Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0001430 (adenoma)
 21,222 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Except for impaired resorption of vitamin D and calcium, the small bowel does not exhibit significant functional impairment during aging. Vascular problems in the small and large bowel are rare, but are of dramatic importance. Chronic constipation and diverticulosis are classical disorders of aging which should be treated by adding fiber to the normal diet. Surgery is only indicated in the case of complicated diverticulitis. Adenoma and colorectal carcinoma show an age-related incidence. Angiodysplasia, preferentially localized in the caecum, is the major cause of lower gastrointestinal tract hemorrhage. Anal incontinence may be multifactorial, behavior modification and biofeedback may help to avoid surgery.
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PMID:[The small and large intestine. Fecal incontinence]. 144 8

CA 72 is a monoclonal antibody (MAb) -defined antigenic determinant expressed on a pancarcinoma antigen (TAG-72) found in more than 85% of human colorectal carcinomas. An immunoradiometric assay has been developed using the murine MAb B72.3 to quantitate CA 72 in human serum. In a simultaneous immunoradiometric assay, the mean CA 72 concentration in 1,099 serum samples from healthy blood donors was 1.83 +/- 2.03 (SD) units/ml. If the upper limit of normal was set at 10 mu/mol of serum, a value including 99% of healthy blood donors, only 4 of 101 serum samples (4%) from patients with benign disease were elevated, whereas 15 of 26 (58%) and 14 of 25 (56%) of rectal and colon carcinoma patient sera, respectively, were positive. Serum samples from 84 benign colorectal disease cases were examined; of these, 0 of 28 (0%) colorectal adenoma, 1 of 39 (3%) ulcerative proctocolitis, 0 of 15 (0%) diverticulosis, and 0 of 2 (0%) irritable bowel disease sera contained more than 10 mu/ml CA 72. At a reference value of 20 mu/ml, 0 of 101 (0%) benign disease and 2 of 1,060 (0.2%) blood donor sera had elevated values, whereas 10 of 26 (38%) and 9 of 25 (36%) rectal and colon patient sera, respectively, remained positive. The majority of patients with pancreatic and ovarian cancer, and a significant fraction of stomach cancer patient sera, also contained elevated levels of CA 72. The ability of this assay to discriminate between malignant and benign diseases suggests its further evaluation for monitoring and diagnosis in groups at risk for development of cancer.
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PMID:Monoclonal antibody immunoradiometric assay for an antigenic determinant (CA 72) on a novel pancarcinoma antigen (TAG-72). 242 34

A case control study of 150 individuals with colonic symptoms and diverticular disease diagnosed by total colonoscopy was performed to ascertain whether adenomas and carcinomas are detected with a higher frequency in these patients than in matched controls with symptoms but not diverticular disease. Adenomas and carcinomas were seen in 36 percent of the patients and in 17 percent of the controls (P less than .001); the overall odds ratio was calculated to be 3.0 (95 percent confidence interval +/- 1.8). When examined separately, adenomas maintained their significantly higher frequency (27 vs. 10 percent, P less than .001), while no difference was observed as regards carcinomas (9 vs. 7 percent). The odds ratios for adenomas and carcinomas were calculated to be 3.5 +/- 2.5 and 1.4 +/- 1.4, respectively. From the fifth to eighth decades there was a fourfold increase in premalignant and malignant lesions in the patient group and a twofold increase in controls. With relation to sex, a statistically significant difference was reached in men but not in women in the sample examined. These data show that symptomatic patients with colonic diverticula have more frequent adenomas, but not carcinomas, than symptomatic control matched by sex and age.
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PMID:Association of colonic diverticula with adenomas and carcinomas. A colonoscopic experience. 271 38

Rectal bleeding often heralds serious colonic disease. The literature suggests that colonoscopy is superior to barium enema plus sigmoidoscopy, although no good comparative studies exist. Seventy one patients with overt rectal bleeding had prospectively flexible sigmoidoscopy, double contrast barium enema and colonoscopy completed independently. Against the gold standard, the sensitivity and specificity of colonoscopy were 0.69 and 0.78 respectively for a spectrum of colonic lesions, while for combined flexible sigmoidoscopy and double contrast barium enema these values were 0.80 and 0.56, respectively. When assessing adenoma or carcinoma, colonoscopy was more sensitive at 0.82 v 0.73, while flexible sigmoidoscopy plus double contrast barium enema was superior for detecting diverticular disease. The positive predictive value for colonoscopy was 0.87 against 0.81 for flexible sigmoidoscopy and double contrast barium enema. This study confirms that colonoscopy should be a first line investigation in subjects likely to require biopsy or therapeutic intervention.
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PMID:Prospective comparison of double contrast barium enema plus flexible sigmoidoscopy v colonoscopy in rectal bleeding: barium enema v colonoscopy in rectal bleeding. 278 76

This study reflects the fact that cancer of the large bowel is uncommon in South African Blacks, and that colorectal polyps do not appear to constitute a precursor to most colorectal cancers. Furthermore, it is shown that dietary factors associated with this cancer in Western populations are not evident in the Black population. In the South African White population, however, the disease behaves in a similar way to that observed in Western countries. Other definitive differences found were the absence of multiple synchronous cancers and diverticular disease in the Blacks with colorectal cancer. It is thus postulated that dietary factors are absent, or have not been present for a sufficient length of time to influence the development of polyps or polyp--cancer sequence in this population. It is also possible that the adenoma--carcinoma progression observed in Western countries may not be relevant to the development of all colorectal carcinomas in communities such as those reported here.
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PMID:Polyps and colorectal cancer in South African Blacks. 728 82

Use of the biofragmentable anastomosis ring (BAR) was attempted in 33 patients at two New York City institutions and employed in 31 instances. Anastomoses performed were end-to-end enterocolic (n = 15), colocolic (n = 15), and side-to-side colocolic (n = 1). Patients ranged in age from 27 to 86 years, with the following diagnoses: primary colon cancer, 15; sessile adenoma, four; colostomy, five; diverticulosis, two; metastatic cancer with obstruction, multiple polyposis, perforated appendiceal mass, malignant carcinoid of appendix, intussuscepting right colon mass, one each. In two instances use of the device was aborted because of concern with the blood supply to the bowel wall in one and tissue edema in another. The average duration of postoperative ileus was 4.7 days. Two patients were subsequently treated for small bowel obstruction thought unrelated to use of the anastomotic device. There were no deaths and no evidence of stricture.
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PMID:Murphy's Button revisited. Clinical experience with the biofragmentable anastomotic ring. 842 5

Over a 4-year period, a direct-access fibreoptic sigmoidoscopy service was evaluated prospectively. In all, 756 patients were referred (median age 58 years, range 18-91 years). The principal indications were rectal bleeding (45%) or change of bowel habit (28%); both features were present in 13%. Abnormalities were present in 68% of examinations. Major disease was identified in 22% (carcinoma 7.0%, adenoma 6.3%, inflammatory bowel disease 8.3%) and minor disease in 53% (haemorrhoids 36.8%, severe diverticular disease 10.9%, non-adenomatous polyp 3.4%, perianal disease 1.4%). In patients under 40 years of age, major disease was rare (one carcinoma, three adenomas). Of the patients, 21% underwent barium enema for incomplete examination or suspected additional disease. No additional major disease was identified, but one carcinoma found in a patient with stricture. These data show that a direct-access fibreoptic sigmoidoscopy service produces a high diagnostic yield and may be of value to both patients and general practitioners in expediting a clinical colorectal service.
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PMID:Four-year evaluation of a direct-access fibreoptic sigmoidoscopy service. 871 66

In colorectal cancer (CRC), a proportion of patients with early stage disease still die of metastatic or recurrent disease within 5 years of "curative" resection. Detection of carcinoma cells in the peripheral circulation at presentation may identify a subgroup of patients with micro-metastatic disease who may benefit from adjuvant chemotherapy or radiotherapy. Our aim was to determine the presence and clinical significance of colon carcinoma cells in peripheral blood at the time of surgery. Preoperative peripheral blood samples were collected from 94 patients with CRC and 64 patients undergoing bowel resection for benign conditions (adenoma, diverticular disease or Crohn's colitis). Blood was also obtained from 20 normal donors not undergoing bowel surgery. Immunomagnetic beads were used to isolate epithelial cells followed by reverse transcription-polymerase chain reaction (RT-PCR) analysis of expression of cytokeratin (CK) 19, CK 20, mucin (MUC) 1 and MUC 2. Nineteen of 94 (20%) CRC patients were positive for epithelial cells in preoperative blood, including 6 with early stage disease. Kaplan-Meier survival analysis showed that detection of epithelial cells in preoperative blood was associated with reduced disease-free and overall survival (log-rank test, p = 0.0001). Surprisingly, circulating epithelial cells were detected in 3/30 (10%) patients resected for adenoma, and in 4/34 (12%) patients resected for benign inflammatory conditions, suggesting that cells from nonmalignant colonic epithelium may also gain entry into the bloodstream in the presence of bowel pathology. All 20 normal control bloods were negative for epithelial cells.
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PMID:Molecular detection of blood-borne epithelial cells in colorectal cancer patients and in patients with benign bowel disease. 1071 24

This was a prospective study performed in a Department of Veterans Affairs Medical Center. The aim of this study was to use endoscopic and histological examinations to determine the potential diagnostic origins of chronic gastrointestinal symptoms among patients who were part of the deployment of troops to the Persian Gulf after August 1990. Twenty-four (8%) male patients (mean age, 42 years) of 308 patients in the Persian Gulf War Registry agreed to undergo endoscopic examination of chronic symptoms, including heartburn (29%), dyspepsia (33%), dysphagia (8%), diarrhea (63%), Hemoccult-positive stool (21%), and rectal bleeding (17%). There were 17 upper endoscopies, 18 colonoscopies, and 4 flexible sigmoidoscopies performed, all with biopsies. Five (33%) of 15 patients had positive serological findings for Helicobacter pylori. With upper endoscopy, major findings included esophagitis (12%), Schatzki's ring (12%), hiatal hernia (47%), antral erythema (59%), and duodenal erythema (29%). With lower endoscopy, major findings included ileitis (5%), lymphoid hyperplasia (9%), polyps (27%), diverticulosis (23%), and hemorrhoids (23%). Major histopathological findings included microscopic esophagitis (24%), gastritis with H. pylori (35%), gastritis without H. pylori (18%), Crohn's disease (5%), tubular adenoma (5%), hyperplastic polyps (18%), and melanosis coli (5%). Most patients with chronic heartburn or dyspepsia have evidence of esophagitis or H. pylori. Individuals with these chronic symptoms should undergo evaluation.
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PMID:Evaluation of chronic gastrointestinal symptoms following Persian Gulf War exposure. 1617 12

We sought to assess the significance of an incidental finding of colorectal wall thickening (CRWT) on computed tomography (CT) scan in African-American and Hispanic patients. We retrospectively reviewed charts of African-American and Hispanic patients from January 1994 to December 2005. Those patients were included in whom the colonoscopy was performed due to incidental CRWT on CT scan. Patients with a history or a family history of colorectal malignancy, inflammatory bowel disease, or colorectal surgery, with an incomplete colonoscopic examination, or <18 years of age were excluded. Endoscopic and pathological findings were abstracted. Thirty-two patients met the criteria. Endoscopic examination was abnormal in 21 (65.6%). The positive predictive value of CRWT for abnormal endoscopic examination was 65.6%. Abnormal endoscopic examination revealed diverticulosis in 9 (43%), erythematous mucosa in 8 (38%), polyps in 6 (29%), mass in 2 (9%), thickened folds in 1 (5%), and diverticulitis in 1 (5%). Histopathological findings revealed colitis in 7 (33%), adenoma in 4 (19%), hyperplastic polyps in 4 (19%), adenocarcinoma in 2 (9%), lymphoid aggregates in 2 (9%), melanosis coli in 1 (5%), and normal in 1 (5%) in the abnormal examination group. Abnormal endoscopic examination was found in 65.6% of patients. The prevalence of colitis, adenomas, and malignancy was high, therefore abnormal CRWT warrants further endoscopic evaluation.
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PMID:Clinical significance of incidental colorectal wall thickening on computed tomography scan in African-American and Hispanic patients. 1740 51


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