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International Journal of Colorectal... Feb 2017Colorectal cancer (CRC) is one of the most common and preventable forms of cancer but remains the second leading cause of cancer-related death. Colorectal adenomas are...
PURPOSE
Colorectal cancer (CRC) is one of the most common and preventable forms of cancer but remains the second leading cause of cancer-related death. Colorectal adenomas are precursor lesions that develop in 70-90 % of CRC cases. Identification of peripheral biomarkers for adenomas would help to enhance screening efforts. This exploratory study examined the methylation status of 20 candidate markers in peripheral blood leukocytes and their association with adenoma formation.
METHODS
Patients recruited from a local endoscopy clinic provided informed consent and completed an interview to ascertain demographic, lifestyle, and adenoma risk factors. Cases were individuals with a histopathologically confirmed adenoma, and controls included patients with a normal colonoscopy or those with histopathological findings not requiring heightened surveillance (normal biopsy, hyperplastic polyp). Methylation-specific polymerase chain reaction was used to characterize candidate gene promoter methylation. Odds ratios (ORs) and 95 % confidence intervals (95% CIs) were calculated using unconditional multivariable logistic regression to test the hypothesis that candidate gene methylation differed between cases and controls, after adjustment for confounders.
RESULTS
Complete data were available for 107 participants; 36 % had adenomas (men 40 %, women 31 %). Hypomethylation of the MINT1 locus (OR 5.3, 95% CI 1.0-28.2) and the PER1 (OR 2.9, 95% CI 1.1-7.7) and PER3 (OR 11.6, 95% CI 1.6-78.5) clock gene promoters was more common among adenoma cases. While specificity was moderate to high for the three markers (71-97 %), sensitivity was relatively low (18-45 %).
CONCLUSION
Follow-up of these epigenetic markers is suggested to further evaluate their utility for adenoma screening or surveillance.
Topics: Adenomatous Polyps; Aged; Case-Control Studies; DNA Methylation; Female; Genetic Association Studies; Humans; Male; Middle Aged; Odds Ratio; Promoter Regions, Genetic
PubMed: 27771773
DOI: 10.1007/s00384-016-2688-1 -
Revista Espanola de Patologia :... 2024Russell bodies (RBs) are round eosinophilic intracytoplasmic inclusions formed by condensed immunoglobulins in mature plasma cells, which are called Mott cells. These...
Russell bodies (RBs) are round eosinophilic intracytoplasmic inclusions formed by condensed immunoglobulins in mature plasma cells, which are called Mott cells. These cells are rarely found in the gastric tract, with even less cases reported in the colorectal region. There are still many questions about this event, as it is still unknown the relationship between the agents reported of increasing the probability of appearance of these cells and the generation of RBs. In this case report we describe the fifth patient presenting an infiltration of Mott cells in a colorectal polyp, being the second case with a monoclonal origin without a neoplastic cause, and the first one monoclonal for lambda. A comparison with previously similar reported cases is also done, and a possible etiopathogenic hypothesis proposed.
Topics: Humans; Colonic Polyps; Plasma Cells; Adenomatous Polyps
PubMed: 38599729
DOI: 10.1016/j.patol.2023.07.001 -
Annali Italiani Di Chirurgia 2015We know the significance of adenomas about the risk of neoplastic transformation defined as adenoma-carcinoma sequence. Although the majority of adenomas removed are... (Review)
Review
UNLABELLED
We know the significance of adenomas about the risk of neoplastic transformation defined as adenoma-carcinoma sequence. Although the majority of adenomas removed are small, it is well recognized that the risk of malignant transformation increases with an increased adenoma size. The term "malignant polyp" refers to an adenoma that macroscopically appears benign, but in which there is an invasion of malignant neoplastic cells within the submucosa through the muscularis mucosae. Malignant Polyps are substantially adenocarcinomas at an early stage; it is estimated that they represent the 0.75-5.6% of all adenomas removed during endoscopic exams. The management of a malignant polyp, diagnosed after an endoscopic removal, is complicated because the presence of residual malignant cells is a possibility. Also the presence of regional lymph nodes metastasis is different in literature and related to different prognostic factors. In this review we will analyze the incidence, the most appropriate methods of diagnosis, the biological parameters that characterize the various classes of risk of malignant polyps, in order to choice a correct treatment. The goal should be the improvement of the survival rate, decreasing the likelihood of residual disease evaluating the risk of overtreatment.
KEY WORDS
Adenoma, Adenoma-carcinoma, "Malignant polyp".
Topics: Adenocarcinoma; Adenoma, Villous; Adenomatous Polyps; Cell Transformation, Neoplastic; Colonic Neoplasms; Colonic Polyps; Colonoscopy; Disease Management; Humans; Hyperplasia; Intestinal Mucosa; Lymphatic Metastasis; Margins of Excision; Muscle, Smooth; Neoplasm Grading; Neoplasm Invasiveness; Neoplasm, Residual; Risk; Tumor Burden
PubMed: 26567607
DOI: No ID Found -
Seminars in Surgical Oncology 1994Studies of risk factors for colonic adenomatous polyps have been reported in greater numbers in 1993 than in all previous years combined. This explosion in interest in... (Comparative Study)
Comparative Study Meta-Analysis
Studies of risk factors for colonic adenomatous polyps have been reported in greater numbers in 1993 than in all previous years combined. This explosion in interest in polyps has not arisen because polyps themselves cause serious illness. They are in the vast majority of cases asymptomatic. However, adenomas have become the surrogate for colon cancer in a number of phase III dietary intervention trials. These trials were undertaken at a time when very little was known of adenoma risk factors. Data accumulated in the past 18 months in general demonstrate a similarity in risk factors for cancer and polyp. Since it has also been recently established that polypectomy diminishes colon cancer risk, the adenomatous polyp has been established as an ethical and convenient surrogate for cancer of the colon. Prevention of colorectal cancer is the goal of all the above studies, and it is hoped that the dietary intervention trials currently under way will generate the data that will make prevention possible.
Topics: Adenomatous Polyps; Animals; Case-Control Studies; Clinical Trials, Phase III as Topic; Cohort Studies; Colonic Neoplasms; Culture; Diet; Dietary Fats; Dietary Fiber; Female; Humans; Incidence; Male; Mexico; Prospective Studies; Risk Factors; United States
PubMed: 8085093
DOI: 10.1002/ssu.2980100304 -
Best Practice & Research. Clinical... Aug 2015The recent advent of advanced imaging technologies has brought real time characterization of polyp histology to the forefront. This concept of optical diagnosis of... (Review)
Review
The recent advent of advanced imaging technologies has brought real time characterization of polyp histology to the forefront. This concept of optical diagnosis of diminutive polyp histology can bring about a huge paradigm shift in the management of these lesions. Instead of resecting and sending all the diminutive polyps to pathology, there is the potential to practice "resect and discard" for those predicted to be adenomas and "do not resect" strategy for the recto-sigmoid polyps predicted to be hyperplastic. However, one of the major steps before the clinical implementation of real-time histology can be a reality, will be training endoscopists with varying levels of experience in novel imaging technologies. The two major methods for training include didactic teaching and the computer based method. After the initial training, it is imperative that the endoscopists practice this skill during performance of routine colonoscopy to auto validate and assess their own competency. Both practice and reinforcement can help endoscopists become high performers in the characterization of polyp histology.
Topics: Adenomatous Polyps; Colonoscopy; Colorectal Neoplasms; Humans; Narrow Band Imaging
PubMed: 26381309
DOI: 10.1016/j.bpg.2015.06.001 -
PloS One 2019Computer-aided polyp detection in gastric gastroscopy has been the subject of research over the past few decades. However, despite significant advances, automatic polyp... (Clinical Trial)
Clinical Trial
Computer-aided polyp detection in gastric gastroscopy has been the subject of research over the past few decades. However, despite significant advances, automatic polyp detection in real time is still an unsolved problem. In this paper, we report on a convolutional neural network (CNN) for polyp detection that is constructed based on Single Shot MultiBox Detector (SSD) architecture and which we call SSD for Gastric Polyps (SSD-GPNet). To take full advantages of feature maps' information from the feature pyramid and to acquire higher accuracy, we re-use information that is abandoned by Max-Pooling layers. In other words, we reuse the lost data from the pooling layers and concatenate that data as extra feature maps to contribute to classification and detection. Meanwhile, in the feature pyramid, we concatenate feature maps of the lower layers and feature maps that are deconvolved from upper layers to make explicit relationships between layers and to effectively increase the number of channels. The results show that our enhanced SSD for gastric polyp detection can realize real-time polyp detection with 50 frames per second (FPS) and can improve the mean average precision (mAP) from 88.5% to 90.4%, with only a little loss in time-performance. And the further experiment shows that SSD-GPNet has excellent performance in improving polyp detection recalls over 10% (p = 0.00053), especially in small polyp detection. This can help endoscopic physicians more easily find missed polyps and decrease the gastric polyp miss rate. It may be applicable in daily clinical practice to reduce the burden on physicians.
Topics: Adenomatous Polyps; Female; Gastroscopy; Humans; Image Processing, Computer-Assisted; Male; Neural Networks, Computer; Stomach Neoplasms
PubMed: 30908513
DOI: 10.1371/journal.pone.0214133 -
Best Practice & Research. Clinical... Aug 2017Gastric polyps include a wide spectrum of lesions with different histology and neoplastic potential. They are found in up to 6% of upper gastrointestinal endoscopy and... (Review)
Review
Gastric polyps include a wide spectrum of lesions with different histology and neoplastic potential. They are found in up to 6% of upper gastrointestinal endoscopy and are usually asymptomatic and incidentally diagnosed, being in the vast majority epithelial gastric polyps. Hyperplastic, fundic gland and adenomas are the most common types of gastric polyps and, although each type may have typical endoscopic appearances, they all must be sampled at the initial endoscopy for histological assessment. Also, the normal appearing gastric mucosa should be sampled to stage atrophic changes, rule out endoscopically non-visible dysplasia and to diagnose Helicobacter pylori. Polyposis syndromes that affect the stomach are rare but should be taken into account. Hamartomatous polyps can be found in Juvenile polyposis, Cowden syndrome and Peutz-Jeghers syndrome. On the other hand, multiple fundic gland polyps are present in the majority of patients with familial adenomatous polyposis. In this study we provide a comprehensive review on the evaluation and management of gastric epithelial polyps, in this way helping physicians to properly handle this type of lesions.
Topics: Adenomatous Polyps; Humans; Intestinal Polyps; Stomach Neoplasms
PubMed: 28842047
DOI: 10.1016/j.bpg.2017.06.001 -
PloS One 2014Cancers exhibit abnormal molecular signatures associated with disease initiation and progression. Molecular signatures could improve cancer screening, detection, drug...
Cancers exhibit abnormal molecular signatures associated with disease initiation and progression. Molecular signatures could improve cancer screening, detection, drug development and selection of appropriate drug therapies for individual patients. Typically only very small amounts of tissue are available from patients for analysis and biopsy samples exhibit broad heterogeneity that cannot be captured using a single marker. This report details application of an in-house custom designed GenomeLab System multiplex gene expression assay, the hCellMarkerPlex, to assess predictive gene signatures of normal, adenomatous polyp and carcinoma colon tissue using archived tissue bank material. The hCellMarkerPlex incorporates twenty-one gene markers: epithelial (EZR, KRT18, NOX1, SLC9A2), proliferation (PCNA, CCND1, MS4A12), differentiation (B4GANLT2, CDX1, CDX2), apoptotic (CASP3, NOX1, NTN1), fibroblast (FSP1, COL1A1), structural (ACTG2, CNN1, DES), gene transcription (HDAC1), stem cell (LGR5), endothelial (VWF) and mucin production (MUC2). Gene signatures distinguished normal, adenomatous polyp and carcinoma. Individual gene targets significantly contributing to molecular tissue types, classifier genes, were further characterised using real-time PCR, in-situ hybridisation and immunohistochemistry revealing aberrant epithelial expression of MS4A12, LGR5 CDX2, NOX1 and SLC9A2 prior to development of carcinoma. Identified gene signatures identify aberrant epithelial expression of genes prior to cancer development using in-house custom designed gene expression multiplex assays. This approach may be used to assist in objective classification of disease initiation, staging, progression and therapeutic responses using biopsy material.
Topics: Adenomatous Polyps; Biomarkers, Tumor; Colonic Neoplasms; Diagnosis, Differential; Gene Expression Profiling; Genetic Markers; Humans; In Situ Hybridization; Real-Time Polymerase Chain Reaction
PubMed: 25423035
DOI: 10.1371/journal.pone.0113071 -
Digestive and Liver Disease : Official... Jan 2007Colorectal adenomas containing invasive carcinoma represent the majority of early colorectal cancers. The malignant polyp carries a significant risk of lympho-haematic... (Review)
Review
Colorectal adenomas containing invasive carcinoma represent the majority of early colorectal cancers. The malignant polyp carries a significant risk of lympho-haematic metastasis and mortality due to the penetration of cancerous cells into the submucosal layer. The therapeutic dilemma is whether to perform endoscopic or surgical resection. A thorough assessment of the endoscopic, histological and clinical variables is needed to unravel the best treatment for each patient. In particular, a unique staging of such lesions, based on certain histopathological features, has been deeply implicated in the therapeutic choice. Aim of this article is to review the main endoscopic, histological and clinical features of the malignant polyp in order to propose a systematic management of this lesion.
Topics: Adenomatous Polyps; Colonic Polyps; Colorectal Neoplasms; Endoscopy; Humans; Models, Anatomic; Neoplasm Staging
PubMed: 17113842
DOI: 10.1016/j.dld.2006.06.039 -
Colorectal Disease : the Official... Apr 2014The study aimed to determine whether Helicobacter pylori infection is associated with colorectal adenocarcinoma and to quantify the extent of the risk. (Meta-Analysis)
Meta-Analysis
AIM
The study aimed to determine whether Helicobacter pylori infection is associated with colorectal adenocarcinoma and to quantify the extent of the risk.
METHOD
A literature search was performed to identify studies published between 1995 and 2012 for relevant risk estimates. Fixed and random effect meta-analytical techniques were conducted for colorectal adenocarcinoma and adenomatous polyp.
RESULTS
Twenty-seven case-controlled studies involving 3450 adenocarcinoma patients, 1304 adenomatous polyp patients and more than 4000 controls were included. Helicobacter pylori was associated with an increased risk of colorectal adenocarcinoma and adenomatous polyp [odds ratio (OR) 1.24, 95% CI 1.12-1.37, P = 0.66; OR 1.87, 95% CI 1.53-2.28, P = 0.81]. There was a significant association between the CagA-positive strain and adenocarcinoma risk (OR 1.22, 95% CI 1.08-1.37, P = 0.05). In addition, there was an increased risk of tubular adenoma and villous adenoma formation (OR 3.06, 95% CI 1.98-4.73, P = 0.14; OR 2.05, 95% CI 0.84-4.97, P = 0.86).
CONCLUSION
The meta-analysis suggests a promoting effect of Helicobacter pylori on the risk of adenocarcinoma. It also suggests that Helicobacter infection might have its influence at the start of the adenomatous polyp disease sequence.
Topics: Adenocarcinoma; Adenomatous Polyps; Colonic Polyps; Colorectal Neoplasms; Disease Progression; Female; Helicobacter Infections; Helicobacter pylori; Humans; Intestinal Mucosa; Male; Odds Ratio; Risk Factors
PubMed: 23692360
DOI: 10.1111/codi.12290