大肠息肉内镜下形态学特点、病理分型与中医证型的相关性

背景大肠息肉(colorectal polyps, CRP)是临床常见病,多发病,治疗上主要依靠内镜下切除为主,但术后易复发,保守治疗CRP的药物临床应用及相关报道较少,且疗效不理想.本文通过探讨不同中医证型的大肠息肉与内镜下息肉形态学特点、病理分型之间的相关性,再结合中医四诊,从而精准辩证得出某一特定阶段CRP的中医证候类型并拟定出个体化的方药,进而调整患者体质类型从而有效预防CRP术后复发,以期减少腺瘤恶变,临床优势明显.目的探讨大肠息肉内镜下形态学特点、病理分型与中医证型之间的相关性,为中医药防治提供依据.方法收集300例大肠息肉患者临床资料进行调查研究,记录中医四诊及内镜下大肠息肉大小、形态、数目、病变部位等信息,确定中医证型,分析并总结内镜下息肉形态学特点、病理分型与中医证型的相互关系及分布规律.结果 300例大肠息肉病理分型以腺瘤性息肉为主,且腺瘤性息肉发生率与性别、职业、各年龄层、息肉大小、山田分型、息肉数量、发病部位等因素相关,差异有显著性(P0.05).与CRP发生相关的中医证型中脾虚湿蕴证、大肠湿热证、寒湿阻滞证中息肉直径多1 cm,呈光滑形多发息肉为主,多无蒂或亚蒂.气滞血瘀证、血虚肠澡证、肝郁气滞证以1-2cm息肉多见,多呈颗粒形单发息肉,多带蒂.各中医证型与息肉数目多少、形态之间差异有统计学意义(P 0.05).脾虚湿蕴证、大肠湿热证、寒湿阻滞证及肝郁气滞证中病理分型以管状腺瘤和增生性息肉多见,其它证型以增生性息肉为主.并发现腺瘤性息肉与非腺瘤性息肉患者的中医证型分布差异有统计学意义(P0.05).结论不同中医证型与大肠息肉数目多少、形态变化有关,但不会影响息肉的大小及发病部位,同时中医证型与病理类型之间存在一定相关性,临床中可通过中医体质调摄预防大肠息肉的发生率及复发率,为防治大肠息肉提供新思路.     

消化内镜的大肠息肉与上皮瘤变的内镜表现与病理特点的临床探讨

目的对消化内镜的大肠息肉与上皮瘤变的内镜表现与病理特点进行探讨与分析。方法回顾性分析我院于2012年5月-2014年5月运用消化内镜检测出的大肠息肉与上皮瘤变患者的临床资料。结果在检查的868例内镜中,有90例检测出大肠息肉与上皮瘤变,共106个息肉,检出率为10.4%,其中47例为腺瘤性息肉,占52.2%。体积大小关系到腺瘤性息肉(大小不等)的恶变率,体积越小恶变率就越小,反之就越大,并且多广基无蒂,腺瘤主要为绒毛状。1.0cm以下的炎性息肉(包含1.0cm)为最多,此类息肉不会发生癌变。结论腺瘤型是大肠息肉的主要类型。腺瘤和上皮瘤变有着一定的关系。通过消化内镜检查有症状患者时,要把大肠检查全,行常规活检息肉,并实施内镜下切除术,这样才能使大肠息肉与上皮瘤变的发生率得到降低。     

电子结肠镜手术治疗小儿大肠息肉95例临床分析

目的观察电子结肠镜手术治疗小儿大肠息肉的效果和安全性。方法对95例（124颗）大肠息肉患儿采用Olympus CF-240I电子结肠镜行内镜治疗,24例较大患儿未用镇静剂、余71例均给予丙泊酚全麻,直径〉1.0cm的有蒂息肉行高频电切术、直径〈1.0 cm的无蒂息肉或较小息肉行高频电凝术、直径〈0.5 cm的半球形息肉行钳除法摘除术;收集息肉切除标本进行病理检查。记录手术情况、术后随访情况及病理类型。结果 124颗息肉中行高频电凝切除98颗、活检钳钳除26颗,病理类型为幼年性息肉70例（73.7%）、P-J息肉11例（11.6%）、炎性息肉7例（7.13%）、增生性息肉4例（4.2%）、腺瘤性息肉3例（3.2%）;术后便血、腹痛症状均消失,且无明显出血、穿孔等并发症;随访1 a,3例发生便血,其中2例为P-J息肉、1例为幼年性息肉,经再次肠镜检查证明息肉复发。结论电子结肠镜手术治疗小儿大肠息肉效果好、安全性高。     

老年人与中青年人大肠息肉临床特点对比研究

目的探索老年人大肠息肉的临床特征。方法收集在上海中医药大学附属曙光医院2006年1月-2019年12月行电子结肠镜检查并且病理证实为大肠息肉的患者1000例,进行回顾性研究,按年龄分为老年组576例,中青年组424例。统计分析老年大肠息肉患者的临床症状、息肉大小、形态、部位、数目、息肉病理分型及其与息肉癌变的相关性,同时与中青年组比较。结果老年组最常见的临床表现为便血或粪隐血阳性(48.1%)及腹胀(45.8%),中青年组主要表现为腹胀(26.7%)和便秘(25.7%);2组患者均以无蒂、多发息肉多见,左半结肠是息肉好发部位;2组均以<2 cm的息肉多见;老年组≥2 cm的息肉多于中青年组(6.2%vs 3.6%,P=0.008);2组病理分型均以管状腺瘤为主,老年组管状绒毛状腺瘤比例高于中青年组(12.6%vs 7.6%,P=0.000);癌变率男女性间无差异;老年组息肉癌变率高于中青年组(9.7%vs 4.7%,P=0.004),左半结肠息肉、无蒂息肉、绒毛状腺瘤、>2 cm息肉癌变率高;老年组<2 cm息肉癌变率高于中青组(2.4%vs 1.0%,P=0.014)。结论腹胀、便血或粪隐血阳性是老年大肠息肉患者常见临床表现,老年患者大肠息肉癌变率高于中青年患者,大肠息肉的癌变率与年龄、息肉大小、部位、病理分型密切相关。     

大肠息肉943例病理与内镜治疗分析

目的探讨大肠息肉的病理特征与内镜治疗效果。方法回顾性分析我院4年内电子结肠镜检出的大肠息肉的部位、大小、形态、病理特征与癌变关系及内镜治疗结果进行分析。结果4801例大肠息肉的检出率为19．64％，腺瘤性息肉占61．72％，其中管状腺瘤276例，绒毛管状腺瘤123例，绒毛状腺瘤46例。炎性息肉占29．16％，增生性息肉占9．12％。息肉分布以直肠、乙状结肠和升结肠为最多；息肉癌变均为腺瘤性息肉，腺瘤体积越大、呈分叶或菜花状、无蒂或广基、含绒毛成分多者越易发生癌变，高频电凝电切摘除息肉242例，氩气刀治疗息肉564例，息肉消除率为100％，并发症率为0．41％。结论腺瘤癌变与体积大小、形态、绒毛成分含量及不典型增生的递增等因素相关，息肉不论大小均应切除，高频电凝电切和氩气刀治疗息肉安全有效，是大肠息肉治疗的首选方案。     

结肠息肉生物学特性与年龄的相关性研究

目的分析结肠息肉的大小、生长方式及病理分型等生物学特性与年龄的相关性。方法选取2009年1月至2016年6月北京航天总医院收治的1 080例结肠息肉患者为研究对象,按年龄分为3组:20~40岁(青年组)、41~60岁(中年组)和60岁(老年组)。对3组患者均行电子结肠镜检查,对各组结肠息肉的大小、生长方式及病理分型与年龄之间的关系进行分析与探讨。结果 1 080例患者中青年组68例(6.30%),中年组498例(46.11%),老年组514例(47.59%)。各组结肠息肉均以0.5 cm为主,0.5~1.0cm次之,2.0cm较少见;各组结肠息肉大小的差异无统计学意义(P0.05)。各组结肠息肉生长方式的差异有统计学意义(P0.05),青年组以亚蒂息肉为主(55.88%),有蒂息肉次之(27.94%),无蒂息肉少见(16.18%);中年组与老年组以无蒂息肉为主(55.42%和61.09%),亚蒂息肉次之(27.91%和25.68%),有蒂息肉较少见(16.67%和13.23%)。3组均以腺瘤性息肉为主;但各组结肠息肉病理分型次差异有统计学意义(P0.05)。随着年龄的增长,腺瘤性息肉的比例呈显著上升趋势,炎性与增生性息肉比例逐渐下降,癌性息肉各组均较少见。结论年龄是结肠息肉生物学特性的重要影响因素,在青年组以亚蒂息肉为主,中年组和老年组以无蒂息肉为主。各年龄组均以腺瘤性息肉为主,而且随着年龄的增长,腺瘤性息肉所占比例明显上升。     

老年人大肠息肉无痛结肠镜切除术结肠镜结果分析

目的探讨无痛结肠镜下老年人大肠息肉切除术后病理及镜下特点。方法回顾性分析117例老年人大肠息肉的临床资料、内镜和病理特点,分析老年患者息肉的病理学、内镜特点（分布、大小、形态）及癌变情况,并与同期中青年患者进行比较。结果所有人群的息肉均好发于左半结肠（直肠、乙状结肠、降结肠）;老年患者息肉检出率高于中青年患者（35.67%vs 9.50%）（P〈0.01）;老年人息肉以腺瘤性息肉最为多见（60.71%）,息肉癌变率高（4.29%）,均高于中青年组（P〈0.05）;老年组直径≥1 cm的息肉和分叶状息肉也多于中青年组（P〈0.05）。结论肿瘤大小、病理类型、发生部位和年龄为腺瘤发生不典型增生的4个最重要的风险因子,老年大肠息肉患者具有以上危险因素。对老年人大肠息肉应该遵循＂见瘤即切＂的原则并密切随访。     

结肠息肉的临床特征分析

目的 研究结肠息肉内镜下的形态和病理组织学等临床特征.方法 回顾分析我院消化内镜中心2005年～2007年期间检出的结肠息肉病例,分析息肉的检出率、内镜下息肉形态、病理组织学类型、息肉癌变率、息肉术后复发、新生等情况.结果 633例电子肠镜检查共检出息肉病例138例,检出率为21.80%,以乙状结肠部位息肉数量最多,为52例,检出率8.21%,占息肉构成比37.68%(P<0.01).息肉直径在1～4 cm之间者90例,占息肉构成比65.22%(P<0.01);内镜下表现为有蒂息肉所占的比例(69.18%)明显高于无蒂息肉(P<0.05).从息肉病理组织学上分析,腺瘤性息肉为96例,占息肉构成比69.57%,明显高于增生性息肉(P<0.01);96例腺瘤性息肉中绒毛状腺瘤占62.50%,明显多于管状腺瘤(P<0.05);绒毛状腺瘤的癌变率为40%,明显高于管状腺瘤的16.67%(P<0.05).所有腺瘤性息肉经摘除术后(包括内镜下摘除和外科手术摘除)1年复查肠镜,发现绒毛状腺瘤和管状腺瘤的术后复发率分别为28.33%和8.82%(P<0.05),而新生率接近,分别为65%和88.24%(P>0.05).结论 结肠息肉的好发部位以乙状结肠居多;内镜下息肉大小多数在1～4 cm,以有蒂息肉居多;绒毛状腺瘤的癌变率、摘除术后1年的复发率均高于管状腺瘤,更具有恶变潜能.     

大肠良恶性息肉的临床特征及内镜、病理形态学特点

目的探讨大肠良恶性息肉的分布、大小、形态和病理特征以及息肉恶变过程中的相关因素。方法对电子结肠镜检出的大肠良恶性息肉患者的临床表现及内镜、病理资料进行分析。结果大肠息肉的检出率为１０．６６％,其中腺瘤性息肉占４７．１６％。主要的临床表现为便血。炎性息肉以≤１．０ｃｍ的为最多,腺瘤性息肉则大小不等,幼年性息肉以１．１～１．９ｃｍ的最多,同时伴肠癌者息肉以＜１．０ｃｍ为主。本组息肉０．６～１．０ｃｍ者恶变率３．５１％,１．１～１．９ｃｍ者恶变率为１２．９０％,≥２．０ｃｍ者恶变率２７．７８％,息肉恶变以山田Ⅱ型为主。结论腺瘤体积大,绒毛状结构者易恶变;大肠腺瘤性息肉常与大肠癌并存;大肠镜检查应尽量检查全大肠,不能满足于远端大肠病变的诊断;息肉不论大小应尽可能予以切除。     

不同病理类型结直肠息肉的差别

目的 根据不同病理类型息肉的临床特点，找出不同息肉之间的差别，为临床诊断提供依据。方法 回顾4年820例结直肠息肉病例，分析患者年龄；息肉的部位、数目、大小、形态、病理类型、不典型增生程度和癌变情况。结果 ①腺瘤性息肉：包括管状、混合状、绒毛状三种息肉，其变化规律为平均体积逐渐增大、分叶和黏膜改变逐渐多见、不典型增生和癌变率亦逐渐增高。②幼年性息肉：发病年龄一般较小，直肠多见，平均体积大，多带蒂，分叶少见。③炎性息肉：平均体积小，多无蒂、光滑和不分叶。结论 各型息肉内镜下具有一定特征，可以做为初步判定息肉性质的参考依据。     

Polyps with different grades of dysplasia and their distribution in the colorectum

BACKGROUND/AIMS: To determine the role of adenomatous polyps in the development of colorectal cancers, we examined the relationship between the distribution and polyps with different grades of dysplasia (low, high), or/and cancers in the colorectum. METHODOLOGY: The distribution of 527 polyps with low-grade dysplasia was compared with that of 121 polyps with high-grade dysplasia, and 10 colorectal cancer lesions with adenomatous polyps in 361 patients who underwent total colonoscopy. RESULTS: The distribution rate of polyps at the distal colon and rectum into polyps with high-grade dysplasia significantly increased in comparison to that into polyps with low-grade dysplasia, respectively (p<0.002). The percentage of polyps with high-grade dysplasia measuring >1 cm significantly increased in comparison to that with low-grade dysplasia measuring >1 cm (p<0.00001). In patients with both adenomatous polyps and colorectal cancers, the polyps with high-grade dysplasia at the distal sites of cancerous lesions increased significantly more than at the proximal sites of cancerous lesions (p<0.05). Polyps with high-grade dysplasia have malignant potentials to intermediate between polyps with low-grade dysplasia and colorectal cancers in our study. CONCLUSIONS: The different distributions of different grades thus suggested that polyps with different grades of dysplasia at various colorectal sites were found to have different malignant potentials for cancer development.     

老年大肠息肉患者临床特点、内镜下处理及安全性分析

目的探讨老年大肠息肉患者临床特点、内镜下处理策略及相关并发症。方法回顾性整理老年大肠息肉患者407例941枚的临床资料,分析息肉的大小、部位、形态、病理学特点、内镜治疗及并发症情况,并与同期中青年人大肠息肉225例305枚进行对比分析。结果大肠息肉检出率在老年及中青年组分别为27.8%及6.3%(P<0.05);直肠、乙状结肠是息肉的好发部位,但老年人右半结肠息肉明显增多,横结肠、升结肠检出率分别为11.2%、10.8%,而中青年人分别为6.6%、6.9%(P<0.05);老年人中多发性息肉占72.7%,明显高于中青年人的43.9%(P<0.05);老年组息肉最大直径≥2 cm的息肉及分叶状息肉比例相对增多分别为(6.6%vs 3.6%及8.4%vs 4.9%,P<0.05);病理结果显示老年人与中青年人腺瘤性息肉所占比例分别为63.0%及46.2%(P<0.01);老年人及中青年组息肉伴癌变率分别为4.4%及2.0%(P<0.05)。老年组941枚息肉中,活检钳除662枚,高频电切223枚,因癌变或息肉较大需外科手术治疗56枚;内镜下均成功切除息肉,无治疗相关肠穿孔及死亡病例。老年组内镜治疗后,有7例并发出血,均为套圈电切术后出血,活检钳除者未见出血并发症。其中,早发性出血(EPPB)2例,迟发性出血(DPPB)5例,均内科及急诊肠镜处理后止血。结论老年人大肠息肉处理应根据大小、部位、形态、病理采用不同的策略,内镜下摘除老年人大肠息肉安全、有效、可行。     

共聚焦激光显微内镜对结直肠腺瘤性息肉的诊断价值

目的 通过共聚焦激光显微内镜(CLE)分析结直肠息肉的镜下组织学特点,制定相应的诊断依据,探讨CLE诊断结直肠腺瘤性息肉和非腺瘤性息肉的价值.方法 2009年6月至12月间共计90例患者纳入本研究,其中包括已被病理证实为结直肠息肉的40例患者(48个结直肠息肉)和前瞻性研究的50例患者(106个结直肠息肉).同时选取10处正常黏膜作为对比.首先对48个经病理证实为结直肠息肉的病变(腺瘤性息肉22个,非腺瘤性息肉26个)进行CLE图像分析,制定CLE下鉴别腺瘤性息肉和非腺瘤性息肉的诊断依据.然后应用该依据对106个结直肠息肉进行前瞻性CLE诊断,最终将CLE诊断结果与病理诊断结果作比较,评价CLE的诊断效率.结果 在48个经病理证实为结直肠息肉中腺瘤性息肉22个,非腺瘤性息肉26个.CLE诊断腺瘤性息肉的敏感度94.0%、特异度92.9%、准确率93.4%、阳性预测值92.2%,阴性预测值94.5%;CLE诊断非腺瘤性息肉的敏感度92.9%、特异度94%、准确率93.4%、阳性预测值94.5%,阴性预测值92.2%.CLE与组织病理在诊断结直肠腺瘤性息肉时的一致性较好(Kappa=0.893).结论 CLE在结直肠腺瘤性息肉和非腺瘤性息肉的鉴别诊断中精度较高,与组织病理学诊断具有较好的一致性,为进一步及时发现结直肠癌前病变提供了经验基础.     

Selenoprotein levels in patients with colorectal adenomas and cancer

OBJECTIVES: Selenium is a trace mineral that, as a constituent of certain selenoproteins, acts as an antioxidant. Results of studies addressing a cancer protective effect of selenium have been controversial. The present study measured selenoprotein-P, extracellular glutathione peroxidase, and plasma selenium in patients with colon cancer and adenomatous colon polyps to determine whether patients who develop colorectal adenomas or cancer are selenium deficient. METHODS: Patients who presented to an endoscopy center for colonoscopy or who were referred to our institution with a newly diagnosed colorectal cancer were offered enrollment in the trial. Each patient underwent phlebotomy, usually immediately after colonoscopy. In all, 103 patients were enrolled in the study. Of these, 33 patients were found to have colorectal cancer, 35 adenomatous colon polyps, and 17 normal examinations. A total of 18 patients had other diagnoses and were not included in the study group. RESULTS: The mean age for the colorectal cancer group was 69 yr, for the adenomatous colon polyp group 62 yr, and for the normal group was 56 yr. The adenomatous colon polyp and normal groups were predominantly female. Based on one way analysis of variance tests, there was no significant difference in selenoprotein-P or plasma selenium levels or extracellular glutathione peroxidase activity among the three groups (p = 0.28, 0.098, and 0.35 respectively). CONCLUSIONS: The present data suggest that patients with adenomatous colon polyps and those with colorectal cancer are not selenium deficient.     

上海松江区结直肠癌普查研究的初步结果

目的探讨粪便隐血试验结合大肠镜检查作为大肠癌普查方式的可行性。方法2006年9月至2007年5月,对上海市松江区无症状且结直肠癌普通危险度的≥50岁人群以及40～49岁志愿参加普查者行免疫组化法粪便隐血试验,连续3次排便中任意2次粪便标本送检,对任何1次粪便隐血阳性（包括弱阳性）的患者行全结肠镜检查。对息肉的数量、分布位置及病理结果进行统计。结果≥50岁受检者共2692例,粪便隐血试验阳性者184例,阳性率6．8％,共56例患者发现了64枚结肠息肉,包括腺瘤性息肉34枚、炎性息肉15枚、增生性息肉15枚,发现直肠癌1例。40～49岁志愿普查者共582例,隐血试验呈阳性者28例,阳性率4．8％,共6例患者发现了6枚息肉,包括腺瘤性息肉1枚、炎性息肉5枚,并发现肠癌2例。多数息肉分布于左半结肠。结论对无症状的结直肠癌普通危险度人群的普查能较早发现结肠息肉,对粪便隐血试验阳性的患者行全结肠镜检查可能较适合社区及广大农村地区结直肠癌的大规模普查。     

Screening for Colon Malignancy with Colonoscopy

Screening of asymptomatic individuals for colon malignancy has been advocated for the past 20 yr in the hopes of reducing colon cancer mortality. Although sigmoidoscopy is an important element of current screening recommendations, the sensitivity of this test in asymptomatic subjects has never been studied. The purpose of this study was to determine the prevalence and location of polyps and cancers in an asymptomatic population by performing full colonoscopy. We wished to assess the sensitivity of screening flexible sigmoidoscopy to 60 cm by determining how many patients with adenomas or cancer had "index" adenomatous polyps in the distal 60 cm. One hundred five healthy male outpatients, over 50 yr old, with negative examinations for occult blood in stools and no prior history of colon pathology, had full colonoscopy. Careful examination of the distal 60 cm was performed, followed by a full colon examination to the cecum. Forty-three patients (41%) had adenomatous polyps, and only 19 of these patients had an index adenomatous polyp in the distal 60 cm. Therefore, the sensitivity of sigmoidoscopy was 44%. The prevalence of adenomas increased with age. Patients were assigned to one of three groups based on the findings in the distal 60 cm. Group 1 (n = 65) had no polyps in the distal 60 cm, but 18 of these patients (28%) had adenomatous polyps in the proximal colon. Among 21 patients with only hyperplastic polyps in the distal 60 cm (group 2), six patients (29%) had proximal adenomas. In group 3, eight of 19 patients (42%) with adenomas in the distal 60 cm also had proximal adenomatous polyps. We conclude that adenomatous polyps are common in asymptomatic men who have negative tests for fecal occult blood. Sigmoidoscopy to 60 cm had a sensitivity of only 44% in this patient population, suggesting that this is an insensitive test for the detection of patients with adenomatous polyps.     

新疆沙湾地区大肠癌筛查研究的初步结果

目的探讨粪便隐血试验及结肠镜检查作为大肠癌筛查主要方式的临床价值。方法 2007～2009年对沙湾地区无症状及有下消化道症状自愿体检的患者,先行大便隐血试验阳性者进行结肠镜检查,对检查结果进行分析。结果≥40岁受检者共413例,粪便隐血试验阳性者69例,阳性率16.71%,共24例发现了58枚结肠息肉,包括腺瘤性息肉38枚,炎性息肉8枚,增生性息肉12枚;发现结肠癌13例,直肠癌5例,恶性淋巴瘤1例。〈40岁自愿体检者94例,粪便隐血试验阳性者6例,阳性率6.38%,3例患者发现了4枚结肠息肉,包括腺瘤性息肉1枚,炎性息肉2枚,增生性息肉1枚;发现直肠癌1例。结论对无症状自愿体检患者进行粪便及结肠镜检查能较早发现大肠息肉,对大便隐血试验阳性患者行全结肠镜检查更适合于对基层广大农牧民结直肠癌的筛查。     

Polyps in a low-risk colonic cancer population in Colombia,South America

Colonic polyps were systematically searched for in 508 specimens collected from unselected autopsies in individuals more than 10 years of age from Medillin, Colombia, a low-indicidence geographic region for colorectal cancer. Adenomatous polyps have a low prevalence rate in both sexes, comparable to that found in Cali, Colombia, and other populations with low risk for cancer. They were found more frequently in the right side of the colon and are rare in the sigmoid colon. They begin to appear in the third decade of life in both sexes. Prevalence rates for single and multiple polyps increase with age in both sexes, males showing higher rates than females at every age group. Adenomatous polyps in this population are usually less than 3 mm in diameter and do not show villous changes or epithelial atypia. Hyperplastic polyps were more frequently observed than adenomatous polyps and rates show a progressive increase with age in both sexes. Multiplicity also increases with age. Most polyps are located in the low rectum and sigmoid followed by the cecum and ascending colon. Usually hyperplastic polyps are smaller than 3 mm in diameter and do not show epithelial atypia. Juvenile polyps were infrequently found in this series because children less than 10 years old were excluded. Diverticular disease was also rare and, when found, was not associated with adenomatous polyps. The association between adenomatous polyps and colonic cancer is discussed based on findings in this report.     

Endoscopic identification and quantification of aberrant crypt foci in the human colon

BACKGROUND: Aberrant crypt foci may be precancerous lesions in the human colon. The occurrence of aberrant crypt foci was compared in patients with an endoscopically normal colon, known adenomatous polyps, and known colorectal cancer. METHODS: In 90 patients (30 colonoscopically normal, 30 with adenomatous polyps, 30 with colorectal cancers) magnification chromoscopy was performed to identify aberrant crypt foci in the distal 10 cm of the rectum. Representative biopsy specimens were obtained for histopathologic assessment. RESULTS: Aberrant crypt foci were readily identified. Median and (mean) numbers of aberrant crypt foci were as follows: endoscopically normal colon, 3.5 (5.0); adenomatous polyp(s), 4.0 (6.9); and colorectal cancer, 7.5 (9.9). The number of aberrant crypt foci detected was significantly associated (p = 0.02) with an increased odds that a patient would be in the group with known colorectal cancer (odds ratio = 1.11; 95% CI [1.02, 1.21]), but not in any other group. CONCLUSIONS: Despite a stepwise increase in the number of aberrant crypt foci across the 3 groups, aberrant crypt foci was significantly associated only with comorbid colorectal cancer. Aberrant crypt foci was not associated with adenomatous polyp(s) or normal colon. Additional studies are needed to further elucidate the role of aberrant crypt foci in the development of colorectal neoplasia in humans.