Effects of sulindac on sporadic colorectal adenomatous polyps
Effects of sulindac on sporadic colorectal adenomatous polyps
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作者：
Matsuhashi, N;Nakajima, A;Oka, T
背景-尽管已知舒林酸可引起家族性腺瘤性息肉病中结直肠腺瘤性息肉的消退，但关于舒林酸对散发性腺瘤的作用知之甚少。这些作用的确切机制也有待确定。将Aims-Sulindac给予散发性结直肠腺瘤性息肉患者以评估其对他们的影响，并进行组织学分析以阐明息肉消退的机制，以及对药物敏感的腺瘤性息肉的种类。受试者-15名患者的20个腺瘤性息肉进行研究。方法-Sulindac（每天300 mg）给予四个月，然后进行结肠镜检查并切除残留的息肉。治疗前后评估息肉大小、异型性程度、息肉内炎症细胞浸润以及突变p53产物的免疫染色。结果20个息肉中有13个缩小或消失。患者性别、息肉位置、大小、异型性程度或 p53 突变不影响疗效，但老年患者息肉对舒林酸更敏感。异型性或炎症细胞浸润的程度不受治疗的影响。含有局灶癌的息肉无反应。结论——舒林酸可以使散发性结直肠腺瘤性息肉消退。
Background-Although sulindac is known to cause regression of colorectal adenomatous polyps in familial adenomatous polyposis, less is known about the effect of sulindac on sporadic adenomas. The precise mechanisms of these effects also remain to be determined.Aims-Sulindac was given to patients with sporadic colorectal adenomatous polyps to evaluate its effects on them, and histological analysis was performed to elucidate the mechanism of the polyp regression, as well the kind of adenomatous polys that are susceptible to the agent.Subjects-20 adenomatous polyps in 15 patients were studied.Methods-Sulindac (300 mg daily) was given for four months, followed by colonoscopy with removal of the residual polyps. Polyp size, degree of atypia, inflammatory cell infiltration in the polyps, and immunostaining for mutant p53 product were evaluated before and after treatment.Results-13 of the 20 polyps shrank or disappeared. Patient sex, polyp location, size, degree of atypia, or p53 mutation did not affect the response, but polyps in older patients were more sensitive to sulindac. The degree of atypia or inflammatory cell infiltration was not affected by the treatment. A polyp containing a focal cancer was unresponsive.Conclusions-Sulindac can cause regression of sporadic colorectal adenomatous polyps.