Polypoidal lesions of the gastrointestinal tract

Background: With increasing usage of endoscopic procedures, gastrointestinal polypoidal lesions are commonly encountered specimens. Histopathological examination is crucial as biological behavior is dependent on its pathological nature. Materials and Methods: A retrospective descriptive study performed in Pathology department, Om Hospital and Research Centre from January 2017 to June 2019. The study included lesions received as polyp or polypoidal lesions of gastrointestinal tract for histopathological examination. Data was analysed using SPSS version 17.0. Gender, number and site were analysed using Chi square test to evaluate its association with neoplastic nature. Correlation with age and size was tested with Pearson’s correlation coefficient. Results: Among 150 cases of gastrointestinal tract polypoidal lesions, 58% were seen in male and 42% in female. Hyperplastic polyp and conventional adenoma were the commonest non-neoplastic and neoplastic lesions respectively. The age of patients ranged from 7 to 84 years with a mean age of 50 years. Rectosigmoid region was the commonest site. 134 patients had single and 16 had multiple polypoidal lesions. Most polypoidal lesion had size <1 cm. Gender, age, number and size showed no correlation with neoplastic nature. A significant association was found with site with notably higher number of neoplastic lesions in large intestine. Conclusion: A spectrum of histological types of polypoidal lesions were found in Gastrointestinal tract, most frequently in colorectal region. Hyperplastic polyp and adenomatous polyp were the commonest non-neoplastic and neoplastic lesions respectively. A notably higher number of polypoidal lesions in the large intestine were found to be neoplastic in nature.

Plasma Biomarkers of Insulin and the Insulin-like Growth Factor Axis, and Risk of Colorectal Adenoma and Serrated Polyp

Background Hyperinsulinemia, high insulin-like growth factor 1 (IGF1) levels, and low IGF binding protein 1 (IGFBP1) levels have been implicated in the relationship between obesity and increased risk of colorectal cancer (CRC). However, it remains inconclusive whether circulating biomarkers of insulin and the IGF axis are associated with conventional adenoma and serrated polyp, the two distinct groups of CRC precursors. Methods We prospectively examined the associations of plasma C-peptide, IGF1, IGFBP1, IGFBP3, and IGF1 to IGFBP3 ratio with conventional adenoma and serrated polyp among 11 072 women from the Nurses’ Health Studies. Multivariable logistic regression was used to calculate the odds ratio (OR) per 1-SD increase in each biomarker for overall risk of conventional adenoma and serrated polyp and according to polyp feature. Results During 20 years of follow-up, we documented 1234 conventional adenomas and 914 serrated polyps. After adjusting for various lifestyle factors (including body mass index), higher concentrations of IGFBP1 were associated with lower risk of serrated polyp (OR = 0.84, 95% confidence interval = 0.75 to 0.95, P = .005). The association was particularly strong for large serrated polyp (≥10 mm) located in the distal colon and rectum (OR = 0.59, 95% confidence interval = 0.39 to 0.87, P = .01). In contrast, we did not find any statistically significant association between the biomarkers and conventional adenoma. Conclusions A higher plasma level of IGFBP1 was associated with lower risk of serrated polyp. Our findings support a potential role of IGFBP1 in the serrated pathway of CRC in women.