Characteristics of familial juvenile polyps expressing cyclooxygenase-2.
OBJECTIVE
Familial juvenile polyposis (FJP) is a dominant genetic disorder characterized by colorectal, gastric, and small bowel juvenile polyps, and high risk for gastrointestinal cancer. Patients are treated by repeated endoscopic polypectomies and elective surgery. We determined the characteristics of FJP polyps expressing cyclooxygenase-2 (COX-2).


METHODS
A total of 115 colorectal and 6 gastric polyps were available from 17 FJP patients. Comparison tissues were 18 sporadic juvenile colorectal polyps, 6 gastric hyperplastic polyps, 9 normal colons, and 3 colorectal cancers (CRCs). Histology sections were classified and stained for COX-2. The polyps' epithelium and stroma and comparison tissues were quantified for COX-2 by: area of staining (0-3) x intensity (0-3). Epithelial and stromal scores (0-9) and total scores (0-18) were evaluated in relationship to patient's age, polyp site, size, dysplasia, and stromal cellularity.


RESULTS
Colonic FJP polyps mean total COX-2 score was 10.3 +/- 6.0, and that of sporadic juvenile polyps 3.6 +/- 2.2 (p < 0.01), and in contrast to the latter, FJP COX-2 scores increased significantly (p < 0.01) with polyp size. Linear regression analysis showed significant associations of COX-2 in FJP polyps with dysplasia (p < 0.01), stromal cellularity (p < 0.01), size (> or =1.5 cm) (p= 0.02), and site (right colon) (p= 0.01), and not with age. COX-2 total scores of gastric FJP polyps and hyperplastic polyps were similar.


CONCLUSIONS
Expression of COX-2 in FJP polyps and its association with size and dysplasia suggest that, in these patients, chemoprevention with selective COX-2 inhibitors might be a useful adjunct therapy to colonoscopic polypectomy.
Brazowski
Eli
E
Departments of Pathology & Gastroenterology, Tel Aviv Medical Center & Tel Aviv University, 6 Weizmann Street, Tel Aviv 64239, Israel.
Rozen
Paul
P
Misonzhnick-Bedny
Faina
F
Gitstein
Gilad
G
D011125:Adenomatous Polyposis Coli / Q000150:complications / Q000201:enzymology* / Q000473:pathology; D000293:Adolescent; D000328:Adult; D002648:Child; D003111:Colonic Polyps / Q000201:enzymology* / Q000209:etiology / Q000473:pathology; D051546:Cyclooxygenase 2; D004847:Epithelial Cells / Q000378:metabolism; D006801:Humans; D007527:Isoenzymes / Q000378:metabolism*; D008565:Membrane Proteins; D011451:Prostaglandin-Endoperoxide Synthases / Q000378:metabolism*; D013274:Stomach Neoplasms / Q000201:enzymology / Q000209:etiology / Q000473:pathology; D017154:Stromal Cells / Q000378:metabolism
D007527:Isoenzymes; D008565:Membrane Proteins; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases