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URL: https://dx.doi.org/10.17504/protocols.io.j6rcrd6

Authors: Zhong Hui LIU, Dominic Chi Chung Foo, Wai Lun LAW, Fion Siu Yin CHAN, Joe King Man FAN, Jun Sheng PENG

Summary: Backgrounds and aims: The association of melanosis coli with the development ofcolorectal polyps remains uncertain.Methods: 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, andpathology of colorectal neoplasm with grades and distribution of melanosis coli wereanalyzed.Results: Melanosis coli was associated with significantly more colorectal polyps thancontrol, a higher incidence of numerous colorectal polyps (number ≥ 20) (7.3% vs0.5%; p 0.01). Patients with melanosis coli had higher incidences of low-grade adenomas(31.1% vs 23.3%, p the controls. On multivariate analysis, melanosis coli was independently associatedwith 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 (OR = 16.2, 95%: 3.66-71.6; p incidence of high-grade adenomas or adenocarcinomas in the two population groups,but the numbers of these lesions were insufficient to permit firm conclusions. Nosignificant differences in incidence, number, and pathology of colorectal polypsbetween individuals with melanosis coli of three different grades of severity were found.Melanosis located predominantly in the right colon had an interestingly lower incidenceof colonic polyps in right colon than did melanosis located predominantly in the leftcolon or total colon (8.9% vs. 26.3%, 24.0%, p had significantly more nonspecific distal ileal ulcers than did controls (8.0% vs 0%, p 0.001).Conclusion: Melanosis coli is associated with a higher incidence and number of colonicnon-adenoma polyps and low-grade adenomas, and higher incidence of distal ilealulcers. Melanosis coli may not be a harmless pigmentation, but a sign of chronic injuryof colonic and intestinal mucosa.

Associated Publications: Liu ZH, Foo DCC, Law WL, Chan FSY, Fan JKM, Peng JS (2017) Melanosis coli: Harmless pigmentation? A case-control retrospective study of 657 cases. PLoS ONE 12(10): e0186668. doi: 10.1371/journal.pone.0186668

Affiliations: The University of Hong Kong-Shenzhen Hospital, Shenzhen, China, The University of Hong Kong, HKSAR, China, The University of Hong Kong, HKSAR, China, The University of Hong Kong, HKSAR, China, The University of Hong Kong, HKSAR, China, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China

External URL: https://doi.org/10.1371/journal.pone.0186668

Version: 1

Publication Date: 2017

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