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Central European Journal of Medicine

, Volume 5, Issue 6, pp 704–711 | Cite as

Prevalence and recurrence rate of colonic lesions in acromegalic patients

  • Dilek Berker
  • Yasemin Ates Tutuncu
  • Serhat Isik
  • Yusuf Aydin
  • Ufuk Ozuguz
  • Gulhan Akbaba
  • Osman Yuksel
  • Gonul Erden
  • Emin Altiparmak
  • Serdar Guler
Research Article

Abstract

Acromegaly is associated with an increased prevalence of colonic polyps. The aim of this study was to evaluate the prevalence and recurrence rate of colonic polyps in acromegalic patients. Ninety-six acromegalic patients and 100 irritable bowel syndrome patients (IBS) were enrolled in the study. Twenty patients who were cured exclusively by surgery, and 20 patients that could not be hormonally controlled were re-examined colonoscopically after 36 months. Twenty-nine of 96 acromegalic patients (30.2%) had colonic polyps. In the IBS group, 10 (10.0%) had colonic polyps. The prevalence of colonic polyps was significantly higher in acromegaly. The group of acromegalic patients with and without polyps did not differ significantly with regard to plasma GH, IGF-I, fasting insulin levels and glycemic status. The presence of colonic polyps was correlated with increased patient age and male gender. We did not observe a difference in terms of polyp recurrence frequencies in the patients cured by surgery compared to uncontrolled patients. Acromegalic patients have a higher prevalence of colonic polyps than that of control subjects. We could not identify any factors that could predict polyps within the acromegalic patients - but age and male sex.

Keywords

Acromegaly Colon polyp IGF-I GH Insulin 

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References

  1. [1]
    Koenuma M., Yamori T., Tsuruo T., Insulin and insulin-like growth factor 1 stimulate proliferation of metastatic variants of colon carcinoma 26, Jpn J Cancer Res., 1989, 80, 51–58PubMedGoogle Scholar
  2. [2]
    Watkins LF., Lewis LR., Levine AE., Characterization of the synergistic effect of insulin and transferring and the regulation of their receptors on a human colon carcinoma cell line, Int J Cancer., 1990, 45, 372–375CrossRefPubMedGoogle Scholar
  3. [3]
    Bjork J., Nilsson J., Hultcrantz R., Johansson C., Growth-regulatory effects of sensory neuropeptides, epidermal growth factor, insulin, and somatostatin on the nontransformed intestinal epithelial cell line IEC-6 and the colon cancer cell line HT 29, Scand J Gastroenterol., 1993, 28, 879–884CrossRefPubMedGoogle Scholar
  4. [4]
    Hansen I., Tsalikian E., Beaufrere B., Gerich J., Haymond M., Rizza R., Insulin resistance in acromegaly: defects in both hepatic and extrahepatic insulin action, Am J Physiol., 1986, 250, E269–273PubMedGoogle Scholar
  5. [5]
    McKeown-Eyssen G., Epidemiology of colorectal cancer revisited: are serum triglycerides and/or plasma glucose associated with risk?, Cancer Epidemiol Biomarkers Prev., 1994, 3, 687–695PubMedGoogle Scholar
  6. [6]
    La Vecchia C., Negri E., Franceschi S., D’Avanzo B., Boyle P., A case-control study of diabetes mellitus and cancer risk, Br J Cancer., 1994, 70, 950–953PubMedGoogle Scholar
  7. [7]
    Le Marchand L., Wilkens LR., Kolonel LN., Hankin JH., Lyu LC., Associations of sedentary lifestyle, obesity, smoking, alcohol use, and diabetes with the risk of colorectal cancer, Cancer Res., 1997, 57, 4787–4794PubMedGoogle Scholar
  8. [8]
    Sandhu MS., Luben R., Khaw KT., Self reported noninsulin dependent diabetes, family history, and risk of prevalent colorectal cancer: population based, cross sectional study, J Epidemiol Community Health., 2001, 55, 804–805CrossRefPubMedGoogle Scholar
  9. [9]
    Ron E., Gridley G., Hrubec Z., Page W., Arora S., Fraumeni JF Jr., Acromegaly and gastrointestinal cancer, Cancer., 1991, 68, 1673–1677CrossRefPubMedGoogle Scholar
  10. [10]
    Pines A., Rozen P., Ron E., Gilat T., Gastrointestinal tumors in acromegalic patients, Am J Gastroenterol., 1985, 80, 266–269PubMedGoogle Scholar
  11. [11]
    Baris D., Gridley G., Ron E., Weiderpass E., Mellemkjaer L., Ekbom A., et al., Acromegaly and cancer risk: a cohort study in Sweden and Denmark, Cancer Causes Control., 2002, 13, 395–400CrossRefPubMedGoogle Scholar
  12. [12]
    Ladas SD., Thalassinos NC., Ioannides G., Raptis SA., Does acromegaly really predispose to an increased prevalence of gastrointestinal tumours?, Clin Endocrinol (Oxf)., 1994, 41, 597–601CrossRefGoogle Scholar
  13. [13]
    Ortego J., Vega B., Sampedro J., Escalada J., Boixeda D., Varela C., Neoplastic colonic polyps in acromegaly, Horm Metab Res., 1994, 26, 609–610CrossRefPubMedGoogle Scholar
  14. [14]
    Renehan AG., Bhaskar P., Painter JE., O’Dwyer ST., Haboubi N., Varma J., et al., The prevalence and characteristics of colorectal neoplasia in acromegaly, J Clin Endocrinol Metab., 2000, 85, 3417–3424CrossRefPubMedGoogle Scholar
  15. [15]
    Jenkins PJ., Besser M., Clinical perspective: acromegaly and cancer: a problem, J Clin Endocrinol Metab., 2001, 86, 2935–2941CrossRefPubMedGoogle Scholar
  16. [16]
    Jenkins PJ., Fairclough PD., Colorectal neoplasia in acromegaly, Clin Endocrinol (Oxf)., 2001, 55, 727–729CrossRefGoogle Scholar
  17. [17]
    Atkin WS., Risk of colorectal neoplasia in acromegaly: an independent view, Clin Endocrinol (Oxf)., 2001, 55, 723–725CrossRefGoogle Scholar
  18. [18]
    Colao A., Pivonello R., Auriemma RS., Galdiero M., Ferone D., Minuto F., et al., The association of fasting insulin concentrations and colonic neoplasms in acromegaly: a colonoscopy-based study in 210 patients, J Clin Endocrinol Metab., 2007, 92, 3854–3860CrossRefPubMedGoogle Scholar
  19. [19]
    Kurimoto M., Fukuda I., Hizuka N., Takano K., The prevalence of benign and malignant tumors in patients with acromegaly at a single institute, Endocr J., 2008, 5, 67–71CrossRefGoogle Scholar
  20. [20]
    Levin B., Lieberman DA., McFarland B., Andrews KS., Brooks D., Bond J., et al., American Cancer Society Colorectal Cancer Advisory Group; US Multi-Society Task Force; American College of Radiology Colon Cancer Committee. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. Gastroenterology., 2008, 134, 1570–1595CrossRefPubMedGoogle Scholar
  21. [21]
    Inoue M., Iwasaki M., Otani T., Sasazuki S., Noda M., Tsugane S., Diabetes mellitus and the risk of cancer: results from a large-scale population-based cohort study in Japan, Arch Intern Med., 2006, 166, 1871–1877CrossRefPubMedGoogle Scholar
  22. [22]
    Ragozzino M., Melton LJ 3d., Chu CP., Palumbo PJ., Subsequent cancer risk in the incidence cohort of Rochester, Minnesota, residents with diabetes mellitus, J Chronic Dis., 1982, 35, 13–19CrossRefPubMedGoogle Scholar
  23. [23]
    La Vecchia C., Negri E., Decarli A., Franceschi S., Diabetes mellitus and colorectal cancer risk, Cancer Epidemiol Biomarkers Prev., 1997, 6, 1007–1010PubMedGoogle Scholar
  24. [24]
    Hu FB., Manson JE., Liu S., Hunter D., Colditz GA., Michels KB., et al., Prospective study of adult onset diabetes mellitus (Type 2) and risk of colorectal cancer in women, J Natl Cancer Inst., 1999, 91, 542–547CrossRefPubMedGoogle Scholar
  25. [25]
    Jee SH., Ohrr H., Sull JW., Yun JE., Ji M., Samet JM., Fasting serum glucose level and cancer risk in Korean men and women, JAMA., 2005, 293, 194–202CrossRefPubMedGoogle Scholar
  26. [26]
    Yang YX., Hennessy S., Lewis JD., Type 2 diabetes mellitus and the risk of colorectal cancer, Clin Gastroenterol Hepatol., 2005, 3, 587–594CrossRefPubMedGoogle Scholar
  27. [27]
    Nilsen TI., Vatten LJ., Prospective study of colorectal cancer risk and physical activity, diabetes, blood glucose and BMI. Exploring the hyperinsulinaemia hypothesis, Br J Cancer., 2001, 84, 417–422CrossRefPubMedGoogle Scholar
  28. [28]
    Larsson SC., Orsini N., Wolk A., Diabetes mellitus and risk of colorectal cancer: a meta-analysis, J Natl Cancer Inst., 2005, 97, 1679–1687CrossRefPubMedGoogle Scholar
  29. [29]
    MacDonald RS., Thornton WH Jr., Bean TL., Insulin and IGE-1 receptors in a human intestinal adenocarcinoma cell line (CACO-2): regulation of Na+ glucose transport across the brush border, J Recept Res., 1993, 13, 1093–1113PubMedGoogle Scholar
  30. [30]
    Guo YS., Narayan S., Yallampalli C., Singh P., Characterization of insulin like growth factor I receptors in human colon cancer, Gastroenterology., 1992, 102, 1101–1108PubMedGoogle Scholar
  31. [31]
    Warren RS., Yuan H., Matli MR., Ferrara N., Donner DB., Induction of vascular endothelial growth factor by insulin-like growth factor 1 in colorectal carcinoma, J Biol Chem., 1996, 271, 29483–29488CrossRefPubMedGoogle Scholar
  32. [32]
    Giovannucci E., Pollak MN., Platz EA., Willett WC., Stampfer MJ., Majeed N., et al., A prospective study of plasma insulin-like growth factor-1 and binding protein-3 and risk of colorectal neoplasia in women, Cancer Epidemiol Biomarkers Prev., 2000, 9, 345–349PubMedGoogle Scholar
  33. [33]
    Ma J., Pollak MN., Giovannucci E., Chan JM., Tao Y., Hennekens CH., et al., Prospective study of colorectal cancer risk in men and plasma levels of insulin like growth factor (IGF)-I and IGF-binding protein-3, J Natl Cancer Inst., 1999, 91, 620–625CrossRefPubMedGoogle Scholar
  34. [34]
    Juul A., Pedersen SA., Sørensen S., Winkler K., Jørgensen JO., Christiansen JS., et al., Growth hormone (GH) treatment increases serum insulin-like growth factor binding protein-3, bone isoenzyme alkaline phosphatase and forearm bone mineral content in young adults with GH deficiency of childhood onset, Eur J Endocrinol., 1994, 131, 41–49CrossRefPubMedGoogle Scholar
  35. [35]
    Ghigo E., Aimaretti G., Maccario M., Fanciulli G., Arvat E., Minuto F., et al., Doseresponse study of GH effects on circulating IGF-I and IGFBP-3 levels in healthy young men and women, Am J Physiol., 1999, 276, E1009–1013PubMedGoogle Scholar
  36. [36]
    Giovannucci E., Pollak M., Risk of cancer after growth hormone treatment, Lancet., 2002, 360, 268–269CrossRefPubMedGoogle Scholar
  37. [37]
    Cohen P., Fielder PJ., Hasegawa Y., Frisch H., Giudice LC., Rosenfeld RG., Clinical aspects of insulin-like growth factor binding proteins, Acta Endocrinol (Copenh)., 1991, 124, 74–85Google Scholar
  38. [38]
    Nam SY., Lee EJ., Kim KR., Cha BS., Song YD., Lim SK., et al., Effect of obesity on total and free insulin-like growth factor (IGF)-I and their relationship to IGFbinding protein (BP)-1, IGFBP-2, IGFBP-3, insulin, and growth hormone, Int J Obes Relat Metab Disord., 1997, 21, 355–359CrossRefPubMedGoogle Scholar
  39. [39]
    Orme SM., McNally RJ., Cartwright RA., Belchetz PE., Mortality and cancer incidence in acromegaly: a retrospective cohort study. United Kingdom Acromegaly Study Group, J Clin Endocrinol Metab., 1998, 83, 2730–2734CrossRefPubMedGoogle Scholar
  40. [40]
    Barzilay J., Heatley GJ., Cushing GW., Benign and malignant tumors in patients with acromegaly, Arch Intern Med., 1991, 151, 1629–1632CrossRefPubMedGoogle Scholar
  41. [41]
    Colao A., Balzano A., Ferone D., Panza N., Grande G., Marzullo P., et al., Increased prevalence of colonic polyps and altered lymphocyte subset pattern in the colonic lamina propria in acromegaly, Clin Endocrinol (Oxf)., 1997, 47, 23–28CrossRefGoogle Scholar
  42. [42]
    Delhougne B., Deneux C., Abs R., Chanson P., Fierens H., Laurent-Puig P., et al., The prevalence of colonic polyps in acromegaly: a colonoscopic and pathological study in 103 patients, J Clin Endocrinol Metab., 1995, 80, 3223–3226CrossRefPubMedGoogle Scholar
  43. [43]
    Pawlikowski M., Lachowicz L., Kunert-Radek J., Winczyk K., Janiszewska G., Szkudlarek J., Differential effects of somatostatin and its analog on protein tyrosine kinases activity in the rat pituitary and the murine colonic tumors, Biochem Biophys Res Commun., 1998, 246, 375–377CrossRefPubMedGoogle Scholar

Copyright information

© © Versita Warsaw and Springer-Verlag Berlin Heidelberg 2010

Authors and Affiliations

  • Dilek Berker
    • 1
  • Yasemin Ates Tutuncu
    • 1
  • Serhat Isik
    • 1
  • Yusuf Aydin
    • 1
  • Ufuk Ozuguz
    • 1
  • Gulhan Akbaba
    • 1
  • Osman Yuksel
    • 2
  • Gonul Erden
    • 3
  • Emin Altiparmak
    • 4
  • Serdar Guler
    • 1
  1. 1.Endocrinology and Metabolism ClinicMinistry Of Health, Ankara Numune Research and Training HospitalAnkaraTurkey
  2. 2.Gastroenterology ClinicMinistry Of Health, Diskapi Yildirim Beyazit Research and Training HospitalAnkaraTurkey
  3. 3.Department of BiochemistryMinistry Of Health, Ankara Numune Research and Training HospitalAnkaraTurkey
  4. 4.Gastroenterology ClinicMinistry Of Health, Ankara Numune Research and Training HospitalAnkaraTurkey

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