title: Colonic chicken-skin mucosa in children with polyps is not a preneoplastic lesion.
abstract: Colonic polyps are common both in adults and children; however, the malignant potential varies according to the type of polyp. Most childhood polyps are solitary juvenile polyps, which have negligible malignant potential. Chicken-skin mucosa (CSM) is an endoscopic finding initially described associated with adenomatous polyps and adenocarcinoma, suggesting a preneoplastic lesion. Subsequently, CSM was described in association with juvenile polyps, suggesting that this mucosal finding is not a precursor to dysplasia. To determine whether CSM represents a preneoplastic lesion, we studied endoscopic colonic mucosal biopsies for markers of cell replication (Ki-67) and malignant transformation (p53) in mucosal biopsies of CSM, normal colonic tissue, tubular adenomas, and adenocarcinomas. Samples were subjected to immunostaining for the presence of Ki-67 and p53. The degree of Ki-67-positive staining cells was similar for CSM and normal colonic tissue, whereas there was significantly increased staining for both tubular adenomas and adenocarcinomas. There was no evidence of p53 staining in CSM and normal colonic mucosa, whereas there was varying degrees of staining in tubular adenomas and adenocarcinomas. The association of CSM with benign juvenile polyps and the absence of histologic markers for increased replication and malignant transformation support the notion that this endoscopic finding is not preneoplastic. Rather, CSM arises in proximity to polyps of all histologic types because of local mucosal damage.
authors.affiliation: Division of Pediatric Gastroenterology, University of Mississippi Medical Center, Jackson, Mississippi, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Nowicki
authors.forename: Phyllis R
authors.initials: PR
authors.lastname: Bishop
authors.forename: Charu
authors.initials: C
authors.lastname: Subramony
authors.forename: Josephine
authors.initials: J
authors.lastname: Wyatt-Ashmead
authors.forename: Warren
authors.initials: W
authors.lastname: May
authors.forename: Maxine
authors.initials: M
authors.lastname: Crawford
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology; D000236:Adenoma / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003106:Colon / Q000473:pathology; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology*; D003111:Colonic Polyps / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007413:Intestinal Mucosa / Q000378:metabolism / Q000473:pathology*; D019394:Ki-67 Antigen / Q000378:metabolism*; D008297:Male; D011446:Prospective Studies; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D016159:Tumor Suppressor Protein p53