Correlation between sentinel polyps and proximal colon carcinoma and analysis of its clinical features

Abstract

Objective To explore the clinical features of sentinel polyps (rectal polyps with proximal colon carcinoma), and the correlation between sentinel polyps and proximal colon carcinoma. Methods The clinical data of 331 patients with rectal polyps were retrospectively analyzed. According to the combination condition of proximal colon carcinoma, the patients were divided into sentinel polyps group (observation group, 37 cases) and pure rectal polyps group (control group, 294 cases). The family history, laboratory examination, colonoscopy, clinical pathological features, treatment, sequelae and shortterm prognosis were compared between 2 groups. Results The family history rate, positive rate of tumor marker and the incidences of polyps maximum diameter > 1 cm, polyps > 5 pieces, adenomatous polyp in observation group were significantly higher than those in control group: 35.1% (13/37) vs. 4.8% (14/294), 67.6% (25/37) vs. 6.8% (20/294), 62.2% (23/37) vs. 46.6% (137/294), 43.2% (16/37) vs. 11.9% (35/294) and 83.8% (31/37) vs. 35.4% (104/294), and there were statistical differences (P <0.01). The patients in control group did not have special find in colonoscopy. The majority patients in observation group had new organisms around the lumen growth in colonoscopy, but the intestinal canal between rectal polyps and proximal colon carcinoma did not have special find. The majority pathologic type of proximal colon carcinoma patients in observation group was papillary adenoearcinoma and tubular adenocarcinoma, 75.7% (28/37). Duke stage: A stage was in 11 cases (29.7%, 11/37), B stage in 11 cases (29.7%, 11/37), C stage in 9 cases (24.3%, 9/37), and D stage in 6 cases (16.2%, 6/37). In control group, 282 patients (95.9%, 282/294) were treated by endoscope, and they were cured and discharged. In observation group, 15 patients (40.5%, 15/37) were treated with radical operation, 9 patients (24.3%, 9/37) by endoscope, 7 patients (18.9%, 7/37) with palliative surgery, 4 patients (10.8%, 4/37) with chemotherapy, and 2 patients (5.4%, 2/37) with symptomatic treatment; the patients were followed up for 6 -12 months, the 23 patients with complete tumor resection did not relapse, 12 patients showed tumor reduction or symptomatic relief, and the other 2 patients died. Conclusions If maximum diameter over 1 cm, multiple and adenomatous polyps exist, the possibility of carcinogenesis of the polyps or the proximal colon should be awared. The patients should be followed up in short-term and complete the whole colon examination. Key words: Polyps; Colonic neoplasms; Colonoscopy; Retrospective studies