Detection of colorectal lesions by using autofluorescence colonoscopy in acromegalics and their relation to serum growth hormone and insulin-like growth factor-1 levels.
OBJECTIVE
Acromegalics have an increased risk of colorectal neoplasm. The aim of this study was to establish the association between acromegaly and colorectal lesions.


METHODS
The study included 51 patients with active acromegaly: 30 women and 21 men (average age 52.95 +/- 13.49 years). Growth hormone (GH), insulin-like growth factor I (IGF-I), prolactin (PRL), thyreothropin (TSH), thyroxine (FT4) were measured in the serum when patients were hospitalized for their first diagnosis of acromegaly, before starting the treatment. All patients underwent colonoscopy--in the first phase conventional in white light; in the second phase fluorescence colonoscopy. Autofluorescence of colonic mucosa was assessed by illumination with monochromatic light. Green fluorescence is characteristic for normal colonic mucose, whereas red fluorescence occur in pathological lesions. Material to histopathological examination was taken from every pathological colorectal lesion.


RESULTS
Using conventional colonoscopy we detected colonic polyps in 21 acromegalic patients (41.17%). Polyps with red fluorescence were found in 7 (13.7%) acromegalics and with green fluorescence in 16 (31.37%) cases of these patients. Histological diagnoses of colorectal lesions are adenoma, hyperplastic and inflammatic polyps. The number of colorectal polyps was dependent on IGF-I, fT4 and sex.


CONCLUSIONS
Acromegaly is associated with high prevalence of colorectal pathology, mainly hyperplastic polyp and adenoma. There is a relationship between number of colorectal polyps and serum IGF-I levels in acromegaly. Adenomas and hyperplastic polyps were associated with higher levels of IGF-I.
Matyja
Violetta
V
Department of Pathophysiology and Endocrinology, Medical University of Silesia, Zabrze, Poland. endoklin@slam.katowice.pl
Kos-Kudla
Beata
B
Foltyn
Wanda
W
Strzelczyk
Janusz
J
Latos
Wojciech
W
Marek
Bogdan
B
Kajdaniuk
Dariusz
D
Karpe
Jacek
J
Ostrowska
Zofia
Z
Sieron-Stoltny
Karolina
K
Sieron
Aleksander
A
D000172:Acromegaly / Q000097:blood* / Q000150:complications; D000236:Adenoma / Q000150:complications / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D003111:Colonic Polyps / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005453:Fluorescence; D013006:Growth Hormone / Q000097:blood*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000150:complications; D015995:Prevalence
D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone