• Asian Pacific Journal of Cancer Prevention
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• v.16 no.13
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• pp.5163-5167
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• 2015

Background: Colon polyps need to be excised upon detection during colonoscopy due to the risk of malignancy irrespective of their size. In our study, we retrospectively evaluated the clinicopathological characteristics of polyps detected during colonoscopy. Materials and Methods: We assessed 379 patients with polyps detected during colonoscopy between January 2010 and May 2012. The demographics, complaints, colonoscopy findings (shape, place and size of the polyp) and histopathological findings were recorded. We carried out statistical analysis using PASW 18.0 for Windows. Results: There were 227 males (59.9%) and 152 females (40.1%) in the trial. The mean age was 53.8 years (32-90). The most common complaint was rectal bleeding (36.1%), followed by abdominal pain (35.4%). Polyps were detected most commonly in the rectosigmoid region (43.8%), followed by the descending colon (17.4%). Some 239 patients had a single polyp (63.1%) while 140 were found to have multiple polyps (36.9%). While tubular adenoma was the most common pathological type, occurring in 181 patients (47.8%), tubulovillous adenoma (14.2%) and hyperplastic polyp (12.7%) followed, occurring in 54 and 48 patients respectively. While 313 patients (82.6%) did not feature dysplasia, 37 patients (9.7%) exhibited low-grade dysplasia, 28 (7.7%) had high-grade dysplasia and 4 had cancer (1.1%). The rates of villous components and dysplasia were detected to be high among pedunculated polyps and polyps larger than 1 cm (p<0.001). Conclusions: Due to the fact that large-diameter polyps with malignant potential are commonly located in the left colon and have a high prevalence among the middle-aged individuals, it would be appropriate to screen this population at regular intervals via rectosigmoidoscopy.

• Clinical Endoscopy
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• v.55 no.5
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• pp.645-654
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• 2022

Background/Aims: Narrow Band Imaging (NBI) International Colorectal Endoscopic (NICE) and Workgroup Serrated Polyps and Polyposis (WASP) classifications were developed for optical diagnosis of neoplastic and sessile serrated polyps, respectively. Near-focus NBI with NICE combined with WASP criteria for optical diagnosis of colonic polyps has not yet been evaluated. We aimed to compare the accuracy of near-focus NBI (group A) with normal-focus NBI (group B) in real-time optical diagnosis of colorectal polyps using combined NICE and WASP criteria. Methods: Among 362 patients, 118 with 227 polyps were recruited. Groups A and B included 62 patients with 130 polyps (three lost polyps) and 56 patients with 106 polyps (six lost polyps), respectively. Optical diagnoses were compared with pathological reports. Results: The accuracy of optical diagnosis of neoplastic polyps in groups A and B was not significantly different (76% vs. 71%, p=0.52). WASP criteria provided all false positive diagnoses of sessile polyps as serrated polyps in 31 (16.2%) patients. Conclusions: Near-focus NBI was not superior to normal-focus NBI in optical diagnostics of neoplastic polyps using NICE criteria. In our study, WASP classification yielded all false positives in the diagnosis of sessile serrated adenomas/polyps. Routine real-life optical diagnosis of polyps is still unadvisable.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.2
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• pp.753-756
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• 2015

Background: Red cell distribution width (RDW) is one of the standard parameters with blood cell counts. Much previous research has indicated that it increases in cases of systemic inflammation or cardiametabolic incident. However, information on the relation of RDW with solid tumors causing systemic inflammation is limited. In the present research, we examined the relation of RDW with malignant and benign lesions of the colon. Materials and Methods: 115 patients with colon polyps (group 1), and 30 with colon cancer (group 2) who were diagnosed histopathologically in our clinic between January 2010-January 2013 were scanned retrospectively. Patients with anemia, hematologic diseases and active inflammation were excluded. RDW, mean corpuscular volume (MCV), hemoglobin (Hgb) and platelet (Plt) measurements were recorded and their relations with the malignant and benign lesions of the colon were examined. Results: Both groups were similar in age and gender distribution. RDW values of patients with colon cancer were significantly higher than the patients with colon polyp (p=0,01). No significant differences were detected between the two groups in terms of MCV and Plt values (p>0,05). Conclusions: RDW can be used as an early warning biomarker for solid colon tumors. Further prospective research is required on the relations of cheap and easily measured RDW parameters with colon malignancies.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.7
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• pp.4435-4440
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• 2013

Aloe vera gel supercritical $CO_2$ extract (AVGE) has been shown to contain five phytosterols, reduce visceral fat accumulation, and influence the metabolism of glucose and lipids in animal model experiments. Recent epidemiologic studies have shown that obesity is an established risk factor for several cancers including colorectal cancer. Therefore, we examined the effects of AVGE on intestinal polyp formation in Apc-deficient Min mice fed a high-fat diet. Male Min mice were divided into normal diet (ND), high fat diet (HFD), low dose AVGE (HFD+LAVGE) and high dose AVGE (HFD+HAVGE) groups. The ND group received AIN-93G diet and the latter 3 groups were given modified high-fat AIN-93G diet (HFD) for 7 weeks. AVGE was suspended in 0.5% carboxymethyl cellulose (CMC) and administered orally to mice in HFD+LAVGE and HFD+HAVGE groups every day (except on Sunday) for 7 weeks at a dose of 3.75 and 12.5 mg/kg body weight, respectively. ND and HFD groups received 0.5% CMC alone. Between weeks 4 and 7, body weights in the HFD and HFD+LAVGE groups were reduced more than those in the ND group. However, body weights were not reduced in the HFD+HAVGE group. Mice were sacrificed at the end of the experiment and their intestines were scored for polyps. No significant differences were observed in either the incidence and multiplicity of intestinal polyps (${\geq}0.5$ mm in a diameter) among the three groups fed HFD. However, when intestinal polyps were categorized by their size into 0.5-1.4, 1.5-2.4, or ${\geq}2.5$ mm, the incidence and multiplicity of large polyps (${\geq}2.5$ mm) in the intestine in the HFD+HAVGE group were significantly lower than those in the HFD group. We measured plasma lipid (triglycerides and total cholesterol) and adipocytokine [interleukin-6 and high molecular weight (HMW) adiponectin] levels as possible indicators of mechanisms of inhibition. The results showed that HMW adiponectin levels in the HFD group were significantly lower than those in the ND group. However, the levels in the HFD+HAVGE group were significantly higher than those in the HFD group. These results indicate that HAVGE reduced large-sized intestinal polyps and ameliorated reduction in plasma HMW adiponectin levels in Min mice fed HFD.

• Clinical Endoscopy
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• v.55 no.6
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• pp.703-725
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• 2022

Colonoscopic polypectomy is effective in decreasing the incidence and mortality of colorectal cancer (CRC). Premalignant polyps discovered during colonoscopy are associated with the risk of metachronous advanced neoplasia. Postpolypectomy surveillance is the most important method for the management of advanced metachronous neoplasia. A more efficient and evidence-based guideline for postpolypectomy surveillance is required because of limited medical resources and concerns regarding colonoscopy complications. In these consensus guidelines, an analytic approach was used to address all reliable evidence to interpret the predictors of CRC or advanced neoplasia during surveillance colonoscopy. The key recommendations state that the high-risk findings for metachronous CRC following polypectomy are as follows: (1) adenoma ≥10 mm in size; (2) 3 to 5 (or more) adenomas; (3) tubulovillous or villous adenoma; (4) adenoma containing high-grade dysplasia; (5) traditional serrated adenoma; (6) sessile serrated lesion (SSL) containing any grade of dysplasia; (7) serrated polyp of at least 10 mm in size; and (8) 3 to 5 (or more) SSLs. More studies are needed to fully comprehend the patients most likely to benefit from surveillance colonoscopy and the ideal surveillance interval to prevent metachronous CRC.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.16
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• pp.6945-6948
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• 2014

Background: Familial adenomatous polyposis (FAP) is a disease inherited in an autosomal dominant fashion. Most FAP patients develop upper gastrointestinal polyps; especially those in the antrum and duodenum are usually neoplastic. The aim of this study was to evaluate the prevalence of gastroduodenal polyps in Iranian FAP patients. Materials and Methods: 28 patients affected by FAP underwent front-view and side-view endoscopy. Papillary biopsies were performed in all patients. Location of polyps, their number and size, pathology study, patient general information (gender, age, family history of FAP or colorectal cancer and gastroduodenal polyps) were analyzed. Results: Gastric polyps were seen in 39.3 % of patients. Some 72.7% of the affected individuals had fundic gland polyps and 36.36% had hyperplastic polyps. Duodenal adenoma was observed in 25% of patients. While 57% of patients had tubular adenoma with low grade dysplasia, 42.8% showed tubulovillous adenoma with low grade dysplasia. Conclusions: Findings of this study indicated that the prevalence of gastroduodenal polyps in FAP patients is high and dysplasia may be evident in duodenal polyps. Therefore, it appears that routine gastroduodenal endoscopy in FAP patients is necessary.