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Arquivos de Gastroenterologia 2017- Gastric polyps are elevated mucosal lesions. Most of them are less than 1 cm and when larger than 2 cm, has a high malignancy probability. The histopathological types... (Review)
Review
BACKGROUND
- Gastric polyps are elevated mucosal lesions. Most of them are less than 1 cm and when larger than 2 cm, has a high malignancy probability. The histopathological types are mainly fundic gland polyps, hyperplastic polyps and adenomatous polyps.
OBJECTIVE
- To evaluate the agreement between three different pathologists in the histopathological diagnosis of 128 biopsied gastric polyps in Digestive Endoscopy Unit from Walter Cantídeo University Hospital, between May 2010 to May 2012.
METHODS
- To describe the intensity of agreement between observers, we use kappa index that is based on the number of concordant measures between them.
RESULTS
- There was substantial agreement in the diagnosis of adenoma (kappa=0.799, CI: 0.899-0.698) and fundic glands (kappa=0.655, CI: 0.755-0.555). Regarding to hyperplastic polyps (kappa=0.415, CI: 0.515-0.315) and inflammatory (kappa=0.401, CI: 0.501-0.301), we obtained a moderate agreement. Regarding the presence of Helicobacter pylori in biopsy of the polyp, there was a low agreement (kappa=0.219, CI: 0.319-0.119).
CONCLUSION
- It is clear that the agreement between pathologists depends on the histological type of the biopsied polyp and this agreement is more substantial in adenoma, or fundic gland polyps.
Topics: Adenomatous Polyps; Biopsy; Cross-Sectional Studies; Helicobacter Infections; Humans; Observer Variation; Retrospective Studies; Stomach Neoplasms
PubMed: 28591245
DOI: 10.1590/S0004-2803.201700000-29 -
Computational Intelligence and... 2021Colorectal cancer originates from adenomatous polyps. Adenomatous polyps start out as benign, but over time they can become malignant and even lead to complications and...
Colorectal cancer originates from adenomatous polyps. Adenomatous polyps start out as benign, but over time they can become malignant and even lead to complications and death which will spread to adherent and surrounding organs over time, such as lymph nodes, liver, or lungs, eventually leading to complications and death. Factors such as operator's experience shortage and visual fatigue will directly affect the diagnostic accuracy of colonoscopy. To relieve the pressure on medical imaging personnel, this paper proposed a network model for colonic polyp detection using colonoscopy images. Considering the unnoticeable surface texture of colonic polyps, this paper designed a channel information interaction perception (CIIP) module. Based on this module, an information interaction perception network (IIP-Net) is proposed. In order to improve the accuracy of classification and reduce the cost of calculation, the network used three classifiers for classification: fully connected (FC) structure, global average pooling fully connected (GAP-FC) structure, and convolution global average pooling (C-GAP) structure. We evaluated the performance of IIP-Net by randomly selecting colonoscopy images from a gastroscopy database. The experimental results showed that the overall accuracy of IIP-NET54-GAP-FC module is 99.59%, and the accuracy of colonic polyp is 99.40%. By contrast, our IIP-NET54-GAP-FC performed extremely well.
Topics: Adenomatous Polyps; Colonic Polyps; Colonoscopy; Databases, Factual; Humans; Perception
PubMed: 34912447
DOI: 10.1155/2021/8429899 -
PloS One 2021Emerging data suggest a negative role of cyclooxygenase-2 (COX-2) in colorectal carcinomas (CRC). Investigating this in developing communities such as ours helps to...
BACKGROUND
Emerging data suggest a negative role of cyclooxygenase-2 (COX-2) in colorectal carcinomas (CRC). Investigating this in developing communities such as ours helps to contribute to existing understanding of these lesions.
METHODS AND FINDINGS
Formalin-fixed paraffin-embedded CRC colectomy tissues and their corresponding non-tumour margins of resected tissues were sectioned and stained with COX-2 antibody. Adenomatous polyp tissues from non-cancer bearing individuals were similarly processed for comparison. COX-2 expression was scored for percentage (< 5% = 0; 6%-25% = 1; 26%-50% = 2; 51%-75% = 3; 76%-100% = 4) and intensity (no staining = 0; yellow = 2; yellowish-brown = 3, brown = 4). Total immunoscore (percentage + intensity score) ≥ 2 was regarded as positive COX-2 expression. Outcome was statistically evaluated with clinicopathological data to determine COX-2 expression-associated and predictor variables. Ninety-five CRC cases and 27 matched non-tumour tissues as well as 31 adenomatous polyps met the inclusion criteria. Individuals with CRC had a mean age of 56.1 ± 12.6 years while those with adenomatous polyps had a median age of 65 years (range 43-88). COX-2 was differentially overexpressed in CRCs (69/95; 72.6%) and in adenomatous polyps (17/31; 54.8%) than in non-tumour tissues 5/27 (18.5%); p < 0.001). The difference in COX-2 expression between CRC and polyps was non-significant (p > 0.065). Tumour grade, advanced pT-stage, tumour-infiltrating lymphocytes, and dirty necrosis were also significantly associated with COX-2 expression (p < 0.035; 0.043, 0.035 and 0.004, respectively). Only dirty necrosis and Crohns-like lymphocytic aggregates predicted COX-2 expression (p < 0.05).
CONCLUSION
This study showed a progressive increase in COX-2 expression from normal to adenomatous polyp and CRC tissues, this being associated with poorer prognostic indicators. Although COX-2 appears early in CRC, it may play a secondary role in promoting tumour growth and invasiveness.
Topics: Adenomatous Polyps; Adult; Aged; Aged, 80 and over; Black People; Case-Control Studies; Colorectal Neoplasms; Cyclooxygenase 2; Female; Humans; Lymphocytes, Tumor-Infiltrating; Male; Middle Aged; Necrosis; Neoplasm Staging; Nigeria; Odds Ratio; Retrospective Studies
PubMed: 34314467
DOI: 10.1371/journal.pone.0255235 -
World Journal of Gastroenterology Nov 2016To perform meta-analysis of the use of Endocuff during average risk screening colonoscopy. (Meta-Analysis)
Meta-Analysis Review
AIM
To perform meta-analysis of the use of Endocuff during average risk screening colonoscopy.
METHODS
Scopus, Cochrane databases, MEDLINE/PubMed, and CINAHL were searched in April 2016. Abstracts from Digestive Disease Week, United European Gastroenterology, and the American College of Gastroenterology meeting were also searched from 2004-2015. Studies comparing EC-assisted colonoscopy (EAC) to standard colonoscopy, for any indication, were included in the analysis. The analysis was conducted by using the Mantel-Haenszel or DerSimonian and Laird models with the odds ratio (OR) to assess adenoma detection, cecal intubation rate, and complications performed.
RESULTS
Nine studies ( = 5624 patients) were included in the analysis. Compared to standard colonoscopy, procedures performed with EC had higher frequencies for adenoma (OR = 1.49, 95%CI: 1.23-1.80; = 0.03), and sessile serrated adenomas detection (OR = 2.34 95%CI: 1.63-3.36; < 0.001). There was no significant difference in cecal intubation rates between the EAC group and standard colonoscopy (OR = 1.26, 95%CI: 0.70-2.27, = 0%; = 0.44). EAC was associated with a higher risk of complications, most commonly being superficial mucosal injury without higher frequency for perforation.
CONCLUSION
The use of an EC on colonoscopy appears to improve pre-cancerous polyp detection without any difference in cecal intubation rates compared to standard colonoscopy.
Topics: Adenomatous Polyps; Chi-Square Distribution; Colonic Neoplasms; Colonic Polyps; Colonoscopes; Colonoscopy; Equipment Design; Humans; Odds Ratio; Predictive Value of Tests; Reproducibility of Results; Risk Factors
PubMed: 27920485
DOI: 10.3748/wjg.v22.i43.9642 -
California Medicine Feb 1955In a series of 48 cases of gastric polyps, 40 patients had benign lesions while the polyps in the remaining eight cases were malignant. Although the symptomatology in...
In a series of 48 cases of gastric polyps, 40 patients had benign lesions while the polyps in the remaining eight cases were malignant. Although the symptomatology in this series was not uniform, only one patient was entirely asymptomatic. Of the eight patients with malignant lesions, three had polyps which could well be described as small, suggesting that size may not be a reliable criterion of benignity even in a single lesion. Laboratory studies indicated that anemia, achlorhydria and occult blood in the stools are frequently associated with gastric polyps. There was no apparent correlation, however, between these phenomena and the benign or malignant nature of the lesions.X-ray examination, performed in every instance, was completely negative in six cases and inconclusive in an additional five. Gastroscopy did not reveal the presence of polyps in three of 15 cases. Malignant change was detected by cytologic examination in one case in which both roentgen and gastroscopic examination were negative. The author believes that in most cases of gastric polyps operative treatment affords the greatest degree of safety. An operative procedure of considerably less extent than total gastric resection often is feasible. However, if true polyps occur where removal can be effected only by total gastric resection, the incidence of malignant change in these lesions would seem to indicate the advisability of such a procedure unless positive contraindicating conditions are present.
Topics: Achlorhydria; Adenomatous Polyps; Aged; Cytodiagnosis; Gastrectomy; Gastroscopy; Humans; Polyps; Stomach Neoplasms
PubMed: 13230920
DOI: No ID Found -
International Journal of Molecular... Nov 2021Gastric hyperplastic polyps (GHP) are frequently found to be benign polyps and have been considered to have a low carcinogenic potential. The characteristics of the...
Gastric hyperplastic polyps (GHP) are frequently found to be benign polyps and have been considered to have a low carcinogenic potential. The characteristics of the hyperplastic polyp-associated gastric cancer (HPAGC) remain unclear. Therefore, we analyzed samples from 102 GHP patients and identified 20 low-grade atypical GHPs (19.6%), 7 high-grade atypical GHPs (6.9%), and 5 intramucosal cancer samples (4.9%). GHP atypia was more common in the elderly and increased with increasing polyp size. In particular, polyps larger than 1 cm were associated with a higher grade and cancer. Furthermore, mucus production decreased with increasing atypia. Although no correlation was found between atypia and Helicobacter pylori infection or intestinal metaplasia, enhanced proliferative ability (Ki-67) did correlate with atypia, as did nuclear 8-hydroxy-2'-deoxyguanosine levels. Interestingly, 4-hydroxynonenal levels in granulation tissue and the area ratio of granulation tissue within polyps also correlated with GHP atypia. In five cases of HPAGC, three cases exhibited caudal type homeobox transcription factor (CDX2)-positive cells and a mixed mucin phenotype, which is considered to be related to infection. By contrast, two cases were CDX2 negative, with a gastric mucin phenotype, and infection was not observed in the tumor or the surrounding mucosa. In these cases, a v-raf murine sarcoma viral oncogene homolog B1 (BRAF) mutation (V600E) was detected. All cancer samples showed high stemness and p53 protein accumulation, but no KRAS mutations. The molecular and phenotypic characteristics of the cases characterized by BRAF mutations may represent a novel subtype of HPAGC, reflecting a conserved pathway to oncogenesis that does not involve infection. These findings are worthy of further investigation in a large-scale study with a substantial cohort of HPAGC patients to establish their clinical significance.
Topics: Adenomatous Polyps; Aged; Biomarkers, Tumor; Female; Follow-Up Studies; Humans; Hyperplasia; Male; Middle Aged; Mutation; Prognosis; Proto-Oncogene Proteins B-raf; Stomach Neoplasms
PubMed: 34884530
DOI: 10.3390/ijms222312724 -
Cancer Prevention Research... Nov 2011Adenomatous polyps are known precursor lesions for colorectal cancer and some hyperplastic polyps also have malignant potential. The use of aspirin and nonsteroidal... (Comparative Study)
Comparative Study
Adenomatous polyps are known precursor lesions for colorectal cancer and some hyperplastic polyps also have malignant potential. The use of aspirin and nonsteroidal anti-inflammatory drugs (NSAID) is associated with a reduced risk of adenomatous polyps; however, less evidence exists with regard to NSAID use and hyperplastic polyp risk. We conducted a colonoscopy-based case-control study including 2,028 polyp cases (1,529 adenomatous and 499 hyperplastic) and 3,431 polyp-free controls. Multivariate logistic regression models were constructed to derived adjusted ORs and 95% CIs as the measure of the association between NSAID use and polyp risk. Use of baby aspirin, regular aspirin, and nonaspirin NSAIDs, were associated with a reduced risk of adenomatous polyps (OR = 0.79, 95% CI: 0.66-0.93, OR = 0.73, 95% CI: 0.58-0.90, and OR = 0.67, 95% CI: 0.53-0.86, respectively). Baby aspirin was also associated with a reduced risk of hyperplastic polyps (OR = 0.74, 0.56-0.97). Although a dose response was seen with adenoma risk and regular use of any NSAIDs (less than 7 doses per week, 7 doses per week, and greater than 7 doses per week), a dose response was not seen with hyperplastic polyps. We found no evidence of interaction between NSAID dose and duration and polyp risk. The use of any NSAID regardless of type was associated with a reduced risk of adenomatous polyps; however, regular aspirin and COX-2 inhibitors use was not associated with hyperplastic polyp risk.
Topics: Adenoma; Adenomatous Polyps; Adult; Aged; Anti-Inflammatory Agents, Non-Steroidal; Case-Control Studies; Colonic Polyps; Colonoscopy; Female; Humans; Hyperplasia; Male; Middle Aged; Prognosis; Risk Factors
PubMed: 21764857
DOI: 10.1158/1940-6207.CAPR-11-0107 -
BMC Gastroenterology Aug 2020Adenomatous gallbladder polyps, premalignant lesions of the gallbladder, have fatal outcomes, whereas cholesterol polyps have benign features. Herein, we proposed a...
BACKGROUND
Adenomatous gallbladder polyps, premalignant lesions of the gallbladder, have fatal outcomes, whereas cholesterol polyps have benign features. Herein, we proposed a novel, predictive scoring model of adenomatous polyps to distinguish them from cholesterol polyps, by analyzing bile components and bile viscosity.
METHODS
Patients with gallbladder polyp pathologically confirmed after cholecystectomies were analyzed. After dividing patients into two groups (adenomatous or cholesterol polyps), the clinicopathologic profiles and bile nature, including components and viscosity were compared and a predictive scoring model for adenomatous polyps was assessed.
RESULTS
Eleven adenomatous polyps and 96 cholesterol polyps were analyzed. The variables significantly associated with adenomatous polyps were age > 55 years (OR = 23.550, p = 0.020), bile viscosity< 7.5 s (OR = 22.539, p = 0.012), and bile cholesterol< 414.5 mg/dl (OR = 10.004, p = 0.023) and the points for each variable in the predictive scoring model were allocated as 3, 3, and 2, respectively. Final scores ranged from 0 to 8 points and the best performance of model at a cutoff of ≥6 points had 90.9% of sensitivity and 80.2% of specificity.
CONCLUSIONS
Bile viscosity and bile cholesterol accompanied by age were revealed as significant predictors of adenomatous polyps, distinguishing them from cholesterol polyps of gallbladder. It can be the cornerstone for creating accurate guidelines for preoperatively determining treatment strategies of gallbladder polyps.
Topics: Adenomatous Polyps; Bile; Cholesterol; Gallbladder Neoplasms; Humans; Middle Aged; Polyps; Viscosity
PubMed: 32799793
DOI: 10.1186/s12876-020-01414-9 -
Journal of Korean Medical Science Dec 2000Previous studies on life style for colorectal cancer risk suggest that serum lipids and glucose might be related to adenomatous polyps as well as to colorectal...
Previous studies on life style for colorectal cancer risk suggest that serum lipids and glucose might be related to adenomatous polyps as well as to colorectal carcinogenesis. This case-control study was conducted to investigate the associations between serum lipids, blood glucose, and other factors and the risk of colorectal adenomatous polyp. Male cases with colorectal adenomatous polyp, histologically confirmed by colonoscopy (n=134), and the same number of male controls matched by age for men were selected in hospitals in Seoul, Korea between January 1997 and October 1998. Serum lipids and glucose levels were tested after the subjects had fasted for at least 12 hr. Conditional logistic regression showed that there was a significant trend of increasing adenomatous polyp risk with the rise in serum cholesterol level (Ptrend=0.07). Increasing trend for the risk with triglyceride was also seen (Ptrend=0.01). HDL-cholesterol and LDL-cholesterol had increasing trends for the risk, which were not significant. In particular, it was noted that higher fasting blood glucose level reduced the adenomatous polyp risk for men (Ptrend=0.001). This study concluded that both serum cholesterol and triglyceride were positively related to the increased risk for colorectal adenomatous polyp in Korea. Findings on an inverse relationship between serum glucose and the risk should be pursued in further studies.
Topics: Adenomatous Polyps; Blood Glucose; Case-Control Studies; Cholesterol; Cholesterol, HDL; Cholesterol, LDL; Colonic Neoplasms; Humans; Korea; Lipids; Male; Rectal Neoplasms; Risk Factors; Triglycerides
PubMed: 11194196
DOI: 10.3346/jkms.2000.15.6.690 -
BMC Family Practice Aug 2018Colorectal cancer (CRC) develops from colorectal adenomatous polyps. This study is to determine if diabetes mellitus (DM), its treatment, and hemoglobin A1c (HbA1c)...
BACKGROUND
Colorectal cancer (CRC) develops from colorectal adenomatous polyps. This study is to determine if diabetes mellitus (DM), its treatment, and hemoglobin A1c (HbA1c) level are associated with increased risk of colorectal adenomatous polyps.
METHODS
This was a retrospective cohort study that included patients who had at least one colonoscopy and were continuously enrolled in a single managed care organization during a 10-year period (2002-2012). Of these patients (N = 11,933), 1800 were randomly selected for chart review to examine the details of colonoscopy and pathology findings and to confirm the diagnosis of DM. Multivariable logistic regression analyses were performed to assess the associations between DM, its treatment, HbA1c level and adenomatous polyps (our main outcome).
RESULTS
Among the total of 11,933 patients with a mean (standard deviation) age of 56 (± 8.8) years, 2306 (19.3%) had DM and 75 (0.6%) had CRC. Among the 1800 under chart review, 445 (24.7%) had DM, 11 (0.6%) had CRC and 537 (29.8%) had adenomatous polyps. In bivariate analysis, patients with DM had 1.45 odds of developing adenomatous polyps compared to those without DM. This effect was attenuated (odds ratio = 1.25, 95% CI: 0.96-1.62, p = 0.09) after adjusting for confounders such as age, gender, race/ethnicity, and body mass index. There was no significant association between type or duration of DM treatment or HbA1c level and adenomatous polyps.
CONCLUSIONS
Our study confirmed the known increased risk of adenomatous polyps with advancing age, male gender, Hispanic race/ethnicity and higher body mass index. Although it suggested an association between DM and adenomatous polyps, a statistically significant association was not observed after controlling for other potential confounders. Further studies with a larger sample size are needed to further elucidate this relationship.
Topics: Adenomatous Polyps; Aged; Cohort Studies; Colonic Polyps; Colorectal Neoplasms; Diabetes Mellitus; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Female; Glycated Hemoglobin; Humans; Hyperglycemia; Hypoglycemic Agents; Male; Middle Aged; Multivariate Analysis; Odds Ratio; Retrospective Studies; Risk Factors; United States
PubMed: 30157768
DOI: 10.1186/s12875-018-0835-1