial adenomatous polyposis bear a particularly increased risk for periampullary tumors. Data on whether the prevalence of colorectal tumors is increased in patients with sporadic ampullary neoplasms are scarce. METHODS: 26 consecutive patients (16 women, 10 men; median age 59 years) with sporadic adenomas (n = 19) or adenocarcinomas (n = 7) of the ampulla of Vater were retrospectively evaluated. The study patients were compared with 104 age-matched asymptomatic controls. All patients had undergone total colonoscopy. RESULTS: Neoplastic colorectal polyps were present in a similar proportion (23%) of patients of the study group compared with 26% in the control group (p > 0.05). Overall, 16 polyps were found among patients with ampullary tumors and 40 in asymptomatic controls (p > 0.05). Colonoscopy detected rectal carcinoma in 2 patients (8%) of the study group. Patients with and without colorectal polyps differed neither significantly by age nor by ampullary histological findings. 50% of the colonic polyps in patients with ampullary neoplasms were located in the ascending colon. CONCLUSIONS: The frequency of colorectal polyps in patients with ampullary tumors did not exceed the risk in the control group. However, the finding of 2 rectal carcinomas among patients with ampullary neoplasms supports the place of screening colonoscopy for the diagnostic work-up of ampullary tumors. Prospective multicenter studies should address this issue to provide a broad basis for future recommendations.

Adenocarcinoma↗
PubMed1985

Cronkhite-Canada syndrome associated with a rectal cancer and adenomatous changes in colonic polyps.

A 52-year-old man with the clinical features of Cronkhite-Canada syndrome developed rectal cancer. Radiologic and endoscopic examinations revealed gastrointestinal polyposis. Histologic examination of the biopsied polyps showed cystic dilatation of glands with an inflammatory stroma. A later biopsy from a rectal polyp proved to be an adenocarcinoma. The totally resected colon and upper rectum had an ulcerated rectal cancer and numerous polyps; most of the polyps showed histological changes typical of the syndrome. Only three polyps had adenomatous changes at their surfaces. Adenomatous and carcinomatous changes of epithelia can occur in non-neoplastic polyposis of Cronkhite-Canada syndrome from which presumably a carcinoma can develop, as in the present case.

Adenocarcinoma↗
PubMed1987

Epithelial misplacement in Peutz-Jeghers polyps. A diagnostic pitfall.

Early difficulties with the interpretation of the histopathology caused overdiagnosis of cancer in the Peutz-Jeghers syndrome; and there is still controversy about the magnitude of risk of gastrointestinal carcinoma. Most workers now believe that there is a small but definite increase in the incidence of gastrointestinal carcinoma in Peutz-Jeghers polyps and most of these cancers occur in the upper gastrointestinal tract. In a review of 491 Peutz-Jeghers polyps in the records of St. Mark's Hospital Pathology department, misplacement of epithelium was found in approximately 10% of small intestinal polyps and closely mimicked adenocarcinoma. This "pseudoinvasion" was not observed in polyps of the stomach or colon. The epithelial misplacement may involve all layers of the bowel wall; and the most helpful histological discriminators include a lack of cytological atypia, the presence of the normal epithelial cell subtypes and a brush border, hemosiderin deposition, and intramural mucinous cysts. Epithelial misplacement may account for the overdiagnosis of carcinoma arising in Peutz-Jeghers polyps as reported in the literature.

Adenoma↗
PubMed2000

Apoptosis and phagocytosis of tissue-dwelling eosinophils in sinonasal polyps.

OBJECTIVE: Sinonasal polyps contain numerous tissue-dwelling eosinophils, but the mechanisms causing their accumulation, functional activities, and resolution are largely unknown. STUDY DESIGN: Nasal polyp tissue from 14 patients was evaluated for cellular expression of CD95, CD68, and annexin-V, for the degree of apoptosis, and for phagocytosis of eosinophils. MATERIAL AND METHODS: Histological sections were immunostained as single stains for CD95, CD68, and annexin-V, and as an immunostaining for CD68 combined with a modified Vital New Red staining. The latter staining is specific for eosinophils. Other sections were stained by terminal d-UTP nick end labeling (TUNEL) assay and routinely stained for H&E. Evaluation of the amount of stained cells was performed by counting the average number in 10 randomly chosen high-power fields. The TUNEL positivity was in all cases confirmed with apoptotic morphology. RESULTS: The inflammatory infiltrate consisted of numerous eosinophils but also a considerable amount of lymphocytes, mast cells, and macrophage-like CD68+ cells. CD95 was frequently expressed on eosinophils, on numerous other inflammatory cells, and also on morphologically apoptotic cells. annexin-V-positive eosinophils were not as frequent as CD95+ cells, but numerous annexin-V-positive eosinophils were found. CD68+ cells approximately equalled the number of eosinophils. The number of cells phagocytosing eosinophils varied between polyps. Apoptosis of eosinophils (as evaluated by TUNEL combined with apoptotic morphology) was a common finding in six of the polyps. CONCLUSIONS: Previous in vitro and ex vivo findings of CD95 on eosinophils are now supported by demonstration of CD95 on eosinophils in this in vivo study. This investigation revealed a switch of the membrane-bound phosphatidylserine of apoptotic cells, which is a novel observation. The study has demonstrated apoptosis of tissue-dwelling eosinophils, and that CD68+ macrophage-like cells phagocytose eosinophils within the sinonasal polyps.

Annexin A5↗
PubMed1998

Rectal cancer after sulindac therapy for a sporadic adenomatous colonic polyp.

Like adenomatous polyps in familial adenomatous polyposis, some sporadic colorectal polyps have been reported to regress in response to sulindac administration. However, a rapidly growing invasive rectal cancer developed in one of 15 patients with sulindac-treated sporadic adenomatous colorectal polyps 16 months after sulindac treatment. In this patient, both the adenomatous polyp that responded partially to sulindac and the rectal cancer developing after sulindac therapy showed immunostaining for cyclooxygenase-2. Although short term sulindac therapy seems to be able to cause some adenomatous colorectal polyps to regress, 4 months of sulindac therapy may not reliably prevent colorectal cancer development in these patients.

Adenocarcinoma↗
PubMed1981

Gastric and duodenal polyps in familial polyposis coli.

Endoscopy with multiple biopsies of the upper gastrointestinal tract was repeated yearly over a two to six year period in nine patients with familial polyposis coli from three families. Adenomatous polyps, one to 20 in number and 2-8 mm in size, were detected in the antrum and the first and second duodenal portions in seven patients, while hyperplastic polyps were detected in four patients in the gastric body. In two patients adenomatous tubules were observed in the biopsies of endoscopically normal mucosa from the same area where adenomatous polyps later developed. Lymphoid polyps were detected in the antrum in three cases. Double contrast radiology correlated poorly with endoscopy in the gastric body; it allowed detection of polyps in the third duodenal portion in two more patients. These results confirm that the incidence of adenomas in the upper gastrointestinal tract in familial polyposis coli may be higher than previously suspected.

Adult↗
PubMed1991

Malignant colorectal polyps: venous invasion and successful treatment by endoscopic polypectomy.

We reviewed the pathology of 81 malignant colorectal polyps in 80 patients treated by endoscopic polypectomy and assessed the importance of carcinomatous invasion of veins in the stalk (submucosa). All the patients were followed up for at least five years. Venous invasion was present in 30 of the polyps (37%). The histological features of lymphatic invasion were considered too subjective to be of value. Most of the tumours were well or moderately differentiated adenocarcinomas, one was poorly differentiated, and one was a signet ring cell carcinoma. Seventy one patients were treated by polypectomy alone, and 58 of these were alive and well five years later, with no evidence of recurrence. Nine died of unrelated causes within five years, but four died of carcinomatosis: one with recurrent tumour, one with a possible metachronous caecal cancer, and in two patients there was late development of malignancy of uncertain nature. The remaining nine patients underwent surgical resection after initial endoscopic polypectomy because of incompleteness of excision, poor differentiation of the tumour, or a decision by the surgeon. Tumour was not present in the resection specimens apart from a single lymph node deposit in the patient with signet ring cell carcinoma. These nine patients were alive and well without evidence of recurrence five years later. The results reemphasize the necessity of good cooperation between endoscopist and pathologist, meticulous laboratory technique, strict histopathological criteria including examination of resection margins and degree of differentiation of the tumour, and regular endoscopic follow up. Endoscopic polypectomy of pedunculated and sessile malignant polyps is adequate treatment if the lesion can be removed in one piece, the tumour is well or moderately differentiated, and local excision is judged complete by endoscopic and histological criteria. Patients with histologically incompletely excised polyps, containing well or moderately differentiated carcinoma, can be safely managed by conservative treatment provided the endoscopist is certain there is no residual tumour. Venous invasion by tumour is a common finding in malignant colorectal polyps and seems to have no prognostic importance.

Adult↗
PubMed1993

Rectal epithelial cell proliferation patterns as predictors of adenomatous colorectal polyp recurrence.

To determine whether proliferative patterns in flat rectal mucosal samples can predict the recurrence of adenomatous colorectal polyps, after polypectomy, biopsy specimens from normal looking rectal mucosa were obtained at endoscopy from 55 patients diagnosed for the first time as having adenomatous colorectal polyps. Epithelial cell proliferation was assessed in biopsy specimens through 3H-thymidine autoradiography. After polypectomy, patients were followed for 24 months and underwent complete colonoscopy every 6 months to detect and remove any metachronous lesions. In 40 patients second biopsy specimens were taken during one of the follow up colonoscopies to evaluate the stability of proliferative indices over time. The ratio of labelled (S phase) to total cells (labelling index) for the entire crypt, as well as ratios for each of the five equal compartments into which the crypt had been divided longitudinally, was calculated for each patient. Mean labelling indices for upper crypt compartments 3 and 4 + 5 in the 22 patients in whom polyps recurred were significantly higher (respectively p < 0.05 and p < 0.01) than those of the 33 without recurrence suggesting that an upward shift of the crypt's replicative compartment is associated with polyp recurrence. Labelling indices remained essentially unchanged in those patients who underwent biopsy twice. Reproducible kinetic parameters such as these might be useful in planning follow up of patients with adenomatous polyps after polypectomy.

Adult↗
PubMed2002

Histogenesis of human colorectal adenomas and hyperplastic polyps: the role of cell proliferation and crypt fission.

BACKGROUND: The histogenesis of human colorectal hyperplastic polyps and colorectal adenomas is poorly understood even now. METHOD: Human colorectal adenomas, hyperplastic polyps, and normal colorectal mucosae (patients with familial adenomatous polyposis and hereditary non-polyposis colorectal carcinoma were excluded) were obtained during colonoscopy and microdissected into individual crypts. Morphology, cell proliferation characteristics, and fission indices of crypts isolated from these lesions were then studied. RESULTS: Crypts isolated from colorectal adenomas and colorectal hyperplastic polyps were significantly larger (p<0.001) than crypts from normal colorectal mucosae. Crypt fission was an uncommon event in normal colonic mucosae but common in crypts isolated from adenomas and hyperplastic polyps (p<0.001). Analysis of the distribution of mitoses suggested an upward expansion of the proliferation compartment in adenomas to the surface of the crypt with no reversal of proliferating cell distribution, as has previously been described. CONCLUSIONS: Sporadic human colorectal adenomas and hyperplastic polyps grow by the process of crypt fission. Expansion of the proliferative compartment was demonstrated in crypts from adenomas, consistent with deregulation of cell cycle control.

Adenoma↗
PubMed1997

Visualization of colorectal polyps with spiral CT colography: evaluation of processing parameters with perspective volume rendering.

PURPOSE: To evaluate two key processing steps for detection of colon polyps with spiral computed tomographic (CT) colography with perspective volume rendering (PVR): image reconstruction and opacity assignment of the attenuation data. MATERIALS AND METHODS: Spiral CT was performed in 10 patients with known polyps confirmed at colonoscopy, and detailed quantitative analyses were performed of data obtained in four. First, anatomic fidelity of three-dimensional (3D) images generated from two-dimensional (2D) source images with equal voxel dimensions (87%-90% overlap) was compared with 3D images generated from 2D source images with unequal voxel dimensions (0%-80% overlap). Next, the relative dimensions of colorectal polyps to adjacent structures were evaluated for various opacity threshold settings. Then, step and sigmoidal opacity functions were compared with respect to image smoothness and edge sharpness. RESULTS: PVR images generated after interpolation of image data reconstructed with at least 60% overlap were equivalent in image quality to PVR images generated from source images with equal voxel dimensions. Relative polyp-to-haustral fold dimensions demonstrated substantial distortions with opacity thresholds below -700 HU. The 3D PVR images generated with the sigmoidal opacity function were significantly smoother than those generated with the step opacity function (paired t test, P < .02), with small differences noted in edge sharpness. CONCLUSION: Use of highly overlapping source images (87%-90%) was not necessary to generate 3D PVR images of colorectal polyps. Image artifacts were suppressed with use of an appropriate opacity threshold and a sigmoidal opacity function without substantial loss in edge sharpness.

Artifacts↗
PubMedDate not supplied

The safety of hot biopsy forceps in the removal of small colonic polyps.

Nine hundred and seven polyps (mean size 3.7 mm; range 2-8) from 460 patients (mean age 67 years; range 34-94) were removed with monopolar electrocoagulation forceps ('hot biopsy forceps'). Sixty-three percent of the polyps were adenomatous and 36% were hyperplastic. In this series there were 3 cancers and 1 neurofibroma. About 42% of the polyps were in the sigmoid-rectum region; the rest were evenly distributed in the remaining part of the colon. There were no complications. Specifically there were no cases of perforation or massive bleeding after removal of these polyps. Within the guidelines mentioned, hot biopsy removal of small colonic polyps is safe.

Adenomatous Polyps↗
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↗
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↗
PubMed1987

Relationship between tobacco smoking and colorectal polyps.

A prospective endoscopic screening examination of a randomized population sample of 200 men and 200 women, aged 50-59 years, enabled the differentiation between individuals with and without polyps in the rectum and sigmoid colon. Both number of years of smoking and percentage years of life with smoking were associated with the presence of adenomas and hyperplastic polyps, both for men and women. No relationship was found between these factors or the daily number of cigarettes and the degree of dysplasia or the size or multiplicity of polyps. Two years' follow-up examination showed a tendency to fewer new polyps among male ex-smokers compared with smokers; however, the difference was not quite significant. No significant difference was found when comparing smokers with never smokers. In the relatively smaller groups of women no significant difference with regard to number of polyps was found among smokers, ex-smokers, and never smokers. The results provide evidence for an association between smoking and colorectal neoplasia and may suggest an initiating effect of smoking on carcinogenesis in the colon and rectum.

Adenoma↗
PubMed1996

Reduced glutamine content in colonic polyps.

BACKGROUND: Glutamine is the most abundant amino acid in the body. It has a key role in nitrogen metabolism and is a major source of energy for the enterocyte and many other cells. Glutamine is also essential for tumor growth, and marked changes in organ glutamine metabolism are characteristic in cancer patients. METHODS: We have investigated the catabolism of glutamine in a classic premalignant condition: the colonic adenomatous polyp. The content of glutamine and activity of two catabolic enzymes, glutamine transferase and phosphate-dependent glutaminase, were studied in normal colon and in polyp mucosa. RESULTS: Free glutamine content and activity of glutaminase were significantly lower in polyps than in their adjacent mucosa. Glutamine transferase activity was significantly lower in polyp mucosa than in normal colon controls. CONCLUSIONS: Adenomatous polyps might behave as a glutamine trap, channeling glutamine to protein and nucleic acid synthesis. These changes in glutamine catabolism could play a role in colonic neoplasia pathogenesis.

Acyltransferases↗
PubMed1999

[Polyps and polyposis of the paranasal sinuses].

Discussion is about the different types of naso-sinusal polyps, isolated inflammatory polyps and some other ambiguous types like inverted papilloma, so-called haemorrhagic polyps, pseudo-polyps and reactional polyps collecting very heterogeneous and various clinical, CT and evolutive entities.

Adult↗
PubMedDate not supplied

Laparoscopic colectomy in the management of large, sessile, transformed colorectal polyps.

BACKGROUND: Colonic polyps are usually removed endoscopically. Surgical intervention is reserved for large, inaccessible colorectal polyps that have underdone malignant transformation. Laparoscopic management of colonic polyps has gained a well-defined role. METHODS: Since 1993, 650 laparoscopic colectomies have been performed in our department. Twenty-eight patients with large, sessile, polyps that have undergone malignant transformation underwent elective laparoscopic colectomy. Operative procedures included 14 sigmoidectomies, 10 low anterior recto-sigmoid resections, 3 right colectomies, and 1 left colectomy. Central ligation of vessels and lymph node dissection were preformed in all patients. RESULTS: The main outcome measures include conversion rate (11%), morbidity (11%), and mortality (3.5%). The mean return of bowel function was 3.1 days, liquid intake 1.4 days, solid food intake 2.5 days, and mean hospital stay 8 days. The mean specimen length was 23 cm, and the mean number of retrieved lymph nodes was 15. Malignancy according to Dukes classification was in situ, n=4; A, n=15; B, n=4; C, n=4; and D, n=1. During follow-up, 2 patients developed liver metastases. CONCLUSION: Laparoscopic colectomy is a technically feasible and effective method for treating large colorectal polyps that have undergone malignant transformation.

Aged↗
PubMed1989

[The role of epidemiologic research of the natural history of cancer for evaluating cancer screening programs--a prospective study of colorectal polyps on the occurrence of colorectal cancer].

In order to elucidate the natural history of colorectal polyps and to examine the effectiveness of endoscopic polypectomy in reducing the incidence of colorectal cancer, we conducted a retrospective cohort study of all patients who had undergone endoscopic examination at the Center for Adult Diseases, Osaka in 1970-82. The study subjects consist of 653 non-polyp cases and 431 colorectal polyp cases including 222 cases treated by endoscopic polypectomy. These were followed up until the end of 1985 by the method of a record linkage with the Osaka Cancer Registry's file. The colorectal polyp group and the endoscopic polypectomy group experienced 4.4 and 2.9 times, respectively, as much incidence of colorectal cancer as the non-polyp group. The magnitude of the prevented fraction by the use of endoscopic polypectomy was estimated at 31.3%. A large-scale and long-term study is necessary to elucidate the original study purpose.

Adult↗