Said Abasse Kassim1, Muhammad Abbas2,3, Weiyan Tang3, Shenzhen Wu1, Qingdao Meng1, Chengcheng Zhang1, Shagufta Naeem4, Xiaobo Li1, Rui Chen5,6. 1. Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China. 2. State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, 210023, China. 3. Department of Medical Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China. 4. Department of Pathology, Ayub Medical College, Abbottabad, Pakistan. 5. Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China. 101011816@seu.edu.cn. 6. State Key Laboratory of Bioelectronics, Southeast University, Nanjing, China. 101011816@seu.edu.cn.
Abstract
BACKGROUND: Melanosis coli (MC) is a colonoscopic finding in which the colonic mucosa appears darkly pigmented than usual and generally caused by extended anthranoid laxative use. METHODS: We performed a retrospective study at Zhuhai Hospital to investigate the risk of MC for CR neoplasm development. A total of 12,776 patients who underwent colonoscopy from 2013 to 2016 including 250 diagnosed with MC and 500 controls were included in this study. Odds ratios (OR) and 95% confidence intervals (95%CI) for associations of MC with CR neoplasm detection were estimated using univariate and multivariable multinomial logistic analyses for known risk factors. RESULTS: The presence of MC was associated with a significant increase in the CR neoplasm detection rate compared with controls (OR = 1.701, 95% CI = 1.252-2.31; P = 0.001). The effect was also observed in different tumor sites, age group, gender, and lifestyle. Using univariate multinomial analysis, patients with MC were significantly associated with both hyperplastic polyp (OR = 2.069, 95% CI = 1.253-3.415; P = 0.005) and low-grade (LG) adenoma (OR = 1.585, 95% CI = 1.115-2.254; P = 0.010). However, there was no significant difference with adenocarcinoma (OR = 1.701, 95% CI = 0.990-2.924; P = 0.055). Using multivariate multinomial analysis, MC patients remained associated with increased hyperplastic polyp (OR = 1.870, 95% CI = 1.119-3.125; P = 0.017) and LG adenoma (OR = 1.474, 95% CI = 1.027-2.114; P = 0.035), but not adenocarcinoma (OR = 1.620, 95% CI = 0.914-2.871; P = 0.098). A significant increase in CR neoplasm rate was observed with drinker, smoker, and elderly patients but not with gender. CONCLUSION: Patients with MC were more likely to have both hyperplastic polyp and LG adenoma. If confirmed, such findings could suggest the discontinuation of anthranoid laxative use particularly in the elderly.
BACKGROUND:Melanosis coli (MC) is a colonoscopic finding in which the colonic mucosa appears darkly pigmented than usual and generally caused by extended anthranoid laxative use. METHODS: We performed a retrospective study at Zhuhai Hospital to investigate the risk of MC for CR neoplasm development. A total of 12,776 patients who underwent colonoscopy from 2013 to 2016 including 250 diagnosed with MC and 500 controls were included in this study. Odds ratios (OR) and 95% confidence intervals (95%CI) for associations of MC with CR neoplasm detection were estimated using univariate and multivariable multinomial logistic analyses for known risk factors. RESULTS: The presence of MC was associated with a significant increase in the CR neoplasm detection rate compared with controls (OR = 1.701, 95% CI = 1.252-2.31; P = 0.001). The effect was also observed in different tumor sites, age group, gender, and lifestyle. Using univariate multinomial analysis, patients with MC were significantly associated with both hyperplastic polyp (OR = 2.069, 95% CI = 1.253-3.415; P = 0.005) and low-grade (LG) adenoma (OR = 1.585, 95% CI = 1.115-2.254; P = 0.010). However, there was no significant difference with adenocarcinoma (OR = 1.701, 95% CI = 0.990-2.924; P = 0.055). Using multivariate multinomial analysis, MCpatients remained associated with increased hyperplastic polyp (OR = 1.870, 95% CI = 1.119-3.125; P = 0.017) and LG adenoma (OR = 1.474, 95% CI = 1.027-2.114; P = 0.035), but not adenocarcinoma (OR = 1.620, 95% CI = 0.914-2.871; P = 0.098). A significant increase in CR neoplasm rate was observed with drinker, smoker, and elderly patients but not with gender. CONCLUSION:Patients with MC were more likely to have both hyperplastic polyp and LG adenoma. If confirmed, such findings could suggest the discontinuation of anthranoid laxative use particularly in the elderly.