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At least 1,261 records · Page 70Linked to original sources
PubMed2004

Hyperplastic polyps and colorectal cancer: is there a link?

Most colorectal cancers (CRCs) are thought to arise in preexisting polyps called adenomas. A second type of colorectal polyp known as a hyperplastic polyp has been regarded as harmless for decades. Patients with hyperplastic polyps are therefore not thought to be at any increased risk of CRC, and best-practice guidelines indicate that these polyps do not require surveillance colonoscopy. Recently, it has become clear that CRC is not a single disease. One type of CRC (30%) shows a chemical alteration in DNA known as methylation, and a proportion of these also show genetic instability at the level of DNA. There is now strong evidence that the hyperplastic polyp is not harmless, but it might serve as the precursor of CRC with DNA methylation and deficient DNA mismatch repair. This novel pathway applies particularly to the subset of hyperplastic polyps that occurs in the proximal colon. If this premise is correct, it would be unsafe to ignore these polyps. There is now a need to define the genetic steps that explain the evolution of CRCs that develop within hyperplastic polyps. At the clinical level, it will be necessary to identify biomarkers for hyperplastic polyps that are especially prone to malignant conversion. Screening can then be targeted more selectively toward patients who are at significantly increased risk of malignant transformation of hyperplastic polyps.

Adenoma↗
PubMed1975

[Cytological diagnosis of rectal polyps].

Cytograms of polyps of the rectum were studied in 62 patients. Impressions of and smears-scrapes from the surface of polyps (taken during rectoromanoscopy) or bioptic specimens served as material of investigation. Smears were stained after Leischman's method. The cytograms were collated with the findings of the investigations of histological preparations stained with hemato-xylin-eosine. The results obtained showed that cytologically, it seemed possible to establish not only the character of the epithelial component of polyps (benign, atypical, or malignant), but to diagnose the histological structure of a tumour (simple, proliferative and malignant forms of adenomatous polyps of the rectum).

Cytodiagnosis↗
PubMed1994

DNA analysis with flow cytometry and image cytometry in colorectal polyps.

Ploidy was studied with flow and image cytometry in 51 polyps removed endoscopically from 44 patients. Evaluation was carried out on frozen material in 34 cases and on material fixed in formalin and embedded in paraffin in the remaining 17. Data analysis showed a statistically significant correlation between polyp size and aneuploidy frequency (P > 0.05). No statistically significant correlation was found between aneuploidy frequency and histological type. The linear correlation study did, however, show a correlation tendency between histological type and aneuploidy (R = 0.42211).

Adenoma↗
PubMed1992

Benign colorectal neoplasms undetected by colonoscopy.

This retrospective investigation assessed the sensitivity of colonoscopy for the detection of colonic polyps seen previously at barium enema examination. Included in the study were 77 patients with 106 polypoid lesions. Films showing lesions not subsequently seen at colonoscopy were reviewed and only those lesions with a visible point of attachment, exhibiting no movement in response to filling or change in position of the patient, and confidently diagnosed as a polyp by both reviewing radiologists were included among the 106 lesions. Sixteen lesions (15%) seen radiologically were not located colonoscopically, indicating an endoscopic sensitivity of 85%. Contrary to previous reports, most of the lesions missed endoscopically were in the left colon in regions thought to have been traversed by the instrument. The 15% false-negative rate found for colonoscopy is consistent with existing reports on colonoscopic errors and is approximately the same as the false-negative error rate for radiologic detection of colonic polyps.

Adult↗
PubMed1986

[Methodological framework of the evaluation of systematic screening and treatment of preexistent lesions of the colon and the rectum].

Among the conditions which need to be filled when generalizing the mass screening of polyps in view of the secondary prevention of colorectal cancers, three are already present: 1) it is a frequent and serious cancer; 2) there is an affiliation between benign tumours and cancer; 3) an effective non-mutilating treatment of benign tumours is available. On the other hand, two additional conditions remain unfilled and yet lie within the domain of research by methodologically rigorous studies: the setting up of a screening test with a high cost-effectiveness relationship; the epidemiological demonstration of the decreasing incidence of colorectal cancers following screening and treatment of precancerous lesions.

Adult↗
PubMed1992

The fate of patients following polypectomy alone for polyps containing invasive carcinoma.

Eighty-two patients with colon and rectal polyps containing invasive adenocarcinoma treated by polypectomy alone were studied. Seven of 34 patients (21 percent) with sessile lesions had an adverse outcome, including five local recurrences and two distant metastases. They occurred from 4 to 68 months after the polypectomy. Forty-seven pedunculated polyps with invasion to the head (Level 1) or to the stalk (Level 3) and one polyp to the base of the stalk (Level 4) had no evidence of local recurrence or signs of metastasis. Twenty-eight percent of patients were found to have adenomatous polyps, and 4 percent had malignant polyps during the follow-up examinations (range, 3-119 months; mean, 53 months). The findings suggested that pedunculated polyps with invasion to the head (Level 1), neck (Level 2), or stalk (Level 3) can be safely treated with a complete polypectomy provided that the carcinoma is not undifferentiated. Sessile lesions as well as Level 4 pedunculated lesions should be treated aggressively. If resection is not performed, a long-term follow-up in these patients is essential.

Adenocarcinoma↗
PubMed1985

Gastroduodenal polyps in familial polyposis coli.

A total of 26 patients with familial polyposis coli without extracolonic manifestations were examined by gastroduodenoscopy. Histologically verified polyps were found in 18 patients (69 percent, 95 percent confidence limits 48-86). Gastric adenoma was diagnosed in one patient, fundic gland polyposis in six patients, and duodenal adenomas in 12 patients. It is concluded that the incidence of gastroduodenal polyps is independent of the clinical presence of other extracolonic manifestations. It is advisable that polyposis patients should be followed with gastroduodenoscopy and biopsy of polyps.

Adenoma↗