Occurrence Of Polyps Research Articles

A Mouse Model for Osseous Heteroplasia

GNAS/Gnas encodes Gsα that is mainly biallelically expressed but shows imprinted expression in some tissues. In Albright Hereditary Osteodystrophy (AHO) heterozygous loss of function mutations of GNAS can result in ectopic ossification that tends to be superficial and attributable to haploinsufficiency of biallelically expressed Gsα. Oed-Sml is a point missense mutation in exon 6 of the orthologous mouse locus Gnas. We report here both the late onset ossification and occurrence of benign cutaneous fibroepithelial polyps in Oed-Sml. These phenotypes are seen on both maternal and paternal inheritance of the mutant allele and are therefore due to an effect on biallelically expressed Gsα. The ossification is confined to subcutaneous tissues and so resembles the ossification observed with AHO. Our mouse model is the first with both subcutaneous ossification and fibroepithelial polyps related to Gsα deficiency. It is also the first mouse model described with a clinically relevant phenotype associated with a point mutation in Gsα and may be useful in investigations of the mechanisms of heterotopic bone formation. Together with earlier results, our findings indicate that Gsα signalling pathways play a vital role in repressing ectopic bone formation.

Pulp polyp in traumatized primary teeth – a case–control study

To assess clinical characteristics and other factors associated with the occurrence of pulp polyp in traumatized primary teeth as well to evaluate the impact of pulp polyp occurrence on clinical decision-making after traumatic injuries. This study was divided into three phases. First, occurrence and clinical characteristics of pulp polyp were assessed followed by a descriptive analysis and categorical tests of association. Secondly, a case-control design was used, and the occurrence of pulp polyp was set as the outcome. In third phase, the occurrence of pulp polyp after fracture with pulp exposure was investigated as a variable possibly associated with clinical decision-making (dental extraction/endodontic treatment). Logistic regression analyses were used, and odds ratios and 95% confidence interval (OR; 95% CI) were calculated in second and third phases. Occurrence of pulp polyp in traumatized primary teeth was of 2.3%. Hyperplastic tissue color and proliferation size were not associated with the time to seek treatment after injury (P > 0.05). Children up to 2 years of age had more chance of having pulp polyp in comparison with older children (3.15; 1.15-8.64). Teeth with crown-root fracture had more chance of dental extraction in the therapeutic approach than the teeth with only crown fracture (4.36; 1.10-17.32). Presence of pulp polyp was not associated with the treatment carried out. Occurrence of pulp polyp in traumatized primary teeth is not frequent and is associated with the age when traumatic dental injury occurs but does not interfere directly with the therapeutic approach.

Association Between Serum Vitamin D Levels and Carcinomatous Polyps

Purpose: Vitamin D is postulated to play a role in carcinogenesis in the colon by modulation of apoptosis and by inhibition of angiogenesis. However literature available regarding this hypothesis is conflicting. A meta-analysis has shown that higher levels of total vitamin D are associated with a lower incidence of carcinomatous polyps but several case-control reports showed no significant association between the two. This retrospective study aims to determine whether an increased vitamin D level is associated with a lower occurrence of carcinomatous polyps. Methods: We conducted a case-control study involving all patients who underwent colonoscopy at Metropolitan Hospital Center in 2011 and who had serum total vitamin D levels taken one month before or after the date of colonoscopy. Total vitamin D levels and the presence of carcinomatous polyps were the main variables studied. Polyp-positive samples were designated as the case group while polyp-negative samples were assigned to the control group. Logistic regression analysis was used to estimate odds ratio at 95% confidence interval. Adjusted variables were chosen a priori and included age, sex, race, smoking history, alcohol history, body mass index, folate and aspirin. The study was approved by the Institutional Review Board of the New York Medical College. Results: A total of 136 [(n=93) control and (n=43) case] subjects were included in the study. The mean vitamin D level for both groups was 25.65 ± 10.65. There was no association between vitamin D levels and carcinomatous polyps; [crude OR 0.991 p(95%): 0.841 (0.962-1.032)] and remained unchanged after adjusting for age, sex, race, smoking history, alcohol history, body mass index, folate and aspirin [adjusted OR 0.982 p(95%): 0.419 (0.941-1.026)]. Conclusion: Our data suggests that vitamin D levels are not associated with carcinomatous polyps as previously suggested.Table: Multivariable-adjusted associations of total vitamin D level and carcinomatous polypsTable: [1960] Selected baseline characteristics of the study subjectsFigure: [1960]

Systemic markers of oxidative status and colorectal adenomatous polyps

PurposeOxidative damage has been implicated in carcinogenesis. We hypothesized that elevated systemic oxidative status would be associated with later occurrence of colorectal adenomatous polyps, a precursor of colorectal cancer. MethodsWe examined the prospective association between four systemic markers of oxidative status and colorectal adenomatous polyps within a nondiabetic subcohort of the Insulin Resistance Atherosclerosis Study (n = 425). Urine samples were collected from 1992 to 1994 and colorectal adenomas prevalence were assessed in 2002 to 2004. Oxidative status markers were assessed, which included four F2-isoprostanes (F2-IsoPs) from the classes III and IV: iPF2α-III, 2,3-dinor-iPF2α-III (a metabolite of iPF2α-III), iPF2α-VI, and 8,12-iso-iPF2α-VI. All biomarkers were quantified using liquid chromatography–tandem mass spectrometry. Prospective associations were assessed using multivariate logistic regression analysis. ResultsThe adjusted odds ratio (OR) (95% confidence interval [CI]) for occurrence of colorectal adenomatous polyps and scaled to 1 SD of F2-IsoP distribution were 1.16 (95% CI, 0.88–1.50), 0.88 (95% CI, 0.63–1.17), 1.04 (95% CI, 0.80–1.34), and 1.16 (95% CI, 0.90–1.48) for iPF2α-III, iPF2α-VI, 8,12-iso-iPF2α-VI, and 2,3-dinor-iPF2α-III, respectively. ConclusionsThe lack of association between F2-IsoPs and adenomatous polyps does not support the hypothesis that elevated oxidative status is associated with colorectal adenomatous polyp occurrence during a 10-year period of follow-up.

Outcomes of a 5-year follow-up of patients with sessile serrated adenomas

Objective. Sessile serrated adenomas (SSAs) are precursors to colorectal cancer (CRC). The purpose of this study is to determine the occurrence of new polyps and CRC in patients with an SSA over a 5-year follow-up interval. Methods. This study is a retrospective chart review of patients with SSAs diagnosed at colonoscopy in 2005. ed information included patient demographics, colonoscopy information, and polyp characteristics. Results. During 2005, 34 SSAs and 5 mixed SSAs were identified in 33 patients. The mean patient age was 66 years and 58% were female. There was a family history of CRC in 45%, prior polyps in 33%, and previous CRC in 15%. The mean SSA size was 11 mm. SSAs were located proximal to the splenic flexure in 70%. Low-grade dysplasia was present in 3% of SSAs and 80% mixed SSAs. Synchronous adenomatous and hyperplastic polyps occurred respectively in 45% and 21%. High-grade dysplasia was present in 12% of the adenomas. Twenty-two patients underwent subsequent colonoscopies with 20 new SSAs and 1 mixed SSA identified. In SSAs low-grade dysplasia occurred in 10% and high-grade dysplasia in 5%. Low-grade dysplasia was present in the mixed SSA. Synchronous adenomatous and hyperplastic polyps occurred respectively in 45% and 37%. High-grade dysplasia was present in 10% of adenomas and CRC occurred in 1 (5%) patient. Conclusions. SSAs occurred more frequently in females and in the right colon. Dysplasia occurred in a small subset of SSAs. There was a high rate of prior and subsequent CRC in patients with SSAs.

Clinico-pathological profile of sinonasal masses: An experience in tertiary care hospital of Uttarakhand

Background:The purpose of this study was to classify various types of non-neoplastic and neoplastic lesions presenting as sinonasal mass and characterize their clinico-pathological profile in a tertiary care center in the state of Uttarakhand.Materials and Methods:This was a prospective study where 110 cases of sinonasal masses were included over a period of 12 months. Clinico-pathological study was carried out in these cases. A provisional diagnosis was made after clinical assessment and radiologic investigations, but final diagnosis was made after histopathologic examination.Observations:The number of non-neoplastic lesions were more than the neoplastic lesion, 60% versus 40% respectively. In the neoplastic group, 19.8% and 23.76% patients presented with benign and malignant lesion, respectively. The incidence was more predominant in the age group of 11-20 years (22.72%) with male to female ratio of 1.08:1. In our study, among non-neoplastic lesions the occurrence of sinonasal polyps was highest seen in 80.30% cases. In neoplastic lesions, angiofibroma was most common benign lesion seen in 35% cases. Carcinoma nasal cavity was the commonest malignant lesion seen in 45.83% cases. In 3.63% patients, clinical and radiologic diagnosis was not correlated with histopathologic diagnosis. Only two cases required immuno-histocytochemistry to confirm the final diagnosis.Conclusion:We concluded that for proper evaluation of a sinonasal mass, clinical, radiologic, and histopathologic evaluation should be carried out conjointly in all the cases. Histopathology always gives a confirmatory diagnosis but in few cases immuno-histocytochemistry becomes the ultimate diagnostic technique for correct and timely intervention.

Recurrent small intestine intussusception in a patient with Peutz-Jeghers syndrome

Peutz-Jeghers syndrome is a rare hereditary autosomal dominant disease caused by a mutation of the tumor suppressor gene serine/threonine kinase 11 located in chromosome 19p13.3. It is characterized by the presence of extensive mucocutaneous pigmentation, especially of the lips and the occurrence of hamartomatous polyps throughout the gastrointestinal tract. Gastrointestinal hamartomas occur predominantly in the small intestine and can become symptomatic leading usually to intestinal obstruction and abdominal pain.We present a case of recurrent intestinal obstruction caused by small bowel intussusception treated by reduction, enterotomy and polypectomy and followed by intraoperative enteroscopy and endoscopic polypectomy.

A method of rapid and cost-effective screening for small mutations in patients with Peutz-Jeghers Syndrome

Peutz-Jeghers syndrome (PJS, MIM # 175200) is a rare, hereditary predisposition characterized by the occurrence of hamartomatous polyps in the gastrointestinal tract, mucocutaneous pigmentation, and increased risk of cancer in multiple internal organs. The incidence of the syndrome, depending on the studied population, has estimated range from 1:25,000 even up to 1:300,000 births. PJS is an autosomal dominant disease and in most of the cases is caused by mutations in the STK11 gene (MIM # 602216) located on a small arm of chromosome 19 at position 19p3.3. The majority of causative DNA changes identified in patients with PJS are small mutations, therefore, developing a rapid and cost-effective method of their detection is a key aspect in the advancement of genetic diagnostics of patients suffering from PJS. In our study we developed a methodology of detection of small mutations in entire coding sequence of the STK11 gene based on High Resolution Melting analysis (HRM). In our group of 41 families with PJS small mutations of the STK11 gene were detected in 22 families (54%). In the remaining cases, where large rearrangements were not detected using MLPA, all of the coding exons were sequenced. However, this did not allow detection of any additional mutations. Therefore, the developed methodology of searching for small mutations using HRM allowed to detect all the STK11 gene sequence changes occurring in our group of patients. The study was financed by the Ministry of Education and Science, Poland, grant number N402 481537.

Sporadic diffuse gastric polyposis: Report of a case

A 50-year-old woman was admitted because of severe sideropenic anemia. The gastrin levels were within normal ranges. Esophagogastroduodenoscopy showed diffuse gastric polyposis with signs of diffuse oozing. Colonoscopy showed the presence of a 3-cm wide pedunculated polyp of the ascending colon, which was removed by diathermy. The patient was treated by total gastrectomy with Roux-Y esophagojejunostomy. Histological examination showed the presence of diffuse gastric polyposis with the contemporary occurrence of hyperplastic polyps and mixed hyperplastic and adenomatous polyps, with a tubular pattern and the focal aspect of serrate adenoma. This is the first case report of sporadic diffuse hyperplastic and adenomatous polyposis of the stomach.

Randomized Double-Blind Trial of Sulindac and Etodolac to Eradicate Aberrant Crypt Foci and to Prevent Sporadic Colorectal Polyps

On the basis of the results of our preliminary trial suggesting that aberrant crypt foci (ACF) could be eradicated by short-term administration of sulindac, in the present study, we explored the feasibility of using ACF as surrogate markers for chemoprevention of colorectal cancer. Randomly assigned to sulindac (300 mg daily), etodolac (400 mg daily), and placebo groups were 189 subjects without polyps or who had undergone polypectomy. Drugs were administered for 2 months. ACF in the rectal region were counted by magnifying endoscopy. Occurrence of polyps was evaluated at 12 months. A planned interim analysis was conducted. ACF number at 2 months was significantly suppressed in the sulindac group (P = 0.0075), but not in the etodolac group (P = 0.73). In the sulindac group, the numbers of adenomas plus hyperplastic polyps (total polyps) and adenomas at 12 months were significantly (P = 0.02) and marginally (P = 0.064) lower, respectively, in comparison with the placebo group; no such difference was observed in the etodolac group. In analysis of only polypectomized subjects, the numbers of total polyps and adenomas in the sulindac group were even more markedly lower, with P values of 0.014 and 0.034, respectively. A similar tendency was confirmed by analyses of the incidence of polyps at 12 months. Suppression rates of total polyps and adenomas in ACF responders to sulindac were significantly greater than in nonresponders. In all groups, compliance was more than 90% and no intolerable adverse effects were observed. ACF may be useful as surrogate lesions for chemoprevention of colorectal cancer.

Serum ALT is an Independent Predictor for Polypectomy During Screening Colonoscopy

Background: Diabetes and its antecedent condition, metabolic syndrome, have been associated with an increased risk of development of colon polyps and colorectal carcinoma. Nonalcoholic fatty liver disease (NAFLD) frequently coexists with these conditions and is associated with elevation in serum alanine aminotransferase (ALT). Our aim was to test our apriori hypothesis that after adjusting for currently established predictors of colon polyps, elevated serum ALT will be associated with increased rate of polypectomy. Methods: We conducted retrospective analysis on ten Veterans affairs (VA) VISN representing half of all VA medical centers, obtained from Veterans Affairs Medical SAS Data sets and Decision Support System from 2002 to 2009. We included adult patients without diabetes mellitus between the ages of 45 and 65 receiving first VA documented outpatient screening colonoscopy using validated methods. We excluded patients with human immunodeficiency virus infection, and those with liver disease from hepatitis C or alcohol abuse as well as those with missing values for ALT. Baseline ALT was defined as the ALT level closest to date of colonoscopy and within 12 months of colonoscopy. We categorized ALT levels to 0 to <30 IU/L (referent), 30 to <40, 40 to <50, 50 to <60 and ≥ 60. Based on literature review, we identified the following as established predictors of polyp occurrence: age, male gender, tobacco use, obesity, and use of nonsteroidal anti-inflammatory drugs and conducted logistic regression analysis with these variables in addition to ALT. Results: A total of 43,533 patients met our study criteria, of this 18591 (42.7%) had polypectomy. On adjusted analysis, ALT remained a significant additional predictor of polypectomy (Table). When compared to patients with ALT < 30, we found a linear increase in the rates of polypectomy with adjusted Odds Ratio (OR) of 1.03, 1.13, 1.19 and 1.26 among patient with ALT of 30 to <40, 40 to <50, 50 to <60 and≥ 60 respectively. Conclusions: In this well powered national Veteran cohort, ALT was found to be an independent additional predictor of polypectomy. More importantly, we found a linear relationship between ALT levels and polypectomy. Utilizing ALT as a surrogate for NAFLD, our data provides further support for NAFLD being an independent risk factor for polyp occurrence.

Outcomes of a 5 Year Follow-up of Patients With Sessile Serrated Adenomas

Abstract Objective. Sessile serrated adenomas (SSAs) are precursors to colorectal cancer (CRC). The purpose of this study is to determine the occurrence of new polyps and CRC in patients with an SSA over a 5-year follow-up interval. Methods. This study is a retrospective chart review of patients with SSAs diagnosed at colonoscopy in 2005. Abstracted information included patient demographics, colonoscopy information, and polyp characteristics. Results. During 2005, 34 SSAs and 5 mixed SSAs were identified in 33 patients. The mean patient age was 66 years and 58% were female. There was a family history of CRC in 45%, prior polyps in 33%, and previous CRC in 15%. The mean SSA size was 11 mm. SSAs were located proximal to the splenic flexure in 70%. Low-grade dysplasia was present in 3% of SSAs and 80% mixed SSAs. Synchronous adenomatous and hyperplastic polyps occurred respectively in 45% and 21%. High-grade dysplasia was present in 12% of the adenomas. Twenty-two patients underwent subsequent colonoscopies ...

Outcome of Sporadic Adenomas and Adenoma-Like Dysplasia in Patients with Ulcerative Colitis Undergoing Polypectomy§†

Ulcerative colitis (UC) patients are at increased risk of colorectal dysplasia and cancer. Few studies have examined the clinical outcomes of dysplastic polyps resembling sporadic adenomas that are removed with endoscopic polypectomy. A centralized diagnostic index identified patients evaluated between 1994 and 2004 with UC and polypoid dysplasia who were followed from the time of polypectomy until the most recent colonoscopy. They were stratified into two groups by polyp occurrence, either within (adenoma-like dysplasia) or outside (sporadic adenoma) the most proximal endoscopic or histologic extent of colitis. The endpoints of interest were the development of subsequent colorectal neoplasia, flat dysplasia, or cancer. The cumulative probabilities of these endpoints were estimated using the Kaplan-Meier method, and the association with clinical factors assessed using Cox proportional hazards regression. Ninety-five patients were found to have polypoid dysplasia; of these, 77 underwent polypectomy. The cumulative probability of subsequent colorectal neoplasia in polypectomy patients was 18% at 1 year and 69% at 5 years. After polypectomy, cumulative incidence of cancer or flat dysplasia was 2% at 1 year and 13% at 5 years. The proportional hazards models indicated that these outcomes were not significantly associated with polyp type, primary sclerosing cholangitis, family history of colorectal cancer, 5-aminosalicylate use, extent of colitis, or duration of disease. While polypectomy may be safe for the management of adenomas occurring in most UC patients, the 5-year cumulative incidence of a combined endpoint (cancer or flat dysplasia) was 13%. Such patients should be followed closely.

Repeated colonoscopic screening of patients with acromegaly: 15-year experience identifies those at risk of new colonic neoplasia and allows for effective screening guidelines

It is suggested that patients with acromegaly have an increased risk of colorectal cancer and pre-malignant adenomatous polyps. However, the optimum frequency with which colonoscopic screening should be offered remains unclear. To determine the optimum frequency for repeated colonoscopic surveillance of acromegalic patients. We retrospectively reviewed the case records of all patients with acromegaly seen in our centre since 1992: 254 patients had at least one surveillance colonoscopy, 156 patients had a second surveillance colonoscopy, 60 patients had a third surveillance colonoscopy and 15 patients had a fourth surveillance colonoscopy. The presence of hyperplastic or adenomatous polyps was assessed in all patients, while one cancer was detected at the second surveillance. At the third surveillance, mean (+/-s.d.) serum IGF1 levels (ng/ml) in patients with hyperplastic polyps were significantly higher than those with normal colons (P<0.05). The presence of an adenoma rather than a normal colon at the first colonoscopy was associated with a significantly increased risk of adenoma at the second (odds ratio (OR) 4.4, 95% confidence interval (CI) 1.9-10.4) and at the third (OR 8.8, 95% CI 2.9-26.5) screens. Conversely, a normal colon at the first surveillance gave a high chance of normal findings at the second (78%) or third surveillance (78%), and a normal colon at the second colonoscopy was associated with normality at the third colonoscopy (81%). Repeated colonoscopic screening of patients with acromegaly demonstrated a high prevalence of new adenomatous and hyperplastic colonic polyps, dependent on both the occurrence of previous polyps and elevated IGF1 levels.

Gallenblasenpolypen: Prävalenz und Risikofaktoren

The objective of the present study was to investigate the prevalence of gallbladder polyps and possible risk factors in a random population sample of an urban population. A total of 2099 subjects (1072 women, 1027 men; aged 19 - 65 years, mean age 42.1 (SD ± 12.8 years) were prospectively examined using ultrasound, a standardized questionnaire and laboratory studies. Gallbladder polyps were identified in 6.1 % (128 / 2099) of all subjects (women: 6.1 % [63 / 1027]); men: 6.1 % [65 / 1072]). Solitary polyps were found in 52.4 % (65 / 124), two polyps in 16.1 % (20 / 124), three polyps in 6.5 % (8 / 124), several polyps in 22.6 % (28 / 124) and multiple polyps in 2.4 % (3 / 124) of subjects. The mean polyp diameter was 4.7 mm (SD ± 2.2; range 2 - 20 mm). The polyp diameter was ≤ 7 mm in 94.5 % of subjects. The polyps were described as pedunculate in 82.3 % (102 / 124). The polyps were broad-based in 11.3 % of subjects (14 / 124; men: 18 % women: 4.8 %). The polyps were homogeneously echogenic in 100 % of cases and with irregular contours in only one male subject. Multiple logistic regression failed to demonstrate an influence on the increased occurrence of gallbladder polyps for the risk factors of male sex, age, body-mass index (BMI), alcohol, nicotine or caffeine consumption or diabetes mellitus. The prevalence of gallbladder polyps reported in the present study (6.1 %) is higher than figures previously published for populations in Germany or Europe. The majority of polyps were pedunculate and solitary. A typical risk factor profile for gallbladder polyps could not be identified in the present population sample.

Abstract 3445: Helicobacter pylori increases the risk of colorectal polyps in African Americans

Abstract Background: H. Pylori infection have linked to colorectal polyps, mainly through hypergastrinemia and its trophic effect on colon mucosa. African Americans were under represented despite both common diseases are more prevalent in them. Aim: The aim of this study was to investigate whether H. Pylori infection has a role in development of colorectal polyps in Africans Americans. Methods: Retrospectively, Africans Americans (n=1262) greater than 40 years old who underwent bidirectional gastrointestinal endoscopy on the same day were enrolled. The pre-procedure indication and post-procedure diagnosis were recorded (n=1262). H. Pylori status was assessed by immunohistochemistry on gastric specimens. Colorectal polyps were confirmed by histological examination of biopsies from complete colonoscopy. Multivariable logistic regression was used to assess the independent risk factors of polyp occurrence. Results: Colorectal polyps (regardless polyp pathology) were more prevalent in H. Pylori-infected subjects (43%; 160/368) compared to (34%; 302/894) uninfected subjects (OR=1.5; 95 %CI=1.2-1.9). Furthermore, there was a trend toward larger polyp size ≥ 1cm in H. Pylori positive patients (P=0.07). There was no difference in histopathology or location of polyps in regard to H. Pylori status. Among the participants, 21 (2%) were defined with baseline above average risk for colorectal polyps justifying colonoscopy and of those; the polyps were detected in 62% (OR; 95%CI=2.9; 1.2-7.1). Age and male gender were independent risk factors for colorectal polyps. Conclusion: H. Pylori increases the risk of developing colorectal polyps and may increase the chances for having a larger size polyp in Africans Americans. These findings suggest that H. Pylori might have a role in the initiation and/or promotion of polyps. Further studies are needed to explore its mechanisms. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 3445.

Abstract 2713: Helicobacter pylori increases the risk of colorectal polyps in African Americans

Abstract Background: H. Pylori infection have linked to colorectal polyps, mainly through hypergastrinemia and its trophic effect on colon mucosa. African Americans were under represented despite both common diseases are more prevalent in them. Aim: The aim of this study was to investigate whether H. Pylori infection has a role in development of colorectal polyps in Africans Americans. Methods: Retrospectively, Africans Americans (n=1262) greater than 40 years old who underwent bidirectional gastrointestinal endoscopy on the same day were enrolled. The pre-procedure indication and post-procedure diagnosis were recorded (n=1262). H. Pylori status was assessed by immunohistochemistry on gastric specimens. Colorectal polyps were confirmed by histological examination of biopsies from complete colonoscopy. Multivariable logistic regression was used to assess the independent risk factors of polyp occurrence. Results: Colorectal polyps (regardless polyp pathology) were more prevalent in H. Pylori-infected subjects (43%; 160/368) compared to (34%; 302/894) uninfected subjects (OR=1.5; 95 %CI=1.2-1.9). Furthermore, there was a trend toward larger polyp size ≥ 1cm in H. Pylori positive patients (P=0.07). There was no difference in histopathology or location of polyps in regard to H. Pylori status. Among the participants, 21 (2%) were defined with baseline above average risk for colorectal polyps justifying colonoscopy and of those; the polyps were detected in 62% (OR; 95%CI=2.9; 1.2-7.1). Age and male gender were independent risk factors for colorectal polyps. Conclusion: H. Pylori increases the risk of developing colorectal polyps and may increase the chances for having a larger size polyp in Africans Americans. These findings suggest that H. Pylori might have a role in the initiation and/or promotion of polyps. Further studies are needed to explore its mechanisms. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 2713.

Influence of Proton Pump Inhibitor Use in Gastrointestinal Polyps

Proton pump inhibitors (PPIs) are the most potent anti-acid agents and are extensively used worldwide. PPI-induced hypergastrinemia is one of the very few side effects associated with these drugs. However, because hypergastrinemia is related to the occurrence of colonic adenomatous polyps, the purpose of this study was to analyze the relationship between the occurrence of gastrointestinal polyps and hypergastrinemia induced by PPIs. This study included 259 patients who underwent colonoscopy and esophagogastroduodenoscopy between January and August 2007. Chart records, including medication history and fasting plasma gastrin level, were reviewed and analyzed. Any subtle polypoid lesions in the stomach and colon were sampled by biopsy for histological examination. Helicobacter pylori infection status was examined by a rapid urea test during esophagogastroduodenoscopy. All patients underwent endoscopy examinations. A total of 122 patients were receiving PPI treatment for either peptic ulcer disease or reflux esophagitis and were included as the study group. The remaining 137 patients were not treated with PPIs and served as the non-PPI group. The mean fasting gastrin level in PPI users versus non-PPI users was 121.8 ng/L versus 56.8 ng/L, respectively (p < 0.001). Although the prevalence of gastric gland polyps was higher in the PPI group (65.6% vs. 37.2%, p < 0.001), there was no difference in the prevalence of colonic adenomatous polyps observed (22.13% vs. 22.62%, p = 0.928). In conclusion, the prevalence of gastric polyps, particularly fundic gland polyps, was higher among PPI users. However, the prevalence of colonic polyps was not affected by PPI use, regardless of past history of colonic adenomatous polyps.

First Polish Cowden syndrome patient with confirmed PTEN gene mutation

Cowden syndrome is a rare hereditary disease. Incidence of the disease is conditioned by occurrence of mutations in the PTEN gene. The disease has a frequency of 1/120,000 newborn and it predisposes to the occurrence of hamartoma polyps in the gastrointestinal tract, skin tumours, as well as tumours of the breast, ovary and thyroid. Here we describe the case of a Polish patient diagnosed with Cowden syndrome with an identified mutation in the PTEN gene. The disease course of the patient is described and discussed along with other cases of carriers of substitution 68T>A in the PTEN gene.

Racial Differences in Colorectal Polyp and Cancer Detection Rates and Their Locations among Individuals Aged Less Than 50y in an Urban Medical Center

Purpose: Colorectal cancer (CRC) is the second leading cause of cancer deaths in the US. The consensus is that most of the CRCs arise from adenomatous polyps. The ASGE, AGA, USMSTF, and ACS guidelines recommend colorectal screening for average-risk individuals at age 50, and colonoscopy is the preferred modality. Death rates from colorectal cancer are ˜30% higher in African Americans (AA) than in whites and twice the rates in Hispanics. The purpose of this study was to examine the racial differences in the occurrence of colorectal polyps and cancers in patients under the age 50. Methods: A retrospective chart review was conducted on 329 individuals <50y old, who underwent a colonoscopy in year 2008 for any indication. We reviewed demographics, medical history, medications, colonoscopy and pathology records. Exclusion criteria: inadequate preparation, incomplete exam, IBD and patients with family history of colon cancer. The data was analyzed in three groups (AA, Hispanic, and non-AA) using chi-square analysis. Results: 305 qualified patients; 117 | (38.37), 188 | (61.63%). M ean age of 40.56y + 8 SD; (age range: 10y-49y). No statistically significant differences were noted in adenomas detection rate between | (13.33%) a nd | (10.53%) (P=0.44). The mean age of occurrence of adenomas in different races was 42 years in AAs, 41 years Hispanics, 40.3 years non-AAs. Two cancers were detected in a 35 year old white female patient and a 47 year old AA patient. Conclusion: (1) Right sided only adenomas were noted in all groups and more frequently in AAs (17.1%) Vs. Hispanics (2%) (P=0.0101) vs. non-AAs (11.8%) (P = 0.0557) which was statistically significant. (2) There is no statistical significance in mean age of occurrence of adenomas in different races. (3) The occurrence of adenomas was similar in males and females (P=0.5568). These findings suggest that a modality to screen both right and left sided colonic polyps (i.e., colonoscopy rather than sigmoidoscopy) should be used for all races and specifically for AAs.Table: Results