Endoscopic identification and quantification of aberrant crypt foci in the human colon.
BACKGROUND
Aberrant crypt foci may be precancerous lesions in the human colon. The occurrence of aberrant crypt foci was compared in patients with an endoscopically normal colon, known adenomatous polyps, and known colorectal cancer.


METHODS
In 90 patients (30 colonoscopically normal, 30 with adenomatous polyps, 30 with colorectal cancers) magnification chromoscopy was performed to identify aberrant crypt foci in the distal 10 cm of the rectum. Representative biopsy specimens were obtained for histopathologic assessment.


RESULTS
Aberrant crypt foci were readily identified. Median and (mean) numbers of aberrant crypt foci were as follows: endoscopically normal colon, 3.5 (5.0); adenomatous polyp(s), 4.0 (6.9); and colorectal cancer, 7.5 (9.9). The number of aberrant crypt foci detected was significantly associated (p = 0.02) with an increased odds that a patient would be in the group with known colorectal cancer (odds ratio = 1.11; 95% CI [1.02, 1.21]), but not in any other group.


CONCLUSIONS
Despite a stepwise increase in the number of aberrant crypt foci across the 3 groups, aberrant crypt foci was significantly associated only with comorbid colorectal cancer. Aberrant crypt foci was not associated with adenomatous polyp(s) or normal colon. Additional studies are needed to further elucidate the role of aberrant crypt foci in the development of colorectal neoplasia in humans.
Adler
Douglas G
DG
Division of Gastroenterology and Hepatology, Developmental Endoscopy Unit, and Department of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Gostout
Christopher J
CJ
Sorbi
Darius
D
Burgart
Lawrence J
LJ
Wang
Linan
L
Harmsen
W Scott
WS
D000236:Adenoma / Q000150:complications / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003111:Colonic Polyps / Q000150:complications / Q000473:pathology*; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000150:complications / Q000473:pathology*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000150:complications / Q000473:pathology*; D012372:ROC Curve; D012680:Sensitivity and Specificity