OBJECTIVETo evaluate the association of colorectal adenoma with metabolic syndrome (MS) and relevant parameters.

METHODSClinical data of 289 subjects who underwent screening colonoscopy in the University of Hong Kong-Shenzhen Hospital from January 2014 to June 2015 were retrospectively analyzed, including 130 normal subjects (normal group) and 159 cases with colorectal adenoma confirmed by pathology(adenoma group). Levels of MS-associated parameters were compared between the two groups, and the association of metabolic diseases with colorectal adenoma was examined.

RESULTSThe gender, smoking and drinking habit, regular physical activity, family history of colorectal cancer, and consumption history of long-term non-steroidal anti-inflammatory drugs were not significantly different between two groups (all P>0.05). As compared to normal group, adenoma group had higher body mass index (BMI) [(23.5±3.2) kg/m(2) vs. (22.7±2.8) kg/m(2), t=1.97, P=0.050], larger abdominal circumference [(83.4±10.3) cm vs. (79.6±13.8) cm, t=2.46, P=0.015], higher serum high-density lipoprotein level [(1.3±0.3) mmol/L vs. (1.2±0.3) mmol/L, t=2.03, P=0.044], and higher serum cholesterol [(5.4±1.0) mmol/L vs. (5.0±1.1) mmol/L, t=2.39, P=0.018]. No significant difference was demonstrated in comparing hip circumference and waist-hip ratio, as well as serum fasting glucose and triglyceride(all P>0.05). Higher incidence of colorectal adenoma was found in subjects with MS [69.8%(37/53) vs. 1.7%(122/236), P=0.017], overweight or obesity [65.1% (56/86) vs. 50.7%(103/203), P=0.025], hypertension [67.3%(37/55) vs. 52.1%(122/234), P=0.046] and hypercholesterolemia [66.7%(64/96) vs. 49.2%(95/193), P=0.005].

CONCLUSIONSMetabolic syndrome increased the risk of developing colorectal adenoma. The mechanism may be related to higher serum cholesterol and high density lipoprotein, which may lead to the elevated catabolism of serum cholesterol. Screening colonoscopy should be performed for patients diagnosed as metabolic syndrome, especially for those with central obesity and hypercholesterolemia, thus early diagnosis and treatment of colorectal adenoma may be available.

Adenoma ; epidemiology ; Blood Glucose ; chemistry ; Body Mass Index ; Case-Control Studies ; Colonoscopy ; Colorectal Neoplasms ; epidemiology ; Humans ; Hypercholesterolemia ; epidemiology ; Hypertension ; epidemiology ; Mass Screening ; Metabolic Syndrome ; epidemiology ; Obesity ; epidemiology ; Overweight ; epidemiology ; Retrospective Studies ; Triglycerides ; blood

To investigate the expression of CD10 in tumor-associated fibroblasts (TAF) in colorectal adenomas and its relation to cancerization and recurrence of adenoma.Tissue samples of low-grade adenoma (=50), high-grade adenoma (=50) and colorectal adenocarcinoma (=50) were collected, and tissue samples at the distal margin of corresponding colorectal lesions were taken as controls. The expression of CD10 in the stromal TAFs, and the expressions of β-catenin, Ki-67, p53 and CyclinD1 in tumor cells were detected by immunohistochemistry (Envision). The correlation of CD10 expression in stromal TAFs with the expressions of β-catenin, Ki-67, p53 and CyclinD1 in tumor cells was analyzed by Spearmen. One hundred samples of low-grade colorectal adenoma were collected, including 57 non-recurrent cases and 43 recurrent cases (16 cases of recurrent adenoma and 27 cases of recurrent adenocarcinoma); the expression of stromal TAF CD10 were determined and compared among groups.There was no TAF in normal colorectal mucosa. The expression rates of TAF CD10 in low-grade adenoma, high-grade adenoma and colorectal adenocarcinoma were 22%, 50% and 78%, respectively (all<0.05). The expression of Ki-67 and β-catenin in low-grade adenoma, high-grade adenoma, colorectal adenocarcinoma was on a rising trend (all<0.01). The expression of CyclinD1 in high-grade adenoma was higher than that in colorectal adenocarcinoma and low-grade adenoma (all>0.05). The expression of p53 in colorectal adenocarcinoma and high-grade adenoma was higher than that in low grade adenoma (all<0.01). The expression of TAF CD10 was correlated with the expression of p53, Ki-67 and β-catenin-nucleus(=0.264、0.307、0.320, all<0.01),but not correlated with CyclinD1 and β-catenin-membrane (=0.012、-0.073, all>0.05). The TAF CD10 level was significantly higher in low-grade adenoma with recurrence than that in those without recurrence (<0.05).The expression of CD10 in recurrent colorectal adenocarcinoma was higher than that in recurrent adenoma (<0.05).The expression of TAF CD10 is increased gradually in the process of adenoma-cancer, indicating that it may play an important role in the canceration of adenoma. Adenomas with high expression of CD10 TAF are likely to be recurrent and cancerized, and detection of TAF CD10 combined with p53, Ki-67 and β-catenin may be of value in predicting canceration or recurrence of colorectal adenoma.
Adenocarcinoma ; chemistry ; genetics ; Adenoma ; chemistry ; genetics ; Biomarkers, Tumor ; analysis ; Cancer-Associated Fibroblasts ; chemistry ; Carcinogenesis ; chemistry ; Colorectal Neoplasms ; chemistry ; genetics ; Cyclin D1 ; analysis ; Disease Progression ; Humans ; Immunohistochemistry ; Ki-67 Antigen ; analysis ; Neoplasm Grading ; Neoplasm Recurrence, Local ; chemistry ; Neprilysin ; analysis ; Predictive Value of Tests ; Tumor Suppressor Protein p53 ; analysis ; beta Catenin ; analysis

No abstract available.
Adenoma, Bile Duct/pathology/*radiography ; Adult ; Aged ; Angiomyolipoma/pathology/*radiography ; Bile Duct Neoplasms/pathology/*radiography ; Bile Ducts, Intrahepatic ; Carcinoma, Hepatocellular/radiography ; Diagnosis, Differential ; Female ; Gadolinium DTPA/*chemistry ; Humans ; Liver Diseases/pathology/*radiography ; Liver Neoplasms/pathology/*radiography ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Pseudolymphoma/pathology/*radiography ; Tomography, X-Ray Computed

Peutz-Jeghers syndrome (PJS) is a very rare genetic disorder. PJS carries a high risk of developing gastrointestinal (GI) cancer or non-GI cancer with advancing years. However, major symptoms of PJS in childhood are obstruction, intussusception, and bleeding from hamartomatous intestinal polyps which in majority of cases are not related to cancer. Generally, first GI symptom develops by 20 years in one half of children diagnosed with PJS. Children under two years of age who had PJS polyp-related intestinal symptoms are rare, and there have been no published report on intestinal carcinoma development, adenomatous change or dysplasia of polyps in Korean children with PJS. Recently, the authors have experienced a case PJS with adenomatous polyp change in a 15-month-old boy who had STK11 gene mutation. Therefore, early evaluation could be necessary and considered in children with PJS.
Adenoma/*diagnosis/pathology ; Base Sequence ; Colonoscopy ; Heterozygote ; Humans ; Infant ; Male ; Peutz-Jeghers Syndrome/*diagnosis/genetics/pathology ; Polymorphism, Single Nucleotide ; Polyps/pathology ; Protein-Serine-Threonine Kinases/chemistry/genetics

OBJECTIVETo investigate the correlation between CT image presentations and biochemical indexes in adrenal adenomas and pheochromocytomas.

METHODSWe retrospectively analyzed the CT features, cortisol rhythm, supine and orthostatic hypertension and 24-h urine methoxy in 209 patients with benign adrenal tumors. The relationship between CT findings and the biochemical indexes were analyzed in patients with different benign adrenal tumors.

RESULTSThe 209 cases analyzed included 53 cases of cortisol adenoma, 65 cases of aldosterone adenoma, 45 cases of non-functional adenoma and 46 cases of pheochromocytomas. The plain CT scan values of the 4 groups were 17.25 ± 1.81, 14.52 ± 1.57, 12.20 ± 2.05, 42.42 ± 0.97 HU, enhanced CT values (arterial phase) were 47.82 ± 3.07, 39.23 ± 2.37, 45.35 ± 6.46, and 104.93 ± 5.84 HU, respectively, and the differences between CT scan and enhanced CT values were 30.58 ± 2.29, 24.71 ± 1.55, 33.15 ± 5.18, and 62.51 ± 5.73 HU, respectively. In cortisol adenoma group, cortisol levels measured at 16:00 and 24:00 were positively correlated with plain CT scan value (r=0.506, P=0.0001; r=0.504, P=0.0001) and enhanced CT value (r=0.514, P=0.0001; r=0.554, P=0.0001). In pheochromocytoma group, plain scan CT value and the difference between plain and enhanced CT scan value were correlated with 24-h urine methoxy adrenaline (Rho;=0.342, 0.350; P=0.020, 0.017, respectively) and norepinephrine (Rho;=0.419, 0.412; P=0.004, 0.004, respectively).

CONCLUSIONPlain and enhanced CT scan values and their combination have important value in differential diagnosis of adenoma and pheochromocytoma tumor, CT values combine with biochemical indexes can reduce misdiagnosis and missed diagnosis of pheochromocytoma.

Adenoma ; chemistry ; diagnosis ; Adrenal Gland Neoplasms ; chemistry ; diagnosis ; Diagnosis, Differential ; Diagnostic Errors ; Humans ; Hydrocortisone ; Hypertension ; Pheochromocytoma ; chemistry ; diagnosis ; Retrospective Studies ; Tomography, X-Ray Computed

Pancreatic endocrine tumours (PETs) are uncommon tumours with typical morphology characterised by relatively uniform cuboidal cells arranged in nests and festoons, with distinctive nuclear salt-and-pepper chromatin. A lipid-rich variant poses diagnostic difficulties in the midst of other pancreatic tumours and metastatic goblet cell carcinoid. A 22-year-old man presented with symptoms of abdominal pain and jaundice. His liver function test and blood glucose level were normal, but computed tomography of the abdomen suggested the presence of a tumour in the head of the pancreas. Specimen obtained by pancreaticoduodenectomy revealed an infiltrating yellow-tan tumour composed of nests and a cribriform arrangement of polygonal vacuolated cells with pyknotic nuclei, along with focal classical areas of PET. Two foci of early serous microcystic adenoma were seen. Immunohistochemistry contributed to the arrival of a conclusive diagnosis. Von Hippel-Lindau disease was excluded in our patient, as other supportive classical features of the syndrome were absent.
Adenoma ; Blood Glucose ; metabolism ; Carcinoid Tumor ; diagnosis ; pathology ; Humans ; Immunohistochemistry ; Lipids ; chemistry ; Male ; Neoplasm Metastasis ; Neuroendocrine Tumors ; diagnosis ; pathology ; Pancreatic Neoplasms ; diagnosis ; pathology ; Pancreaticoduodenectomy ; Young Adult

BACKGROUND/AIMS: This study was performed to determine the association between RUNX3 expression and Helicobacter pylori infection in premalignant gastric lesions. METHODS: We examined 107 patients with gastric epithelial dysplasia who had undergone endoscopic mucosal resection or submucosal dissection. All tissue samples were evaluated by RUNX3 staining and subclassified by immunophenotype. H. pylori infection in dysplastic lesions and the normal surrounding tissue was examined by silver staining, and cagA status was assessed by polymerase chain reaction. RESULTS: The loss of RUNX3 expression was observed in 62 cases (57.9%), and an association with H. pylori infection was found in 54 cases (50.5%). The infection rate with the cagA-positive H. pylori strain was 63.0%. In RUNX3-negative lesions, the rate of H. pylori infection (p=0.03) and the frequency of category 4 lesions (according to the revised Vienna classification) were high (p=0.02). In addition, the gastric mucin phenotype was predominant. In RUNX3-negative category 4 lesions, the rate of cagA-positive H. pylori infection rate was high but not significantly increased (p=0.08). CONCLUSIONS: Infection with H. pylori is associated with inactivation of RUNX3 in early gastric carcinogenesis. This mechanism was prominent in gastric cancer with a gastric mucin phenotype.
Adenoma/*chemistry ; Aged ; Antigens, Bacterial/genetics ; Bacterial Proteins/genetics ; Carcinoma/*chemistry ; Cell Transformation, Neoplastic ; Core Binding Factor Alpha 3 Subunit/*analysis ; Female ; Gastric Mucosa/*chemistry/pathology ; Helicobacter Infections/*metabolism ; Helicobacter pylori/*genetics ; Humans ; Male ; Middle Aged ; Mucin 5AC/analysis ; Mucin-2/analysis ; Mucin-6/analysis ; Neprilysin/analysis ; Phenotype ; Precancerous Conditions/*chemistry/pathology ; Stomach Neoplasms/*chemistry

We report a case of carcinoma ex pleomorphic adenoma of a sublingual gland in a 70-year-old man. Under a clinical diagnosis of benign salivary gland tumor, excision of the mass with the sublingual salivary gland in an en bloc fashion via an intraoral approach was performed. Histopathologically, there was a rupture of the fibrous capsule and diffuse cell-rich sheets composed of myoepithelial cells with round nuclei were also seen. Immunohistochemically, the cells that composed of cell rich sheets were positive to smooth muscle actin. Final diagnosis of myoepithelial carcinoma ex pleomorphic adenoma was made.
Adenoma, Pleomorphic ; pathology ; Aged ; Carcinoma ; chemistry ; pathology ; Diagnosis, Differential ; Glial Fibrillary Acidic Protein ; analysis ; Humans ; Keratins ; analysis ; Male ; Myoepithelioma ; chemistry ; pathology ; Neoplasm Invasiveness ; S100 Proteins ; analysis ; Sublingual Gland Neoplasms ; chemistry ; pathology

OBJECTIVETo develop a bioinformatic tool and to use it to identify proteomic patterns in serum, distinguishing colorectal cancer from colorectal adenoma and healthy individuals.

METHODS182 serum samples including 55 colorectal cancer patients, 35 colorectal adenoma and 92 healthy individuals were subjected to analysis by surface-enhanced laser desorption/ionization (SELDI) mass spectrometry.

RESULTThe diagnostic pattern combined of 4 candidate biomarkers (M/Z 5911, 8922, 8 944, and 8817) could separate colorectal patients from healthy control with a specificity of 93.3%, sensitivity of 90.9%, and Youden index value of 0.84242. The diagnostic pattern combined of 7 candidate biomarkers (M/Z 17247, 18420 ,5911, 9294, 4654, 21694, and 21742) could separate colorectal cancer patients from colorectal adenoma patients with a specificity of 83.2%, sensitivity of 89.3%, and Youden index value of 0.72484.

CONCLUSIONCombination of SELDI with bioinformatics tool can identify some new biomarkers from the sera of colorectal cancer patients, which has a high sensitivity and specificity to distinguish colorectal cancer patients from healthy control.

Adenoma ; blood ; classification ; diagnosis ; Adult ; Aged ; Biomarkers, Tumor ; analysis ; Blood Proteins ; analysis ; chemistry ; Carcinoma ; blood ; classification ; diagnosis ; Case-Control Studies ; Colorectal Neoplasms ; classification ; diagnosis ; Computational Biology ; Female ; Humans ; Male ; Middle Aged ; Proteome ; analysis ; Proteomics ; methods ; Sensitivity and Specificity ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; instrumentation ; methods

BACKGROUND/AIMS: De novo colorectal carcinoma shows more aggressive behavior including submucosal invasiveness. Both p53 and cyclo-oxygenase-2 (COX-2) have been shown to be involved in colon carcinogenesis, progression from adenoma to carcinoma, and submucosal invasion by tumor. We performed this study to evaluate the expression of p53 and COX-2 protein in de novo carcinoma, compared with ex-adenoma carcinoma. METHODS: Twenty three flat adenomas, 19 ex-adenoma carcinomas, 6 de novo carcinomas were included in this study. The expression of p53, COX-2 and Ki-67 were examined immunohistochemically. RESULTS: Both ex- adenoma carcinomas and de novo carcinomas showed similar size and shape. Positive staining for p53 was detected in 3 of 23 (13%) flat adenomas, in 11 of 19 (57.8%) ex-adenoma carcinomas (p<0.05), and in 1 of 6 (16.6%) de novo carcinomas. Increased numbers of COX-2 positive tumor cells were observed in 1 of 23 (4.3%) flat adenomas, in 2 of 19 (10.5%) ex-adenoma carcinomas, and in 3 of 6 (50%) de novo carcinomas. COX-2 positive expression showed increased tendency in de novo carcinoma (p=0.073). There was no correlation between COX-2, p53, and Ki-67 expression. CONCLUSION: De novo carcinoma shows increased tendency of COX-2 expression, but decreased p53 expression when compared to ex-adenoma carcinoma. These immunohistochemical findings are in accordance with the fact that de novo carcinoma has no preceding adenoma, with more frequent submucosal invasion despite the small lesion size.
Adenoma/chemistry/pathology ; Carcinoma/chemistry/pathology ; Colorectal Neoplasms/chemistry/*pathology ; Cyclooxygenase 2/*analysis ; Female ; Humans ; Immunohistochemistry ; Ki-67 Antigen/analysis ; Male ; Middle Aged ; Tumor Markers, Biological/analysis ; Tumor Suppressor Protein p53/*analysis