Effects of sulindac on sporadic colorectal adenomatous polyps.
BACKGROUND
Although sulindac is known to cause regression of colorectal adenomatous polyps in familial adenomatous polyposis, less is known about the effect of sulindac on sporadic adenomas. The precise mechanisms of these effects also remain to be determined.


OBJECTIVE
Sulindac was given to patients with sporadic colorectal adenomatous polyps to evaluate its effects on them, and histological analysis was performed to elucidate the mechanism of the polyp regression, as well the kind of adenomatous polys that are susceptible to the agent.


METHODS
20 adenomatous polyps in 15 patients were studied.


METHODS
Sulindac (300 mg daily) was given for four months, followed by colonoscopy with removal of the residual polyps. Polyp size, degree of atypia, inflammatory cell infiltration in the polyps, and immunostaining for mutant p53 product were evaluated before and after treatment.


RESULTS
13 of the 20 polyps shrank or disappeared. Patient sex, polyp location, size, degree of atypia, or p53 mutation did not affect the response, but polyps in older patients were more sensitive to sulindac. The degree of atypia or inflammatory cell infiltration was not affected by the treatment. A polyp containing a focal cancer was unresponsive.


CONCLUSIONS
Sulindac can cause regression of sporadic colorectal adenomatous polyps.
Matsuhashi
N
N
Third Department of Internal Medicine, Faculty of Medicine, University of Tokyo, Japan.
Nakajima
A
A
Fukushima
Y
Y
Yazaki
Y
Y
Oka
T
T
D018256:Adenomatous Polyps / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009154:Mutation; D013467:Sulindac / Q000627:therapeutic use*; D016159:Tumor Suppressor Protein p53 / Q000032:analysis / Q000235:genetics
D000894:Anti-Inflammatory Agents, Non-Steroidal; D016159:Tumor Suppressor Protein p53; D013467:Sulindac