4494 Increased prevalence of colonic adenomatous polyps in patients with acromegaly despite suppression of growth hormone production

Autor: Evridiki Papadopoulou, K. Patsiaoura, Avraam Avramidis, John Goulis, Marianthi Tzoiti, Evangelos Akriviadis
Rok vydání: 2000
Předmět:
Zdroj: Gastrointestinal Endoscopy. 51:AB150
ISSN: 0016-5107
DOI: 10.1016/s0016-5107(00)14341-x
Popis: Background and Aims: An increased prevalence of colonic adenomatous polyps and colon cancer has been reported in patients (pts) with acromegaly in previous uncontrolled studies; however it remains unclear if treatment of acromegaly has an effect on the risk of colonic polyp development. The aims of the present study were: a) to assess the prevalence of colorectal polyps in a group of acromegalic pts followed long-term after diagnosis and initiation of treatment and b) to correlate the risk with duration and activity of the disease. Patients and Methods: Twenty consecutive acromegalic pts (12 males) were enrolled in the study over a 12-month period. Mean duration from diagnosis was 6.9 years (range 1-16). All pts were treated with transphenoidal resection; adjuvant radiation was given to 8. Long-term suppression of growth hormone (GH) was achieved with octreotide (n=15), supplemented with bromocryptine (n=2) or cinagolide (n=3). Median plasma GH levels were 4.4 (range 0.22-31.7) ng/ml. Control group consisted of 47 consecutive pts (13 males) with irritable bowel syndrome. Exclusion criteria were hematochezia, family history of colon cancer or abnormal findings on physical examination. All pts underwent full colonoscopy by the same endoscopist. All polypoid lesions seen at endoscopy were biopsied or removed. Results: Mean age was 51+12 years in the acromegaly group and 50+15 in control pts (p=0.72). Twenty polypoid lesions were found in 9 (45%) acromegalic pts and in 9 (19%) controls (p=0.03). Histologic examination showed adenomatous polyps in 6 (30%) and in 3 (6%) pts respectively (p=0.02). One additional patient with acromegaly had an invasive adenocarcinoma but none in the control group. Multiple polyps were seen in 4 (20%) acromegalic and in 1 (2 %) control pts (p=0.025). Total number of polyps were 20 in the acromegaly and 9 in the control group. Fourteen of the 20 (70%) polyps in the acromegaly group were located proximal to the splenic flexure vs 3 of the 9 (33%) polyps in the control group (p=0.065). Presence of adenomatous polyps in acromegaly pts was not correlated with age, gender, duration of disease or plasma GH levels. Conclusions: 1. Pts with acromegaly have an increased prevalence of colonic adenomatous polyps. Most of the polypoid lesions are located proximal to the splenic flexure and will be missed without full colonoscopy. 2. The risk of colonic polyps persists despite long-term treatment of acromegaly and suppression of GH production
Databáze: OpenAIRE
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