Chicken Skin Mucosa Surrounding Adult Colorectal Adenomas is a Risk Factor for Carcinogenesis

Guan, Jing-Ming; Zhao, Rongsheng; Zhang, Xueyan; Cheng, Yanqiu; Guo, Yu‐Dong; Wang, Liyan; Mi, Li-na; Liu, Fei; Ma, Xiao; Li, BaoJie

doi:10.1097/coc.0b013e31821dedf7

Cited by 8 publications

(10 citation statements)

References 24 publications

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“…Previous data indicated that adenocarcinomas and colorectal adenomas with CSM expressed similar levels of Ki-67 and COX-2 proteins; survivin and caspase-3, key regulators of apoptosis, were suppressed in colorectal adenomas with CSM. 12 Although these findings have important implications that the occurrence of colorectal cancer is associated with apoptosis, the sample size of the study was small and the clinical characteristics of the CSM patients were poorly characterized. It is uncertain whether CSM surrounding adult colorectal adenoma is a risk factor for colon carcinogenesis.…”

Section: Discussionmentioning

confidence: 98%

“… 10 However, a recent study showed that colorectal neoplasm with CSM was associated with increased risk of carcinogenesis. 12 Colorectal adenomas with CSM in adults demonstrated higher Ki-67 and COX-2 expression as markers of cell proliferation and lower caspase-3 expression as a marker of apoptosis compared to colorectal adenoma without CSM. 12 In addition, the prevalence of CSM was higher in carcinoma patients (64.3%) than in adenoma patients (22.1%).…”

Section: Introductionmentioning

confidence: 90%

“… 12 Colorectal adenomas with CSM in adults demonstrated higher Ki-67 and COX-2 expression as markers of cell proliferation and lower caspase-3 expression as a marker of apoptosis compared to colorectal adenoma without CSM. 12 In addition, the prevalence of CSM was higher in carcinoma patients (64.3%) than in adenoma patients (22.1%). Therefore, it is still unclear whether CSM is associated with carcinogenetic process or is only a trauma-related mucosal change.…”

Section: Introductionmentioning

confidence: 90%

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Colonic Chicken Skin Mucosa is an Independent Endoscopic Predictor of Advanced Colorectal Adenoma

et al. 2015

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Background/AimsChicken skin mucosa (CSM), surrounding colorectal adenoma, is an endoscopic finding with pale yellow-speckled mucosa; however, its clinical significance is unknown. This study aimed to evaluate the prevalence and clinical characteristics of CSM, and the association between colorectal carcinogenesis and CSM.MethodsThis cross-sectional study was performed in 733 consecutive patients who underwent endoscopic polypectomy for colorectal adenoma after the screening of colonoscopy at the Asan Health Promotion Center between June 2009 and December 2011. The colonoscopic and pathological findings of colorectal adenoma including number, size, location, dysplasia, morphology, and clinical parameters were reviewed.ResultsThe prevalence of CSM was 30.7% (225 of 733 patients), and most CSM-related adenomas were located in the distal colon (93.3%). Histological analysis revealed lipid-laden macrophages in the lamina propria of the mucosa. Multivariate analyses showed that CSM was significantly associated with advanced pathology, including villous adenoma and high-grade dysplasia (odds ratio [OR], 2.078; 95% confidence interval [CI], 1.191-3.627; P=0.010), multiple adenomas (i.e., ≥2 adenomas; OR, 1.692; 95% CI, 1.143-2.507; P=0.009), and a protruding morphology (OR, 1.493; 95% CI, 1.027-2.170; P=0.036). There were no significant differences in polyp size or clinical parameters between patients with and without CSM.ConclusionsCSM-related adenoma was mainly found in the distal colon, and was associated with advanced pathology and multiple adenomas. CSM could be a potential predictive marker of the carcinogenetic progression of distally located colorectal adenomas.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 90%

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Colonic Chicken Skin Mucosa is an Independent Endoscopic Predictor of Advanced Colorectal Adenoma

et al. 2015

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“…CSM-related adenoma was mainly found in the distal colon (93.3%). Adenomas with CSM, compared to those without CSM, presented more high-grade dysplasia and carcinoma, higher expression of Ki-67, COX2 protein and survivin, and lower expression of caspase-3, which indicated the carcinogenetic progression of colorectal adenomas 28,29 . Hence, CSM is generally considered a tumor marker in colorectal adenomas.…”

Section: Discussionmentioning

confidence: 96%

Characteristics and potential malignancy of colorectal juvenile polyps in adults: a single-center retrospective study in China

Dong

Chen

et al. 2021

Preprint

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BackgroundColorectal juvenile polyps are rare and usually considered benign in adults. Carcinogenesis or neoplastic changes are rarely mentioned in the literature. We aimed to systematically evaluate the characteristics and potential malignancy of colorectal juvenile polyps in adults.MethodsWe retrospectively reviewed the medical records of 103 adults diagnosed with colorectal juvenile polyps from 9/2007 to 5/2020 in our hospital. The characteristics, endoscopic findings, occurrence of intraepithelial neoplasia, carcinogenesis and diagnostic value of chicken skin mucosa (CSM) were analyzed.ResultsThe average age of patients with juvenile polyps was 43.2 years (range, 19 to 78). A total of 101 patients (101/103, 98.1%) had a single juvenile polyp, while two had multiple polyps (107 polyps in total). Polyp sizes ranged from 0.5 to 5 cm. One (1/107, 0.9%) juvenile polyp was cancerous, and 7 (7/107, 6.5%) developed low-grade intraepithelial neoplasia. Neoplasia or cancerization was not associated with the number of polyps. A 27-year-old female had a polyp with well-differentiated adenocarcinoma in the mucosa that was 2 cm in the sigmoid colon with erosion on the surface. According to immunohistochemistry, the Ki-67 was approximately 80%. P53 was mutated with diffuse and strongly positive expression. CSM was observed beside 17 polyps, which were all located in the rectum and sigmoid colon; one polyp had low-grade intraepithelial neoplasia.ConclusionsColorectal juvenile polyps in adults have neoplastic potential. Neither neoplasia nor carcinogenesis was associated with the number of polyps. CSM was not a tumorigenesis marker in colorectal juvenile polyps in the distant colorectum. Colorectal juvenile polyps in adult may go through a ‘low-grade intraepithelial neoplasia to high-grade intraepithelial neoplasia to carcinoma’ path and should be treated and regularly followed up as adenomas.

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“…Histopathologically, it represents fat accumulation in macrophages within the muscularis propria and, rarely, intestine-like microvilli. In two studies[31,32], the prevalence of chicken-skin-like mucosa was higher in carcinoma patients than in adenoma patients, and its role as a potential predictive marker of carcinogenetic progression was taken into consideration. However, it is a colonoscopic sign to search for a polyp in challenging locations.…”

Section: Factors Predicting Lymph Node Status In Malignant Pedunculatmentioning

confidence: 99%

Current strategies for malignant pedunculated colorectal polyps

Ciocalteu

Gheonea

Săftoiu

et al. 2018

WJGO

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Despite significant advances in imaging techniques, the incidence of colorectal cancer has been increasing in recent years, with many cases still being diagnosed in advanced stages. Early detection and accurate staging remain the main factors that lead to a decrease in the cost and invasiveness of the curative techniques, significantly improving the outcome. However, the diagnosis of pedunculated early colorectal malignancy remains a current challenge. Data on the management of pedunculated cancer precursors, apart from data on nonpolypoid lesions, are still limited. An adequate technique for complete resection, which provides the best long-term outcome, is mandatory for curative intent. In this context, a discussion regarding the diagnosis of malignancy of pedunculated polyps, separate from non-pedunculated variants, is necessary. The purpose of this review is to provide a critical review of the most recent literature reporting the different features of malignant pedunculated colorectal polyps, including diagnosis and management strategies.

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Chicken Skin Mucosa Surrounding Adult Colorectal Adenomas is a Risk Factor for Carcinogenesis

Cited by 8 publications

References 24 publications

Colonic Chicken Skin Mucosa is an Independent Endoscopic Predictor of Advanced Colorectal Adenoma

Colonic Chicken Skin Mucosa is an Independent Endoscopic Predictor of Advanced Colorectal Adenoma

Characteristics and potential malignancy of colorectal juvenile polyps in adults: a single-center retrospective study in China

Current strategies for malignant pedunculated colorectal polyps

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