Chicken Skin Mucosa Surrounding Adult Colorectal Adenomas is a Risk Factor for Carcinogenesis

Background: Nonalcoholic fatty liver disease (NAFLD) is the most common liver disorder worldwide. Previous studies have suggested an association between colorectal adenomas and NAFLD but are limited by a lack of biopsy-proven NAFLD or comparison with matched controls. Objectives: We aimed to determine whether histologically demonstrated NAFLD is an independent risk factor for colorectal adenomas. Methods: Patients who underwent liver biopsy showing steatosis who had also undergone screening or surveillance colonoscopy in 2007–2017 were retrospectively studied by manual chart review, excluding patients with liver disease other than NAFLD. Adenoma detection rates and characteristics such as location, histologic type, and size were compared in the resulting 123 NAFLD patients against controls without liver disease matched by age, gender, and endoscopist. Results: Adenoma prevalence was significantly higher in the NAFLD group at 40.7 versus 28.1% in controls (OR 1.87, 95% CI 1.15–3.03, p = 0.01) and remained significant on multivariable analysis controlling for rates of hyperlipidemia, diabetes, and obesity (OR 1.74, 95% CI 1.05–2.88, p = 0.032). Comparing NAFLD patients with advanced fibrosis to those with simple steatosis, there was a trend toward higher adenoma prevalence in advanced fibrosis (50.0 vs. 36.8%; OR 1.84, 95% CI 0.50–6.70, p = 0.36). Conclusions: Patients with histologically demonstrated NAFLD had a significantly higher adenoma prevalence on colonoscopy compared to matched controls, which remained significant after adjusting for rates of diabetes, obesity, and hyperlipidemia. NAFLD should be investigated further as an independent risk factor for colorectal neoplasia.

Mo1584 Clinical Characteristics and Significance of Colonic Chicken Skin Mucosa in Asymptomatic Adults With Colorectal Neoplasm

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2013.03.332 ◽

2013 ◽

Vol 77 (5) ◽

pp. AB436

Author(s):

Ji Young Lee ◽

Eun Ju Chung ◽

Jaewon Choe ◽

Byong Duk Ye ◽

Jeong-Sik Byeon ◽

...

Keyword(s):

Clinical Characteristics ◽

Colorectal Neoplasm ◽

Chicken Skin ◽

Skin Mucosa

Helicobacter pyloriinfection with intestinal metaplasia: An independent risk factor for colorectal adenomas

World Journal of Gastroenterology ◽

10.3748/wjg.v23.i8.1443 ◽

2017 ◽

Vol 23 (8) ◽

pp. 1443 ◽

Cited By ~ 7

Author(s):

Ye Yan ◽

Yi-Na Chen ◽

Qian Zhao ◽

Chao Chen ◽

Chun-Jing Lin ◽

...

Keyword(s):

Risk Factor ◽

Intestinal Metaplasia ◽

Independent Risk Factor ◽

Colorectal Adenomas

Body Mass Index Category as a Risk Factor for Colorectal Adenomas: A Systematic Review and Meta-Analysis

The American Journal of Gastroenterology ◽

10.1038/ajg.2012.180 ◽

2012 ◽

Vol 107 (8) ◽

pp. 1175-1185 ◽

Cited By ~ 85

Author(s):

Koji Okabayashi ◽

Hutan Ashrafian ◽

Hirotoshi Hasegawa ◽

Jae-Hoon Yoo ◽

Vanash M Patel ◽

...

Keyword(s):

Systematic Review ◽

Body Mass Index ◽

Risk Factor ◽

Body Mass ◽

Meta Analysis ◽

Body Mass Index Category ◽

Colorectal Adenomas

Chicken Skin Mucosa (CSM): An Endoscopic Marker of Colonic Intestinal Metaplasia

The American Journal of Gastroenterology ◽

10.14309/00000434-201210001-01141 ◽

2012 ◽

Vol 107 ◽

pp. S457

Author(s):

Leon Kundrotas ◽

Karthik Garapati

Keyword(s):

Intestinal Metaplasia ◽

Chicken Skin ◽

Skin Mucosa

Is rectal bleeding similar to family history as a risk factor for colorectal adenomas?

Gastroenterology ◽

10.1016/s0016-5085(00)83139-x ◽

2000 ◽

Vol 118 (4) ◽

pp. A265

Author(s):

Fiona B. Nicholson ◽

Melvyn G. Korman ◽

Anthony I. Stern ◽

Jack Hansky

Keyword(s):

Risk Factor ◽

Family History ◽

Rectal Bleeding ◽

Colorectal Adenomas

Colonic Chicken Skin Mucosa is an Independent Endoscopic Predictor of Advanced Colorectal Adenoma

Intestinal Research ◽

10.5217/ir.2015.13.4.318 ◽

2015 ◽

Vol 13 (4) ◽

pp. 318 ◽

Cited By ~ 3

Author(s):

Eun Ju Chung ◽

Ji Young Lee ◽

Jaewon Choe ◽

Hye-Sook Chang ◽

Jongcheol Kim ◽

...

Keyword(s):

Colorectal Adenoma ◽

Chicken Skin ◽

Skin Mucosa

Colonic Chicken Skin Mucosa Surrounding Colon Polyps Is an Endoscopic Predictive Marker for Colonic Neoplastic Polyps

Gut and Liver ◽

10.5009/gnl210271 ◽

2022 ◽

Author(s):

Yu Mi Lee ◽

Kyung Ho Song ◽

Hoon Sup Koo ◽

Choong-Sik Lee ◽

Inseok Ko ◽

...

Keyword(s):

Predictive Marker ◽

Colon Polyps ◽

Chicken Skin ◽

Skin Mucosa

Characteristics and potential malignancy of colorectal juvenile polyps in adults: a single-center retrospective study in China

10.21203/rs.3.rs-362901/v1 ◽

2021 ◽

Author(s):

Jie Dong ◽

Tian-Shi Ma ◽

Yuan-Hong Xu ◽

Peng Li ◽

Wan-Yuan Chen ◽

...

Keyword(s):

Sigmoid Colon ◽

Intraepithelial Neoplasia ◽

Diagnostic Value ◽

Juvenile Polyp ◽

Low Grade ◽

Ki 67 ◽

Juvenile Polyps ◽

Chicken Skin ◽

Well Differentiated ◽

Skin Mucosa

Abstract BackgroundColorectal juvenile polyps are rare and usually considered benign in adults. Carcinogenesis or neoplastic changes are rarely mentioned in the literature. We aimed to systematically evaluate the characteristics and potential malignancy of colorectal juvenile polyps in adults.MethodsWe retrospectively reviewed the medical records of 103 adults diagnosed with colorectal juvenile polyps from 9/2007 to 5/2020 in our hospital. The characteristics, endoscopic findings, occurrence of intraepithelial neoplasia, carcinogenesis and diagnostic value of chicken skin mucosa (CSM) were analyzed.ResultsThe average age of patients with juvenile polyps was 43.2 years (range, 19 to 78). A total of 101 patients (101/103, 98.1%) had a single juvenile polyp, while two had multiple polyps (107 polyps in total). Polyp sizes ranged from 0.5 to 5 cm. One (1/107, 0.9%) juvenile polyp was cancerous, and 7 (7/107, 6.5%) developed low-grade intraepithelial neoplasia. Neoplasia or cancerization was not associated with the number of polyps. A 27-year-old female had a polyp with well-differentiated adenocarcinoma in the mucosa that was 2 cm in the sigmoid colon with erosion on the surface. According to immunohistochemistry, the Ki-67 was approximately 80%. P53 was mutated with diffuse and strongly positive expression. CSM was observed beside 17 polyps, which were all located in the rectum and sigmoid colon; one polyp had low-grade intraepithelial neoplasia.ConclusionsColorectal juvenile polyps in adults have neoplastic potential. Neither neoplasia nor carcinogenesis was associated with the number of polyps. CSM was not a tumorigenesis marker in colorectal juvenile polyps in the distant colorectum. Colorectal juvenile polyps in adult may go through a ‘low-grade intraepithelial neoplasia to high-grade intraepithelial neoplasia to carcinoma’ path and should be treated and regularly followed up as adenomas.