Recurrence and Carcinogenetic Rates of Colorectal Polyps (original) (raw)
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Evaluation of the risk for developing colon polyps malignancy
Most colorectal tumours develop from initi- ally benign bowel polyps. The degeneration of adenomas which ultimately progress to malignant colorectal cancer (the adenoma-carcinoma sequ- ence) is a process which may extend over a num- ber of years. Causes of this degeneration include successive changes (mutations) to genes in the cells of the mucosal membrane of the bowel wall. These lead to a loss of the natural mechanisms which curb the uncontrolled growth of these cells, allowing them to spread as cancer cells. (1,2,3) Colorectal carcinomas are among the most frequent malignant diseases in western industri- al countries. Colorectal cancer is the third most common cancer in both men and women in the United States. Every year, about 146.000 persons develop colorectal cancer, with about 50.000 de- aths. Colorectal cancer incidence rates have been decreasing for most of the past two decades. This is a result of the increase in screening, that allows the detection and removal of colorec...
Malignancy and mortality of colorectal polyps
Revista medico-chirurgicala a Societatii de Medici si Naturalisti din Iasi, 2014
OBJECTIVES To evaluate the rate of morbidity and mortality associated with colorectal polyps after the next 8-years period of endoscopic polypectomy, in a high risk managed care population. MATERIAL AND METHOD Cohorts of 77 subjects with benign neoplasms were identified with a colonoscopy in 1999. Three groups of subjects: benign neoplasms with polypectomy, benign neoplasms without polypectomy, and no neoplasms were evaluated. Five years recurrence rates (1999-2004) of benign or new malignant colorectal neoplasms were identified: for the benign determined for the baseline benign neoplasms with polypectomy and no neoplasm groups neoplasm without polypectomy, only rates for malignancy were observed. Malignancy was evaluated with immunohistochemical p53 (tumor protein 53) and PCNA (Proliferating Cell Nuclear Antigen) staining pattern. Over the next 8 years 2004-2012 were evaluated the mortality and the recurrence rate of the benign polyps. RESULTS 77 subjects were enrolled in our study...
Gut, 1996
BACKGROUND, AIMS, AND PATIENTS: In a prospective follow up and intervention study of colorectal polyps, leaving all polyps less than 10 mm in situ for three years, analysis of redetection rate, growth, and new polyp formation was carried out in 116 patients undergoing annual colonoscopy. The findings in relation to growth and new polyp formation were applied to 58 subjects who received placebo. Redetection rate varied from 75-90% for each year, and was highest in the rectum and sigmoid colon. There was no net change in size of all polyps in the placebo group, however, polyps less than 5 mm showed a tendency to net growth, and polyps 5-9 mm a tendency to net regression in size, both for adenomas and hyperplastic polyps. This pattern was verified by computerised image analysis. Patients between 50 and 60 years showed evidence of adenoma size increase compared with the older patients, and the same was true for those with multiple adenomas (four to five) compared with those with a single adenoma. The new adenomas were significantly smaller and 71% were located in the right side of the colon. Patients with multiple adenomas had more new polyps at all the follow up examinations than patients with a single adenoma. One patient developed an invasive colorectal carcinoma, which may be evolved from a previously overlooked polyp. Two polyps, showing intramucosal carcinoma after follow up for three years, were completely removed, as judged by endoscopy and histological examination. The results show that follow up of unresected colorectal polyps up to 9 mm is safe. The consistency of growth retardation of medium sized polyps suggests extended intervals between the endoscopic follow up examinations, but the increased number of new polyps in the proximal colon indicates total colonoscopy as the examination of choice. The growth retardation of the medium sized polyps may partly explain the discrepancy between the prevalence of polyps and the incidence of colorectal cancer.
RESUMO: O câncer colorretal é a terceira causa de morte nas regiões sul e sudeste do Brasil. Os tumores crescem lentamente seguindo a seqüência adenoma-carcinoma. A colonoscopia permite o diagnóstico e a ressecção dos pólipos. Atualmente discute-se a colonoscopia para pacientes portadores de pólipos retais não-neoplásicos e pólipos pequenos, além dos adenomas. Objetivo: Verificar a prevalência dos pólipos colônicos nos pacientes portadores de pólipos retais, correlacionar o tipo histológico e o tamanho do pólipo retal com o achado de neoplasia proximal. Pacientes e Método: Estudo transversal, entre 2000 e 2003, com pacientes portadores de pólipos retais submetidos a colonoscopia. Dividiram-se os pacientes por faixa etária, tipo e tamanho do pólipo retal. Pólipos e câncer foram considerados achados positivos na colonoscopia. Foram excluídas síndromes polipóides genéticas e câncer retal. Resultados: Examinaram-se 1.715 pacientes dos quais 74 (4,31%) tinham pólipos retais. O estudo histopatológico mostrou que 54,1% eram adenomatosos, 23% hiperplásicos, 12,2% inflamatórios e 10,8%, excrescências de mucosa. A maioria dos pólipos foi encontrada em pacientes acima de 40 anos, havendo significância estatística no grupo dos neoplásicos (p < 0,0001). Não houve diferença estatística quando comparados os achados positivos na colonoscopia entre os grupos de pólipos retais adenomatosos e hiperplásicos (p = 0,052). O tamanho do pólipo retal não foi estatisticamente significante para achados positivos na colonoscopia. Conclusões: Prevalência de pólipos proximais em portadores de pólipos retais foi 49,1%. Prevalência de neoplasia proximal foi de 42,5% e 11,7% nos portadores de pólipos retais neoplásicos e não-neoplásicos, respectivamente. O tamanho do pólipo retal não foi preditivo para achado de neoplasia proximal.
Slovenian Journal of Public Health, 2016
BackgroundColorectal polyps (CP) are common among individuals older than 50 years. Some polyp types can precede colorectal cancer (CRC). This study aimed at describing histopathological characteristics of colorectal polyps in relation to age and gender among symptomatic patients referred for a colonoscopy examination during 2011-2014 in Tirana, Albania.MethodsStudy population included 267 individuals aged ≥ 20 years and diagnosed with ≥ 1 polyp during a colonoscopy examination. A total of 346 polyps were identified, excised and measured, and underwent histopathological examination.ResultsAdenomas accounted for 79.8% of all polyps and tubular type was the most frequent one (74.4%). The majority of polyps (42.5%) were small (<1 cm), 38.7% of a medium size (1-2 cm) and 18.8% large (>2 cm). Adenomas were larger than non-adenomatous polyps (p<0.01)There was no gender difference with regard to patient age (p=0.22) or polyp size (p=0.84) Adenomas were more frequent among men compa...
Asian Pacific Journal of Cancer Prevention
Aim: This study was designed to report epidemiologic findings of polyps in Iranian patients, and predict histology of polyp regarding to demographic and colonoscopic findings. Background: Classification of colorectal polyps had been revised in the past two decades and there is a need for polyp categorization in the Iranian Health System. Patients and methods: In this retrospective study, the medical records of patients with colonoscopic diagnosis of polyp in pathology departments of SBMU affiliated teaching hospitals were reviewed. Patient's slides evaluated and demographics findings were assessed. The anatomical location, macroscopic appearance including size and histological assessment of all polyps were recorded. Results: From total number of 1106 polyps (detected in 862 patients), adenomatous polyps (638 [57.7%]) were the most prevalent findings, followed by colon mucosal tag (184[16.6%]), hyperplastic and serrated polyps (122[11%]), inflammatory polyps (110[9.9%]), hamartomatous (21[1.9%]), and malignant lesions (13[1.2%]). Multivariate logistic regression showed age (each one year increasing age; odds ratio [OR] = 1.026, 95%confidence interval [CI] = 1.016-1.036, p < 0.0001), location of polyp (right colon; OR = 1.905, 95%CI = 1.366-2.656, p < 0.0001), and polyp size of 5-10 mm (OR = 1.662, 95%CI = 1.214-2.276, p = 0.002), and polyp size of >10 mm (OR = 2.778, 95%CI = 1.750-4.411, p< 0.0001) were independently associated with neoplastic polyps. Also, polyp size of >10 mm (OR= 2.613, 95%CI= 1.083-6.307, p=0.033), tubulovillous pattern of polyp (OR= 3.508, 95%CI= 1.666-7.387, p=0.001) and villous pattern of polyp (OR= 10.444, 95%CI= 4.211-25.905, p<0.0001) were associated with high grade dysplasia in neoplastic polyps. Conclusion: Increased age, location of polyp (right colon), increased size of polyp and villous component of polyp could classify patients in high risk groups.
High Rate of Advanced Colorectal Polyps in a 10-Year-Long Retrospective Study in Qazvin, Iran
Background: Polyps are common lesions in the gastrointestinal (GI) tract. Colon cancer is mostly a result of progression from polyps. The present study aimed to evaluate demographic, clinical, and histological characteristics of colorectal polyps in Iran, particularly neoplastic and advanced types. Materials and Methods: Over a period of 10 years, specimens of all colorectal polyps obtained from colonoscopy were studied. The variables subjected to statistical analysis were age, sex, and the chief clinical complaint of the patients who underwent colonoscopy, their motivation, and the site, size, and histological types of detected polyps. The level of significance was set at p value <0.05. Results: Data were obtained from a total of 352 patients. No difference was seen between male and female patients regarding histological types. Only in nine patients was screening the reason for colonoscopy. Almost two-thirds (66.2%) of the polyps were neoplastic. Familial polyposis syndrome and inflammatory bowel disease were seen in 4.3% and 3.0% of the patients with neoplastic polyps, respectively. Sites of polyps were the sigmoid, rectum, and descending colon in 40.1%, 34.5%, and 17% of the cases, respectively. The advanced type made up 58.8% of neoplastic polyps. Only 3.6% of the patients undergoing colonoscopy in the study period had biopsied polyps. Discussion: No difference was observed between male and female patients in terms of overall incidence of polyps, histological and anatomical profiles, and mean age distribution. Anatomical and histological profiles agreed with the studies performed in areas with a low risk of colon cancer. The findings show that colonoscopy was not performed when it was necessary. A meaningful increase in the number polyp biopsy cases and a corresponding decrease in polyp size in the last few years of the study can be associated with the presence of more GI specialist clinicians in hospital centers, and this holds out much hope for the further improvement of the situation in the future.