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Frontline Gastroenterology 2020Colorectal cancer (CRC) is the second leading cause of death from cancer in the UK. Sporadic CRC evolves by the cumulative effect of genetic and epigenetic alterations.... (Review)
Review
Colorectal cancer (CRC) is the second leading cause of death from cancer in the UK. Sporadic CRC evolves by the cumulative effect of genetic and epigenetic alterations. Typically, over the course of several years, this leads to the transformation of normal colonic epithelium to benign adenomatous polyp, low-grade to high-grade dysplasia and finally cancer-the adenoma-carcinoma sequence. Over the last decade, the serrated neoplasia pathway which progresses by methylation of tumour suppressing genes has been increasingly recognised as an important alternative pathway accounting for up to 30% of CRC cases. Endoscopists should be aware of the unique features of serrated lesions so that their early detection, appropriate resection and surveillance interval can be optimised.
PubMed: 32419916
DOI: 10.1136/flgastro-2018-101153 -
Cancer Control : Journal of the Moffitt... 2023There are few clinical symptoms in early colorectal cancer, so it is necessary to find a simple and economical tumor detection index for auxiliary diagnosis. This study...
BACKGROUND
There are few clinical symptoms in early colorectal cancer, so it is necessary to find a simple and economical tumor detection index for auxiliary diagnosis. This study aims to explore the diagnostic value of preoperative inflammation-related indicators, such as neutrophil, lymphocyte, platelet count, platelet to lymphocyte ratio (PLA), neutrophil to lymphocyte ratio (NLR), and systemic immune-inflammation index (SII), for early colorectal cancer, and determine whether inflammation-related indicators can provide more accurate diagnostic judgment for patients.
METHODS
This study was a retrospective study. Patients who were first diagnosed with colorectal cancer or colorectal adenomatous polyp at Beijing Friendship Hospital from October 2016 to October 2017 were retrospectively collected. According to inclusion and exclusion criteria, a total of 342 patients were included, including 216 patients with colorectal cancer and 126 patients with colorectal adenomatous polyp. Fasting venous blood and other clinical features were collected to compare the differences between colorectal cancer and colorectal adenoma.
RESULTS
There were statistically significant differences in age, carcinoembryonic antigen, albumin, hemoglobin, mean platelet volume, lymphocyte, monocyte, NLR, PLA, SII, and mean platelet volume to platelet count ratio between colorectal cancer group and colorectal adenoma group ( < .05), and a Nomogram model was established. Using inflammatory markers to differentiate colorectal and colorectal polyps produced greater AUC than using tumor markers alone (.846 vs .695).
CONCLUSION
Inflammation-related indicators, such as lymphocyte, monocyte, and mean platelet volume, may serve as potential indicators to assist in the diagnosis of early colorectal cancer.
Topics: Humans; Retrospective Studies; Colorectal Neoplasms; Colonic Neoplasms; Adenomatous Polyps; Lymphocytes; Adenoma; Rectal Neoplasms; Inflammation; Polyesters
PubMed: 37421141
DOI: 10.1177/10732748231180745 -
Healthcare (Basel, Switzerland) Aug 2022Colorectal cancer is the leading cause of cancer-associated morbidity and mortality worldwide. One of the causes of developing colorectal cancer is untreated colon...
Colorectal cancer is the leading cause of cancer-associated morbidity and mortality worldwide. One of the causes of developing colorectal cancer is untreated colon adenomatous polyps. Clinically, polyps are detected in colonoscopy and the malignancies are determined according to the biopsy. To provide a quick and objective assessment to gastroenterologists, this study proposed a quantitative polyp classification via various image features in colonoscopy. The collected image database was composed of 1991 images including 1053 hyperplastic polyps and 938 adenomatous polyps and adenocarcinomas. From each image, textural features were extracted and combined in machine learning classifiers and machine-generated features were automatically selected in deep convolutional neural networks (DCNN). The DCNNs included AlexNet, Inception-V3, ResNet-101, and DenseNet-201. AlexNet trained from scratch achieved the best performance of 96.4% accuracy which is better than transfer learning and textural features. Using the prediction models, the malignancy level of polyps can be evaluated during a colonoscopy to provide a rapid treatment plan.
PubMed: 36011151
DOI: 10.3390/healthcare10081494 -
World Journal of Gastroenterology Mar 2015In recent years, a second pathway for colonic carcinogenesis, distinct from the adenomatous pathway, has been explored. This is referred to as serrated pathway and... (Review)
Review
In recent years, a second pathway for colonic carcinogenesis, distinct from the adenomatous pathway, has been explored. This is referred to as serrated pathway and includes three types of polyp, characterised by a serrated appearance of the crypts: hyperplastic polyps (HP), sessile serrated adenomas (SSA) or lesions, and traditional serrated adenomas. Each lesion has its own genetic, as well as macroscopic and microscopic morphological features. Because of their flat aspect, their detection is easier with chromoendoscopy (carmin indigo or narrow-band imaging). However, as we show in this review, the distinction between SSA and HP is quite difficult. It is now recommended to resect in one piece as it is possible the serrated polyps with a control in a delay depending on the presence or not of dysplasia. These different types of lesion are described in detail in the present review in general population, in polyposis and in inflammatory bowel diseases patients. This review highlights the need to improve characterization and understanding of this way of colorectal cancerogenesis.
Topics: Adenomatous Polyps; Chromogenic Compounds; Colonic Neoplasms; Colonic Polyps; Colonoscopy; Diagnosis, Differential; Humans; Hyperplasia; Microscopy; Narrow Band Imaging; Precancerous Conditions; Predictive Value of Tests; Prognosis
PubMed: 25780286
DOI: 10.3748/wjg.v21.i10.2896 -
World Journal of Gastroenterology Nov 2014Familial adenomatous polyposis (FAP) is an autosomal dominant inherited syndrome characterized by multiple adenomatous polyps (predisposing to colorectal cancer... (Review)
Review
Familial adenomatous polyposis (FAP) is an autosomal dominant inherited syndrome characterized by multiple adenomatous polyps (predisposing to colorectal cancer development) and numerous extracolonic manifestations. The underlying genetic burden generates variable clinical features that may influence operative management. As a precancerous hereditary condition, the rationale of performing a prophylactic surgery is a mainstay of FAP management. The purpose of the present paper is to bring up many controversial aspects regarding surgical treatment for FAP, and to discuss the results and perspectives of the operative choices and approaches. Preferably, the decision-making process should not be limited to the conventional confrontation of pros and cons of ileorectal anastomosis or restorative proctocolectomy. A wide discussion with the patient may evaluate issues such as age, genotype, family history, sphincter function, the presence or risk of desmoid disease, potential complications of each procedure and chances of postoperative surveillance. Therefore, the definition of the best moment and the choice of appropriate procedure constitute an individual decision that must take into consideration patient's preferences and full information about the complex nature of the disease. All these facts reinforce the idea that FAP patients should be managed by experienced surgeons working in specialized centers to achieve the best immediate and long-term results.
Topics: Adenomatous Polyposis Coli; Colectomy; Humans; Patient Selection; Risk Assessment; Risk Factors; Treatment Outcome
PubMed: 25469031
DOI: 10.3748/wjg.v20.i44.16620 -
Cancer Prevention Research... Apr 2022Why celecoxib exerts chemopreventive activity in only some familial adenomatous polyposis (FAP) patients remains poorly understood. We conducted a phase II clinical...
UNLABELLED
Why celecoxib exerts chemopreventive activity in only some familial adenomatous polyposis (FAP) patients remains poorly understood. We conducted a phase II clinical study to identify potential predictive biomarkers for celecoxib chemopreventive activity in FAP. Twenty-seven patients with FAP completed a 6-month oral course of 400 mg of celecoxib twice a day; they underwent colonoscopies before and after celecoxib treatment to assess colorectal polyp tumor burden and to obtain normal and polyp colorectal biopsies to measure celecoxib, 13-S-hydroxyoctadecadienoic acid (13-HODE), 15-HETE, 12-HETE, and LTB4 levels by LC/MS-MS. Celecoxib levels in sera from those patients were also measured before treatment and after 2, 4, and 6 months of treatment. Nineteen of the 27 patients experienced a response to celecoxib, with a ≥ 28% reduction of colonic polyp burden on the basis of a reproducible quantitative assessment of colonoscopy results. Celecoxib levels were significantly lower in polyp tissues than in normal colorectal tissues. Celecoxib levels in sera and normal colorectal tissues were correlated in patients who experienced a response to celecoxib but not in those who did not. Among the measured lipoxygenase products, only 13-HODE levels were significantly lower in polyp tissues than in normal tissues. Our findings demonstrate the differential bioavailability of celecoxib between normal and polyp tissues and its potential effects on clinical response in patients with FAP.
PREVENTION RELEVANCE
This study evaluated potential predictive biomarkers for celecoxib chemopreventive activity in patients with FAP. Our findings demonstrated the differential bioavailability of celecoxib between normal and polyp tissues and its potential effects on clinical chemopreventive response in patients with FAP. See related Spotlight, p. 205.
Topics: Adenomatous Polyposis Coli; Biological Availability; Celecoxib; Humans; Pyrazoles; Sulfonamides
PubMed: 34610992
DOI: 10.1158/1940-6207.CAPR-21-0066 -
Surgical Laparoscopy, Endoscopy &... Apr 2023Colorectal cancer primarily arises from colorectal polyps. Early screening and removal is beneficial, especially in asymptomatic populations. This research aimed to...
BACKGROUND
Colorectal cancer primarily arises from colorectal polyps. Early screening and removal is beneficial, especially in asymptomatic populations. This research aimed to reveal the risk factors detected in medical check-ups for colorectal polyps in asymptomatic people.
MATERIALS AND METHODS
Clinical data of 933 asymptomatic people who underwent colonoscopies from May 2014 to December 2021 was analyzed retrospectively. Data included sex, age, colonoscopy findings, polyp pathology, polyp number, and blood test results. The distribution of colorectal lesions was analyzed. Participants were divided into control and polyp groups, adenomatous and non-adenomatous polyp groups, and single and multiple adenoma groups.
RESULTS
Participants' age, proportion of males, carcinoembryonic antigen (CEA), uric acid and glycosylated hemoglobin levels were significantly higher ( P ≤0.05) in the polyp group. Age (>40 y), sex (male), and CEA level (>1.435 ng/mL) were independent risk factors for polyps. CEA, uric acid, carbohydrate antigen 19-9, triglyceride, and total cholesterol levels were significantly higher ( P <0.05) in the adenoma group than in the non-adenomatous group. CEA level (>1.435 ng/mL) was an independent predictor for adenomas ( P <0.05). Participants' age, proportion of males, CEA, glycosylated hemoglobin, and fasting blood glucose levels were significantly higher ( P <0.05) in the multiple adenoma group than in the single group; the high-density lipoprotein cholesterol level was lower ( P <0.05). No independent risk factors were found for the number of adenomas.
CONCLUSIONS
Serum CEA level (>1.435 ng/mL) was independent risk factor for colorectal polyps. It may be conducive to improve discriminative ability of colorectal cancer risk stratification model.
Topics: Humans; Male; Colonic Polyps; Carcinoembryonic Antigen; Retrospective Studies; Colorectal Neoplasms; Uric Acid; Glycated Hemoglobin; Colonoscopy; Adenoma; Cholesterol
PubMed: 36847698
DOI: 10.1097/SLE.0000000000001152 -
BMC Medical Genomics Jun 2022As a well-known protein, Bid links the extrinsic and intrinsic apoptotic pathways and plays important roles in cell proliferation. In this study, we evaluated the...
BACKGROUND
As a well-known protein, Bid links the extrinsic and intrinsic apoptotic pathways and plays important roles in cell proliferation. In this study, we evaluated the expression of two isoforms of the Bid gene (BidSi6 and BidEL) in colorectal adenomatous polyps as a biomarker and investigated the relationship between their expression levels with clinicopathological factors.
METHODS
The expression of BidSi6 and BidEL isoforms in 22 pairs of Adenomatous polyps and adjust non-polyp tissues was measured by qReal-Time PCR and compared with 10 normal colon tissues. ROC curve was performed to examine the diagnostic capacity. Also, sequencing was performed for molecular identification of BidSi6 isoform in adenomatous polyp.
RESULTS
Our results showed that BidSi6 and BidEL isoforms were significantly overexpressed in Adenomatous polyps and non-polyp adjacent tissues from the same patients compared to that in normal colon tissues, but there was no significant expression between polyps and adjust non-polyp tissues. There were no significant correlations between the expression of two isoforms and other features of clinicopathology. The area under the curve of BidSi6 and BidEL isoforms indicated powerful diagnostic capability. The phylogenetic tree was constructed based on the sequence of idSi6 isoform, and the results showed that adenomatous polyp tissue and adjust non-polyp tissue were separated from healthy colorectal tissue and reference sequence (EU678292).
CONCLUSIONS
These findings suggest that BidSi6 and BidEL isoforms can be used as new potential biomarkers in adenomatous polyps.
Topics: Adenomatous Polyps; Biomarkers; Colorectal Neoplasms; Humans; Phylogeny; Protein Isoforms
PubMed: 35668495
DOI: 10.1186/s12920-022-01282-0 -
Medical Science Monitor : International... Nov 2016BACKGROUND The aim of our study was to evaluate all lesions in the adenoma-dysplasia-cancer sequence of the colon and to examine whether the neutrophil-to-lymphocyte...
BACKGROUND The aim of our study was to evaluate all lesions in the adenoma-dysplasia-cancer sequence of the colon and to examine whether the neutrophil-to-lymphocyte ratio (NLR) can distinguish polyps indicating dysplasia and cancer. MATERIAL AND METHODS A total of 397 patients who had colonoscopic polypectomy between January 2010 and December 2014 were included in our retrospective study. The patients were divided into four groups: patients with hyperplastic polyps, patients with adenomatous polyps, patients with dysplasia, and patients with cancer. The NLR was calculated as a simple ratio indicating the relationship between counts of absolute neutrophil and absolute lymphocyte. RESULTS The NLR increased in line with the adenomatous polyp-dysplasia-cancer sequence, with the highest ratio established among cancer patients (2.05 (0.27-10), 2.34 (0.83-14.70) and 3.25 (0.81-10.0), respectively). The NLR was significantly higher among cancer patients than among patients with adenomatous polyps and hyperplastic polyps (p values were 0.001 and 0.004, respectively). The lymphocyte count of cancer patients was prominently lower when compared to those in groups with adenomatous polyps and hyperplastic polyps (p values were 0.001 and 0.003, respectively). The NLR was found to be significantly higher in patients with polyps larger than 10 mm [2.71 (0.90-14.70)] when compared to those with polyps smaller than 10 mm [2.28 (0.27-11.67)] (p<0.001). With the NLR threshold set at 2.20, it was possible to predict cancerous polyps with a sensitivity of 71.4% and a specificity of 52.5% (AUC: 0.665, 95% CI: 0.559-0.772, p=0.001). CONCLUSIONS NLR is a cheap, universally available, simple and reliable test that can help predict cancerous polyps. It can be used as a non-invasive test for monitoring polyps.
Topics: Adenoma; Adenomatous Polyps; Adolescent; Adult; Aged; Aged, 80 and over; Colonic Polyps; Colonoscopy; Colorectal Neoplasms; Female; Humans; Lymphocytes; Male; Middle Aged; Neutrophils; Predictive Value of Tests; Retrospective Studies; Young Adult
PubMed: 27881836
DOI: 10.12659/msm.898879 -
Acta Gastro-enterologica Belgica 2020In childhood, clinical presentation of intes- tinal polyps is variable. Painless rectal red blood loss is the most common presenting sign. Most polyps are sporadic,...
BACKGROUND/AIMS
In childhood, clinical presentation of intes- tinal polyps is variable. Painless rectal red blood loss is the most common presenting sign. Most polyps are sporadic, isolated and benign. However, it is important to correctly identify exceptions. Rare inherited polyposis syndromes need to be recognized because of their increased risk of intestinal and extra-intestinal malignancies. Furthermore, a correct diagnosis and treatment of rare gastro-intestinal malignancies is crucial.
METHODS
Between 2016 and 2018 we encountered 4 different types of intestinal polyps. A database search was performed and patient files were checked for clinical manifestations and histo- pathology. Literature was searched to recapitulate red flags for these syndromes, probability of underlying genetic disorders and diagnostic criteria.
RESULTS
Between 2016 and 2018, 28 patients presented at the Ghent University Hospital with 30 juvenile polyps. Furthermore, we diagnosed juvenile polyposis syndrome, Li Fraumeni syndrome and familial adenomatous polyposis (FAP) in 1 patient each, whilst 2 FAP patients were in follow-up. Each of these diagnoses has a different lifetime risk of (extra)-intestinal malignancy and requires a different approach and follow-up. Histopathology and genetic testing play an important role in identifying these syndromes in pediatric patients.
CONCLUSION
Although most intestinal polyps in childhood are benign juvenile polyps that require no follow-up, rare inherited syndromes should be considered and correctly diagnosed since adequate follow-up is necessary to reduce morbidity and mortality from both gastrointestinal and extraintestinal complications and malignancies.
Topics: Adenomatous Polyposis Coli; Adolescent; Child; Genetic Testing; Humans; Intestinal Polyposis; Intestinal Polyps
PubMed: 33094585
DOI: No ID Found