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PubMed1985

Immunochromatography and cardiotoxicity of sea nettle (Chrysaora quinquecirrha) polyps and cysts.

The cardiotoxicity and polypeptide content of sea nettle (Chrysaora quinquecirrha) polyps and cysts were studied. Crude polyp preparations were lethal to mice. Both crude polyp and cyst preparations were toxic to embryonic chick cardiocytes. The polyp cardiotoxin factor was purified ten-fold by immunosorbent chromatography using anti-sea nettle or anti-man-o'war (Physalia physalis) monoclonal antibodies. Even though the polyps were incubated at a constant temperature, it appeared that there was an inverse relationship between the presence of proteins of 160,000 and 55,000 mol. wt as winter progressed.

Animals↗
PubMedDate not supplied

Recurrent polyps in the ileo-anal pouch or rectum in familial adenomatous polyposis.

Most small bowel polyps in familial adenomatous polyposis (FAP) occur in the peri-ampullary region, and distal small bowel adenomas and carcinomas are comparatively less common. As standard therapy in FAP consists of proctocolectomy with ileal pouch anal anastomosis, or ileorectal anastomosis, it is essential to be aware of the potential for adenomatous polyp formation in the terminal ileum and rectum. Ileal adenomas are found in 9-20% of patients with FAP, and new polyps may develop after colectomy. Ileal lymphoid hyperplasia and polyps are 2-4 times more common than adenomas, may be indistinguishable from adenomas on examination (requiring biopsy for diagnosis), and tend to regress after colectomy. Adenomas may arise in pouches, usually after an interval of several years, and have been documented to occur in the terminal ileum up to 25 years after colectomy. At pouch construction, rectal mucosectomy may theoretically fail to remove all mucosa at risk. Small islets of rectal mucosa may remain after this technically difficult operation, and the late development of cancer, up to 20 years postoperation has been noted. A stapled anastomosis may arguably have a better physiological result, but a greater amount of residual rectal mucosa may increase late cancer risk. Annual endoscopic follow-up of pouches is recommended. All polyps or suspicious lesions should be biopsied, excised or destroyed, preserving a sample for histology. After ileorectal anastomosis, cancer risk in the rectal stump increases with chronological age, with risk ranging from 5-10% at age 50 years, to 14-29% at age 60 years. Surveillance of the rectal stump in FAP is recommended every 4-6 months. There may be a role for prostaglandin synthesis inhibitors in some patients.

Adenomatous Polyposis Coli↗
PubMed1999

Wheat bran fiber and development of adenomatous polyps: evidence from randomized, controlled clinical trials.

Mutations in oncogenes and tumor suppressor genes are thought to initiate and promote the pathway to colorectal cancer, leading to hyperproliferation, the development of adenomas, and progression to gross malignancy. Intervention at any of these steps can potentially prevent the development of cancer. Several randomized, controlled trials have investigated the effect of dietary interventions, including the addition of wheat bran fiber, on the development of adenomatous polyps. In a familial adenomatous polyposis trial, patients were treated with 4 g of ascorbic acid plus 400 mg of alpha-tocopherol per day alone or with a grain fiber supplement (22.5 g/day) over a 4-year period. On an actual-intake basis, the combined intervention inhibited the development of rectal polyps. However, the Toronto Polyp Prevention Trial found no significant differences in polyp recurrence rates between patients who were counseled to follow a low-fat, high-fiber diet and patients consuming a typical Western diet with placebo fiber. A 9-month study of patients with resected colon adenomas found that dietary wheat bran fiber significantly reduced total, primary, and secondary fecal bile acid concentrations and excretion rates. Such bile acid levels are thought to be related to the risk of developing cancer. The Australian Polyp Prevention Project reported that the combination of fat reduction and a supplement of wheat bran reduced the incidence of large colorectal adenomas. These latter results suggest that intervention with a low-fat wheat bran supplemented diet inhibits the transition from smaller to larger adenomas, which may be a critical step in determining which adenomas progress to malignancy.

Adenomatous Polyposis Coli↗
PubMed2005

Correlation of polyp number and family history of colon cancer with germline MYH mutations.

BACKGROUND & AIMS: Affected individuals with biallelic MYH mutations are believed to display multiple adenomatous polyps without evidence of vertical transmission. Our goal was to determine the detection rate of germline MYH mutations in a high-risk gastrointestinal cancer clinic population by using polyp number as a selection criterion. METHODS: Patients were screened for the 2 most common MYH mutations: Y165C and G382D. The complete MYH coding region was sequenced in cases with a heterozygous mutation. RESULTS: Among 45 patients with more than 15 adenomatous polyps not diagnosed with familial adenomatous polyposis, 7 (15.6%) had biallelic MYH mutations. When 122 participants from a high-risk gastrointestinal cancer clinic who did not fulfill these criteria were tested, 2 additional patients with biallelic mutations were identified. Both had young-onset colorectal cancer (age, <50 y) with fewer than 15 polyps. Surprisingly, most of the 9 patients with biallelic MYH mutations reported family histories consistent with the hereditary nonpolyposis colorectal cancer syndrome (HNPCC), with 7 cases meeting at least 1 of the Bethesda criteria, 5 cases fulfilling 3 Bethesda criteria, and 2 cases fulfilling the Amsterdam II criteria. CONCLUSIONS: Most individuals with MYH mutations exhibit multiple adenomatous polyps. However, 22% of cases were missed when this was the sole criterion for germline testing. A significant number reported a strong family history of cancer that was consistent with HNPCC. MYH testing thus can be considered for patients who meet clinical criteria for HNPCC in the absence of DNA mismatch repair gene mutations.

Adult↗
PubMed2003

Rofecoxib reduces polyp recurrence in familial polyposis.

The long-term (mean of 16.4 +/- 4.2 months) efficacy and safety of rofecoxib (a specific COX-2 inhibitor) in maintaining the colon free of polyps in familial polyposis patients was assessed. Eight patients were treated with rofecoxib 25 mg every day. Sigmoidoscopy/colonoscopy was performed at study entry and every six months. At each endoscopy the number, size, and histological grade of all polyps were assessed, and the polyps were removed. The drug was well tolerated with no significant adverse events throughout the study. A highly significant reduction in the rate of polyp formation (70-100%) was observed in all patients from a mean number of 15.1 +/- 11.7 at baseline to 6.0 +/- 5.8 at one year and 1.6 +/- 1.6 at the end of follow-up (P = 0.016 and 0.008, respectively). No patient developed cancer or high-grade adenoma. In conclusion, Long-term use of rofecoxib is well tolerated and effective in inhibiting polyp formation in polyposis patients.

Adenomatous Polyposis Coli↗
PubMed2004

MYH mutations in patients with attenuated and classic polyposis and with young-onset colorectal cancer without polyps.

BACKGROUND & AIMS: MYH-associated polyposis is a recently described disease that is characterized by multiple colorectal adenomas and a recessive pattern of inheritance. Individuals with MYH-associated polyposis have biallelic mutations in MYH, a base excision repair gene, and are negative for germline mutations in the APC gene. In this study, the 2 most prevalent MYH mutations in white persons, Y165C and G382D, were analyzed for their presence in 984 subjects selected from 3 groups: 400 undergoing screening colonoscopy and found to have 0-3 polyps, 444 with colorectal cancer (CRC), and 140 referred for APC mutation analysis in which a germline mutation was not identified. METHODS: Genotyping for Y165C and G382D was performed by Pyrosequencing. RESULTS: Biallelic mutations for Y165C and/or G382D were not found in any of those undergoing screening colonoscopy with 0-3 polyps (n = 400), in those APC-negative patients with <20 adenomatous polyps (n = 26), or in those with CRC who were older than 50 years (n = 328). Furthermore, these 2 MYH mutations were not found among patients whose tumors showed the presence of defective DNA mismatch repair (n = 62). However, the presence of biallelic germline MYH mutations correlated with the presence of >or=20 adenomatous polyps. Interestingly, 2 of the 116 individuals with CRC diagnosed at 50 years of age or younger also presented with biallelic germline mutations in MYH. CONCLUSIONS: These data suggest that screening of MYH should be considered not only in patients with multiple polyps but also in patients with early-onset CRC.

Adenomatous Polyposis Coli↗
PubMed1996

Relation of vegetable, fruit, and grain consumption to colorectal adenomatous polyps.

Previous studies suggest that colorectal cancer risk decreases with higher intake of vegetables, fruits, and grains. Few studies, however, have examined these factors in relation to occurrence of colorectal polyps. The authors used case-control data from 488 matched pairs to evaluate associations of vegetables, fruits, and grains with polyps. Subjects were southern Californians aged 50-74 years who had a sigmoidoscopy in 1991-1993. Diet in the year before sigmoidoscopy was measured with a food frequency questionnaire. Frequent consumption of vegetables, fruits, and grains was associated with decreased polyp prevalence. Specifically, the adjusted odds ratio comparing the highest with the lowest quintile of intake for vegetables was 0.47 (95% confidence interval (CI) 0.29-0.76), for fruits was 0.65 (95% CI 0.40-1.05), and for grains was 0.55 (95% CI 0.33-0.91). The authors also found inverse associations for high carotenoid vegetables, cruciferae, high vitamin C fruits, garlic, and tofu (or soybeans). After further adjusting for potentially anticarcinogenic constituents of these foods, high carotenoid vegetables, cruciferous vegetables, garlic, and tofu (or soybeans) remained inversely associated with polyps. These findings support the hypothesis that high intake of vegetables, fruits, or grains decreases the risk of polyps and suggest that any protective effects might reflect unmeasured constituents in these foods.

Adenomatous Polyposis Coli↗
PubMed1999

[Hysteroscopic diagnosis and treatment of endometrial polyps].

The aim of the retrospective study was to analyse the frequency of polyps, anamnestic data and the result of histological examination overviewing 163 polyps which was find during 1900 hysteroscopy. In the history of patients dilatation and curettage was find in 22% one time and in 6.6% two times, but the polyps were removed by hysteroscopy in the end. The indication of hysteroscopy was haemorrhage in 55%, abnormal ultrasonographic results in 25% and sterility in 15%. During 153 polypectomy were two perforations (0.89%), no other major complication. The result of histological examination of 153 removed polyps was surprising, because in 22 cases proliferative endometrium, in 17 cases hyperplasia, in 6 cases secretory endometrium, in 5-5 cases fibroid and dyshormonal effect and in 1-1 case endometritis, adenomyosis, atrophy and malignant transformation was the histological diagnosis. Despite of relatively high false positive hysteroscopic results, the endoscopic procedure is useful method for treatment of endometrial polyps if the aim is the minimal invasivity and organ saving surgery.

Endometrial Hyperplasia↗
PubMedDate not supplied

Colorectal cancer risk in first-degree relatives of patients with colorectal adenomatous polyp.

BACKGROUND/AIMS: To evaluate any risk of colorectal cancer in first-degree relatives of patients with colorectal adenomatous polyp. METHODOLOGY: In a screening program-based cross-sectional study, 44821 subjects received an immunochemical fecal occult blood test using a 2-consecutive-day method. They were divided into two groups, according to the results of a self-completed questionnaire on family history of colorectal adenomatous polyps, and the positivity rate of an immunochemical fecal occult blood test as well as the positive predictive value for colorectal cancer were determined in these two groups. RESULTS: The fecal occult blood test was positive in 8.5% of subjects with family history and in 4.8% of subjects without family history, and the positive predictive value for colorectal cancer was 6.8% and 2.4% in subjects with and without family history of colorectal adenomatous polyps, respectively, indicating a significant difference in the positivity rate of the fecal occult blood test (P < 0.01) as well as the positive predictive value for colorectal cancer (P < 0.05) between these two groups. CONCLUSIONS: These results show that first-degree relatives of patients with colorectal adenomatous polyp have an increased risk for colorectal cancer, and that the subjects with family history of colorectal adenomatous polyps as well as cancers should be considered as a priority group for prevention of colorectal cancer.

Adenocarcinoma↗
PubMed2002

The CAST/Ei strain confers significant protection against Apc(Min) intestinal polyps, independent of the resistant modifier of Min 1 (Mom1) locus.

Intestinal adenoma development in Apc(Min) mice is influenced by genetic background. We generated a congenic line between the CAST and B6 inbred strains to study the effects of a resistant CAST background in the absence of a major modifier locus, Modifier of Min 1 (Mom1(R)). Progeny from a CAST.B6 Mom1(R/S) x B6 Apc(Min/+) intercross were 110 or 200 days of age and screened for intestinal polyps. There was a significant decrease (P < 0.0001) in polyp multiplicity and size in CASTB6F1 Mom1(R/S), Apc(Min/+) and CASTB6F1 Mom1(S/S), Apc(Min/+) progeny compared with B6 Mom1(S/S), Apc(Min/+) controls. A complete absence of colon polyps was observed in all mice heterozygous for the CAST background. These results demonstrate that the CAST strain carries dominant modifier loci, in addition to Mom1(R), that dramatically reduce polyp burden in the small intestine and eliminate polyp burden in the colon of Apc(Min) mice.

Adenomatous Polyposis Coli↗
PubMed2005

[An experience with clinical endoscopy and argon-plasma coagulation for removal of large bowel polyps].

Fifty-one loop polypectomies assisted by argon-plasma coagulation were performed in 40 patients, aged 18-85. Polyps presented as sitting on a wide pedicle (25), sprawling (19) or spreading flat (7) in rectum (24), sigmoid (18) or colon (9). Polyp diameter ranged 1.0-1.9 cm (12 adenomas), 2-2.9 (18) or 3-5 cm (21). Coagulation was carried out immediately after partial removal of polyp with the aid of diathermic loop. Endoscopic follow-up and biopsy were conducted after 1, 3, 6 and 12 months. Complete destruction of adenomas was achieved by 1-6 coagulations (mean - 1.4) performed at an interval of 3-4 weeks. During follow-up (6-24 months), out of 40 patients with 51 polyps, histologically identifiable villous adenoma was detected in 3 (during 12 months). The latter underwent repeat argon-plasma coagulation. That technique proved more effective and safer than traditional methods in dealing with large polyps of the large bowel having a wide pedicle and/or sprawling.

Adenomatous Polyposis Coli↗
PubMed1987

[The efficacy of temporary retention chemotherapy of the treatment of polyps in the remnant rectum of familial polyposis after total colectomy and ileorectostomy--a case report].

A case of familial polyposis is reported. The patient was a 24-year-old woman on whom total colectomy followed by ileorectostomy had been performed. However, there were multiple polyps remaining in the remnant rectum. For the treatment of these residual polyps, a new chemotherapeutic method known as Temporary Retention Chemotherapy (TRC), originally devised by us for the treatment of advanced gastric cancer, was applied. A balloon catheter was inserted and fixed into the rectum via the anus for the treatment of the rectal tumors. Through the catheter, high-dose 5-fluorouracil (5-FU) solution was injected into the rectum and retained there for one hour before being discarded. During the therapy, the patient was asked to change her position of recumbency at certain intervals, so that the 5-FU solution could act evenly on the lesions in question. This therapy was repeated twice a week, and followed by routine endoscopic studies. A total dose of 5,700 mg of 5-FU was necessary for obtaining a complete response of the remnant lesions. 6 months later, 4 polyps were found, and TRC was again applied, resulting in disappearance of the polyps again after the therapy. So far, no side-effect have been noted as a result of this therapy. She is currently still alive without any residual polyps, carcinoma or metastasis 6 years after the operation.

Adenomatous Polyposis Coli↗
PubMed1984

Giant fibrovascular polyp of the esophagus.

An adult patient with a giant fibrovascular esophageal polyp, measuring 17 cm in length, is described in this report. The patient presented with dysphagia and intermittent partial regurgitation of a fleshy mass in the mouth, only after the polyp had attained giant proportions. The polyp appeared as a large polypoid filling defect on a barium swallow and the findings were confirmed at endoscopy. The stalk was attached just below the cricopharyngeus muscle, and the club-shaped polyp extended almost up to the gastroesophageal junction. Because of the vascularity of this large structure and the proximity of respiratory passages to the site of attachment of the stalk, surgical resection of the polyp was undertaken.

Deglutition Disorders↗
PubMed1977

Gastric mucosal polyps in pernicious anaemia.

In a 4-year follow-up study of 68 patients with pernicious anaemia gastric polyps were observed in 25 patients. In some patients the polyps seemed to vanish completely from one year to another, while they might ascen or increase in other patients. None of these polyps underwent malignanttransformation during thperiod f observation, and by histological examination they could be classified as non-neoplastic regenerative benign polyps in an atrophic gastric mucosa. In our opinion the surgical attitude to these nonneoplastic gastric polyps in pernicious anaemia should be restrictive.

Adult↗
PubMed1995

Gastric carcinoma arising from a hyperplasiogenic polyp with a diameter of less than 2 centimeters.

As there are only few reports on the occurrence of carcinoma in hyperplasiogenic polyps there is at present no general agreement concerning the malignant potency of these polyps in the stomach. In this paper we review the literature and present the unusual case of a patient who developed carcinoma in a hyperplasiogenic polyp with a diameter of 15 x 5 mm. Whereas in nearly all the reported cases cancer developed in polyps with a diameter greater than 2 cm our findings demonstrate that even in smaller polyps malignant changes have to be suspected.

Adenocarcinoma↗
PubMed1995

[Treatment with sulindac of adenomatous polyps in familial polyposis].

BACKGROUND: The effect of sulindac, a nonsteroid antiinflammatory drug, has been reported to cause both regression and suppression of colon polyps in patients with familial adenomatous polyposis and Gardner's syndrome. We report our experience with seven patients with diffuse colonic polyposis treated with sulindac. PATIENTS AND METHODS: Seven patients with familiar adenomatous polyposis, four men and three women (mean age, 30 years; range 16 to 41 years) were included in this study. Two patients that underwent prior colectoctomy with ileorectal anastomosis and had polyps in the rectum were also included. The polyps ranged in size from 0.2 to 2.5 cm; most of them were less than 1 cm. Sulindac was given 150 mg. twice a day. Further colonoscopic examination was done at 6-month intervals during follow-up in all patients. RESULTS: A disappearance or a marked reduction in the number and size of polyps was observed in all patients after 24 months of treatment with sulindac. The drug was well tolerated and no side effects were observed during treatment. CONCLUSION: The authors conclude that sulindac is effective in inducing the regression of rectal polyps in familial, adenomatous polyposis.

Adenomatous Polyposis Coli↗
PubMed1993

Hyperplastic polyp and colonic neoplasia. Is there an association?

Hyperplastic polyps are regarded as non-neoplastic lesions with no malignant potential. However, several case reports and a clustering phenomenon suggest that they may arise in abnormal colonic that is predisposed to develop neoplastic lesions. The hyperplastic polyp also displays markers associated with colorectal cancer. In addition, several recent articles have addressed the question of hyperplastic polyp in the distal colon as a marker of more proximal adenomatous polyp. Many endoscopists discovering a distal hyperplastic polyp will wish to ensure the absence of a proximal neoplastic lesion.

Colonic Neoplasms↗
PubMed1980

Gastric hamartomatous polyps in the absence of familial polyposis coli.

Hamartomatous polyps in the stomach have been described as gastric lesions of familial polyposis coli. Four cases of multiple gastric hamartomatous polyps not associated with polyposis coli were encountered. Histologically, all these polyps consisted of normal oxyntic glands with numerous cystic dilatations of the glandular lumens of various sizes. Endoscopically, the polyps were all located in the acid secreting area and had an acid secreting function, which was revealed by the endoscopic Congo red test.

Adult↗