Sulindac in Familial Adenomatous Polyposis: Evaluation by Nuclear Morphometry

Abstract

To find out if nuclear morphometry is a useful indicator of prognosis in patients with familial adenomatous polyposis (FAP) before and after treatment with sulindac. Open study. Teaching hospital, Spain. 29 patients (17 women and 12 men) with FAP who had been treated by colectomy. There were two control groups: 17 people with healthy rectal mucosa and 10 patients with colorectal cancer. The 29 patients with FAP were treated with sulindac 150 mg orally twice daily for 6 months. Results of histological examination of biopsy specimens and nuclear morphometry. Before treatment, all patients with FAP had nuclei of cells in the rectal mucosa that were intermediate in size between those in healthy mucosa (small nuclei) and those in cancer (large nuclei). After 6 months' treatment with sulindac the patients with FAP no longer had any polyps and the size of the nuclei was similar to those in healthy mucosa. Only 1 patient failed to respond, and in this patient one of the polyps subsequently became malignant. Nuclear morphometry may be useful in identifying patients with FAP who are at high risk of malignant degeneration.