An Exploratory Analysis of the Geographical Distribution of Trauma Incidents in Shenzhen, China

The Health Services Research Unit receives funding from the Chief Scientist Office of the Scottish Government Health and Social Care Directorates

Melanosis coli: Harmless pigmentation? A case-control retrospective study of 657 cases.

The association of melanosis coli with the development of colorectal polyps remains uncertain.From a total of 18263 patients who had received colonoscopy in our hospital, 219 with melanosis coli cases and 438 controls matched by age and sex (at 1:2 ratio) were included in this study. The association of incidence, number, location, and pathology of colorectal neoplasm with grades and distribution of melanosis coli were analyzed.Melanosis coli was associated with significantly more colorectal polyps than control, a higher incidence of numerous colorectal polyps (number ≥ 20) (7.3% vs 0.5%; p < 0.001), and higher number of small colorectal polyps (diameter ≤ 5 mm; p < 0.01). Patients with melanosis coli had higher incidences of low-grade adenomas (31.1% vs 23.3%, p < 0.05) and non-adenoma polyps (20.1% vs 12.8%, p < 0.05) than the controls. On multivariate analysis, melanosis coli was independently associated with increased detecting rates of low grade adenoma (OR = 1.54; 95%: 1.06-2.23; p < .05), non-adenoma polyp (OR = 1.72; 95%: 1.11-2.70; p < .05) and numerous polyps (OR = 16.2, 95%: 3.66-71.6; p < .05). There was no significant difference in the incidence of high-grade adenomas or adenocarcinomas in the two population groups, but the numbers of these lesions were insufficient to permit firm conclusions. No significant differences in incidence, number, and pathology of colorectal polyps between individuals with melanosis coli of three different grades of severity were found. Melanosis located predominantly in the right colon had an interestingly lower incidence of colonic polyps in right colon than did melanosis located predominantly in the left colon or total colon (8.9% vs. 26.3%, 24.0%, p < 0.05). Patients with melanosis coli had significantly more nonspecific distal ileal ulcers than did controls (8.0% vs 0%, p < 0.001).Melanosis coli is associated with a higher incidence and number of colonic non-adenoma polyps and low-grade adenomas, and higher incidence of distal ileal ulcers. Melanosis coli may not be a harmless pigmentation, but a sign of chronic injury of colonic and intestinal mucosa

Melanosis coli: Harmless pigmentation? A case-control retrospective study of 657 cases

<div><p>Backgrounds and aims</p><p>The association of melanosis coli with the development of colorectal polyps remains uncertain.</p><p>Methods</p><p>From a total of 18263 patients who had received colonoscopy in our hospital, 219 with melanosis coli cases and 438 controls matched by age and sex (at 1:2 ratio) were included in this study. The association of incidence, number, location, and pathology of colorectal neoplasm with grades and distribution of melanosis coli were analyzed.</p><p>Results</p><p>Melanosis coli was associated with significantly more colorectal polyps than control, a higher incidence of numerous colorectal polyps (number ≥ 20) (7.3% vs 0.5%; p < 0.001), and higher number of small colorectal polyps (diameter ≤ 5 mm; p < 0.01). Patients with melanosis coli had higher incidences of low-grade adenomas (31.1% vs 23.3%, p < 0.05) and non-adenoma polyps (20.1% vs 12.8%, p < 0.05) than the controls. On multivariate analysis, melanosis coli was independently associated with increased detecting rates of low grade adenoma (OR = 1.54; 95%: 1.06–2.23; p < .05), non-adenoma polyp (OR = 1.72; 95%: 1.11–2.70; p < .05) and numerous polyps (OR = 16.2, 95%: 3.66–71.6; p < .05). There was no significant difference in the incidence of high-grade adenomas or adenocarcinomas in the two population groups, but the numbers of these lesions were insufficient to permit firm conclusions. No significant differences in incidence, number, and pathology of colorectal polyps between individuals with melanosis coli of three different grades of severity were found. Melanosis located predominantly in the right colon had an interestingly lower incidence of colonic polyps in right colon than did melanosis located predominantly in the left colon or total colon (8.9% vs. 26.3%, 24.0%, p < 0.05). Patients with melanosis coli had significantly more nonspecific distal ileal ulcers than did controls (8.0% vs 0%, p < 0.001).</p><p>Conclusion</p><p>Melanosis coli is associated with a higher incidence and number of colonic non-adenoma polyps and low-grade adenomas, and higher incidence of distal ileal ulcers. Melanosis coli may not be a harmless pigmentation, but a sign of chronic injury of colonic and intestinal mucosa.</p></div

Association of melanosis coli with detecting rates of colonic polyps of different histological types.

<p>Association of melanosis coli with detecting rates of colonic polyps of different histological types.</p

Multivariate analysis of risk factors for development of colonic polyps.

<p>Multivariate analysis of risk factors for development of colonic polyps.</p

Melanosis coli of different grades and distal ileum ulcer.

<p>(A), (B): Melanosis coli Grade I, macroscopically appearing as light brown colonic mucosa, without clear boundary with normal mucosa (C), (D): Melanosis coli Grade II, macroscopically appearing as brown colonic mucosa, with clear linear or non-continuous boundary with normal mucosa. (E), (F): Melanosis coli Grade III, macroscopically appearing as dark black colonic mucosa with linear or spotted boundary with normal mucosa (G), (H): Distal ileum ulcers endoscopically discovered at six patients suffering from melanosis coli. The ulcers were multiple, small, and superficial, and mucosa around the ulcers seems normal. Pathology of the ulcers was all nonspecific inflammation.</p

Melanosis coli was associated with a significantly increased incidence of distal ileum ulcer.

<p>Melanosis coli was associated with a significantly increased incidence of distal ileum ulcer.</p

Demographics of patients and control subjects and characteristics of melanosis coli.

<p>Demographics of patients and control subjects and characteristics of melanosis coli.</p

Melanosis coli was associated with a significantly increased incidence of numerous polyps (≥20).

<p>Melanosis coli was associated with a significantly increased incidence of numerous polyps (≥20).</p