[Correlation of adenomatous polyps and early colorectal cancer. Diagnostic and therapeutic implications].
OBJECTIVE
To detect the patients with colorectal adenomatous polyps or those with adenocarcinoma areas with a view to prevent and to treat the malignant disease.


METHODS
A prospective study including 309 patients hospitalized between 2000-2005 diagnosed with isolated adenomatous polyps after repeated colonoscopies. The research method was selective screening with identification of risk factors regarding the evolution of colorectal polyps in early cancer, using colonoscopy and histopathological examination.


RESULTS
We identified 464 single or multiple isolated polyps of which 399 were adenomas, 59 hyperplastic polyps and 6 other types of lesions. Histologically we recorded 41 (13.27%) polyps with a low grade of dysplasia, 56 (18.12%) with severe dysplasia and 30 (9.7%) intramucosal adenocarcinoma with submucosal invasion.


METHODS
Colonoscopic polypectomy was used for benign polyps and in situ carcinoma. In case of adenocarcinoma is probable the invasion of submucosal lymphatics being shown a colorectal resection as appropriate. We performed 279 colonoscopic polypectomies and 30 conventional resections.


CONCLUSIONS
High grade of dysplasia, the number of polyps, ulceration, bleeding, intraepithelial areas of neoplastic transformation are predictive factors for early colorectal cancer. Depth of submucosal invasion of malignant transformed polyps are important pathological factors to predict lymphatic metastasis and to select the therapeutic procedure.
Ghelase
F
F
Clinica I Chirurgie, UMF Craiova, Dolj. mghelase@lycos.com
Mogoş
D St
DS
Mărgăritescu
D
D
Iordache
Sevastiţa
S
Ghelase
M St
MS
Râmboiu
S
S
Mogoş
G
G
Bică
M
M
Săftoiu
A
A
Georgescu
I
I
D000230:Adenocarcinoma / Q000175:diagnosis / Q000601:surgery; D018256:Adenomatous Polyps / Q000175:diagnosis* / Q000601:surgery*; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000601:surgery; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D003082:Colectomy / Q000379:methods*; D003111:Colonic Polyps / Q000175:diagnosis / Q000601:surgery; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome