title: Number of aberrant crypt foci in the rectum is a useful surrogate marker of colorectal adenoma recurrence.
abstract: OBJECTIVE
  Endoscopic screening and removal of colorectal adenomas can reduce the incidence of colorectal cancer. However, given the possibility of adenoma recurrence, surveillance colonoscopy is currently recommended after the initial screening and removal of colorectal adenomas. Aberrant crypt foci (ACF) have been shown to serve as a reliable surrogate marker of colorectal carcinogenesis. In this study, the relationship between the number of ACF at the initial endoscopic polypectomy and the likelihood of colorectal adenoma recurrence after polypectomy were investigated.
  
  
  METHODS
  High-magnification chromoscopic colonoscopy was performed in 82 subjects who underwent endoscopic polypectomy to identify ACF in the lower rectum. Surveillance colonoscopy was then performed 3 years after the baseline polypectomy at Yokohama City University Hospital.
  
  
  RESULTS
  The number of ACF was greater in patients who showed adenoma recurrence (7.88 ± 6.35) than in those who did not (2.19 ± 2.95) (P < 0.001). Receiver-operating curve analysis showed that the number of ACF was a highly specific predictor of the risk of adenoma recurrence.
  
  
  CONCLUSIONS
  This is the first study conducted to investigate the relationship between the number of ACF after endoscopic polypectomy and the likelihood of recurrence of colorectal adenomas. These results suggest that the number of ACF is a useful predictor of the likelihood of colorectal adenoma recurrence.
authors.affiliation: Gastroenterology Division, Yokohama City University School of Medicine, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Uchiyama
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Takahashi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Endo
authors.forename: Shingo
authors.initials: S
authors.lastname: Kato
authors.forename: Eiji
authors.initials: E
authors.lastname: Sakai
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Hosono
authors.forename: Masato
authors.initials: M
authors.lastname: Yoneda
authors.forename: Masahiko
authors.initials: M
authors.lastname: Inamori
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Hippo
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Nakagama
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakajima
mesh_terms: D058739:Aberrant Crypt Foci / Q000473:pathology*; D000236:Adenoma / Q000473:pathology*; D000368:Aged; D020685:Colonoscopes; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000473:pathology*; D003937:Diagnosis, Differential; D004867:Equipment Design; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000473:pathology*; D012189:Retrospective Studies