Advanced Colorectal Adenomas in Patients Under 45 Years of Age Are Mostly Sporadic
Background The presence of advanced adenomas in younger individuals is a criterion for Lynch syndrome (LS). However, the utility of screening advanced adenomas for loss of mismatch repair (MMR) protein expression to identify suspected LS remains unclear. Aims Determine the prevalence of MMR defects...
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| مؤلفون آخرون: | , , , , , , |
| التنسيق: | article |
| منشور في: |
2014
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| الوصول للمادة أونلاين: | http://hdl.handle.net/10725/4533 http://dx.doi.org/10.1007/s10620-014-3245-9 http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php http://link.springer.com/article/10.1007/s10620-014-3245-9 |
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| _version_ | 1864513463962828800 |
|---|---|
| author | Azar, Riad R. |
| author2 | Kushnir, Vladimir M. Nalbantoglu, ILKe Watson, Rao Goodwin, Johnathan Safar, Elyas Chokshi, Reena V. Davidson, Nicholas O. |
| author2_role | author author author author author author author |
| author_facet | Azar, Riad R. Kushnir, Vladimir M. Nalbantoglu, ILKe Watson, Rao Goodwin, Johnathan Safar, Elyas Chokshi, Reena V. Davidson, Nicholas O. |
| author_role | author |
| dc.creator.none.fl_str_mv | Azar, Riad R. Kushnir, Vladimir M. Nalbantoglu, ILKe Watson, Rao Goodwin, Johnathan Safar, Elyas Chokshi, Reena V. Davidson, Nicholas O. |
| dc.date.none.fl_str_mv | 2014 2016-10-07T12:10:07Z 2016-10-07T12:10:07Z 2016-10-07 |
| dc.identifier.none.fl_str_mv | 0163-2116 http://hdl.handle.net/10725/4533 http://dx.doi.org/10.1007/s10620-014-3245-9 Kushnir, V. M., Nalbantoglu, I., Watson, R., Goodwin, J., Safar, E., Chokshi, R. V., ... & Davidson, N. O. (2014). Advanced colorectal adenomas in patients under 45 years of age are mostly sporadic. Digestive diseases and sciences, 59(11), 2757-2764. http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php http://link.springer.com/article/10.1007/s10620-014-3245-9 |
| dc.language.none.fl_str_mv | en |
| dc.relation.none.fl_str_mv | Digestive Diseases and Sciences |
| dc.rights.*.fl_str_mv | info:eu-repo/semantics/openAccess |
| dc.title.none.fl_str_mv | Advanced Colorectal Adenomas in Patients Under 45 Years of Age Are Mostly Sporadic |
| dc.type.none.fl_str_mv | Article info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/article |
| description | Background The presence of advanced adenomas in younger individuals is a criterion for Lynch syndrome (LS). However, the utility of screening advanced adenomas for loss of mismatch repair (MMR) protein expression to identify suspected LS remains unclear. Aims Determine the prevalence of MMR defects to understand whether these patients harbor a defined genetic risk for CRC. Methods The study cohort included adult patients ≤45 years of age with advanced adenomas (villous histology, ≥1 cm in diameter, ≥3 polyps of any size) endoscopically removed between 2001 and 2011. Clinical records were reviewed along with detailed pathological review and immunohistochemical MMR analysis. Results A total of 76 (40.1 % male, age 40.6 ± 5.4 years) patients met inclusion and exclusion criteria. Indications for colonoscopy were gastrointestinal (GI) bleeding 39 (51.3 %), CRC in a first-degree relative 17 (22.4 %) and somatic GI symptoms 20 (26.3 %). Index colonoscopy revealed a median of 1 adenoma (range 1–4), mean diameter of 12.9 ± 7.1 mm, 40 (52.6 %) with villous histology. The mean follow-up duration was 3.3 ± 2 years. Recurrent adenomas developed in 24 (31.6 %), of which 8 (10.5 %) were advanced adenomas; none of these patients developed CRC. One of 66 (1.5 %) adenomas available for immunohistochemical (IHC) testing revealed loss of MLH1 and PMS2. Conclusions IHC screening of advanced adenomas from patients younger than 45 years of age identified potential LS in one of 64 patients. The low yield of IHC screening in this population suggests that universal IHC screening of advanced adenomas from patients younger than 45 years of age for MMR defects is not an efficient strategy for identifying LS subjects. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | LAURepo_c14e9a85a5423b85d7a8b9534d34b8fb |
| identifier_str_mv | 0163-2116 Kushnir, V. M., Nalbantoglu, I., Watson, R., Goodwin, J., Safar, E., Chokshi, R. V., ... & Davidson, N. O. (2014). Advanced colorectal adenomas in patients under 45 years of age are mostly sporadic. Digestive diseases and sciences, 59(11), 2757-2764. |
| language_invalid_str_mv | en |
| network_acronym_str | LAURepo |
| network_name_str | Lebanese American University repository |
| oai_identifier_str | oai:laur.lau.edu.lb:10725/4533 |
| publishDate | 2014 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| spelling | Advanced Colorectal Adenomas in Patients Under 45 Years of Age Are Mostly SporadicAzar, Riad R.Kushnir, Vladimir M.Nalbantoglu, ILKeWatson, RaoGoodwin, JohnathanSafar, ElyasChokshi, Reena V.Davidson, Nicholas O.Background The presence of advanced adenomas in younger individuals is a criterion for Lynch syndrome (LS). However, the utility of screening advanced adenomas for loss of mismatch repair (MMR) protein expression to identify suspected LS remains unclear. Aims Determine the prevalence of MMR defects to understand whether these patients harbor a defined genetic risk for CRC. Methods The study cohort included adult patients ≤45 years of age with advanced adenomas (villous histology, ≥1 cm in diameter, ≥3 polyps of any size) endoscopically removed between 2001 and 2011. Clinical records were reviewed along with detailed pathological review and immunohistochemical MMR analysis. Results A total of 76 (40.1 % male, age 40.6 ± 5.4 years) patients met inclusion and exclusion criteria. Indications for colonoscopy were gastrointestinal (GI) bleeding 39 (51.3 %), CRC in a first-degree relative 17 (22.4 %) and somatic GI symptoms 20 (26.3 %). Index colonoscopy revealed a median of 1 adenoma (range 1–4), mean diameter of 12.9 ± 7.1 mm, 40 (52.6 %) with villous histology. The mean follow-up duration was 3.3 ± 2 years. Recurrent adenomas developed in 24 (31.6 %), of which 8 (10.5 %) were advanced adenomas; none of these patients developed CRC. One of 66 (1.5 %) adenomas available for immunohistochemical (IHC) testing revealed loss of MLH1 and PMS2. Conclusions IHC screening of advanced adenomas from patients younger than 45 years of age identified potential LS in one of 64 patients. The low yield of IHC screening in this population suggests that universal IHC screening of advanced adenomas from patients younger than 45 years of age for MMR defects is not an efficient strategy for identifying LS subjects.PublishedN/A2016-10-07T12:10:07Z2016-10-07T12:10:07Z20142016-10-07Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article0163-2116http://hdl.handle.net/10725/4533http://dx.doi.org/10.1007/s10620-014-3245-9Kushnir, V. M., Nalbantoglu, I., Watson, R., Goodwin, J., Safar, E., Chokshi, R. V., ... & Davidson, N. O. (2014). Advanced colorectal adenomas in patients under 45 years of age are mostly sporadic. Digestive diseases and sciences, 59(11), 2757-2764.http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.phphttp://link.springer.com/article/10.1007/s10620-014-3245-9enDigestive Diseases and Sciencesinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/45332021-03-19T10:00:50Z |
| spellingShingle | Advanced Colorectal Adenomas in Patients Under 45 Years of Age Are Mostly Sporadic Azar, Riad R. |
| status_str | publishedVersion |
| title | Advanced Colorectal Adenomas in Patients Under 45 Years of Age Are Mostly Sporadic |
| title_full | Advanced Colorectal Adenomas in Patients Under 45 Years of Age Are Mostly Sporadic |
| title_fullStr | Advanced Colorectal Adenomas in Patients Under 45 Years of Age Are Mostly Sporadic |
| title_full_unstemmed | Advanced Colorectal Adenomas in Patients Under 45 Years of Age Are Mostly Sporadic |
| title_short | Advanced Colorectal Adenomas in Patients Under 45 Years of Age Are Mostly Sporadic |
| title_sort | Advanced Colorectal Adenomas in Patients Under 45 Years of Age Are Mostly Sporadic |
| url | http://hdl.handle.net/10725/4533 http://dx.doi.org/10.1007/s10620-014-3245-9 http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php http://link.springer.com/article/10.1007/s10620-014-3245-9 |