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[The effects of sulindac on the pathology of colorectal remnant polyps of familial adenomatous polyposis (FAP) patients].

OBJECTIVE
To evaluate the long-term effectiveness of sulindac on the pathology of colorectal adenomas of familial adenomatous polyposis (FAP) patients.


METHODS
FAP patients were treated with sulindac 400 mg per day. The change of colorectal polyps was assessed every 3 months in the first year. After the significant regression of colorectal polyps was achieved, sulindac was used to maintain the effects. The patients received colonoscopy examination regularly. Biopsies of remnant polyps and other lesions were obtained. The type and dysplasia grade of biopsies were evaluated and compared with baseline.


RESULTS
Before the study, 90.8% of adenoma biopsies were tubular, while 9.2% was tubulovillous adenoma. The dysplasia of grades I, II and III were 42.1%, 45.6% and 12.3%, respectively. After sulindac treatment, 99.8% of adenoma biopsies were tubular, while 0.2% tubulovillous adenoma. There was significant difference compared with baseline (P<0.01). The dysplasia of grades I, II and III were 55.8%, 41.8% and 2.4% respectively, which had significant difference with baseline (P<0.01). Minor flat elevation and erythema were found during the treatment, in which approximately 65% was adenoma.


CONCLUSION
Long-term use of sulindac seems to be effective in reducing dysplasia grade and tubulovillous adenoma of retained colorectal adenoma of FAP patients. Minor flat elevation and erythema may be the lesions appearing during the regression of adenoma.