Skip to main content
Log in

Duodenal adenomatosis in familial adenomatous polyposis

International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

In order to evaluate the prevalence of duodenal adenomas in familial adenomatous polyposis (FAP) and the risk of carcinoma development, a multicenter study was initiated in Denmark, Finland, Holland, Norway and Sweden, which have national polyposis registers with an almost complete registration. Patients aged 20 years or more are being examined with biennial gastroduodenoscopy during 1990–2000. Multiple duodenal biopsies are examined by one pathologist from each country, and the endoscopic and histological criteria of Spigelman have been adopted. At the end of August 1992, 312 patients with a median age of 37 years (range 20–86) had completed their first endoscopy. The duodenum was examined in 310 patients, of whom 199 (64%) had duodenal adenomas. Twenty-two patients (11% of all patients with duodenal adenomas) had no endoscopically visible polyps. One patient had an asymptomatic adenocarcinoma. The Spigelman stage worsened significantly (P<0.05) with time from the diagnosis of FAP, which may suggest an increasing risk of carcinoma by time.

Résumé

Afin d'évaluer la prévalence des adénomes duodénaux chez des sujets porteurs d'une polypose adénomateuse familiale, et établir le risque d'un développement d'un cancer, une étude multicentrique a été débutée an Danemark, Finlande, Hollande, Norvége et Suède, pays qui possèdent un registre national des polyposes avec un enregistrement le plus souvent complet. Les patients âgés de 20 ans ou plus seront examinés tous les deux ans par une gastro-duodénoscopie de 1990 à 2000. De multiples biopsies duodénales sont examinées par un seul pathologue par pays et les critères endoscopiques et histologiques de Spigelman ont été retenus. A la fin du mois d'août 1992, 312 patients dont l'âge moyen est de 37 ans (20 à 86) ont complété leur première endoscopie. Le duodénum a été examiné chez 310 patients dont 199 (64%) étaient porteurs d'adénomes duodénaux. Vingt-deux patients (11% de tous les patients porteurs d'adénomes duodénaux) étaient porteurs de polypes visibles à l'endoscopie. Un patient était porteur d'un adéno-carcinome asymptomatique. Le stade de Spigelman se péjorait de manière significative (P<0.05) avec le temps qui s'écoule depuis le diagnostic de la FAP, ce qui peut suggérer un risque accru de cancers avec la durée d'évolution.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Cabot RC (1935) Case 21061. N Engl J Med 212:263–267

    Google Scholar 

  2. Yao T, Iida M, Ohsato K et al. (1977) Duodenal lesions in familial polyposis of the colon. Gastroenterology 73:1086–1092

    Google Scholar 

  3. Iida M, Yao T, Itoh H, Ohsato K, Watanabe H (1981) Endoscopic features of adenoma of the duodenal papilla in familial polyposis of the colon. Gastrointest Endosc 27:6–8

    Google Scholar 

  4. Järvinen H, Nyberg M, Peltokallio P (1983) Upper gastrointestinal tract polyps in familial adenomatosis coli. Gut 24:333–339

    Google Scholar 

  5. Bülow S, Lauritsen KB, Johansen Aa, Svendsen LB, Søndergaard JO (1985) Gastroduodenal polyps in familial polyposis coli. Dis Colon Rectum 28:90–93

    Google Scholar 

  6. Järvinen HJ, Sipponen P (1986) Gastroduodenal polyps in familial adenomatous and juvenile polyposis. Endoscopy 18:230–234

    Google Scholar 

  7. Sarre RG, Frost AG, Jagelman DG, Petras RE, Sivak MV, McGannon E (1987) Gastric and duodenal polyps in familial adenomatous polyposis: a prospective study of the nature and prevalence of upper gastrointestinal polyps. Gut 28:306–314

    Google Scholar 

  8. Kurtz RC, Sternberg SS, Miller HH, DeCosse JJ (1987) Upper gastrointestinal neoplasia in familial polyposis. Dig Dis Sci 32:459–465

    Google Scholar 

  9. Spigelman AD, Williams CB, Talbot IC, Domizio P, Phillips RKS (1989) Upper gastrointestinal cancer in patients with familial adenomatous polyposis. Lancet 2:783–785

    Google Scholar 

  10. Church JM, McGannon E, Hull-Boiner S, Sivak MV, Van Stolk R, Jagelman DG, Fazio VW, Oakley JR, Lavery IC, Milsom JW (1992) Gastroduodenal polyps in patients with familial adenomatous polyposis. Dis Colon Rectum 35:1170–1173

    Google Scholar 

  11. Sugihara K, Muto T, Kamiya J, Konishi F, Sawada T, Morioka Y (1982) Gardner's syndrome associated with periampullary carcinoma, duodenal and gastric adenomatosis. dis Colon Rectum 25:766–771

    Google Scholar 

  12. Jagelman DG, DeCosse JJ, Bussey HJR and the Leeds Castle Polyposis Group (1988) Upper gastrointestinal cancer in familial adenomatous polyposis. Lancet 1:1149–1151

    Google Scholar 

  13. Offerhaus GJA, Giardello FM, Krush AJ, Booker SV, Tersmette AC, Kelley NC, Hamilton SR (1992) The risk of upper gastrointestinal cancer in familial adenomatous polyposis. Gastroenterology 102:1980–1982

    Google Scholar 

  14. Arvanitis ML, Jagelman DG, Fazio VW, Lavery IC, McGannon E (1990) Mortality in patients with familial adenomatous polyposis. Dis Colon Rectum 33:639–642

    Google Scholar 

  15. Iida M, Yao T, Itoh H, Watanabe H, Matsui T, Iwashita A, Fujishima M (1989) Natural history of duodenal lesions in Japanese patients with familial adenomatosis coli (Gardner's syndrome). Gastroenterology 96:1301–1306

    Google Scholar 

  16. Bülow S, Holm NV, Hauge M (1986) The incidence and prevalence of polyposis coli in Denmark. Scand J Soc Med 14:67–74

    Google Scholar 

  17. Alm T, Licnerski G (1973) The intestinal polyposes. Clin Gastroenterol 2:577–602

    Google Scholar 

  18. Spigelman AD, Scates DK, Venitt S, Phillips RKS (1991) DNA adducts, detected by 32P-postlabelling, in the foregut of patients with familial adenomatous polyposis and in unaffected controls. Carcinogenesis 12:1717–1732

    Google Scholar 

  19. Penna C, Phillips RKS, Tiret E, Spigelman AD (1993) Surgical polypectomy of duodenal adenomas in familial adenomatous polyposis: experience of two European centres. Br J Surg 80: 1027–1029

    Google Scholar 

  20. Herrera-Ornelas L (1987) Endoscopic Nd-YAG laser treatment of gastrointestinal polyps in patients with familial polyposis. Semin Surg Oncol 3:146–148

    Google Scholar 

  21. Nugent KP, Farmer KCR, Spigelman AD, Williams CB, Phillips RKS (1993) Randomized controlled trial of the effect of sulindac on duodenal and rectal polyposis and cell proliferation in patients with familial adenomatous polyposis. Br J Surg 80:1618–1619

    Google Scholar 

  22. Norfeet R (1992) Editorial: screening for upper gastrointestinal neoplasms in patients with familial adenomatous polyposis and Gardner's syndrome. J Clin Gastroent 14:95–96

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Consortia

Additional information

The DAF Project Group includes the present authors and A. Mellon Mogensen, F. Moesgaard, L. B. Svendsen, J. Søndergaard and L. Karlsen (Denmark), J.-P. Mecklin and A. Kahri (Finland), G. Griffioen, F. Nagengast and G.J.A. Offerhaus (Holland), A. Bakka, S. Norheim Andersen (Norway), C. Rubio (Sweden)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bülow, S., Alm, T., Fausa, O. et al. Duodenal adenomatosis in familial adenomatous polyposis. Int J Colorect Dis 10, 43–46 (1995). https://doi.org/10.1007/BF00337586

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00337586

Keywords

Navigation