Clinical And Pathologic Analysis Of Colorectal Polyps And Expression Of GRP78in Colorectal Adenomas

Objective1.Investigate the clinical and pathologic characteristics of colorectal high-risk adenomas to provide a basis for reasonable colonoscopy follow-up.2. Observe the expression of GRP78in colorectal adenomas,and analyze the relationship of the expression and malignant adenoma.Methods Retrospectively collected625colon polyp patients who underwent colonoscopic resection between2003and2010at the department of gastroenterology of the No.2hospital of lu’an city,there were563cases met the diagnostic criteria confirmed by pathology of colorectal polyps. Make a kind of registration forms and fill clinical data into the registration forms and research the the common data, Clinical manifestations, endoscopic description and pathological features. record the clinical,pathological and endoscopic information of every patients into the unified excell rigistration form,then analyze the data. We divided patients with colorectal polyps into the groups of adenomas and non adenomas,then according to the2006postpolypectomy colonoscopy surveillance guideline,563cases with colonic polyps were stratified into low-risk adenomas group and high-risk adenoma group and compared the the the common data, clinical manifestations, endoscopic description and pathological features of the two groups. From the above cases, we selected105wax blocks,which was pathologically confirmed colorectal polyps and have a complete archive in our hospital pathology.In them,there were63blocks confirmed adenoma,20inflammatory polyps,22local gland carcinogenesis of colorectal adenomas surgically. We selected20normal colorectal mucosa specimens (from hospital surgical colorectal surgical margin of normal mucosa) as the control group. Trough Immunohistochemical methods(S-P), we detected GRP78expression in colorectal adenomas, inflammatory polyps, cancerizated polyps and normal tissue.Results1.Clinical analysis of colorectal polyps and advanced adenomas:In563patients with colonic polyps, there were204cases of non-adenomatous polyp,359cases of adenomatous polyp which were divided into197cases of low-risk adenoma and162cases of high-risk adenoma. The average age of adenomatous polyp patients was older than those of the non-adenomatous polyp patients(59.10±12.95VS.54.88±14.92,P<0.05); Compared with non-adenomatous polyposis, adenomatous polyposis was higher in incidence of hematochezia (45.4%,163/359Vs.12.3%,25/204,P<0.05);Compared with non-adenomatous polyposis, adenomatous polyps was significantly different in size and number of polyps, adenomatous polyp patients whose polyp diameters≥1cm and quantity>3pieces of adenomas were more than non-adenomatouss polyp patients (40.7%,146/359Vs.21.1%,43/204)、(13.6%,49/359Vs5.9%,12/204,P<0.01,respectively).There were85.8%patients whose age>50-year-old in high-risk adenomas group, higher than the low-risk adenomas (71.1%,P<0.05);Compared with low-risk adenomas, the high-risk adenomas group was higher incidence of hematochezia (63.0%Vs.31.0%,P<0.05);Compared with low-risk adenomas, the high-risk adenoma group had more mucosal rough and erosion than low-risk adenoma group(68.5%,111/162Vs.10.1%,20/197,P<0.01); Compared with low-risk adenomas, the high-risk adenoma group had more surface lobulation(36.6%Vs.2.0%)(P<0.01).2.Expression of GRP78in colorectal adenomas:In our study,positive staining of GRP78was detected in the cytoplasm of all samples of cancerated polyps(100%) and adenoma (87.3%), while it was detected in small quantity of normal mucosa (40.0%)and inflammatory polyps(50%), there was significant difference (P<0.05). The GRP78expression rate in adenoma with high-level intraepithelial neoplasia(100%) was significantly higher than the low-level intraepithelial neoplasia organization(77.8%), the difference was statistically significant (P<0.05).Conclusion The incidence rate of blood in the stool was higher in patients of high-risk colorectal than low-risk adenoma. Rough mucosa, changes in erosion, surface leaf were more easily observed in endoscopic in the polyps of patients of high-risk adenoma. Old ages, blood in the stool, polyps, large diameter and number of rough surface mucosa erosion, leaf and histopathological villous were the risk factors of adenoma; GRP78was higher expression in the cancerated polyps and adenoma, while it had low expression in normal mucosa and inflammatory polyps.