Mucin Abnormalities in the Radiation-Damaged Colon

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Abstract
Patients receiving abdominal or pelvic radiotherapy are at increased risk of developing colorectal carcinoma. In the presence of colonic carcinomas, there is a change in colonic mucus from normal sulphomucin to sialomucin. This also occurs during experimental carcinogenesis and is associated with the dysplastic changes of chronic ulcerative colitis. Twenty-six patients with radiation colitis were compared with 20 controls. All patients had received radiation for genito-urinary malignancy. There were 22 women and 4 men (median age 55 years). Biopsies were taken from 20 resected specimens, 5 sigmoidoscopic biopsies and 1 colonoscopic procedure. The specimens were examined by conventional and histochemical techniques for the presence of sialomucin. Neither sialomucin nor dysplasia were demonstrated in the control group. In the radiation group, there was no evidence of sialomucin in 8 cases, a mixed pattern in 9 cases and a positive reaction in 9. Dysplasia was seen in 2 of 8 patients with no sialomucin, 4 of 9 with a mixed pattern and 7 of the 9 showing a positive reaction. Four patients with recurrent squamous cell carcinomas for which the colon had been excised showed no evidence of sialomucin or dysplasia. Sialomucin and dysplasia appear in the radiation-damaged colon significantly more often than in controls (p

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