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. 1983 Nov;24(11):1048–1056. doi: 10.1136/gut.24.11.1048

Epithelial cell proliferation in the rectal stump of patients with ileorectal anastomosis for ulcerative colitis.

T Lehy, M Mignon, J L Abitbol
PMCID: PMC1420104  PMID: 6629115

Abstract

Epithelial cell proliferation in the rectal stump after ileorectal anastomosis for ulcerative colitis was studied in 19 patients. This was achieved through in vitro incorporation of tritiated thymidine in mucosal biopsies and radioautographic analysis of the number and position of labelled nuclei in the crypts. Rectal biopsies from nine unoperated patients with ulcerative colitis and from 10 controls, were processed simultaneously. Except for one, all patients were clinically in remission. The crypt length and number of labelled cells per crypt column were found to be similar in the rectal mucosa from the three groups of subjects. The mean labelling index, although low 8.9%, was higher (p less than 0.05) in operated patients compared with controls; but the dispersion of individual values was similar in both groups. There was an extension of the proliferative compartment towards the surface in 88% of unoperated patients and in 60% of operated patients. In addition, there was a shift of the major zone of proliferation from the lower to the middle third of the crypt in 17% of operated patients and from the lower to the upper third of the crypt in 14% of unoperated patients. No correlation was found between the labelling index and either the age of patient, the duration of disease or the period elapsed after ileorectal anastomosis. Interestingly, among operated patients with a colitis for over 10 years, 42% had a quite normal proliferative pattern with a corresponding mean postoperative period of 7.5 years.

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Selected References

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  1. AYLETT S. O. Diffuse ulcerative colitis and its treatment by ileo-rectal anastomosis. Ann R Coll Surg Engl. 1960 Oct;27:260–284. [PMC free article] [PubMed] [Google Scholar]
  2. Alpers D. H., Philpott G., Grimme N. L., Margolis D. M. Control of thymidine incorporation in mucosal explants from patients with chronic ulcerative colitis. Gastroenterology. 1980 Mar;78(3):470–478. [PubMed] [Google Scholar]
  3. BARON J. H., CONNELL A. M., LENNARD-JONES J. E. VARIATION BETWEEN OBSERVERS IN DESCRIBING MUCOSAL APPEARANCES IN PROCTOCOLITIS. Br Med J. 1964 Jan 11;1(5375):89–92. doi: 10.1136/bmj.1.5375.89. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Baker W. N., Glass R. E., Ritchie J. K., Aylett S. O. Cancer of the rectum following colectomy and ileorectal anastomosis for ulcerative colitis. Br J Surg. 1978 Dec;65(12):862–868. doi: 10.1002/bjs.1800651211. [DOI] [PubMed] [Google Scholar]
  5. Bleiberg H., Mainguet P., Galand P., Chretien J., Dupont-Mairesse N. Cell renewal in the human rectum. In vitro autoradiographic study on active ulcerative colitis. Gastroenterology. 1970 Jun;58(6):851–855. [PubMed] [Google Scholar]
  6. Bransom C. J., Boxer M. E., Palmer K. R., Clark J. C., Underwood J. C., Duthie H. L. Mucosal cell proliferation in duodenal ulcer and duodenitis. Gut. 1981 Apr;22(4):277–282. doi: 10.1136/gut.22.4.277. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. De Dombal F. T., Watts J. M., Watkinson G., Goligher J. C. Local complications of ulcerative colitis: stricture, pseudopolyposis, and carcinoma of colon and rectum. Br Med J. 1966 Jun 11;1(5501):1442–1447. doi: 10.1136/bmj.1.5501.1442. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Deschner E. E., Lipkin M. Proliferative patterns in colonic mucosa in familial polyposis. Cancer. 1975 Feb;35(2):413–418. doi: 10.1002/1097-0142(197502)35:2<413::aid-cncr2820350217>3.0.co;2-b. [DOI] [PubMed] [Google Scholar]
  9. Eastwood G. L., Trier J. S. Epithelial cell renewal in cultured rectal biopsies in ulcerative colitis. Gastroenterology. 1973 Mar;64(3):383–390. [PubMed] [Google Scholar]
  10. Eastwood G. L., Trier J. S. Organ culture of human rectal mucosa. Gastroenterology. 1973 Mar;64(3):375–382. [PubMed] [Google Scholar]
  11. Galand P., Mainguet P., Arguello M., Chretien J., Douxfils N. In vitro autoradiographic studies of cell proliferation in the gastrointestinal tract of man. J Nucl Med. 1968 Jan;9(1):37–39. [PubMed] [Google Scholar]
  12. Glotzer D. J., Glick M. E., Goldman H. Proctitis and colitis following diversion of the fecal stream. Gastroenterology. 1981 Mar;80(3):438–441. [PubMed] [Google Scholar]
  13. Greenstein A. J., Sachar D. B., Smith H., Pucillo A., Papatestas A. E., Kreel I., Geller S. A., Janowitz H. D., Aufses A. H., Jr Cancer in universal and left-sided ulcerative colitis: factors determining risk. Gastroenterology. 1979 Aug;77(2):290–294. [PubMed] [Google Scholar]
  14. Grundfest S. F., Fazio V., Weiss R. A., Jagelman D., Lavery I., Weakley F. L., Turnbull R. B., Jr The risk of cancer following colectomy and ileorectal anastomosis for extensive mucosal ulcerative colitis. Ann Surg. 1981 Jan;193(1):9–14. doi: 10.1097/00000658-198101000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Hughes E. S., McDermott F. T., Masterton J. P. Ileorectal anastomosis for inflammatory bowel disease: 15-year follow-up. Dis Colon Rectum. 1979 Sep;22(6):399–400. doi: 10.1007/BF02586908. [DOI] [PubMed] [Google Scholar]
  16. Lennard-Jones J. E., Morson B. C., Ritchie J. K., Shove D. C., Williams C. B. Cancer in colitis: assessment of the individual risk by clinical and histological criteria. Gastroenterology. 1977 Dec;73(6):1280–1289. [PubMed] [Google Scholar]
  17. Lipkin M., Bell B., Sherlock P. CELL PROLIFERATION KINETICS IN THE GASTROINTESTINAL TRACT OF MAN. I. CELL RENEWAL IN COLON AND RECTUM. J Clin Invest. 1963 Jun;42(6):767–776. doi: 10.1172/JCI104769. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Lipkin M. Phase 1 and phase 2 proliferative lesions of colonic epithelial cells in diseases leading to colonic cancer. Cancer. 1974 Sep;34(3):suppl–suppl:888. doi: 10.1002/1097-0142(197409)34:3+<878::aid-cncr2820340715>3.0.co;2-r. [DOI] [PubMed] [Google Scholar]
  19. Loygue J., Lévy E., Malafosse M., Parc R., Huguet C. Faut-il conserver le rectum lors du traitement chirurgical de la rectocolite ulcéro-hémorragique? Gastroenterol Clin Biol. 1981 Dec;5(12):1146–1154. [PubMed] [Google Scholar]
  20. Maskens A. P., Deschner E. E. Tritiated thymidine incorporation into epithelial cells of normal-appearing colorectal mucosa of cancer patients. J Natl Cancer Inst. 1977 May;58(5):1221–1224. doi: 10.1093/jnci/58.5.1221. [DOI] [PubMed] [Google Scholar]
  21. Mignon M., Bonnefond A., Vilotte J., Soullard J., Potet F., Lambling A., Bonfils S. Les indications de la conservation du rectum dans les colectomies pour rectocolite hémorragique. Arch Fr Mal App Dig. 1974 Oct-Nov;63(7):541–553. [PubMed] [Google Scholar]
  22. Morson B. C., Pang L. S. Rectal biopsy as an aid to cancer control in ulcerative colitis. Gut. 1967 Oct;8(5):423–434. doi: 10.1136/gut.8.5.423. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Nugent F. W., Haggit R. C., Colcher H., Kutteruf G. C. Malignant potential of chronic ulcerative colitis. Preliminary report. Gastroenterology. 1979 Jan;76(1):1–5. [PubMed] [Google Scholar]
  24. Ribet M., wurtz A., Paris J. C., Quandalle P., Debaert M., crinquette J. F., Chambon J. P. La conservation du rectum dans la chirurgie de la recto-colite hémorragique. (Etude à long terme de 73 opérés). Gastroenterol Clin Biol. 1981 Dec;5(12):1140–1145. [PubMed] [Google Scholar]
  25. Serafini E. P., Kirk A. P., Chambers T. J. Rate and pattern of epithelial cell proliferation in ulcerative colitis. Gut. 1981 Aug;22(8):648–652. doi: 10.1136/gut.22.8.648. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Shorter R. G., Spencer R. J., Hallenbeck G. A. Kinetic studies of the epithelial cells of the rectal mucosa in normal subjects and patients with ulcerative colitis. Gut. 1966 Dec;7(6):593–596. doi: 10.1136/gut.7.6.593. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Spencer R. J., Huizenga K. A., Hammer C. S., Shorter R. G. Further studies of the kinetics of rectal epithelium in normal subjects and patients with ulcerative or granulomatous colitis. Dis Colon Rectum. 1969 Nov-Dec;12(6):406–408. doi: 10.1007/BF02617722. [DOI] [PubMed] [Google Scholar]
  28. Vissuzaine C., Danne O., Jouglen J., Soullard J., Mignon M. Les lésions histologiques du rectum restant après anastomose iléo-rectale pour recto-colite hémorragique. Méthodes d'analyses et interprétation des résultats dans la surveillance à long terme. Gastroenterol Clin Biol. 1979 Aug-Sep;3(8-9):631–636. [PubMed] [Google Scholar]

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