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Occurrence of New Adenomas in Patients After Performed Radical Endoscopic Polypectomy

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Matłok M., Budzyński A., Pędziwiatr M., Bahyrycz J., Kulawik J., Zazula M., Kuczia P.
Polish Journal of Surgery
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2009
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vol. 81
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issue 12
628-634
EN
The aim of the study was to analyze recurence of large intestine adenomas after polypectomy and its co-incidence with DNA microsatellite instability (MSI).Material and methods. Among 2880 patients who underwent polypectomy during colonoscopy in our department from June 2004 to February 2007 we revealed adenomas in 259 cases (8.99%). Then we chose 97 patients who agreed to participate in further study. Mean age of the group was 65.1 yrs. In these patiens we removed 207 adenomas of the large intestine. Within 90-360 days all of the patients underwent control colonoscopy in our department. All removed lesions were verified histologically and genetically to determine presence of microsatellite instability.Results. In 15 (17.4%) patients we revealed recurence of adenomas. Microsatellite instability was detected in 16 (18.6%) patients. The recurence of polyps was more frequent in patients with MSI (4 cases - 25%) than in patients without MSI (11 cases - 15.7%).Conclusions. In our opinion further study may help to determine the group of patients with faster adenoma recurence. In those cases more frequent colonoscopy may be justified.
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Dysplasia and Microsatellite DNA Instability in Colorectal Adenomas

100%
Matłok M., Zazula M., Rembiasz K., Budzyński A., Pędziwiatr M., Major P.
Polish Journal of Surgery
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2009
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vol. 81
|
issue 12
595-602
EN
Microsatellite DNA instability (MSI) is a consequence of disorder within mismatch repair genes coding DNA repair proteins, protecting the cell against replication errors. Their dysfunction leads to gathering of adverse mutations within a cell, which may result in its neoplastic transformation.The aim of the study was to analyse the occurrence of microsatellite DNA instability in polypoid adenomas of large intestine removed during endoscopic polypectomy.Material and methods. The study covered 97 patients (30 women and 67 men), who underwent colonoscopic polypectomy in Endoscopy Ward, 2nd Department of Surgery, Jagiellonian University, Medical College in Cracow, between 2004 and 2007. Sampled materials was verified histopathologically and genetic tests were performed with the use of ABI PRISM 310 sequenator, which enabled to diagnose microsatellite DNA instability. Between 90 and 360 days from the first colonoscopy, 86 (78.2%) patients underwent following endoscopic colonoscopy in order to search for new polyps of large intestine.Results. 130 polypoid adenomas were removed in 97 patients. Sigmoid colon was the most common location of lesions. Microsatellite DNA instability was diagnosed in 21 (16.6%) polyps, loss of heterozygosity was observed in 25 (19%) polyps. During control colonoscopy performed a year after the initial colonoscopy recurrence of polyps was stated in 15% of patients (7% of women and 15% of men). Microsatellite DNA instability was most commonly diagnosed for loci p53 di and DCC. Microsatellite DNA instability was more common in group of younger people and was related with larger polyps.Conclusions. Analysis of microsatellite DNA instability in polypoid adenomas of large intestine provides further essential information within the scope of studies on transformation of adenomas in malignant adenoma of large intestine.
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