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Hoffmann, R. A wiki for the life sciences where authorship matters. Nature Genetics (2008)

Rectal proliferation and polyp occurrence in patients with familial adenomatous polyposis after sulindac treatment.

BACKGROUND/AIMS: Sulindac, a nonsteroidal anti-inflammatory drug (NSAID), decreases the occurrence of polyps in patients with familial adenomatous polyposis ( FAP). The effects of colectomy with ileorectal anastomosis (IRA) and sulindac treatment on rectal mucosa proliferation and polyp occurrence were examined in patients with FAP. METHODS: The number and size of rectal polyps were measured with colonoscopy. The labeling index, the percentage of labeled cells per crypt compartment, was assessed in rectal biopsy specimens with [3H]thymidine incorporation and autoradiography in 6 non-IRA and 14 IRA patients before and after treatment with 200 mg of sulindac/day for 60 days. RESULTS: The IRA patients had a lower labeling index and a decrease in the percentage of labeled cells in the upper compartment of the crypt (P < 0.01) relative to non-IRA subjects. Sulindac did not influence the labeling index and the distribution of labeled cells along the crypt. On the contrary, a dramatic decrease in the size and number of polyps was observed after sulindac treatment (P < 0.001). CONCLUSIONS: The persistence of a abnormal mucosal proliferation after sulindac therapy, in spite of the reduction of polyp number, suggests caution in assuming a lower risk of rectal cancer in patients with FAP.[1]


  1. Rectal proliferation and polyp occurrence in patients with familial adenomatous polyposis after sulindac treatment. Spagnesi, M.T., Tonelli, F., Dolara, P., Caderni, G., Valanzano, R., Anastasi, A., Bianchini, F. Gastroenterology (1994) [Pubmed]
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