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Rectal Cell Proliferation and Colon Cancer Risk in Ulcerative Colitis¹

Istituto di Clinica Medica e Gastroenterologia e Centro Interdipartimentale di Ricerche sul Cancro "Giorgio Prodi," University of Bologna, Bologna [G. B., G. M. P., S. B., G. D. F., G. G., M. C., L. B.]; Istituto di Fisiopatologia Medica, University of Chieti, Chieti [M. M.]; and Istituto di Patologia Medica, University of Modena, Modena [M. P.], Italy

Cell proliferation kinetics of 30 patients affected by extensive ulcerative colitis in remission have been studied with autoradiography of rectal biopsies incubated with tritiated thymidine. The results have been compared with those of 20 control subjects without evidence of colonic diseases, and of 16 patients with multiple nonfamilial colonic adenomas.

The labeling index was similar in the three groups (P = NS). On the contrary, the labeling frequency (SEM) in the upper 40% of the crypt (_h value) was 0.04 ± 0.01 in controls, 0.16 ± 0.02 in ulcerative colitis, and 0.10 ± 0.01 in adenoma patients (P < 0.001 ulcerative colitis versus controls, P < 0.01 adenomas versus controls, P = NS ulcerative colitis versus adenomas). The distribution of _h values in ulcerative colitis showed a bimodal trend with 22 patients having mean _h values similar to adenoma patients (0.10 ± 0.01) and 8 with higher values (0.30 ± 0.02). No relationship was found between _h values and duration of colitis, age of patients, or age at onset of symptoms.

These data show that cell kinetics studies can detect patients at particularly high risk of colon cancer, and that additional factors should determine colon cancer risk level in ulcerative colitis.

¹ This work and G. M. P. were supported by grants from Associazione Italiana per la Ricerca sul Cancro, Milano, Italy.

² To whom requests for reprints should be addressed, at Istituto di Clinica Medica e Gastroenterologia, Policlinico S. Orsola, Via Massarenti 9, 40138 Bologna, Italy.

Received 7/19/89. Revised 10/13/89. Accepted 10/25/89.

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