Intestinal Research

Original Articles

Colonic Chicken Skin Mucosa is an Independent Endoscopic Predictor of Advanced Colorectal Adenoma: Eun Ju Chung, Ji Young Lee, Jaewon Choe, Hye-Sook Chang, Jongcheol Kim, Dong Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Kyung-Jo Kim, Suk-Kyun Yang, Jin-Ho Kim, Seung-Jae Myung; Intest Res 2015;13(4):318-325. Published online October 15, 2015; DOI: https://doi.org/10.5217/ir.2015.13.4.318

Background/Aims

Chicken skin mucosa (CSM), surrounding colorectal adenoma, is an endoscopic finding with pale yellow-speckled mucosa; however, its clinical significance is unknown. This study aimed to evaluate the prevalence and clinical characteristics of CSM, and the association between colorectal carcinogenesis and CSM.

Methods

This cross-sectional study was performed in 733 consecutive patients who underwent endoscopic polypectomy for colorectal adenoma after the screening of colonoscopy at the Asan Health Promotion Center between June 2009 and December 2011. The colonoscopic and pathological findings of colorectal adenoma including number, size, location, dysplasia, morphology, and clinical parameters were reviewed.

Results

The prevalence of CSM was 30.7% (225 of 733 patients), and most CSM-related adenomas were located in the distal colon (93.3%). Histological analysis revealed lipid-laden macrophages in the lamina propria of the mucosa. Multivariate analyses showed that CSM was significantly associated with advanced pathology, including villous adenoma and high-grade dysplasia (odds ratio [OR], 2.078; 95% confidence interval [CI], 1.191-3.627; P=0.010), multiple adenomas (i.e., ≥2 adenomas; OR, 1.692; 95% CI, 1.143-2.507; P=0.009), and a protruding morphology (OR, 1.493; 95% CI, 1.027-2.170; P=0.036). There were no significant differences in polyp size or clinical parameters between patients with and without CSM.

Conclusions

CSM-related adenoma was mainly found in the distal colon, and was associated with advanced pathology and multiple adenomas. CSM could be a potential predictive marker of the carcinogenetic progression of distally located colorectal adenomas.

Citations

Citations to this article as recorded by

Active Rectal Bleeding Due to Polyp Avulsion Induced by Bowel Preparation: A Case Report
Jiaming Lei, Ling Wu
Cureus.2025;[Epub] CrossRef
Mucosa color and size may indicate malignant transformation of chicken skin mucosa-positive colorectal neoplastic polyps
Ying-Jie Zhang, Meng-Xia Yuan, Wu Wen, Fan Li, Yi Jian, Chuan-Ming Zhang, Ye Yang, Feng-Lin Chen
World Journal of Gastrointestinal Oncology.2024; 16(3): 750. CrossRef
White spots around colorectal tumors are cancer-related findings and may aid endoscopic diagnosis: a prospective study in Japan
Kai Korekawa, Yusuke Shimoyama, Fumiyoshi Fujishima, Hiroshi Nagai, Takeo Naito, Rintaro Moroi, Hisashi Shiga, Yoichi Kakuta, Yoshitaka Kinouchi, Atsushi Masamune
Clinical Endoscopy.2024; 57(5): 637. CrossRef
Solitary juvenile polyp of the rectum with intramucosal adenocarcinoma
Kazuki Nagai, Uichiro Fuchizaki, Yoshimichi Ueda
Clinical Journal of Gastroenterology.2023; 16(4): 532. CrossRef
Chicken skin mucosa surrounding small colorectal cancer could be an endoscopic predictive marker of submucosal invasion
Ying-Jie Zhang, Wu Wen, Fan Li, Yi Jian, Chuan-Ming Zhang, Meng-Xia Yuan, Ye Yang, Feng-Lin Chen
World Journal of Gastrointestinal Oncology.2023; 15(6): 1062. CrossRef
Characteristics and potential malignancy of colorectal juvenile polyps in adults: a single-center retrospective study in China
Jie Dong, Tian-Shi Ma, Yuan-Hong Xu, Peng Li, Wan-Yuan Chen, Jiang-Feng Tu, You-Wei Chen
BMC Gastroenterology.2022;[Epub] CrossRef
Colonic Chicken Skin Mucosa Surrounding Colon Polyps Is an Endoscopic Predictive Marker for Colonic Neoplastic Polyps
Yu Mi Lee, Kyung Ho Song, Hoon Sup Koo, Choong-Sik Lee, Inseok Ko, Sang Hyuk Lee, Kyu Chan Huh
Gut and Liver.2022; 16(5): 754. CrossRef
Diagnosis and management of a solitary colorectal juvenile polyp in an adult during follow-up for ulcerative colitis: A case report
You-Wei Chen, Jiang-Feng Tu, Wen-Juan Shen, Wan-Yuan Chen, Jie Dong
World Journal of Gastroenterology.2020; 26(8): 877. CrossRef
Hepatitis B Virus Infection Is Independently Associated With Advanced Colorectal Adenoma
Su Hwan Kim, Ji Won Kim, Kook Lae Lee, Seohui Lee, Seong-Joon Koh, Ji Bong Jeong, Byeong Gwan Kim
The American Journal of the Medical Sciences.2018; 356(2): 141. CrossRef
Current strategies for malignant pedunculated colorectal polyps
Adriana Ciocalteu, Dan Ionut Gheonea, Adrian Saftoiu, Liliana Streba, Nicoleta Alice Dragoescu, Tiberiu Stefanita Tenea-Cojan
World Journal of Gastrointestinal Oncology.2018; 10(12): 465. CrossRef

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Inhibitory Effect of Metformin Therapy on the Incidence of Colorectal Advanced Adenomas in Patients With Diabetes: Yo Han Kim, Ran Noh, Sun Young Cho, Seong Jun Park, Soung Min Jeon, Hyun Deok Shin, Suk Bae Kim, Jeong Eun Shin; Intest Res 2015;13(2):145-152. Published online April 27, 2015; DOI: https://doi.org/10.5217/ir.2015.13.2.145

Abstract PDF PubReader

Background/Aims

Metformin use has been associated with decreased colorectal cancer risk and mortality among diabetic patients. Recent research suggests that metformin use may decrease the incidence of colorectal adenomas in diabetic patients with previous colorectal cancer. This study aimed to assess the clinical effect of metformin use on the development of colorectal adenomas in diabetic patients without previous colorectal cancer.

Methods

Among 604 consecutive diabetic patients who underwent colonoscopic surveillance after initial colonoscopy between January 2002 and June 2012, 240 patients without previous colorectal cancer were enrolled in this study and were divided in two groups: 151 patients receiving metformin and 89 patients not receiving metformin. Patient demographics and clinical characteristics as well as the colorectal adenoma incidence rate were retrospectively analyzed.

Results

The incidence rate of total colorectal adenomas was not different according to metformin use (P=0.349). However, the advanced adenoma incidence rate was significantly lower in the metformin group compared with the non-metformin group (relative risk [RR], 0.09; P=0.011). Metformin use was independently associated with a decreased incidence of advanced colorectal adenomas after adjustment for clinically relevant factors (RR, 0.072; P=0.016). In addition, the cumulative development rate of advanced adenomas during follow-up was significantly lower in the metformin group compared with the non-metformin group (P=0.007).

Conclusions

Metformin use in diabetic patients without previous colorectal cancer is associated with a lower risk of advanced colorectal adenomas.

Citations

Citations to this article as recorded by

Metformin for primary prevention of colorectal neoplasms in adenoma-free populations: a systematic review and dose-response meta-analysis
Mengdan Shen, Shan Lu, Zihao Xu, Feifei Zhou, Li-Ting Sheng, Qiang Yu
Frontiers in Pharmacology.2025;[Epub] CrossRef
Metformin Use Is Inversely Associated with Prevalent, but Not Incident Colorectal Adenomas
Anna Krigel, Snow Trinh T. Nguyen, Nawar Talukder, Ching-Ho Huang, Carlos Buitrago, Gabriel Karkenny, Benjamin Lebwohl, Julian A. Abrams, James L. Araujo
Digestive Diseases and Sciences.2022; 67(10): 4886. CrossRef
The Impact of Diabetes Mellitus on the Second Primary Malignancies in Colorectal Cancer Patients
Jana Halamkova, Tomas Kazda, Lucie Pehalova, Roman Gonec, Sarka Kozakova, Lucia Bohovicova, Ondrej Slaby, Regina Demlova, Marek Svoboda, Igor Kiss
Frontiers in Oncology.2021;[Epub] CrossRef
Suppressive effects of metformin on colorectal adenoma incidence and malignant progression
Min Deng, Siqin Lei, Dongdong Huang, Hui Wang, Shuli Xia, Enping Xu, Yihua Wu, Honghe Zhang
Pathology - Research and Practice.2020; 216(2): 152775. CrossRef
Metformin and colorectal cancer: a systematic review, meta-analysis and meta-regression
Cheng-Ann Winston Ng, Amy Aimei Jiang, Emma Min Shuen Toh, Cheng Han Ng, Zhi Hao Ong, Siyu Peng, Hui Yu Tham, Raghav Sundar, Choon Seng Chong, Chin Meng Khoo
International Journal of Colorectal Disease.2020; 35(8): 1501. CrossRef
Cirrhosis and insulin resistance: current knowledge, pathophysiological mechanisms, complications and potential treatments
Frédéric Clarembeau, Georgia Bale, Nicolas Lanthier
Clinical Science.2020; 134(16): 2117. CrossRef
Age at menarche and risk of colorectal adenoma
Nam Hee Kim, Jung Ho Park, Dong Il Park, Chong Il Sohn, Kyuyong Choi, Yoon Suk Jung
The Korean Journal of Internal Medicine.2019; 34(5): 998. CrossRef
Diabetes Mellitus: a Clinical Condition Associated with Metabolic Syndrome and Colorectal Cancer Risk
Vesna Brzacki, Aleksandar Nagorni, Manolis Kallistratos, Athanasios Manolis, Dragan Lovic
Current Pharmacology Reports.2019; 5(4): 205. CrossRef
Diabetes Mellitus and Colon Carcinogenesis: Expectation for Inhibition of Colon Carcinogenesis by Oral Hypoglycemic Drugs
Junichi Kato, Yohei Shirakami, Masahito Shimizu
Gastrointestinal Disorders.2019; 1(2): 273. CrossRef
Metformin Is Associated With Reduced Odds for Colorectal Cancer Among Persons With Diabetes
Joshua Demb, Armaan Yaseyyedi, Lin Liu, Ranier Bustamante, Ashley Earles, Pradipta Ghosh, J. Silvio Gutkind, Andrew J. Gawron, Tonya R. Kaltenbach, Maria Elena Martinez, Samir Gupta
Clinical and Translational Gastroenterology.2019; 10(11): e00092. CrossRef
Metformin in colorectal cancer: molecular mechanism, preclinical and clinical aspects
Muhamad Noor Alfarizal Kamarudin, Md. Moklesur Rahman Sarker, Jin-Rong Zhou, Ishwar Parhar
Journal of Experimental & Clinical Cancer Research.2019;[Epub] CrossRef
Postoperative adjuvant chemotherapy is associated with a lower incidence of colorectal adenomas in patients with previous colorectal cancer
Hee Seung Lee, Sung Bae Kim, Hyun Jung Lee, Soo Jung Park, Sung Pil Hong, Jae Hee Cheon, Won Ho Kim, Tae Il Kim
Gastrointestinal Endoscopy.2018; 87(3): 688. CrossRef
Metformin use and the risk of colorectal adenoma: A systematic review and meta‐analysis
Yoon Suk Jung, Chan Hyuk Park, Chang Soo Eun, Dong Il Park, Dong Soo Han
Journal of Gastroenterology and Hepatology.2017; 32(5): 957. CrossRef
The effect of metformin on the recurrence of colorectal adenoma in diabetic patients with previous colorectal adenoma
Min Seok Han, Hyun Jung Lee, Soo Jung Park, Sung Pil Hong, Jae Hee Cheon, Won Ho Kim, Tae Il Kim
International Journal of Colorectal Disease.2017; 32(8): 1223. CrossRef
Ursodeoxycholic acid inhibits the proliferation of colon cancer cells by regulating oxidative stress and cancer stem-like cell growth
Eun-Kyung Kim, Jae Hee Cho, EuiJoo Kim, Yoon Jae Kim, Aamir Ahmad
PLOS ONE.2017; 12(7): e0181183. CrossRef
Serum CEA and CA 19-9 Levels are Associated with the Presence and Severity of Colorectal Neoplasia
Nam Hee Kim, Mi Yeon Lee, Jung Ho Park, Dong Il Park, Chong Il Sohn, Kyuyong Choi, Yoon Suk Jung
Yonsei Medical Journal.2017; 58(5): 918. CrossRef
Synergistic Benefit of Statin and Metformin in Gastrointestinal Malignancies
George K. Nimako, Zachary A. P. Wintrob, Dmitriy A. Sulik, Jennifer L. Donato, Alice C. Ceacareanu
Journal of Pharmacy Practice.2017; 30(2): 185. CrossRef
Risk Factors for False Fecal Immunochemical Test Results in Colorectal Cancer Screening
Nam Hee Kim, Jung Ho Park, Dong Il Park, Chong Il Sohn, Kyuyong Choi, Yoon Suk Jung
Journal of Clinical Gastroenterology.2017; 51(2): 151. CrossRef
Parameters of Glucose and Lipid Metabolism Affect the Occurrence of Colorectal Adenomas Detected by Surveillance Colonoscopies
Nam Hee Kim, Jung Yul Suh, Jung Ho Park, Dong Il Park, Yong Kyun Cho, Chong Il Sohn, Kyuyong Choi, Yoon Suk Jung
Yonsei Medical Journal.2017; 58(2): 347. CrossRef
Are Hemorrhoids Associated with False-Positive Fecal Immunochemical Test Results?
Nam Hee Kim, Jung Ho Park, Dong Il Park, Chong Il Sohn, Kyuyong Choi, Yoon Suk Jung
Yonsei Medical Journal.2017; 58(1): 150. CrossRef
Association Between Low Relative Muscle Mass and the Risk of Colorectal Neoplasms
Yoon Suk Jung, Nam Hee Kim, Seungho Ryu, Jung Ho Park, Dong Il Park, Chong Il Sohn
Journal of Clinical Gastroenterology.2017; 51(10): e83. CrossRef
Metformin therapy and the risk of colorectal adenoma in patients with type 2 diabetes: A meta-analysis
Yi-Chao Hou, Qiang Hu, Jiao Huang, Jing-Yuan Fang, Hua Xiong
Oncotarget.2017; 8(5): 8843. CrossRef
Metformin therapy and risk of colorectal adenomas and colorectal cancer in type 2 diabetes mellitus patients: A systematic review and meta-analysis
Feifei Liu, Lijing Yan, Zhan Wang, Yuanan Lu, Yuanyuan Chu, Xiangyu Li, Yisi Liu, Dongsheng Rui, Shaofa Nie, Hao Xiang
Oncotarget.2017; 8(9): 16017. CrossRef
Kaffee senkt Rückfallrate bei Patienten mit Kolonkarzinom im Stadium III
Michael Fink
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Oxidative stress and metabolic disorders: Pathogenesis and therapeutic strategies
Vibha Rani, Gagan Deep, Rakesh K. Singh, Komaraiah Palle, Umesh C.S. Yadav
Life Sciences.2016; 148: 183. CrossRef
Weight Change and Obesity Are Associated with a Risk of Adenoma Recurrence
Yoon Suk Jung, Jung Ho Park, Dong Il Park, Chong Il Sohn, Kyuyong Choi
Digestive Diseases and Sciences.2016; 61(9): 2694. CrossRef

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27 Web of Science
26 Crossref

Alcohol Drinking Increased the Risk of Advanced Colorectal Adenomas: Yoon Kyung Song, Young Sook Park, Choon Sik Seon, Hye Jin Lim, Byung Kwan Son, Sang Bong Ahn, Young Kwan Jo, Seong Hwan Kim, Yun Ju Jo, Ji Hyun Lee, Seung Chan Kim; Intest Res 2015;13(1):74-79. Published online January 29, 2015; DOI: https://doi.org/10.5217/ir.2015.13.1.74

Abstract PDF PubReader

Background/Aims

Age, sex, gene and life style are modulating risks for colon cancer. Although alcohol intake may impact on colorectal adenoma, clear association has not been established yet. We aimed to investigate effects of alcohol consumption on the characteristics of colorectal adenoma.

Methods

Patients who underwent colonoscopic polypectomy of colorectal adenoma in the department of gastroenterology of Eulji hospital through 2005 to 2012, having both blood tests and ultrasound or abdominal CT examination were enrolled. The alcohol drinking patients were subdivided into normal or abnormal laboratory group, and alcoholic liver diseases group.

Results

212 patients with colorectal adenoma were analyzed; advanced adenoma and multiple adenoma were found in 68 (32.0%) and 79 (37.2%) patients. When compared to the nondrinker group (120/212 patients), the alcohol drinker group (92/212 patients) represented significantly high odds ratios (ORs) for advanced adenoma (OR, 2.697; P=0.002), and multiple adenoma (OR, 1.929; P=0.039). Among alcohol drinker (92 patients), the ORs of advanced adenoma were 6.407 (P=0.003) in alcoholic liver diseases group (17 patients), 3.711 (P=0.002) in the alcohol drinker with abnormal lab (24 patients), and 2.184 (P=0.034), in the alcohol drinker with normal lab (51 patients) compared to nondrinker group.

Conclusions

This study showed that alcohol drinking may influence on the development of advanced colorectal adenoma and multiplicity. Especially in the group with alcoholic liver diseases and with abnormal lab presented significantly higher ORs of advanced adenoma.

Citations

Citations to this article as recorded by

Association between drinking patterns and advanced colorectal adenomas
Sheng-Yan Lu, Si-Yuan Ding, Li-Yuan Cui, Jia-Yu Li, Xiao-Lei Qin, Xu Liu
World Chinese Journal of Digestology.2025; 33(7): 562. CrossRef
Association between severe hepatic steatosis examined by Fibroscan and the risk of high-risk colorectal neoplasia
Kwang Woo Kim, Hyoun Woo Kang, Hosun Yoo, Yukyung Jun, Hyun Jung Lee, Jong Pil Im, Ji Won Kim, Joo Sung Kim, Seong-Joon Koh, Yong Jin Jung, Atsushi Hosui
PLOS ONE.2022; 17(12): e0279242. CrossRef
Value of combined detection of IFOBT, tumor markers, and inflammatory markers in predicting occurrence of advanced colorectal adenoma
Xu Wang, Jing-Yu Zhang, Zhong-Qing Zheng, Tao Wang, Mei-Yu Piao, Heng Liu, Jing Liu, Wen-Tian Liu
World Chinese Journal of Digestology.2021; 29(7): 347. CrossRef
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Shiyu Zhang, Junyong Zhang, Yonghwan Kim, Wangyang Zhang
Healthcare.2021; 9(10): 1400. CrossRef
Associations of Novel Dietary and Lifestyle Inflammation Scores With Incident Colorectal Cancer in the NIH-AARP Diet and Health Study
Doratha A Byrd, Suzanne E Judd, W Dana Flanders, Terryl J Hartman, Veronika Fedirko, Tanya Agurs-Collins, Roberd M Bostick
JNCI Cancer Spectrum.2020;[Epub] CrossRef
Adenoma Characteristics and the Influence of Alcohol and Cigarette Consumption on the Development of Advanced Colorectal Adenomas
Maja Čebohin, Senka Samardžić, Ksenija Marjanović, Martina Tot Vesić, Kristina Kralik, Andreja Bartulić, Dijana Hnatešen
International Journal of Environmental Research and Public Health.2020; 17(22): 8296. CrossRef
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Doratha A. Byrd, Suzanne Judd, W. Dana Flanders, Terryl J. Hartman, Veronika Fedirko, Roberd M. Bostick
Cancer Epidemiology, Biomarkers & Prevention.2020; 29(11): 2300. CrossRef
Age at menarche and risk of colorectal adenoma
Nam Hee Kim, Jung Ho Park, Dong Il Park, Chong Il Sohn, Kyuyong Choi, Yoon Suk Jung
The Korean Journal of Internal Medicine.2019; 34(5): 998. CrossRef
Interplay of Liver Disease and Gut Microbiota in the Development of Colorectal Neoplasia
Michael W. Gleeson
Current Treatment Options in Gastroenterology.2019; 17(3): 378. CrossRef
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Yen‐Ling Liu, Jin‐Shang Wu, Yi‐Ching Yang, Feng‐Hwa Lu, Chih‐Ting Lee, Wan‐Ju Lin, Chih‐Jen Chang
Journal of Gastroenterology and Hepatology.2018; 33(4): 800. CrossRef
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Nam Hee Kim, Jung Ho Park, Dong Il Park, Chong Il Sohn, Kyuyong Choi, Yoon Suk Jung
Digestive and Liver Disease.2017; 49(5): 557. CrossRef
Risk Factors for False Fecal Immunochemical Test Results in Colorectal Cancer Screening
Nam Hee Kim, Jung Ho Park, Dong Il Park, Chong Il Sohn, Kyuyong Choi, Yoon Suk Jung
Journal of Clinical Gastroenterology.2017; 51(2): 151. CrossRef
Sarcopenia is associated with an increased risk of advanced colorectal neoplasia
Youn Su Park, Ji Won Kim, Byeong Gwan Kim, Kook Lae Lee, Jae Kyung Lee, Joo Sung Kim, Seong-Joon Koh
International Journal of Colorectal Disease.2017; 32(4): 557. CrossRef
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Tae Hoon Ha, Byeong Gwan Kim, Donghyong Jeong, Sohee Oh, Won Kim, Yong Jin Jung, Dong Won Ahn, Ji Bong Jeong, Ji Won Kim, Kook Lae Lee, Seong-Joon Koh
Digestive Diseases and Sciences.2017; 62(1): 273. CrossRef
Metformin therapy and the risk of colorectal adenoma in patients with type 2 diabetes: A meta-analysis
Yi-Chao Hou, Qiang Hu, Jiao Huang, Jing-Yuan Fang, Hua Xiong
Oncotarget.2017; 8(5): 8843. CrossRef
Statin use and the risk of colorectal adenoma: A meta‐analysis
Yoon Suk Jung, Chan Hyuk Park, Chang Soo Eun, Dong Il Park, Dong Soo Han
Journal of Gastroenterology and Hepatology.2016; 31(11): 1823. CrossRef
Weight Change and Obesity Are Associated with a Risk of Adenoma Recurrence
Yoon Suk Jung, Jung Ho Park, Dong Il Park, Chong Il Sohn, Kyuyong Choi
Digestive Diseases and Sciences.2016; 61(9): 2694. CrossRef
Metabolic syndrome is a risk factor for adenoma occurrence at surveillance colonoscopy
Nam Hee Kim, Jung Ho Park, Dong Il Park, Chong Il Sohn, Kyuyong Choi, Yoon Suk Jung
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Seung Eun Lee, Hee Bum Jo, Won Gun Kwack, Yun Jin Jeong, Yeo-Jin Yoon, Hyoun Woo Kang
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Nam Hee Kim, Hyo-Joon Yang, Soo-Kyung Park, Jung Ho Park, Dong Il Park, Chong Il Sohn, Kyuyong Choi, Yoon Suk Jung
Digestive Diseases and Sciences.2016; 61(9): 2685. CrossRef
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Asian Pacific Journal of Cancer Prevention.2015; 16(14): 6105. CrossRef

9,488 View
43 Download
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