Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Polyps”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,783 records · Page 99Linked to original sources
PubMed2004

Frequent CpG island methylation in sporadic and syndromic gastric fundic gland polyps.

We studied methylation of 2 tumor suppressor genes (p14, p16) and 4 MINT (methylated in tumor) clones (MINT1, MINT2, MINT25, MINT31) among 51 fundic gland polyps (FGPs) and 27 normal gastric body biopsy samples using bisulfite treatment of genomic DNA followed by methylation-specific polymerase chain reaction. Thirty-two FGPs were syndromic polyps from 14 patients with familial adenomatous polyposis (FAP); 19 were sporadic FGPs from 15 patients without FAP. Significantly higher mean methylation indices were found between FGPs and normal gastric mucosa (P = .012). FGPs arising in a background of proton pump inhibitor (PPI) effect had significantly higher mean methylation indices than those that did not (P = .023). Perhaps because sporadic FGPs were more likely to be associated with PPI effect than were FAP-associated FGPs, they also demonstrated higher mean methylation indices than syndromic polyps (P = .024). Among FAP-associated FGPs, there was no statistical difference in methylation indices between polyps that were dysplastic, indefinite for dysplasia, or nondysplastic (P = .87). Epigenetic alterations involving methylation of CpG islands might have a role in the development of some FGPs, particularly those with a PPI effect. They do not account for the presence or absence of a dysplastic phenotype in FGPs.

Adenomatous Polyposis Coli↗
PubMed1977

Lipid-chemical features of human gastric cancerous, polypous and ulcerative tissues.

Fourteen cases of gastric cancer, 9 cases of gastric polyp and 4 cases of gastric ulcer were studied on their tissues lipid-chemically with the aim to clarify the biochemical differences between malignant and benign growth of the human gastric tissue. Tissues were collected by surgical operation or a biopsy together with the normal tissues surrounding the lesions. One part of each tissue was subjected to histologic examination and the other part to lipid analyses by means of TLC and GLC. The total lipid content was dcreased in 71% of gastric cancerous cases and in 75% of both cases of gastric polyp and gastric ulcer as compared with the respective control tissues. The phospholipid fatty acid content of the lesions was decreased in 83% of cancerous cases but in 50% of polypous cases as compared with the respective control tissues. As for the phospholipid fatty acid composition, the percentage value of C20:4 was increased and the percentage value of C18:2 was decreased in gastric cancerous tissues when compared with those of gastric polypous tissues. Such a change of the phospholipid fatty acid composition may produce the change of the fluidity of the cell membrane and may provoke a malignant growth of human gastric cancer cells.

Fatty Acids↗
PubMed2003

Cost effectiveness of nasal budesonide versus surgical treatment for nasal polyps.

OBJECTIVE: To conduct a cost-effectiveness study of nasal budesonide versus surgical treatment in the management of nasal polyps. DESIGN AND METHODS: A decision-tree model reflecting two different treatment strategies for nasal polyps in Sweden was developed. The first strategy was initial polypectomy, performed under three different sets of circumstances: inpatient functional endoscopic surgery, outpatient evulsion with sedation, or outpatient evulsion with local anaesthesia; all treatments were followed by intranasal treatment with budesonide (Rhinocort) 128 microg twice daily. The second strategy was initial intranasal treatment with budesonide 128 microg twice daily. PERSPECTIVE: Healthcare provider perspective. OUTCOME MEASURES AND RESULTS: After 1 month, treatment with nasal budesonide was classified as a success (82.5%) or a failure (17.5%) based on clinical study data. In cases of success, the treatment was continued, and in cases of failure, polypectomy was undertaken, followed by budesonide 128 microg twice daily. Treatments were evaluated after 4 months using prices from the Central Hospital in Skövde, Sweden. The expected reduction in cost from using initial nasal budesonide treatment compared with the different alternatives of polypectomy were 9760 Swedish kronors (SEK) for inpatient functional endoscopic surgery, SEK2747 for outpatient evulsion with sedation, and SEK672 for outpatient evulsion with anaesthesia (1998 values). Nasal budesonide 128 microg twice daily treatment for nasal polyps revealed a potential reduction in costs of 53% compared with the primary surgery approach. CONCLUSION: Initial treatment of nasal polyps with nasal budesonide provides lower costs than treatment with initial polypectomy with maintained effectiveness.

Administration, Intranasal↗
PubMed1980

Sensitivity of double-contrast barium enema: emphasis on polyp detection.

Colonoscopically verified lesions (230 in 178 patients) were reviewed and compared to results of double-contrast barium enema studies performed by radiologists specifically interested in gastrointestinal disease. Eighteen carcinomas and 22 cases of colitis found endoscopically were accurately identified radiographically. In 140 patients with 190 polyps, 16 lesions were missed radiologically, a false-negative error for polyps of 8.4%. All undetected polyps were distal to the splenic flexure with the majority located in the sigmoid colon. Thus, the double-contrast barium enema study was quite effective in finding colon polyps, particularly proximal to the splenic flexure.

Barium Sulfate↗
PubMed1983

Colon polyp morphology on double-contrast barium enema: its pathologic predictive value.

The morphologic appearance of 96 polyps seen on double-contrast barium enema was reviewed to assess the predictive value of various signs described to diagnose malignancy. Size, surface contour, basal indentation, and pedunculation were studied. Sessile polyps had an appreciable incidence of malignancy, with size being the best indicator of that risk. Pedunculation was found to be a reliable sign of benignity in predicting the absence of malignant invasion into the adjacent colonic wall. Polyps under 1 cm and having a smooth contour were invariably benign. Conversely, polyps larger than 1 cm with a lobulated contour and basal indentation had a significant incidence of malignancy.

Adenoma↗
PubMed1984

Radiologic recognition of colonic diverticula simulating polyps.

The differentiation of colonic polyps and diverticula on the double-contrast barium enema is generally straightforward, using current diagnostic criteria. However, diverticula may be misinterpreted on the double-contrast barium enema as polyps when they appear uncommonly as filling defects within the barium pool. As a result of such erroneous interpretation, the patient may subsequently undergo costly and inconvenient repeat barium enema or colonoscopy. Carefully studied scout films, oblique views, compression spot images, and postevacuation films generally can differentiate these diverticula from polyps. The usual reason that a diverticulum assumes the appearance of a polyp is that it contains impacted stool.

Aged↗
PubMed1996

Fibrovascular polyps of the esophagus: clinical, radiographic, and pathologic findings in 16 patients.

OBJECTIVE: Fibrovascular polyps of the esophagus are rare benign nonneoplastic intraluminal masses. Most published reports of patients with these polyps have been anecdotal. The purpose of this study was to reassess the clinical, radiographic, and pathologic findings in a relatively large series of patients with this unusual tumorlike lesion. MATERIALS AND METHODS: A search of the radiologic archives of the Armed Forces Institute of Pathology revealed 16 cases of fibrovascular polyps of the esophagus. We reviewed the clinical, radiographic, and pathologic findings in these 16 cases. RESULTS: All 16 patients were symptomatic. Fourteen (87%) had dysphagia and four (25%) had respiratory symptoms. The average duration of symptoms was 17 months, but seven patients (44%) had symptoms for 6 or fewer months. Two patients (12%) had a history of regurgitating the tumor into the pharynx or mouth, but none had the known complication of asphyxiation due to occlusion of the larynx. Chest radiographs revealed a right-sided superior mediastinal mass and/or anterior tracheal bowing in seven patients (44%). Barium studies revealed smooth but variably lobulated intraluminal masses that originated in the lower cervical esophagus and had variable sizes and distal extents, with an average length of 15 cm. Depending on the amount of fat and fibrovascular tissue in the lesion, CT revealed a heterogeneous appearance in four patients, lesions of predominantly fat density in two, and lesions of predominantly soft-tissue density in two. CONCLUSION: Knowledge of the clinical and radiographic features of fibrovascular polyps of the esophagus is important because surgical removal of these lesions is warranted in most patients.

Adult↗
PubMed2001

Colon cancer screening with virtual colonoscopy: promise, polyps, politics.

Virtual colonoscopy (CT colonography) promises to become a primary method for colorectal cancer screening and return radiologists to a major role in colon cancer prevention. Results from major centers in the United States show accuracy to be comparable to conventional colonoscopy for detection of polyps of significant size--that is, greater than 10 mm--with few false-positives. The advent of virtual colonoscopy has also heightened awareness of the natural history of colonic polyps, particularly in terms of identifying an appropriate target size for detection in colorectal screening programs. Small polyps (<10 mm) are often either hyperplastic on histology or are unlikely to progress to frank cancer in the patient's lifetime and are therefore of little clinical significance for the average adult. Thus, the rationale for detecting and removing each and every colonic polyp regardless of size has come under increasing scrutiny in the context of cost-benefit analysis of various test strategies for colorectal cancer screening. Virtual colonoscopy may allow patients to obtain reliable information about the status of their colonic mucosa noninvasively and thus make a more informed decision as to whether to proceed to conventional colonoscopy for polypectomy.

Colonic Polyps↗
PubMed2004

The effect of reconstruction algorithm on conspicuity of polyps in CT colonography.

OBJECTIVE: CT colonography studies to date have used a standard CT algorithm. To determine whether nonstandard algorithms may result in better performance of CT colonography, we conducted a prospective, blinded-observer study of the effect of the reconstruction algorithm on the conspicuity of colonic polyps and folds. SUBJECTS AND METHODS: CT colonography of patients with proven polyps, masses, or polypoid folds was performed on an MDCT scanner, and the images were reconstructed using the standard, soft, lung, and detail algorithms. Two experiments were performed. The first used four patient data sets of a short segment of colon (30-60 images), each reconstructed using all four algorithms and then viewed on a workstation in a four-on-one format that allowed all four reconstructions to be viewed simultaneously. The second used six sets of cut-film images (four or eight images each); images within each set differed only in the reconstruction algorithm used to generate them (eight-image sets were prepared with two different level settings). Twenty-one reviewers with varying levels of experience who were unaware of the purpose of the study were asked to rank the images within each set according to their value in the detection of either polyps or masses. RESULTS: Reviewers showed statistically significant differences in preference for the four algorithms (p = 0.037 in the computer-based experiment; for the cut-film experiment, p = 0.029 for the four-image sets and p = 0.041 for the eight-image sets). In the computer-based experiment, reviewers preferred the detail algorithm to the standard algorithm with an estimated probability of 0.67 (95% confidence interval [CI], 0.57-0.75) and the soft algorithm over the standard algorithm with an estimated probability of 0.59 (95% CI, 0.51-0.66). However, reviewers with the most experience (having interpreted at least 250 cases) preferred the soft algorithm over the standard algorithm by the same two-to-one margin as observed for the detail algorithm. In contrast, the standard and detail algorithms were ranked similarly in the cut-film experiment, with the soft and lung algorithms ranked worst. CONCLUSION: To our knowledge, ours is the first observer study on the effect of the reconstruction algorithm on conspicuity of folds and polyps in CT colonography. Our results indicate significant differences in the reconstruction algorithms, with the soft and detail algorithms being preferred over the standard algorithm by experienced reviewers when interpreting images on a workstation. These results indicate the need for further research into the effect of reconstruction algorithms on CT colonography.

Algorithms↗
PubMedDate not supplied

A macrolide antibiotic, roxithromycin, inhibits the growth of nasal polyp fibroblasts.

Recently, the efficacy of macrolide antibiotics in cystic fibrosis and bleomycin-induced lung injury was reported. Nasal polyposis is a chronic inflammatory disease of the upper airway characterized by structural abnormalities including stromal fibrosis. Fibroblasts are resident cells thought to play an important role in the development of fibrosis. Although the effect of Roxithromycin (RXM) on inflammatory cells is well known, there is no evidence on the effect of RXM on fibroblasts. The purpose of the present study was two-fold: to examine the effect of RXM on the growth of fibroblasts in vitro and to examine the effect of RXM on the proliferation of fibroblasts in vivo. Nasal polyp fibroblast lines were generated from untreated patients, and those who were treated with RXM (300 mg/day) for one month before biopsy. Nasal polyp fibroblast lines from untreated patients were cultured for 72 hours with or without RXM, and the direct effect of RXM on fibroblast growth in vitro was examined by cell counting and 3H thymidine uptake. Next, we examined the in vivo effect of RXM on nasal polyp fibroblasts (NPFs) by comparing the growth characteristics of NPF lines from RXM treated and untreated patients. Finally, we examined the proliferating rate of NPF lines from the same patient before and after treatment with RXM. NPF lines that were treated with RXM exhibited a lower proliferating rate in vitro as compared to those that were not treated with RXM. Treatment of NPF lines with RXM suppressed the proliferation of fibroblasts in a dose-dependent manner. In addition, NPF lines from patients treated with RXM exhibited a lower proliferating rate in vitro as compared to NPF lines from the same patient taken before RXM treatment. We demonstrated that RXM directly suppressed nasal polyp fibroblast proliferation, and that this effect of RXM on fibroblast growth was persistent, indicating that RXM may prevent the progression of nasal polyposis by inhibiting the development of fibrosis.

Adult↗
PubMedDate not supplied

Flexible fiberoptic rhinoscopy in the diagnosis of nasal polyps in cystic fibrosis.

The incidence of nasal polyps in patients with CF in various studies varies from 6.7% to 48%. Fiberoptic rhinoscopy, a safe and minimally invasive diagnostic procedure, has the major advantage over routine physical examination of the nares because of the ability to examine the nose beyond the nasal vestibule. In examinations of both nostrils of 34 patients with CF age 4-30 years, nasal polyps were detected by rhinoscopic examination, but missed by physical examination in 17 (25%) of the nostrils. In 7% (5/64) of the nostrils in this series, rhinoscopy ruled out polyps that were reportedly identified on physician examination. This study confirms that even a careful physical examination of the nose is often inadequate to uncover significant nasal pathology such as nasal polyps.

Child↗
PubMedDate not supplied

Nasal polyps treatment: medical management.

The objectives of medical management of nasal polyposis are 1) to eliminate nasal polyps and rhinitis symptoms, 2) to reestablish nasal breathing and olfaction, and 3) to prevent recurrence of nasal polyps. Although antibiotics are used for infectious complications of nasal polyposis, only glucocorticosteroids (steroids) have a proven effect on the symptoms and signs of nasal polyps. Topically applied steroids is the therapeutic modality that has been best studied in controlled trials. It reduces rhinitis symptoms, improves nasal breathing, reduces the size of polyps and the recurrence rate, but it has a negligible effect on the sense of smell and on any sinus pathology. Topical steroids can, as long-term therapy, be used alone in mild cases, or combined with systemic steroids/surgery in severe cases. Systemic steroids, which are less well studied, have an effect on all types of symptoms and pathology, including the sense of smell. This type of treatment, which can serve a "medical polypectomy," is only used for short-term improvement due to the risk of adverse effects. Individualized management of nasal polyposis may use long-term topical steroids, short-term systemic steroids, as well as surgery, in various combinations. Exactly how these therapies, which differ in their control of various symptoms, are optimally combined is not yet well established.

Administration, Topical↗
PubMedDate not supplied

Endoscopic sinus surgery for the excision of nasal polyps: A systematic review of safety and effectiveness.

BACKGROUND: Functional endoscopic sinus surgery (FESS) has been used for >20 years for the management of sinus disease including the excision of nasal polyps. Our objective was to perform a systematic review of safety and effectiveness of FESS for the removal of nasal polyps. METHODS: The Cochrane Library, MEDLINE, Embase, Science Citation Index, other databases, and websites were searched in January and December 2005 using key words for nasal polyps and endoscopic surgery. All randomized controlled trials, nonrandomized comparative studies, and case series studies that described outcomes associated with FESS for the excision of nasal polyps were included. Forty-two publications were included from the 632 (6.6%) articles initially identified. Two reviewers assessed validity of included studies and extracted relevant data. RESULTS: Three randomized controlled trials, 4 nonrandomized comparative studies, and 35 case series studies were included in the review. FESS was compared with endoscopic polypectomy, Caldwell-Luc, radical nasalization, and intranasal ethmoidectomy. In general, studies were of poor quality and lacked description of important variables influencing surgical outcome. Overall complications for FESS from case series studies ranged from 0.3 to 22.4% (median, 7.0%). Major complications ranged from 0 to 1.5% (median, 0%) and minor complications ranged from 1.1 to 20.8% (median, 7.5%). The potentially most serious complications were cerebrospinal fluid leaks, injury to the internal carotid artery, dural exposure, meningitis, bleeding requiring transfusion, periorbital/orbital fat exposure, and orbital penetration. Symptomatic improvement ranged from 78 to 88% for FESS compared with 43 to 84% for comparative procedures. From case series, symptomatic improvement ranged from 40 to 98% (median, 88%). CONCLUSION: FESS may offer some advantages in safety and effectiveness over comparative techniques, but wide variation in reported results and methodological shortcomings of studies limit the certainty of these conclusions. Wide variation in complication rates suggests the need for audit of existing practice. Additional high-quality studies with a fuller description of potential confounding factors and effect modifiers will help to define the effectiveness of FESS more clearly.

Adolescent↗
PubMed1999

Polyps as biomarkers for colorectal neoplasia.

Current understanding of colorectal carcinogenesis suggests a series of genetic changes occurring pari passu with morphological changes ultimately resulting in a cancerous lesion. The adenomatous polyp was originally the prototype of the preneoplastic lesion but recently, other colonic polyps, primarily the hamartomas, have been clinically characterized as colorectal cancer biomarkers with genetic changes found mainly in the mesenchymal component as opposed to the ectodermal, or epithelial element. This, with the current interest in angiogenesis playing a role in the propagation of neoplastic lesions, has now encompassed every tissue element and opened the way for an understanding of the oncogenic process. This has suggested that considerable interaction occurs between all tissue elements, including what was previously described as epithelial-matrix interactions. While hyperplastic polyps are thought not to confer risk for cancer, they may offer clues as to the first steps of the overall process. Microadenomas have introduced new clinical as well as biological considerations, as unique risk factors. Investigation of these lesions has moved from purely morphological correlations to mechanistic dissections of important biological pathways using both genetic and protein chemistry tools. This review explores the microcosm of the colonic polyp and its relation to cancer as the quintessential premalignant biomarker.

Adenoma↗
PubMed1993

Metastasis from breast lobular carcinoma to an endometrial polyp. Report of a case with immunohistochemical study.

A case of lobular carcinoma of the breast metastatic to an endometrial polyp is described. The patient underwent a simple mastectomy and axillary lymphadenectomy because of infiltrating lobular carcinoma diagnosed three years before. Abdominal ultrasound revealed an endometrial polyp. An endometrial biopsy was performed but only scanty material insufficient for diagnosis was obtained. A total hysterectomy and bilateral salpingo-oophorectomy was made. The uterus contained a large polyp which microscopically showed sheets and ribbons of small atypical cells infiltrating the stroma. Immunohistochemical stains were positive for epithelial cell markers. To our knowledge this is the first case of an infiltrating lobular carcinoma metastasizing to an endometrial polyp.

Aged↗
PubMed1989

Dysplastic and malignant areas in hyperplastic polyps of the large intestine.

The clinical and pathological findings in a patient with 3 adenocarcinomas of the colon, 16 pure hyperplastic polyps, 1 hyperplastic polyp with adenomatous elements and 1 hyperplastic polyp with malignant transformation to adenocarcinoma within an area of adenomatous dysplasia are described. The possibility of neoplastic transformation of hyperplastic polyps is discussed.

Adenocarcinoma↗
PubMed1992

Sialic acid and epithelial differentiation in colorectal polyps and cancer--a morphological, mucin and lectin histochemical study.

Loss of O-acetyl substituents from sialic acid expressed in mucin secreted by hyperplastic polyps (21), adenomas (9), a mixed polyp (1) and adenocarcinomas (41) of the colorectum was investigated by mucin histochemistry (diastase PAS and mild PAS) and by lectin histochemistry (Arachis hypogaea or peanut agglutinin) with (nPNA) and without (PNA) prior neuraminidase digestion. Mild PAS and nPNA reactivity were closely correlated, indicating that loss of O-acetyl substituents at C7, C8 and C9 (hence mild PAS positive) and at C4 (hence neuraminidase labile) occur pari passu. These sialic acid alterations were characteristic of mucin secreted by both adenocarcinoma and hyperplastic polyp. The same changes occurred patchily or focally in adenoma. Five "serrated" adenocarcinomas resembled the hyperplastic polyp both morphologically and histochemically. Luminal secretions within cancers were classified as mucin-like (type I) and non-mucin-like (type II). Mild PAS was the most specific technique for mucin-like intraluminal material. However, accumulated luminal secretions (type I or II) and intracytoplasmic lumina were quite specific features of colorectal cancer and could be effectively highlighted by means of dPAS. PNA reactivity without prior neuraminidase digestion showed a distribution unlike nPNA. Whilst PNA expression was more cancer specific than either mPAS or nPNA, it was observed mainly in cancers secreting little or no mucus, thus limiting its value as a tumor marker.

Adenocarcinoma↗
PubMed1992

Colonoscopic screening examination of relatives of patients with colorectal cancer. II. Relations between tumour characteristics and the presence of polyps.

Colonoscopy was offered to 206 first-degree relatives of 181 patients operated on for colorectal cancer (CRC). Findings of polyps in relatives correlated with Dukes staging, extent of dedifferentiation and localization of tumour in the operated patient, and type of family relationship. Adenomas in relatives and Dukes staging of carcinoma in the patients were inversely related. Relatives of patients with Dukes stage A tumour had more than twice as many adenomas as and a higher prevalence of multiple adenomas than relatives of patients with advanced cancer at the time of operation. If the patient had polyp(s) in addition to tumour, the number of adenomas per relative was almost doubled. Hyperplastic polyps in relatives were associated with poorly differentiated carcinoma in their related patients. These results support the theory that not all CRC are derived from polyps and that adenoma-derived CRC may have a better prognosis than 'de novo' CRC. An adenoma prevalence risk table is also presented.

Adenoma↗