151
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Wong MCS, Chan CH, Cheung W, Fung DH, Liang M, Huang JLW, Wang YH, Jiang JY, Yu CP, Wang HH, Wu JCY, Chan FKL, Sung JJY. Association between investigator-measured body-mass index and colorectal adenoma: a systematic review and meta-analysis of 168,201 subjects. Eur J Epidemiol 2017; 33:15-26. [PMID: 29288474 PMCID: PMC5803281 DOI: 10.1007/s10654-017-0336-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 11/23/2017] [Indexed: 12/11/2022]
Abstract
The objective of this meta-analysis is to evaluate the odds of colorectal adenoma (CRA) in colorectal cancer screening participants with different body mass index (BMI) levels, and examine if this association was different according to gender and ethnicity. The EMBASE and MEDLINE were searched to enroll high quality observational studies that examined the association between investigator-measured BMI and colonoscopy-diagnosed CRA. Data were independently extracted by two reviewers. A random-effects meta-analysis was conducted to estimate the summary odds ratio (SOR) for the association between BMI and CRA. The Cochran’s Q statistic and I2 analyses were used to assess the heterogeneity. A total of 17 studies (168,201 subjects) were included. When compared with subjects having BMI < 25, individuals with BMI 25–30 had significantly higher risk of CRA (SOR 1.44, 95% CI 1.30–1.61; I2 = 43.0%). Subjects with BMI ≥ 30 had similarly higher risk of CRA (SOR 1.42, 95% CI 1.24–1.63; I2 = 18.5%). The heterogeneity was mild to moderate among studies. The associations were significantly higher than estimates by previous meta-analyses. There was no publication bias detected (Egger’s regression test, p = 0.584). Subgroup analysis showed that the magnitude of association was significantly higher in female than male subjects (SOR 1.43, 95% CI 1.30–1.58 vs. SOR 1.16, 95% CI 1.07–1.24; different among different ethnic groups (SOR 1.72, 1.44 and 0.88 in White, Asians and Africans, respectively) being insignificant in Africans; and no difference exists among different study designs. In summary, the risk conferred by BMI for CRA was significantly higher than that reported previously. These findings bear implications in CRA risk estimation.
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Affiliation(s)
- Martin Chi-Sang Wong
- Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China.,School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China
| | - Chun-Hei Chan
- School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China
| | - Wilson Cheung
- School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China
| | - Din-Hei Fung
- School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China
| | - Miaoyin Liang
- School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China
| | - Jason Li-Wen Huang
- School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China
| | - Yan-Hong Wang
- School of Basic Medicine, Peking Union Medical College and Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, 100050, China
| | - Johnny Yu Jiang
- Peking Union School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100050, China
| | - Chun-Pong Yu
- Li Ping Medical Library, Chinese University of Hong Kong, Shatin, HKSAR, China
| | - Harry Haoxiang Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Justin Che-Yuen Wu
- Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China.,Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China.,State Key Laboratory of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China
| | - Francis Ka-Leung Chan
- Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China.,Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China.,State Key Laboratory of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China
| | - Joseph Jao-Yiu Sung
- Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China. .,Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China. .,State Key Laboratory of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Shatin, China.
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152
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Research progression of blood and fecal metabolites in colorectal
cancer. INTERNATIONAL JOURNAL OF SURGERY: ONCOLOGY 2017. [DOI: 10.1097/ij9.0000000000000051] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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153
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Abdominal obesity and colorectal cancer risk: systematic review and meta-analysis of prospective studies. Biosci Rep 2017; 37:BSR20170945. [PMID: 29026008 PMCID: PMC5725611 DOI: 10.1042/bsr20170945] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 10/02/2017] [Accepted: 10/04/2017] [Indexed: 01/11/2023] Open
Abstract
The association between abdominal obesity (as measured by waist circumference (WC) and waist-to-hip ratio (WHR)) and colorectal cancer (CRC) has not been fully quantified, and the magnitude of CRC risk associated with abdominal obesity is still unclear. A meta-analysis of prospective studies was performed to elucidate the CRC risk associated with abdominal obesity. Pubmed and Embase were searched for studies assessing the association between abdominal obesity and CRC risk. Relative risks (RRs) with 95% confidence intervals (95% CIs) were pooled using random-effects model of meta-analysis. Nineteen prospective cohort studies from eighteen publications were included in this meta-analysis. A total of 12,837 CRC cases were identified among 1,343,560 participants. Greater WC and WHR were significantly associated with increased risk of total colorectal cancer (WC: RR 1.42, 95% CI 1.30, 1.55; WHR: RR 1.39, 95% CI 1.25, 1.53), colon cancer (WC: RR 1.53, 95% CI 1.36, 1.72; WHR: 1.39, 95% CI 1.18, 1.63), and rectal cancer (WC: RR 1.20, 95% CI 1.03, 1.39; WHR: RR 1.22, 95% CI 1.05, 1.42). Subgroup analyses further identified the robustness of the association above. No obvious risk of publication bias was observed. In summary, abdominal obesity may play an important role in the development of CRC.
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154
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Lin XH, Luo JC. Fecal immunochemical tests for surveillance of the colorectal neoplasia after polypectomy. ADVANCES IN DIGESTIVE MEDICINE 2017. [DOI: 10.1002/aid2.12119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Xi-Hsuan Lin
- National Yang-Ming University; School of Medicine; Taipei Taiwan
- Division of Gastroenterology & Hepatology Department of Medicine; Taipei Veterans General Hospital; Taipei Taiwan
| | - Jiing-Chyuan Luo
- National Yang-Ming University; School of Medicine; Taipei Taiwan
- Division of Gastroenterology & Hepatology Department of Medicine; Taipei Veterans General Hospital; Taipei Taiwan
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155
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Endoscopic Resection of Cecal Polyps Involving the Appendiceal Orifice: A KASID Multicenter Study. Dig Dis Sci 2017; 62:3138-3148. [PMID: 28936593 DOI: 10.1007/s10620-017-4760-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 09/08/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Endoscopic resection of polyps located at the appendiceal orifice (AO) is challenging, and the feasibility and outcomes of endoscopic resection for cecal polyps involving AO are unconfirmed. AIMS We evaluated the feasibility and outcomes of endoscopic resection for cecal polyps involving AO. METHODS In this retrospective, multicenter study involving nine tertiary referral centers, we evaluated 131 patients who underwent endoscopic resection for cecal polyps involving AO. RESULTS The median size of polyps resected was 10 mm (range 3-60 mm). Endoscopic mucosal resection, endoscopic piecemeal mucosal resection, and endoscopic submucosal dissection were performed in 75 (57.3%), 31 (23.7%), and 5 (3.8%) patients, respectively. The en bloc resection rate was 68.7%. Endoscopic complete resection was achieved in 123 lesions (93.9%). Intraprocedural and delayed bleeding occurred in 14 (10.7%) and three patients (2.3%), respectively, and perforation occurred in two patients (1.5%). Seven patients (5.3%) underwent additional surgery because of treatment failure or recurrence. Polyps of ≥20 mm in size showed significantly higher rates of perforation and additional surgery (p < 0.05), and a lower rate of en bloc resection (p < 0.005). Patients with polyps involving ≥75% of AO circumference exhibited a significantly lower rate of en bloc resection (p < 0.001), and significantly higher rates of surgery and recurrence (p < 0.05). Recurrence during follow-up occurred in 12 patients (15.6%); polyps involving ≥75% of AO circumference were an independent risk factor for recurrence. CONCLUSION Endoscopic resection of cecal polyps involving AO is safe and effective in select patients.
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156
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Chandrasinghe PC, Ediriweera DS, Hewavisenthi J, Kumarage SK, Fernando FR, Deen KI. Colorectal cancer burden and trends in a South Asian cohort: experience from a regional tertiary care center in Sri Lanka. BMC Res Notes 2017; 10:535. [PMID: 29084610 PMCID: PMC5663050 DOI: 10.1186/s13104-017-2869-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 10/24/2017] [Indexed: 11/18/2022] Open
Abstract
Objective Colorectal cancer (CRC) burden is increasing in the south Asian region due to the changing socio-economic landscape and population demographics. There is a lack of robust high quality data from this region in order to evaluate the disease pattern and comparison. Using generalized linear models assuming Poisson distribution and model fitting, authors describe the variation in the landscape of CRC burden along time since 1997 at a regional tertiary care center in Sri Lanka. Results Analyzing 679 patients, it is observed that both colon and rectal cancers have significantly increased over time (pre 2000—61, 2000 to 2004—178, 2005 to 2009—190, 2010 to 2014–250; P < 0.05). Majority of the cancers were left sided (82%) while 77% were rectosigmoid. Over 25% of all CRC were diagnosed in patients less than 50 years and the median age at diagnosis is < 62 years. Increasing trend is seen in the stage at presentation while 33% of the rectal cancers received neoadjuvant chemoradiation. Left sided preponderance, younger age at presentation and advanced stage at presentation was observed. CRC disease pattern in the South Asian population may vary from that observed in the western population which has implications on disease surveillance and treatment.
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Affiliation(s)
- P C Chandrasinghe
- Department of Surgery, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka.
| | - D S Ediriweera
- Centre for Health Informatics, Biostatistics and Epidemiology, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
| | - J Hewavisenthi
- Department of Pathology, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
| | - S K Kumarage
- Department of Surgery, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
| | - F R Fernando
- Department of Surgery, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
| | - K I Deen
- Department of Surgery, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
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157
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Zhang M, Mu TH. Contribution of different molecular weight fractions to anticancer effect of sweet potato protein hydrolysates by six proteases on HT-29 colon cancer cells. Int J Food Sci Technol 2017. [DOI: 10.1111/ijfs.13625] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Miao Zhang
- Laboratory of Food Chemistry and Nutrition Science, Institute of Food Science and Technology, Chinese Academy of Agricultural Sciences; Key Laboratory of Agro-Products Processing, Ministry of Agriculture; No. 2 Yuan Ming Yuan West Road, Haidian District, P.O. Box 5109 Beijing 100193 China
| | - Tai-Hua Mu
- Laboratory of Food Chemistry and Nutrition Science, Institute of Food Science and Technology, Chinese Academy of Agricultural Sciences; Key Laboratory of Agro-Products Processing, Ministry of Agriculture; No. 2 Yuan Ming Yuan West Road, Haidian District, P.O. Box 5109 Beijing 100193 China
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158
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Wu H, Wu R, Chen M, Li D, Dai J, Zhang Y, Gao K, Yu J, Hu G, Guo Y, Lin C, Li X. Comprehensive analysis of differentially expressed profiles of lncRNAs and construction of miR-133b mediated ceRNA network in colorectal cancer. Oncotarget 2017; 8:21095-21105. [PMID: 28177879 PMCID: PMC5400568 DOI: 10.18632/oncotarget.15045] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 01/09/2017] [Indexed: 01/15/2023] Open
Abstract
Background Growing evidence suggests that long non-coding RNAs (lncRNAs) play a key role in tumorigenesis. However, the mechanism remains largely unknown. Results Thousands of significantly dysregulated lncRNAs and mRNAs were identified by microarray. Furthermore, a miR-133b-meditated lncRNA-mRNA ceRNA network was revealed, a subset of which was validated in 14 paired CRC patient tumor/non-tumor samples. Gene set enrichment analysis (GSEA) results demonstrated that lncRNAs ENST00000520055 and ENST00000535511 shared KEGG pathways with miR-133b target genes. Materials and Methods We used microarrays to survey the lncRNA and mRNA expression profiles of colorectal cancer and para-cancer tissues. Gene Ontology (GO) and KEGG pathway enrichment analyses were performed to explore the functions of the significantly dysregulated genes. An innovate method was employed that combined analyses of two microarray data sets to construct a miR-133b-mediated lncRNA-mRNA competing endogenous RNAs (ceRNA) network. Quantitative RT-PCR analysis was used to validate part of this network. GSEA was used to predict the potential functions of these lncRNAs. Conclusions This study identifies and validates a new method to investigate the miR-133b-mediated lncRNA-mRNA ceRNA network and lays the foundation for future investigation into the role of lncRNAs in colorectal cancer.
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Affiliation(s)
- Hao Wu
- Department of Gastrointestinal Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P. R. China
| | - Runliu Wu
- Department of Gastrointestinal Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P. R. China
| | - Miao Chen
- Department of Gastrointestinal Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P. R. China
| | - Daojiang Li
- Department of Gastrointestinal Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P. R. China
| | - Jing Dai
- Department of Gastrointestinal Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P. R. China
| | - Yi Zhang
- Department of Gastrointestinal Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P. R. China
| | - Kai Gao
- Department of Gastrointestinal Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P. R. China
| | - Jun Yu
- Department of Gastrointestinal Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P. R. China
| | - Gui Hu
- Department of Gastrointestinal Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P. R. China
| | - Yihang Guo
- Department of Gastrointestinal Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P. R. China
| | - Changwei Lin
- Department of Gastrointestinal Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P. R. China
| | - Xiaorong Li
- Department of Gastrointestinal Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P. R. China
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159
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Kim HK, Lwin MO. Cultural Effects on Cancer Prevention Behaviors: Fatalistic Cancer Beliefs and Risk Optimism Among Asians in Singapore. HEALTH COMMUNICATION 2017; 32:1201-1209. [PMID: 27613075 DOI: 10.1080/10410236.2016.1214224] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Although culture is acknowledged as an important factor that influences health, little is known about cultural differences pertaining to cancer-related beliefs and prevention behaviors. This study examines two culturally influenced beliefs-fatalistic beliefs about cancer prevention, and optimistic beliefs about cancer risk-to identify reasons for cultural disparity in the engagement of cancer prevention behaviors. We utilized data from national surveys of European Americans in the United States (Health Information National Trends Survey 4, Cycle3; N = 1,139) and Asians in Singapore (N = 1,200) to make cultural comparisons. The odds of an Asian adhering to prevention recommendations were less than half the odds of a European American, with the exception of smoking avoidance. Compared to European Americans, Asians were more optimistic about their cancer risk both in an absolute and a comparative sense, and held stronger fatalistic beliefs about cancer prevention. Mediation analyses revealed that fatalistic beliefs and absolute risk optimism among Asians partially explain their lower engagement in prevention behaviors, whereas comparative risk optimism increases their likelihood of adhering to prevention behaviors. Our findings underscore the need for developing culturally targeted interventions in communicating cancer causes and prevention.
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Affiliation(s)
- Hye Kyung Kim
- a Wee Kim Wee School of Communication and Information , Nanyang Technological University
| | - May O Lwin
- a Wee Kim Wee School of Communication and Information , Nanyang Technological University
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160
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The role of socioeconomic and region disparity on colorectal cancer screening: what matters more in developing countries? Int J Colorectal Dis 2017; 32:1519-1520. [PMID: 28744625 DOI: 10.1007/s00384-017-2868-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/20/2017] [Indexed: 02/04/2023]
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161
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Impact of non-alcoholic fatty liver disease and smoking on colorectal polyps. Oncotarget 2017; 8:74927-74935. [PMID: 29088835 PMCID: PMC5650390 DOI: 10.18632/oncotarget.20462] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 07/25/2017] [Indexed: 12/19/2022] Open
Abstract
Objectives Non-alcoholic fatty liver disease (NAFLD) and smoking have similar mechanisms of promoting colorectal polyps. The potential link between NAFLD and smoking in men and colorectal polyps has not been adequately evaluated. The aim is to investigate this association. Methods A retrospective cross-sectional study was conducted on 2409 individuals undergoing a health check. Univariate and multivariate logistic regression were performed for analyzing the association between risk factors and colorectal polyps. Individuals were divided into four groups: Q1: NAFLD (-)/smoking (-); Q2: NAFLD (+)/smoking (-); Q3: NAFLD (-)/smoking (+); Q4: NAFLD (+)/smoking (+). Logistic analyses were used to explore associations for the whole study population and stratified groups. Results The prevalence of colorectal polyps was 38.8% in males, and that of colorectal polyps in smokers and individuals with NAFLD were 47.0% (428/911) and 42.9% (267/622), respectively. With Q1 as reference, subjects with NAFLD (+) and smoking habits (+) had the highest ORs for colorectal polyps (OR = 2.64, 95% CI: 1.91 - 3.64, P < 0.001), adenomatous polyps (OR = 2.06, 95% CI: 1.38 - 3.05, P < 0.05), non-adenomatous polyps (OR = 1.97, 95% CI: 1.39 - 2.80, P < 0.05), ≥ 3 polyps (OR = 2.05, 95% CI: 1.31 - 3.22, P < 0.05) and proximal polyps (OR = 1.58, 95% CI: 1.02 - 2.45, P < 0.05) after adjusting for confounding variables. Conclusions Men with NAFLD and smoking habits have an increasing risk of colorectal polyps.
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162
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Kim NH, Lee MY, Park JH, Park DI, Sohn CI, Choi K, Jung YS. Serum CEA and CA 19-9 Levels are Associated with the Presence and Severity of Colorectal Neoplasia. Yonsei Med J 2017; 58:918-924. [PMID: 28792134 PMCID: PMC5552645 DOI: 10.3349/ymj.2017.58.5.918] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 04/29/2017] [Accepted: 05/29/2017] [Indexed: 01/13/2023] Open
Abstract
PURPOSE Limited data are available regarding the association between circulating serum carcinoembryonic antigen (CEA) or carbohydrate antigen 19-9 (CA 19-9) concentrations and colorectal adenoma. We aimed to investigate whether elevated serum CEA and CA 19-9 levels are correlated with the presence of colorectal neoplasia (CRN) and whether the levels of these antigens vary according to CRN severity. MATERIALS AND METHODS A cross-sectional study was performed on asymptomatic subjects who underwent colonoscopy between 2010 and 2014 as part of a comprehensive health screening program in Korea. RESULTS A total of 124509 participants with measured serum CEA levels and 115833 participants with measured serum CA 19-9 levels were analyzed. Elevated CEA concentrations were associated with a higher rate of any adenoma, advanced adenoma, high-risk adenoma, advanced CRN (ACRN), overall CRN, and colorectal cancer (CRC). Elevated CA 19-9 concentrations were also associated with a higher rate of advanced adenoma, high-risk adenoma, ACRN, and CRC. Both elevated levels of CEA and CA 19-9 were identified as independent predictors of ACRN. Among patients with CRN, the proportions of elevated CEA/CA 19-9 levels were significantly higher in patients with ACRN than in those with non-ACRN, and these levels were correlated with larger lesion size and multiplicity of adenomas. CONCLUSION Both elevated serum CEA and CA 19-9 levels were associated with the presence of ACRN, as well as CRC. Elevated CEA levels were also associated with the presence of overall CRN. Moreover, both CEA and CA 19-9 levels were correlated with the severity of CRN.
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Affiliation(s)
- Nam Hee Kim
- Preventive Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mi Yeon Lee
- Division of Biostatistics, Department of R&D Management, Kangbuk Samsung Hospital, Seoul, Korea
| | - Jung Ho Park
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Il Park
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chong Il Sohn
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyuyong Choi
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon Suk Jung
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
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163
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Seo IK, Kim BJ, Kim B, Choi CH, Kim JW, Kim JG, Chang SK, Kang H. Abdominal fat distribution measured using computed tomography is associated with an increased risk of colorectal adenoma in men. Medicine (Baltimore) 2017; 96:e8051. [PMID: 28906398 PMCID: PMC5604667 DOI: 10.1097/md.0000000000008051] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
A few studies have shown inconsistent results regarding the association between the visceral fat proportion and colorectal adenomas. We aimed to investigate the association between abdominal fat distribution measured by computed tomography (CT) and colon adenoma.A total of 336 participants underwent physical examination, blood tests, colonoscopy, and abdominal computed tomography at Chung-Ang University Hospital. The associations between the obesity indicies (body mass index, visceral fat area (VFA), subcutaneous fat area (SFA), VFA-to-SFA ratio (VFA/SFA), and colorectal adenomas were evaluated.Of 309 subjects, 119 patients (38.5%) had colorectal adenoma. Mean age and fasting plasma glucose were higher in the patients with colorectal adenoma (P < .05, respectively). The mean VFA (153.3 cm vs 131.4 cm, P < .01) and VFA/SFA (1.07 vs 0.92, P < .05) were higher in the adenoma group than in the nonadenoma group. Males had higher mean VFA and VFA/SFA (P < .001). The mean VFA, SFA, and VFA/SFA were not associated with the location, size, number, and advancement of colorectal adenoma. In multivariate analysis, colorectal adenoma was significantly associated with VFA rather than VFA/SFA. In addition, colorectal adenoma was significantly associated with VFA rather than VFA/SFA in the men. The VFA, SFA, and VFA/SFA were not associated with colorectal adenoma in the women.The VFA measured by using a CT scan was positively associated with the presence of colorectal adenoma, especially in men. Furthermore, average risk men with large visceral fat volume should be examined carefully in screening colonoscopy.
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Affiliation(s)
| | | | | | | | | | | | | | - Hyun Kang
- Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
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164
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Aliyev V, Yasuchika K, Hammad A, Badawy A, Nigmet Y, Tajima T, Fukumitsu K, Yagi S, Hata K, Okajima H, Uemoto S. Coexistent End-stage Nonalcoholic Steatohepatitis and Colon Cancer: Should We Do Liver Transplantation? Transplant Proc 2017; 49:1649-1651. [PMID: 28838457 DOI: 10.1016/j.transproceed.2017.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 06/16/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Colon cancer accompanying decompensated liver cirrhosis is a rare clinical condition. Usually, treatment of colon cancer is prioritized, with cirrhosis dealt with later. CASE REPORT We present a case of end-stage liver disease due to nonalcoholic steatohepatitis evaluated for living donor liver transplant. During the pretransplant examination, an ascending colon cancer was detected. Liver function was too poor to perform colon resection first. Simultaneous living donor liver transplant and colonic resection were carried out. The patient developed left lung metastasis at 2 different times during the first postoperative year, and both of them were resected. The patient received the standard chemoradiotherapy. Now, the patient is alive at 42 months postprocedure and recurrence-free at 31 months postoperatively. CONCLUSION Simultaneous liver transplantation and colon resection are possible with acceptable long-term outcomes. Immunosuppressive therapy after transplantation increases the risk for cancer recurrence. So the patient should undergo close surveillance.
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Affiliation(s)
- V Aliyev
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - K Yasuchika
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - A Hammad
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Surgery, Mansoura University, Mansoura, Egypt
| | - A Badawy
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Surgery, Alexandria University, Alexandria, Egypt
| | - Y Nigmet
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Tajima
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - K Fukumitsu
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - S Yagi
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - K Hata
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - H Okajima
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - S Uemoto
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Takahashi K, Ito H, Hashimoto M, Mita K, Asakawa H, Hayashi T, Fujino K. Does antithrombotic therapy improve survival with colorectal cancer? World J Surg Oncol 2017; 15:161. [PMID: 28836988 PMCID: PMC5571652 DOI: 10.1186/s12957-017-1235-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 08/05/2017] [Indexed: 12/21/2022] Open
Abstract
Background The study aimed to evaluate the prognosis for patients with colorectal cancer who underwent surgery while receiving antithrombotic therapy (ATT) across all disease stages and for patients at disease stages 0–III. Methods This retrospective cohort study included 710 Japanese patients who underwent surgery for colorectal cancer between January 2009 and November 2015 at our institution. Approximately 35% of these patients received ATT. Of these, 199 (28.0%) received antiplatelet therapy, and 76 (10.7%) received anticoagulant therapy. We investigated the prognosis among patients with colorectal cancer receiving ATT, antiplatelet therapy, or anticoagulant therapy in all-stage and stage 0–III cancers. Results For all disease stages combined, no benefit was observed for ATT, antiplatelet therapy, and anticoagulant therapy groups in the overall survival rates (ATT: 87.8 vs. 78.4%, P = 0.23; antiplatelet therapy: 87.8 vs. 78.6%, P = 0.25; and anticoagulant therapy: 92.2 vs. 80.2%, P = 0.26). However, overall survival rates of patients with stage 0–III colorectal cancer undergoing ATT, antiplatelet therapy, and anticoagulant therapy significantly improved. (ATT: 98.5 vs. 92.7%, P = 0.01; antiplatelet therapy: 98.3 vs. 91.1%, P = 0.02; and anticoagulant therapy: 100 vs. 92.1%, P = 0.00). Conclusion Receiving ATT significantly improves overall survival rates in patients with stage 0–III colorectal cancer.
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Affiliation(s)
- Kodai Takahashi
- Department of Surgery, New-Tokyo Hospital, 1271 Wanagaya, Matsudo-city, Chiba, 270-2232, Japan.
| | - Hideto Ito
- Department of Surgery, New-Tokyo Hospital, 1271 Wanagaya, Matsudo-city, Chiba, 270-2232, Japan
| | - Masatoshi Hashimoto
- Department of Surgery, New-Tokyo Hospital, 1271 Wanagaya, Matsudo-city, Chiba, 270-2232, Japan
| | - Kazuhito Mita
- Department of Surgery, New-Tokyo Hospital, 1271 Wanagaya, Matsudo-city, Chiba, 270-2232, Japan
| | - Hideki Asakawa
- Department of Surgery, New-Tokyo Hospital, 1271 Wanagaya, Matsudo-city, Chiba, 270-2232, Japan
| | - Takashi Hayashi
- Department of Surgery, New-Tokyo Hospital, 1271 Wanagaya, Matsudo-city, Chiba, 270-2232, Japan
| | - Keiichi Fujino
- Department of Surgery, New-Tokyo Hospital, 1271 Wanagaya, Matsudo-city, Chiba, 270-2232, Japan
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Abstract
PURPOSE OF REVIEW Colorectal cancer (CRC) is increasing in Asia, especially in regions with higher levels of economic development. Several Asian countries have launched population CRC screening programs to combat this devastating disease because previous studies have demonstrated that either fecal occult blood test or lower gastrointestinal endoscopy can effectively reduce CRC mortality. RECENT FINDINGS Screening includes engaging the population, testing, administering a confirmation examination, and treating screening-detected neoplasms; thus, monitoring the whole process using measurable indicators over time is of utmost importance. Only when the quality of every step is secured can the effectiveness of CRC screening be maximized. Screening and verification examination rates remain low in Asian countries, and important infrastructure, including cancer or death registry systems, colonoscopy capacity, and reasonable subsidization for screening, is lacking or insufficient. Future research should identify potential local barriers to screening. Good communication and dialog among screening organizers, clinicians, professional societies, and public health workers are indispensible for successful screening programs.
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Affiliation(s)
- Han-Mo Chiu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan.
| | - Wen-Feng Hsu
- Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, Taiwan
| | - Li-Chun Chang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan
| | - Ming-Hsiang Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan
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167
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Secretory RAB GTPase 3C modulates IL6-STAT3 pathway to promote colon cancer metastasis and is associated with poor prognosis. Mol Cancer 2017; 16:135. [PMID: 28784136 PMCID: PMC5547507 DOI: 10.1186/s12943-017-0687-7] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 06/26/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND RAB GTPases are important in the regulation of membrane trafficking and cell movement. Recently, exocytic RABs have received increasing attention in cancer research. However, the functional roles of exocytic RABs in colorectal carcinogenesis remain to be elucidated. METHODS Immunohistochemistry analysis of a microarray containing 215 colorectal adenocarcinoma tissues was used to identify the association between exocytic RABs and patient prognosis. Complementary functional RAB3C overexpression and knockdown experiments were performed. The molecular mechanism of RAB3C in inducing colon cancer cell metastasis was determined. RESULTS High RAB3C expression in patients was found to be significantly associated with advanced pathological stage, distant metastasis and poor prognosis. Multivariate analyses showed that high RAB3C expression was an independent prognostic marker in overall (P = 0.001) and disease-free survival (P < 0.001). Furthermore, our experimental results showed an increase in the migration and invasion ability of RAB3C-overexpressing colon cancer cells and increased metastatic nodules in a mouse metastasis model. The effect of RAB3C-overexpressing cell-conditioned medium was found to significantly promote the migration ability of parental colon cancer cells, thus suggesting that the promotion of migration is exocytosis dependent. Upregulation of other exocytic RABs was also seen in RAB3C-overexpressing cells. Through microarray and proteomics analyses, increased production of multiple cytokines was observed in RAB3C-overexpressing cell lines, and the IL-6 pathway was the top pathway whose members exhibited gene expression changes after RAB3C overexpression, according to Ingenuity Pathway Analysis. Blocking IL-6 with IL-6 antibody treatment or IL-6 knockdown significantly inhibited the migration potential of RAB3C-overexpressing colon cancer cells. In addition, IL-6 was found to induce STAT3 phosphorylation in RAB3C-overexpressing colon cancer cells, thus promoting migration. Ruxolitinib, a JAK2 inhibitor, was found to significantly inhibit RAB3C-induced colon cancer cell migration. CONCLUSIONS Our study revealed that RAB3C overexpression promotes tumor metastasis and is associated with poor prognosis in colorectal cancer, through modulating the ability of cancer cells to release IL-6 through exocytosis and activate the JAK2-STAT3 signaling pathway. These results further suggest that inhibition of STAT3 phosphorylation in the RAB3C-IL-6-STAT3 axis by using Ruxolitinib may be a new therapeutic strategy to combat metastatic colon cancers.
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A polymorphism in ABCC4 is related to efficacy of 5-FU/capecitabine-based chemotherapy in colorectal cancer patients. Sci Rep 2017; 7:7059. [PMID: 28765596 PMCID: PMC5539293 DOI: 10.1038/s41598-017-07491-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 06/28/2017] [Indexed: 12/25/2022] Open
Abstract
To investigate the association of microRNA (miRNA) binding-site polymorphisms in the drug transporter genes with the efficacy of 5-Fluorouracil (5-FU)/capecitabine-based chemotherapy in colorectal cancer (CRC), 6 polymorphisms were determined in 432 CRC patients by using DNA sequencing method. The impacts of the polymorphisms on the miRNA-mediated regulation of gene expression were evaluated by using the methods including quantitative real-time PCR, western blotting, and luciferase reporter assays. The effects of miRNA on the intracellular concentration and cytotoxicity of 5-FU in CRC cells were measured by high performance liquid chromatography conjected tandem mass spectrometry (HPLC-MS/MS) and MTT methods, respectively. Statistical analysis showed that a polymorphism rs3742106 in the 3'-UTR of ATP-binding cassette subfamily C member 4 (ABCC4) gene was significantly associated with the efficacy of 5-FU/capecitabine-based chemotherapy in CRC. The patients with T/T genotype had significantly higher response rate than those with G/G and G/T genotypes. The expression of ABCC4 was inhibited by miR-3190-5p through binding to the 3'-UTR of the ABCC4 gene. This regulatory role of miR-3190-5p was disrupted by rs3742106. Furthermore, we found that the intracellular concentration of 5-FU was elevated by miR-3190-5p, and consequently the sensitivity of CRC cells to 5-FU was also enhanced. Rs3742106 might be regarded as a genetic biomarker for individualized use of 5-FU and capecitabine in CRC.
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Wong SH, Kwong TNY, Chow TC, Luk AKC, Dai RZW, Nakatsu G, Lam TYT, Zhang L, Wu JCY, Chan FKL, Ng SSM, Wong MCS, Ng SC, Wu WKK, Yu J, Sung JJY. Quantitation of faecal Fusobacterium improves faecal immunochemical test in detecting advanced colorectal neoplasia. Gut 2017; 66:1441-1448. [PMID: 27797940 PMCID: PMC5530471 DOI: 10.1136/gutjnl-2016-312766] [Citation(s) in RCA: 192] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 09/14/2016] [Accepted: 10/03/2016] [Indexed: 12/12/2022]
Abstract
OBJECTIVE There is a need for an improved biomarker for colorectal cancer (CRC) and advanced adenoma. We evaluated faecal microbial markers for clinical use in detecting CRC and advanced adenoma. DESIGN We measured relative abundance of Fusobacterium nucleatum (Fn), Peptostreptococcus anaerobius (Pa) and Parvimonas micra (Pm) by quantitative PCR in 309 subjects, including 104 patients with CRC, 103 patients with advanced adenoma and 102 controls. We evaluated the diagnostic performance of these biomarkers with respect to faecal immunochemical test (FIT), and validated the results in an independent cohort of 181 subjects. RESULTS The abundance was higher for all three individual markers in patients with CRC than controls (p<0.001), and for marker Fn in patients with advanced adenoma than controls (p=0.022). The marker Fn, when combined with FIT, showed superior sensitivity (92.3% vs 73.1%, p<0.001) and area under the receiver-operating characteristic curve (AUC) (0.95 vs 0.86, p<0.001) than stand-alone FIT in detecting CRC in the same patient cohort. This combined test also increased the sensitivity (38.6% vs 15.5%, p<0.001) and AUC (0.65 vs 0.57, p=0.007) for detecting advanced adenoma. The performance gain for both CRC and advanced adenoma was confirmed in the validation cohort (p=0.0014 and p=0.031, respectively). CONCLUSIONS This study identified marker Fn as a valuable marker to improve diagnostic performance of FIT, providing a complementary role to detect lesions missed by FIT alone. This simple approach may improve the clinical utility of the current FIT, and takes one step further towards a non-invasive, potentially more accurate and affordable diagnosis of advanced colorectal neoplasia.
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Affiliation(s)
- Sunny H Wong
- State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong
- Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- CUHK Shenzhen Research Institute, Shenzhen, China
| | - Thomas N Y Kwong
- State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong
- Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Tai-Cheong Chow
- State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong
- Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Arthur K C Luk
- State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong
- Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Rudin Z W Dai
- State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong
- Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Geicho Nakatsu
- State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong
- Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Thomas Y T Lam
- State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong
- Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Lin Zhang
- State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong
- Faculty of Medicine, Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Justin C Y Wu
- State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong
- Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Francis K L Chan
- State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong
- Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Simon S M Ng
- State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong
- Faculty of Medicine, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Martin C S Wong
- State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong
- Faculty of Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Siew C Ng
- State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong
- Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - William K K Wu
- State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong
- Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- CUHK Shenzhen Research Institute, Shenzhen, China
- Faculty of Medicine, Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Jun Yu
- State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong
- Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- CUHK Shenzhen Research Institute, Shenzhen, China
| | - Joseph J Y Sung
- State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong
- Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- CUHK Shenzhen Research Institute, Shenzhen, China
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Park JW, Lee JH, Park YH, Park SJ, Cheon JH, Kim WH, Kim TI. Sex-dependent difference in the effect of metformin on colorectal cancer-specific mortality of diabetic colorectal cancer patients. World J Gastroenterol 2017; 23:5196-5205. [PMID: 28811714 PMCID: PMC5537186 DOI: 10.3748/wjg.v23.i28.5196] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Revised: 05/29/2017] [Accepted: 07/04/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To assess factors associated with the higher effect of metformin on mortality in diabetic colorectal cancer (CRC) patients, since the factors related to the effectiveness of metformin have not been identified yet.
METHODS Between January 2000 and December 2010, 413 patients diagnosed with both stage 3/4 CRC and diabetes mellitus were identified. Patients’ demographics and clinical characteristics were analyzed. The effect of metformin on CRC-specific mortality and the interactions between metformin and each adjusted factor were evaluated.
RESULTS Total follow-up duration was median 50 mo (range: 1-218 mo). There were 85 deaths (45.9%) and 72 CRC-specific deaths (38.9%) among 185 patients who used metformin, compared to 130 total deaths (57.0%) and 107 CRC-specific deaths (46.9%) among 228 patients who did not use metformin. In multivariate analysis, survival benefit associated with metformin administration was identified (HR = 0.985, 95%CI: 0.974-0.997, P = 0.012). Interaction test between metformin and sex after adjustment for relevant factors revealed that female CRC patients taking metformin exhibited a significantly lower CRC-specific mortality rate than male CRC patients taking metformin (HR = 0.369, 95%CI: 0.155-0.881, P = 0.025). Furthermore, subgroup analysis revealed significant differences in CRC-specific mortality between the metformin and non-metformin groups in female patients (HR = 0.501, 95%CI: 0.286-0.879, P = 0.013) but not male patients (HR = 0.848, 95%CI: 0.594-1.211, P = 0.365). There were no significant interactions between metformin and other adjusted factors on CRC-specific mortality.
CONCLUSION We showed a strong sex-dependent difference in the effect of metformin on CRC-specific mortality in advanced stage CRC patients with diabetes.
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Leung DYP, Chen JMT, Lou VWQ, Wong EML, Chan AWK, So WKW, Chan CWH. Effects of Promotional Materials on Attitudes and Fear towards Colorectal Cancer Screening among Chinese Older Adults: An Experimental Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14070769. [PMID: 28703752 PMCID: PMC5551207 DOI: 10.3390/ijerph14070769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 07/04/2017] [Accepted: 07/09/2017] [Indexed: 11/30/2022]
Abstract
Colorectal cancer (CRC) screening is a cost-effective prevention and control strategy. However, the promotion of CRC screening for older adults may be difficult because reading CRC prevention information may evoke embarrassment, fear, and anxiety towards the screening procedure and cancer diagnosis. This study aims to (1) examine the effects of three promotional materials for CRC screening on the attitudes toward CRC screening tests (screening interest, screening effectiveness, and trust in the screening results) and cancer fear, and (2) to explore the interaction effect of cancer fear with screening effectiveness and trust in the screening results on screening interest of the three screening tests (fecal occult blood test (FOBT), flexible sigmoidoscopy, and colonoscopy) among Chinese older adults. A total of 114 community-dwelling older adults were asked to look at the corresponding promotional materials (pamphlet, cartoon, and video) of one of the three study groups. The pamphlet and video represent convention strategies and the cartoon represents an innovative strategy. No significant difference was observed in the screening interest and cancer fear across groups. FOBT was the most preferred screening modality. The video group has a large proportion agreed screening effectiveness of flexible sigmoidoscopy than pamphlet and cartoon groups and trusted in the screening results for FOBT and flexible sigmoidoscopy than the pamphlet group. Logistic regression results showed that the effect of trust in the screening results on screening interest for colonoscopy was greater among participants with higher cancer fear than those with lower cancer fear level. In conclusion, the three promotional groups had produced similar results in their attitudes toward CRC screening and cancer fear. The use of cartoons may be a comparable approach with conventional methods in the promotion of CRC screening. Additional components that can arouse fear and boost response efficacy simultaneously might also be useful for the effective promotion of colonoscopy among Chinese older adults.
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Affiliation(s)
- Doris Y P Leung
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.
| | - Joanne M T Chen
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.
- School of Health Sciences, Caritas Institute of Higher Education, Hong Kong, China.
| | - Vivian W Q Lou
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China.
| | - Eliza M L Wong
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.
| | - Aileen W K Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.
| | - Winnie K W So
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.
| | - Carmen W H Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.
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Paszat L, Sutradhar R, Liu Y, Baxter NN, Tinmouth J, Rabeneck L. Risk of colorectal cancer among immigrants to Ontario, Canada. BMC Gastroenterol 2017; 17:85. [PMID: 28683721 PMCID: PMC5500923 DOI: 10.1186/s12876-017-0642-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 06/29/2017] [Indexed: 02/07/2023] Open
Abstract
Background The risk of colorectal cancer (CRC) varies around the world and between females and males. We aimed to compare the risk of CRC among immigrants to Ontario, Canada, to its general population. Methods We used an exposure-control matched design. We identified persons in the Immigration, Refugees and Citizenship Canada Permanent Resident Database with first eligibility for the Ontario Health Insurance Plan between July 1, 1991 and June 30, 2008 at age 40 years or older, and matched five controls by year of birth and sex on the immigrant’s first eligibility date. We identified CRC from the Ontario Cancer Registry between the index date and December 31, 2014. All analyses were stratified by sex. We calculated crude and relative rates of CRC. We estimated risk of CRC over time by the Kaplan-Meier method and compared immigrants to controls in age and sex stratified strata using log-rank tests. We modeled the hazard of CRC using Cox proportional hazards regression, accounting for within-cluster correlation by a robust sandwich variance estimation approach, and assessed an interaction with time since eligibility. Results Among females, 1877 cases of CRC were observed among 209,843 immigrants, and 16,517 cases among 1,049,215 controls; the crude relative rate among female immigrants was 0.623. Among males, 1956 cases of CRC were observed among 191,792 immigrants and 18,329 cases among 958,960 controls; the crude relative rate among male immigrants was 0.582.. Comparing immigrants to controls in all age and sex stratified strata, the log rank test p < 0.0001 except for females aged > = 75 years at index, where p = 0.01. The age-adjusted hazard ratio (HR) for CRC among female immigrants was 0.63 (95% CI 0.59, 0.67) during the first 10 years, and 0.66 (95% CI 0.59, 0.74) thereafter. Among male immigrants the age-adjusted HR = 0.55 (95% CI 0.52, 0.59) during the first 10 years and increased to 0.63 (95% CI 0.57, 0.71) thereafter. The adjusted HR > = 1 only among immigrants born in Europe and Central Asia. Conclusions The risk of CRC among immigrants to Ontario relative to controls varies by origin and over time since immigration.
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Affiliation(s)
- Lawrence Paszat
- University of Toronto, Institute for Clinical Evaluative Sciences, G106 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada.
| | - Rinku Sutradhar
- University of Toronto, Institute for Clinical Evaluative Sciences, G106 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada
| | - Ying Liu
- University of Toronto, Institute for Clinical Evaluative Sciences, G106 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada
| | - Nancy N Baxter
- University of Toronto, St Michael's Hospital, 30 Bond Street, Toronto, ON, M5B1W8, Canada
| | - Jill Tinmouth
- University of Toronto, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada
| | - Linda Rabeneck
- University of Toronto, Prevention and Cancer Control, Cancer Care Ontario, 620 University Avenue, Toronto, ON, M4, Canada
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173
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Emerging Gastrointestinal and Liver Diseases in Asia Pacific: Implications to Health Care in the Region (World Gastroenterology Organization: Asian Pacific Association of Gastroenterology Distinguished Global Lecture 2015). J Clin Gastroenterol 2017; 51:479-485. [PMID: 28591070 DOI: 10.1097/mcg.0000000000000847] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Colorectal cancer (CRC), gastroesophageal reflux disease (GERD), inflammatory bowel disease (IBD), and nonalcoholic fatty liver disease are considered important emerging diseases in the Asia Pacific (AP) region. The incidence rate of CRC is the highest among gastrointestinal cancers in the region surpassing that of gastric cancer. However, population CRC screening is limited by availability of adequate health resources and financing. GERD is a highly prevalent disease in AP with the prevalence of GERD symptoms and reflux esophagitis reported to be increasing. The usage of proton pump inhibitors has also been reported to be high. The incidence and prevalence of IBD is not as high as in the west but is now an increasingly recognizable disease in the AP region. Being a complicated disease, IBD will pose a huge financial burden with the increasing use of expensive biological drugs. In tandem with the exponential increase in obesity and diabetes mellitus in AP, nonalcoholic fatty liver disease will become the most important liver disease in the region in the coming years. These emerging diseases reflect the continued fast-paced socioeconomic development in the region with marked lifestyle changes and increasing affluence.
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174
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Nie Y, Wu K, Yu J, Liang Q, Cai X, Shang Y, Zhou J, Pan K, Sun L, Fang J, Yuan Y, You W, Fan D. A global burden of gastric cancer: the major impact of China. Expert Rev Gastroenterol Hepatol 2017; 11:651-661. [PMID: 28351219 DOI: 10.1080/17474124.2017.1312342] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Gastric cancer (GC) is a highly aggressive cancer and a major cause of cancer-related deaths worldwide. Approximately half of the world's GC cases and deaths occur in china. GC presents challenges in early diagnosis and effective therapy due to a lack of understanding of the underlying molecular biology. The primary goals of this review are to outline current GC research in china and describe future trends in this field. Areas covered: This review mainly focuses on a series of GC-related advances China has achieved. Considerable progress has been made in understanding the role of H. pylori in GC by a series of population-based studies in well-established high-risk areas; A few germline and somatic alterations have been identified by 'omics' studies; Studies on the mechanisms of malignant phenotypes have helped us to form an in-depth understanding of GC and advance drug discovery. Moreover, identification of potential biomarkers and targeted therapies have facilitated the diagnosis and treatment of GC. However, many challenges remain. Expert commentary: To combat GC, sufficient funding is important. More attention should be paid on early diagnosis and the discovery of novel efficient biomarkers and the development of biomarker-based or targeted therapeutics in GC.
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Affiliation(s)
- Yongzhan Nie
- a State Key Laboratory of Cancer Biology and Xijing Hospital of Digestive Diseases , Fourth Military Medical University , Xi'an , China
| | - Kaichun Wu
- a State Key Laboratory of Cancer Biology and Xijing Hospital of Digestive Diseases , Fourth Military Medical University , Xi'an , China
| | - Jun Yu
- b Department of Medicine and Therapeutics and Institute of Digestive Disease , Chinese University of Hong Kong , Hong Kong , China
| | - Qiaoyi Liang
- b Department of Medicine and Therapeutics and Institute of Digestive Disease , Chinese University of Hong Kong , Hong Kong , China
| | - Xiqiang Cai
- a State Key Laboratory of Cancer Biology and Xijing Hospital of Digestive Diseases , Fourth Military Medical University , Xi'an , China
| | - Yulong Shang
- a State Key Laboratory of Cancer Biology and Xijing Hospital of Digestive Diseases , Fourth Military Medical University , Xi'an , China
| | - Jinfeng Zhou
- a State Key Laboratory of Cancer Biology and Xijing Hospital of Digestive Diseases , Fourth Military Medical University , Xi'an , China
| | - Kaifeng Pan
- c Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Cancer Epidemiology, Peking University School of Oncology , Peking University Cancer Hospital & Institute , Beijing , China
| | - Liping Sun
- d Tumor Etiology and Screening, Department of Cancer Institute and General Surgery , The First Affiliated Hospital of China Medical University , Shenyang , China
| | - Jingyuan Fang
- e Renji Hospital , Shanghai Jiao-Tong University School of Medicine , Shanghai , China
| | - Yuan Yuan
- d Tumor Etiology and Screening, Department of Cancer Institute and General Surgery , The First Affiliated Hospital of China Medical University , Shenyang , China
| | - Weicheng You
- c Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Cancer Epidemiology, Peking University School of Oncology , Peking University Cancer Hospital & Institute , Beijing , China
| | - Daiming Fan
- a State Key Laboratory of Cancer Biology and Xijing Hospital of Digestive Diseases , Fourth Military Medical University , Xi'an , China
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Tsuchida C, Yoshitake N, Kino H, Kaneko Y, Nakano M, Tsuchida K, Tominaga K, Sasai T, Masuyama H, Yamagishi H, Imai Y, Hiraishi H. Clinical importance of colonoscopy in patients with gastric neoplasm undergoing endoscopic submucosal dissection. World J Gastroenterol 2017; 23:4262-4269. [PMID: 28694666 PMCID: PMC5483500 DOI: 10.3748/wjg.v23.i23.4262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 03/29/2017] [Accepted: 05/19/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the usefulness of total colonoscopy (TCS) for patients undergoing gastric endoscopic submucosal dissection (ESD) and to assess risk factors for colorectal neoplasms.
METHODS Of the 263 patients who underwent ESD at our department between May 2010 and December 2013, 172 patients undergoing TCS during a one-year period before and after ESD were targeted. After excluding patients with a history of surgery or endoscopic therapy for colorectal neoplasms, 158 patients were analyzed. Of the 868 asymptomatic patients who underwent TCS during the same period because of positive fecal immunochemical test (FIT) results, 158 patients with no history of either surgery or endoscopic therapy for colorectal neoplasms who were matched for age and sex served as the control group for comparison.
RESULTS TCS revealed adenoma less than 10 mm in 53 patients (33.6%), advanced adenoma in 17 (10.8%), early colorectal cancer in 5 (3.2%), and advanced colorectal cancer in 4 (2.5%). When the presence or absence of adenoma less than 10 mm, advanced adenoma, and colorectal cancer and the number of adenomas were compared between patients undergoing ESD and FIT-positive patients, there were no statistically significant differences in any of the parameters assessed. The patients undergoing ESD appeared to have the same risk of colorectal neoplasms as the FIT-positive patients. Colorectal neoplasms were clearly more common in men than in women (P = 0.031). Advanced adenoma and cancer were significantly more frequent in patients with at least two of the following conditions: hypertension, dyslipidemia, and diabetes mellitus (P = 0.019).
CONCLUSION In patients undergoing gastric ESD, TCS appears to be important for detecting synchronous double neoplasms. Advanced adenoma and cancer were more common in patients with at least two of the following conditions: hypertension, dyslipidemia, and diabetes mellitus. Caution is therefore especially warranted in patients with these risk factors.
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Sinn DH, Min YW, Son HJ, Rhee PL, Paik SW, Hong SN, Gwak GY. Metabolically-healthy obesity is associated with higher prevalence of colorectal adenoma. PLoS One 2017. [PMID: 28636624 PMCID: PMC5479542 DOI: 10.1371/journal.pone.0179480] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background The risk of colorectal adenoma (CRA), an important precursor of colorectal cancer, is largely unknown among obese individuals without obesity-related metabolic abnormalities, a condition described as metabolically-healthy obese (MHO). The aim of this study was to examine the association among metabolic status, the different categories of body mass index (BMI), and CRA in a large cohort of adults. Methods We analyzed the association among metabolic status, BMI categories and CRA in asymptomatic adults who underwent a first-time colonoscopy as part of the comprehensive health check-up program at the Health Promotion Center of Samsung Medical Center, from January 2005 to December 2012. Being metabolically healthy was defined as lacking any metabolic syndrome components and having a homeostasis model assessment of insulin resistance <2.5. Results The prevalence of “any,” “multiple,” and “high-risk” CRA was 25.6%, 8.3%, and 4.4% among 9,182 metabolically-healthy participants, and 35.9%, 12.5%, and 7.0% among 17,407 metabolically-unhealthy participants, respectively. Increased BMI showed a significant dose-dependent relationship with the prevalence of “any,” “multiple,” and “high-risk” CRA, in both metabolically-healthy and unhealthy participants. In multivariable-adjusted models that accounted for potential confounders including age, sex, smoking, alcohol, first-degree family history of colorectal cancer, and aspirin use, the odds ratio (OR) for any CRA comparing MHO with metabolically-healthy normal-weight (MHNW) participants was 1.25 (95% confidence interval (CI), 1.09–1.43). Further adjustment for metabolic components associated with obesity did not significantly change the association. Similarly, the ORs for multiple CRAs and high risk CRA were higher in MHO participants than MHNW participants [ORs (95% CI), 1.63 (1.31–2.04) and 1.53 (1.14–2.04), respectively]. Conclusions The MHO phenotype was closely associated with higher prevalence of CRA, including high-risk adenoma. This finding supports the conclusion that MHO increases the risk of colorectal cancer.
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Affiliation(s)
- Dong Hyun Sinn
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yang Won Min
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hee Jung Son
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- Center for Health Promotion, Samsung Medical Center, Seoul, South Korea
| | - Poong-Lyul Rhee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seung Woon Paik
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sung Noh Hong
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- * E-mail: (SNH); (GYG)
| | - Geum-Youn Gwak
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- * E-mail: (SNH); (GYG)
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Application of the Parametric Regression Model with the Four-Parameter Log-Logistic Distribution for Determining of the Effecting Factors on the Survival Rate of Colorectal Cancer Patients in the Presence of Competing Risks. IRANIAN RED CRESCENT MEDICAL JOURNAL 2017. [DOI: 10.5812/ircmj.55609] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Immunohistochemical Expression of P16ink4a in Colorectal Adenocarcinoma Compared to Adenomatous and Normal Tissue Samples: A Study on Southeast Iranian Samples. IRANIAN RED CRESCENT MEDICAL JOURNAL 2017. [DOI: 10.5812/ircmj.15174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Singh R, Cheong KL, Zorron Cheng Tao Pu L, Mangira D, Koay DSC, Kee C, Ng SC, Rerknimitr R, Aniwan S, Ang TL, Goh KL, Ho SH, Lau JYW. Multicenter randomised controlled trial comparing the high definition white light endoscopy and the bright narrow band imaging for colon polyps. World J Gastrointest Endosc 2017; 9:273-281. [PMID: 28690771 PMCID: PMC5483420 DOI: 10.4253/wjge.v9.i6.273] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 04/04/2017] [Accepted: 05/19/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To compare high definition white light endoscopy and bright narrow band imaging for colon polyps’ detection rates.
METHODS Patients were randomised to high definition white light endoscopy (HD-WLE) or the bright narrow band imaging (bNBI) during withdrawal of the colonoscope. Polyps identified in either mode were characterised using bNBI with dual focus (bNBI-DF) according to the Sano’s classification. The primary outcome was to compare adenoma detection rates (ADRs) between the two arms. The secondary outcome was to assess the negative predictive value (NPV) in differentiating adenomas from hyperplastic polyps for diminutive rectosigmoid lesions.
RESULTS A total of 1006 patients were randomised to HD-WLE (n = 511) or bNBI (n = 495). The mean of adenoma per patient was 1.62 and 1.84, respectively. The ADRs in bNBI and HD-WLE group were 37.4% and 39.3%, respectively. When adjusted for withdrawal time (OR = 1.19, 95%CI: 1.15-1.24, P < 0.001), the use of bNBI was associated with a reduced ADR (OR = 0.69, 95%CI: 0.52-0.92). Nine hundred and thirty three polyps (86%) in both arms were predicted with high confidence. The sensitivity (Sn), specificity (Sp), positive predictive value and NPV in differentiating adenomatous from non-adenomatous polyps of all sizes were 95.9%, 87.2%, 94.0% and 91.1% respectively. The NPV in differentiating an adenoma from hyperplastic polyp using bNBI-DF for diminutive rectal polyps was 91.0%.
CONCLUSION ADRs did not differ between bNBI and HD-WLE, however HD-WLE had higher ADR after adjustment of withdrawal time. bNBI surpassed the PIVI threshold for diminutive polyps.
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Kandel ME, Sridharan S, Liang J, Luo Z, Han K, Macias V, Shah A, Patel R, Tangella K, Kajdacsy-Balla A, Guzman G, Popescu G. Label-free tissue scanner for colorectal cancer screening. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:66016. [PMID: 28655054 DOI: 10.1117/1.jbo.22.6.066016] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 05/22/2017] [Indexed: 05/20/2023]
Abstract
The current practice of surgical pathology relies on external contrast agents to reveal tissue architecture, which is then qualitatively examined by a trained pathologist. The diagnosis is based on the comparison with standardized empirical, qualitative assessments of limited objectivity. We propose an approach to pathology based on interferometric imaging of “unstained” biopsies, which provides unique capabilities for quantitative diagnosis and automation. We developed a label-free tissue scanner based on “quantitative phase imaging,” which maps out optical path length at each point in the field of view and, thus, yields images that are sensitive to the “nanoscale” tissue architecture. Unlike analysis of stained tissue, which is qualitative in nature and affected by color balance, staining strength and imaging conditions, optical path length measurements are intrinsically quantitative, i.e., images can be compared across different instruments and clinical sites. These critical features allow us to automate the diagnosis process. We paired our interferometric optical system with highly parallelized, dedicated software algorithms for data acquisition, allowing us to image at a throughput comparable to that of commercial tissue scanners while maintaining the nanoscale sensitivity to morphology. Based on the measured phase information, we implemented software tools for autofocusing during imaging, as well as image archiving and data access. To illustrate the potential of our technology for large volume pathology screening, we established an “intrinsic marker” for colorectal disease that detects tissue with dysplasia or colorectal cancer and flags specific areas for further examination, potentially improving the efficiency of existing pathology workflows.
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Affiliation(s)
- Mikhail E Kandel
- University of Illinois at Urbana-Champaign, Beckman Institute of Advanced Science and Technology, Quantitative Light Imaging Laboratory, Urbana, Illinois, United StatesbUniversity of Illinois at Urbana-Champaign, Department of Electrical and Computer Engineering, Urbana, Illinois, United States
| | - Shamira Sridharan
- University of Illinois at Urbana-Champaign, Beckman Institute of Advanced Science and Technology, Quantitative Light Imaging Laboratory, Urbana, Illinois, United StatescUniversity of Illinois at Urbana-Champaign, Department of Bioengineering, Urbana, Illinois, United StatesdUniversity of California, Biomedical Engineering Department, Davis, California, United States
| | - Jon Liang
- University of Illinois at Urbana-Champaign, Beckman Institute of Advanced Science and Technology, Quantitative Light Imaging Laboratory, Urbana, Illinois, United States
| | - Zelun Luo
- University of Illinois at Urbana-Champaign, Beckman Institute of Advanced Science and Technology, Quantitative Light Imaging Laboratory, Urbana, Illinois, United States
| | - Kevin Han
- University of Illinois at Urbana-Champaign, Beckman Institute of Advanced Science and Technology, Quantitative Light Imaging Laboratory, Urbana, Illinois, United States
| | - Virgilia Macias
- University of Illinois at Chicago, Department of Pathology, Chicago, Illinois, United States
| | - Anish Shah
- University of Illinois at Chicago, Department of Pathology, Chicago, Illinois, United States
| | - Roshan Patel
- University of Illinois at Chicago, Department of Pathology, Chicago, Illinois, United States
| | | | - Andre Kajdacsy-Balla
- University of Illinois at Chicago, Department of Pathology, Chicago, Illinois, United States
| | - Grace Guzman
- University of Illinois at Chicago, Department of Pathology, Chicago, Illinois, United States
| | - Gabriel Popescu
- University of Illinois at Urbana-Champaign, Beckman Institute of Advanced Science and Technology, Quantitative Light Imaging Laboratory, Urbana, Illinois, United StatesbUniversity of Illinois at Urbana-Champaign, Department of Electrical and Computer Engineering, Urbana, Illinois, United StatescUniversity of Illinois at Urbana-Champaign, Department of Bioengineering, Urbana, Illinois, United States
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Uchiyama K, Yagi N, Mizushima K, Higashimura Y, Hirai Y, Okayama T, Yoshida N, Katada K, Kamada K, Handa O, Ishikawa T, Takagi T, Konishi H, Kuriu Y, Nakanishi M, Otsuji E, Itoh Y, Naito Y. Serum metabolomics analysis for early detection of colorectal cancer. J Gastroenterol 2017; 52:677-694. [PMID: 27650200 DOI: 10.1007/s00535-016-1261-6] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 09/01/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although colorectal cancer (CRC) is one of the most common causes of cancer mortality, early-stage detection improves survival rates dramatically. Because cancer impacts important metabolic pathways, the alteration of metabolite levels as a potential biomarker of early-stage cancer has been the focus of many studies. Here, we used CE-TOFMS, a novel and promising method with small injection volume and high resolution, to separate and detect ionic compounds based on the different migration rates of charged metabolites in order to detect metabolic biomarkers in patients with CRC. METHODS A total of 56 patients with CRC (n = 14 each of Stages I-IV), 60 healthy controls, and 59 patients with colonic adenoma were included in this study. Metabolome analysis was conducted by CE-TOFMS on serum samples of patients and controls using the Advanced Scan package (Human Metabolome Technologies). RESULTS We obtained 334 metabolites in the serum, of which 139 were identified as known substances. Among these 139 known metabolites, 16 were correlated with CRC stage by upregulation and 44 by downregulation, with benzoic acid (r = -0.649, t = 11.653, p = 6.07599E-24), octanoic acid (r = 0.557, t = 9.183, p = 7.9557E-17), decanoic acid (r = 0.539, t = 8.749, p = 1.24352E-15), and histidine (r = -0.513, t = 8.194, p = 3.90224E-14) exhibiting significant correlation. CONCLUSIONS To the best of our knowledge, this is the first report to determine the correlation between serum metabolites and CRC stage using CE-TOFMS. Our results show that benzoic acid exhibited excellent diagnostic power and could potentially serve as a novel disease biomarker for CRC diagnosis.
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Affiliation(s)
- Kazuhiko Uchiyama
- Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Hirokoji Kawaramachi Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Nobuaki Yagi
- Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Hirokoji Kawaramachi Kamigyo-ku, Kyoto, 602-8566, Japan.,Department of Gastroenterology, Murakami Memorial Hospital, Asahi University, 3-23 Hashimotocho Gifu-city, Gifu, 500-8523, Japan
| | - Katsura Mizushima
- Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Hirokoji Kawaramachi Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yasuki Higashimura
- Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Hirokoji Kawaramachi Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yasuko Hirai
- Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Hirokoji Kawaramachi Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Tetsuya Okayama
- Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Hirokoji Kawaramachi Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Naohisa Yoshida
- Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Hirokoji Kawaramachi Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Kazuhiro Katada
- Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Hirokoji Kawaramachi Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Kazuhiro Kamada
- Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Hirokoji Kawaramachi Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Osamu Handa
- Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Hirokoji Kawaramachi Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Takeshi Ishikawa
- Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Hirokoji Kawaramachi Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Tomohisa Takagi
- Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Hirokoji Kawaramachi Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Hideyuki Konishi
- Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Hirokoji Kawaramachi Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yoshiaki Kuriu
- Department of Surgery, Division of Digestive Surgery, Kyoto Prefectural University of Medicine, 465 Kajiicho Hirokoji Kawaramachi Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Masayoshi Nakanishi
- Department of Surgery, Division of Digestive Surgery, Kyoto Prefectural University of Medicine, 465 Kajiicho Hirokoji Kawaramachi Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Eigo Otsuji
- Department of Surgery, Division of Digestive Surgery, Kyoto Prefectural University of Medicine, 465 Kajiicho Hirokoji Kawaramachi Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yoshito Itoh
- Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Hirokoji Kawaramachi Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yuji Naito
- Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Hirokoji Kawaramachi Kamigyo-ku, Kyoto, 602-8566, Japan. .,Department of Endoscopy and Ultrasound Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho Hirokoji Kawaramachi Kamigyo-ku, Kyoto, 602-8566, Japan.
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Trends in colorectal cancer in the Caribbean: A population-based study in Martinique, 1982–2011. Rev Epidemiol Sante Publique 2017; 65:181-188. [DOI: 10.1016/j.respe.2016.11.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 11/07/2016] [Accepted: 11/09/2016] [Indexed: 01/20/2023] Open
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Targeted sequencing-based analyses of candidate gene variants in ulcerative colitis-associated colorectal neoplasia. Br J Cancer 2017; 117:136-143. [PMID: 28524162 PMCID: PMC5520210 DOI: 10.1038/bjc.2017.148] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 04/25/2017] [Accepted: 04/26/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Long-standing ulcerative colitis (UC) leading to colorectal cancer (CRC) is one of the most serious and life-threatening consequences acknowledged globally. Ulcerative colitis-associated colorectal carcinogenesis showed distinct molecular alterations when compared with sporadic colorectal carcinoma. METHODS Targeted sequencing of 409 genes in tissue samples of 18 long-standing UC subjects at high risk of colorectal carcinoma (UCHR) was performed to identify somatic driver mutations, which may be involved in the molecular changes during the transformation of non-dysplastic mucosa to high-grade dysplasia. Findings from the study are also compared with previously published genome wide and exome sequencing data in inflammatory bowel disease-associated and sporadic colorectal carcinoma. RESULTS Next-generation sequencing analysis identified 1107 mutations in 275 genes in UCHR subjects. In addition to TP53 (17%) and KRAS (22%) mutations, recurrent mutations in APC (33%), ACVR2A (61%), ARID1A (44%), RAF1 (39%) and MTOR (61%) were observed in UCHR subjects. In addition, APC, FGFR3, FGFR2 and PIK3CA driver mutations were identified in UCHR subjects. Recurrent mutations in ARID1A (44%), SMARCA4 (17%), MLL2 (44%), MLL3 (67%), SETD2 (17%) and TET2 (50%) genes involved in histone modification and chromatin remodelling were identified in UCHR subjects. CONCLUSIONS Our study identifies new oncogenic driver mutations which may be involved in the transition of non-dysplastic cells to dysplastic phenotype in the subjects with long-standing UC with high risk of progression into colorectal neoplasia.
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184
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Yang TW, Gao YH, Ma SY, Wu Q, Li ZF. Low-grade slightly elevated and polypoid colorectal adenomas display differential β-catenin-TCF/LEF activity, c-Myc, and cyclin D1 expression. World J Gastroenterol 2017; 23:3066-3076. [PMID: 28533663 PMCID: PMC5423043 DOI: 10.3748/wjg.v23.i17.3066] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Revised: 12/07/2016] [Accepted: 01/18/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To comparatively investigate the cellular and molecular characteristics of low-grade slightly elevated adenomas and polypoid adenomas.
METHODS Colorectal tumors were collected from 24 patients with slightly elevated adenomas and 23 patients with polypoid adenomas. Five commonly mutated genes (APC, BRAF, KRAS, NRAS, and PIK3CA) were selected for mutational analysis. Paraffin-embedded tumor sections were used to calculate the apoptotic index (AI) and Ki-67 labeling index (KLI). Two pure colorectal epithelial cell lines were created by pooling the slightly elevated and polypoid tumors. Western blots, luciferase assays for β-catenin-T-cell factor protein/β-catenin-lymphoid enhancer factor (β-catenin-TCF/LEF)-driven transcriptional activity, and caspase activity assays were conducted on the two cell lines.
RESULTS Slightly elevated lesions showed a significantly lower APC mutational frequency and a significantly higher KRAS mutational frequency (both P < 0.05). Slightly elevated lesions showed a significantly lower AI (P < 0.05). β-catenin and β-catenin-TCF/LEF-driven transcriptional activity was significantly upregulated in slightly elevated lesions (both P < 0.05). In slightly elevated lesions, c-Myc was significantly downregulated, while cyclin D1 was significantly upregulated (both P < 0.05). β-catenin-TCF/LEF-driven transcriptional activity was negatively correlated with c-Myc (ρ = -0.78). Slightly elevated lesions displayed significant Bcl-2 and Bcl-xL upregulation (both P < 0.05) along with significant decreases in caspase-9 and caspase-3 activity (both P < 0.05). c-Myc was negatively correlated with Bcl-2 and Bcl-xL (ρ = -0.74 and -0.78, respectively).
CONCLUSION The lower apoptotic activity of low-grade slightly elevated adenomas can be partly attributed to upregulated β-catenin pathway activity and downregulated c-Myc expression.
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Bui TP, Hoang AN, Le PL, Pham BT, Nguyen LTT, Do HM, Ta TV, Trinh TH. Matrix metalloproteinases in Vietnamese patients with colorectal cancer. Oncol Lett 2017; 13:2097-2104. [PMID: 28454367 PMCID: PMC5403361 DOI: 10.3892/ol.2017.5680] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 11/30/2016] [Indexed: 01/12/2023] Open
Abstract
Matrix metalloproteinases (MMPs), a family of endopeptidases also known as gelatinases, have been reported to affect the acquisition of the cell proliferative, cell invasive and metastatic phenotype of several types of cancer. In particular, the gelatinases MMP-2 and −9 have been revealed to facilitate tumor growth and invasion in patients with colorectal cancer (CRC). However, it is not known whether the gelatinase activity of MMP-2 and −9 is also elevated in Vietnamese patients with CRC. The activity of MMP-2 and −9 in the tissue samples of 103 patients with CRC was evaluated by gelatin zymography and quantified using ImageJ. The association between the level of activity of MMP-2 and −9 and various clinicopathological factors was analyzed, and Chisio BioPAX Editor software was used to visualize the biological pathways regulating the activity of the MMPs. The present study noticed significantly increased activity of active MMP-2 and MMP-9 in tumor tissues (P<0.01), and significantly decreased levels of pro-form MMP-2 and MMP-9 in tumor tissues (P<0.01), compared with that in adjacent tissues in patients with CRC. A correlation between the normalized different activity of MMP-2 and −9 and various clinicopathological features was observed. Furthermore, bioinformatics analysis indicated that the alteration in the activity of MMP-2 and MMP-9 may have been controlled by biological pathways involving the tissue inhibitors of metalloprotease-2 and −1. These findings indicate that the activity of the gelatinases MMP-2 and −9 affects the tumor progression and metastasis of patients with CRC, providing a potential novel approach for determining the prognosis of CRC.
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Affiliation(s)
- Thao Phuong Bui
- Department of Biology and Key Laboratory of Enzyme and Protein Technology, College of Science, Vietnam National University, Hanoi 10000, Vietnam
| | - Anh Ngoc Hoang
- Department of Biology and Key Laboratory of Enzyme and Protein Technology, College of Science, Vietnam National University, Hanoi 10000, Vietnam
| | - Phuong Lan Le
- Department of Biology and Key Laboratory of Enzyme and Protein Technology, College of Science, Vietnam National University, Hanoi 10000, Vietnam
| | - Bich Thi Pham
- Department of Biology and Key Laboratory of Enzyme and Protein Technology, College of Science, Vietnam National University, Hanoi 10000, Vietnam
| | - Linh Thi Tu Nguyen
- Department of Biology and Key Laboratory of Enzyme and Protein Technology, College of Science, Vietnam National University, Hanoi 10000, Vietnam
| | - Ha Minh Do
- Department of Biology and Key Laboratory of Enzyme and Protein Technology, College of Science, Vietnam National University, Hanoi 10000, Vietnam
| | - To Van Ta
- Department of Anatomical Pathology-Cytopathology, Vietnam National Cancer Hospital, Hanoi 10000, Vietnam
| | - Thai Hong Trinh
- Department of Biology and Key Laboratory of Enzyme and Protein Technology, College of Science, Vietnam National University, Hanoi 10000, Vietnam
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Koyel B, Priyabrata D, Rittwika B, Swati D, Soma M, Jayasri B, Ashis M. Deterministic Role of CEA and MSI Status in Predicting Outcome of CRC Patients: a Perspective Study Amongst Hospital Attending Eastern Indian Populations. Indian J Surg Oncol 2017; 8:462-468. [PMID: 29203974 DOI: 10.1007/s13193-017-0651-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 03/22/2017] [Indexed: 12/25/2022] Open
Abstract
Carcinoembryonic antigen (CEA) is an important deterministic factor in predicting colorectal carcinoma (CRC) progression. It is also evident that microsatellite instability (MSI) which results in a hypermutable phenotype of genomic DNA is common in CRC. Owing to the scarcity of reports from India, our aim of this study was to understand the clinicopathological correlations of CEA status with surgery and chemotherapy, correlate the same with socio-demographic status of the patients, determine the MSI status amongst them and understand the prognostic implications of CEA and MSI as CRC progression marker amongst patients. The serum CEA level was estimated by chemiluminescence assay (CLIA). Serum liver enzyme assay was carried out following the manufacturer's instructions using auto-analysers (E. Merck and Sera mol. Health Care, India). MSI analysis was carried out by PCR-SSCP. From our study, most frequently detected colorectal cancer was in 40-49 years age group (25.26%) with 61.05% male and 38.95% females. CEA showed a significant association with higher TNM staging, tumour size, smoking habit and MSI status (p < 0.05) but not with sex and site of cancer (p > 0.05). After surgery and chemotherapy, CEA and WBCs were decreased significantly (p < 0.05), while liver enzymes did not change significantly (p > 0.05). Overall, microsatellite instability was observed in approximately 40% of the populations. From our study, it was also evident that for both, MSI and abnormal CEA level predicted poor prognosis for the patient (by using Kaplan-Meier survival analysis; p = 0.04). Thus, CEA and initial MSI status can be used as prognostic markers of CRC.
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Affiliation(s)
- Banerjee Koyel
- Department of Molecular Biology, Netaji Subhas Chandra Bose Cancer Research Institute, 16 A Park Lane, Kolkata, 700016 India
| | - Das Priyabrata
- Department of Molecular Biology, Netaji Subhas Chandra Bose Cancer Research Institute, 16 A Park Lane, Kolkata, 700016 India
| | - Bhattacharya Rittwika
- Department of Molecular Biology, Netaji Subhas Chandra Bose Cancer Research Institute, 16 A Park Lane, Kolkata, 700016 India
| | - Dasgupta Swati
- Department of Molecular Biology, Netaji Subhas Chandra Bose Cancer Research Institute, 16 A Park Lane, Kolkata, 700016 India
| | - Mukhopadhyay Soma
- Department of Molecular Biology, Netaji Subhas Chandra Bose Cancer Research Institute, 16 A Park Lane, Kolkata, 700016 India
| | - Basak Jayasri
- Department of Molecular Biology, Netaji Subhas Chandra Bose Cancer Research Institute, 16 A Park Lane, Kolkata, 700016 India
| | - Mukhopadhyay Ashis
- Department of Haemato-Oncology, Netaji Subhas Chandra Bose Cancer Research Institute, 16 A Park Lane, Kolkata, West Bengal 700016 India
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187
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Fateh A, Feizi MAH, Safaralizadeh R, Azarbarzin S. Importance of miR-299-5p in colorectal cancer. Ann Gastroenterol 2017; 30:322-326. [PMID: 28469363 PMCID: PMC5411383 DOI: 10.20524/aog.2017.0139] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 02/07/2017] [Indexed: 12/13/2022] Open
Abstract
Background MicroRNAs (miRNAs) are effective regulators of gene expression that play a pivotal role in the pathogenesis of colorectal cancer (CRC) and various other cancers. The high prevalence of aberrant miRNA expression in CRC suggests that they can be used as biomarkers and anticancer molecules for therapeutic purposes. There is evidence that microRNA-299-5p (miR-299-5p) is associated with vital cell processes (e.g. epithelial-mesenchymal transition, proliferation, and tumorigenicity) and its improper expression with tumorigenesis in many types of human cancer. This prospective study investigated the contribution of miR-299-5p to CRC tumorigenesis. Methods The real-time reverse transcription-polymerase chain reaction was used to examine miR-299-5p expression levels prospectively in 40 sample pairs of CRC tissue and adjacent noncancerous tissue (>2 cm from cancer tissue). The ability of miR-299-5p to function as a tumor marker was also examined. Results The expression levels of miR-299-5p were significantly downregulated in the group of CRC samples compared with matched noncancerous tissue samples. No significant relationship was found between miR-299-5p expression levels and clinicopathological features. Receiver operating characteristic analysis gave an area under the curve of 71% for miR-299-5p with 68% sensitivity and 78% specificity (P=0.001). Conclusion The miRNA miR-299-5p may be considered as a tumor marker in CRC and could be of assistance as a potential predictive biomarker in the diagnosis of this cancer.
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Affiliation(s)
- Alavieh Fateh
- Department of Animal Biology, Faculty of Natural Science, University of Tabriz, Tabriz, Iran
| | | | - Reza Safaralizadeh
- Department of Animal Biology, Faculty of Natural Science, University of Tabriz, Tabriz, Iran
| | - Shirin Azarbarzin
- Department of Animal Biology, Faculty of Natural Science, University of Tabriz, Tabriz, Iran
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188
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Kirana C, Ruszkiewicz A, Stubbs RS, Hardingham JE, Hewett PJ, Maddern GJ, Hauben E. Soluble HLA-G is a differential prognostic marker in sequential colorectal cancer disease stages. Int J Cancer 2017; 140:2577-2586. [PMID: 28233298 DOI: 10.1002/ijc.30667] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 02/08/2017] [Indexed: 12/14/2022]
Abstract
The expression of HLA-G by tumour cells is an established mechanism to escape recognition and immune mediated destruction, allowing tumour survival, growth and metastasis. However, the prognostic value of soluble HLA-G (sHLA-G) remains unknown. Mucinous carcinoma (MC) is a distinct form of colorectal cancer (CRC) found in 10 to 15% of patients, which has long been associated with poor response to treatment. To investigate the prognostic value of plasma sHLA-G levels in CRC patients, preoperative plasma sHLA-G levels were determined by ELISA in CRC patients (n = 133). In addition, the local expression of HLA-G in tumour biopsies was assessed using tissue microarray analysis (n = 255). Within the high 33rd percentile of sHLA-G levels (265-890 U/mL; n = 44) we observed higher frequency of MC patients (p = 0.012; Chi-square), and higher sHLA-G levels in patients with vascular invasion (p = 0.035; two-tailed t-test). Moreover, MC patients had significantly higher sHLA-G levels compared to those with adenocarcinoma not otherwise specified (p = 0.036; two-tailed t-test). Surprisingly, while stage II patients showed negative correlation between sHLA-G levels and liver metastasis free survival (LMFS) (p = 0.041; R = -0.321), in stage III patients high sHLA-G levels were associated with significantly longer LMFS (p = 0.002), and sHLA-G levels displayed positive correlation with LMFS (p = 0.006; R = 0.409). High HLA-G expression in tumours was associated with poor cancer specific overall survival in stage II to III (p = 0.01), and with shorter LMFS in stage II patients (p = 0.004). Our findings reveal that sHLA-G levels are associated with distinct progression patterns in consecutive disease stages, indicating a potential value as surrogate marker in the differential prognosis of CRC.
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Affiliation(s)
- Chandra Kirana
- Liver Metastasis Research Group, Department of Surgery, The Basil Hetzel Institute, University of Adelaide, South Australia
| | - Andrew Ruszkiewicz
- Division of Surgical Pathology, The Royal Adelaide Hospital, North Terrace Adelaide, South Australia
| | - Richard S Stubbs
- Department of Pathology and Molecular Medicine, Wakefield Biomedical Research Unit, University of Otago, Wellington, New Zealand.,Department of Surgery, The Wakefield Clinic, Wakefield Hospital, Wellington, New Zealand
| | - Jennifer E Hardingham
- Department of Medical Oncology, The Queen Elizabeth Hospital, Adelaide, South Australia.,Department of Physiology, School of Medicine, University of Adelaide, South Australia
| | - Peter J Hewett
- Department of Surgery, University of Adelaide, The Queen Elizabeth Hospital, Woodville, South Australia
| | - Guy J Maddern
- Liver Metastasis Research Group, Department of Surgery, The Basil Hetzel Institute, University of Adelaide, South Australia.,Department of Surgery, University of Adelaide, The Queen Elizabeth Hospital, Woodville, South Australia
| | - Ehud Hauben
- Liver Metastasis Research Group, Department of Surgery, The Basil Hetzel Institute, University of Adelaide, South Australia
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189
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Jauhri M, Bhatnagar A, Gupta S, Bp M, Minhas S, Shokeen Y, Aggarwal S. Prevalence and coexistence of KRAS, BRAF, PIK3CA, NRAS, TP53, and APC mutations in Indian colorectal cancer patients: Next-generation sequencing-based cohort study. Tumour Biol 2017; 39:1010428317692265. [PMID: 28222664 DOI: 10.1177/1010428317692265] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Colorectal cancer incidences are on a rise in India. In this study, we have analyzed the mutation frequencies of six potential biomarkers, their coexistence, association with clinicopathological characteristics, and tumor location in Indian colorectal cancer patients. Next-generation sequencing was performed to identify mutations in the six potential biomarker genes using formalin-fixed paraffin-embedded tissue blocks of 112 colorectal cancer patients. The mutation frequency observed in KRAS, BRAF, PIK3CA, NRAS, TP53, and APC was 35.7%, 7.1%, 16.1%, 6.3%, 39.3%, and 29.5%, respectively. The significant associations of mutations were KRAS with age less than 60 years (p = 0.041), PIK3CA with males (p = 0.032), tumor stage I-II (p = 0.013), lack of metastasis in lymph nodes (p = 0.040), NRAS with rectum (p = 0.002), and APC with T2 stage of tumor growth (p = 0.013). No single patient harbored mutations in these six genes or any five genes simultaneously. Significance was noted in coexistence of KRAS with APC (p = 0.024) and mutual exclusion of KRAS with BRAF (p = 0.029). PIK3CA exon 9 was observed to be more frequently associated with KRAS mutations than PIK3CA exon 20 (p = 0.072). NRAS mutations were mutually exclusive with BRAF and PIK3CA mutations. As per our knowledge, this is the first next-generation sequencing-based biomarker study in Indian colorectal cancer patients. Frequent coexistence of gene mutations in pairs and triplets suggests that synergistic effect of overlapping mutations might further trigger the disease. In addition, infrequent coexistence of multiple gene mutations hints toward different signaling pathways for colorectal cancer tumorigenesis.
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Affiliation(s)
- Mayank Jauhri
- 1 Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
| | | | | | - Manasa Bp
- 3 Strand Life Sciences, Bangalore, India
| | - Sachin Minhas
- 1 Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
| | - Yogender Shokeen
- 1 Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
| | - Shyam Aggarwal
- 1 Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
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190
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Zhang G, Liu X, Li Y, Wang Y, Liang H, Li K, Li L, Chen C, Sun W, Ren S, Zhu P, Zhang L. EphB3-targeted regulation of miR-149 in the migration and invasion of human colonic carcinoma HCT116 and SW620 cells. Cancer Sci 2017; 108:408-418. [PMID: 28370854 PMCID: PMC5378266 DOI: 10.1111/cas.13161] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 12/28/2016] [Accepted: 12/30/2016] [Indexed: 01/07/2023] Open
Abstract
microRNAs play key roles during various crucial cell processes such as proliferation, migration, invasion and apoptosis. Also, microRNAs have been shown to possess oncogenic and tumor-suppressive functions in human cancers. Here, we describe the regulation and function of miR-149 in colorectal cancer cell lines. miR-149 expression patterns were detected in human colorectal cell lines and tissue samples, and then focused on its role in regulation of cell growth, migration, invasion, and its target gene identification. Furthermore, the function of the target gene of miR-149 was analyzed in vitro and in vivo. miR-149 expression was downregulated in human colorectal cancer HCT116 and SW620 cell lines compared to the normal colon epithelial NCM460 cell line using quantitative real-time polymerase chain reaction methods. Further studies indicated that introduction of miR-149 was able to suppress cell migration and invasion. Then, EphB3 was identified as a direct target gene of miR-149 in colorectal cancer cells. Moreover, experiments in vitro showed that knockdown expression of EphB3 could suppress cell proliferation and invasion, and ectopic expression of EphB3 restored the phenotypes of CRC cell lines transfected with miR149. In addition, silencing of EphB3 significantly affected cycle progression distribution and increased apoptosis in CRC cell lines. Finally, in vivo results demonstrated that knockdown of EphB3 by siRNA inhibited tumor growth. In conclusion,the important role of miR-149 in colorectal cancer progression suggesting that miR-149 may serve as a therapeutic target for colorectal cancer treatment.
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Affiliation(s)
- Guodong Zhang
- Department of Medical OncologyCancer Center of Guangzhou Medical UniversityGuangzhouGuangdongChina
| | - Xiaozhu Liu
- School of Light Industry EngineeringGuizhou Institute of TechnologyGuiyangGuizhouChina
| | - Yinfeng Li
- School of Light Industry EngineeringGuizhou Institute of TechnologyGuiyangGuizhouChina
| | - Yan Wang
- Shangdong Medicine Technician CollegeTai'anShandongChina
| | - Huankun Liang
- Guangzhou Youdi Biotechnology CompanyGuangzhouGuangdongChina
| | - Kangyan Li
- Guangzhou Youdi Biotechnology CompanyGuangzhouGuangdongChina
| | - Laiqing Li
- Guangzhou Youdi Biotechnology CompanyGuangzhouGuangdongChina
| | - Cuicui Chen
- Guangzhou Youdi Biotechnology CompanyGuangzhouGuangdongChina
| | - Wenqiao Sun
- Cancer Center of The 88 Hospital of People's Liberation ArmyTai'anShandongChina
| | - Shoulei Ren
- Shangdong Medicine Technician CollegeTai'anShandongChina
| | - Pengfei Zhu
- Shangdong Medicine Technician CollegeTai'anShandongChina
| | - Licheng Zhang
- Cancer Center of The 88 Hospital of People's Liberation ArmyTai'anShandongChina
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191
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Bae JM, Kim JH, Kang GH. Molecular Subtypes of Colorectal Cancer and Their Clinicopathologic Features, With an Emphasis on the Serrated Neoplasia Pathway. Arch Pathol Lab Med 2017; 140:406-12. [PMID: 27128298 DOI: 10.5858/arpa.2015-0310-ra] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
CONTEXT -Colorectal cancer is a heterogeneous disease entity with 3 molecular carcinogenesis pathways and 2 morphologic multistep pathways. Right-sided colon cancers and left-sided colon and rectal cancers exhibit differences in their incidence rates according to geographic region, age, and sex. A linear tendency toward increasing frequencies of microsatellite instability-high or CpG island methylator phenotype-high cancers in subsites along the bowel from the rectum to the cecum or the ascending colon accounts for the differences in tumor phenotypes associated with these subsites. The molecular subtypes of colorectal cancers exhibit different responses to adjuvant therapy, which might be responsible for differences in subtype-specific survival. OBJECTIVES -To review the clinicopathologic and molecular features of the molecular subtypes of colorectal cancer generated by combined CpG island methylator phenotype and microsatellite statuses, to integrate these features with the most recent findings in the context of the prognostic implications of molecular subtypes, and to emphasize the necessity of developing molecular markers that enable the identification of adenocarcinomas involving the serrated neoplasia pathway. DATA SOURCES -Based on the authors' own experimental data and a review of the pertinent literature. CONCLUSIONS -Because colorectal cancers arise from 2 different morphologic multistep carcinogenesis pathways with varying contributions from 3 different molecular carcinogenesis pathways, colorectal cancer is a heterogeneous and complex disease. Thus, molecular subtyping of colorectal cancers is an important approach to characterizing their heterogeneity with respect to not only prognosis and therapeutic response but also biology and natural history.
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Affiliation(s)
| | | | - Gyeong Hoon Kang
- From the Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
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192
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Shi Q, Liu S, Li W, Zong S, Han S, Yang W, Li H, Hou F. Exploring the medication duration based on the effect of traditional Chinese medicine on postoperative stage I-III colorectal patients: a retrospective cohort study. Oncotarget 2017; 8:13488-13495. [PMID: 28086238 PMCID: PMC5355114 DOI: 10.18632/oncotarget.14567] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 12/27/2016] [Indexed: 01/30/2023] Open
Abstract
PURPOSE To clarify the effect of tradional Chinese medicine (TCM) on different stage patients and to explore medication duration based on survival analysis. RESULTS 523 and 294 patients were respectively in the TCM group and the control group. For all patients, 6-year disease-free survival (DFS) was 57.6% after TCM and 46.6% after non-TCM (p = 0.0006). 6-year DFS for patients with stage I disease in the TCM group was 79.5% compared with 89.1% in the control group (p = 0.65). For patients with stage II disease, 6-year DFS was 63.1% in the TCM group compared with 50.2% in the control group (p = 0.054), and for patients with stage III disease, it was 43.3% in the TCM group compared with 22.0% in the control group (p = 0.0000). MATERIALS AND METHODS Data for patients with stage I-III disease between 2004 and 2013 were retrieved for this study, who underwent TCM after surgery were in the TCM group and the others were in the control group. Clinic appointments or phone were used to collect data by research assistants. Survival data were collected on Nov 2015 from the database, which is continuously updated by the researchers. CONCLUSIONS TCM is associated with significantly improved disease-free survival, in particular for patients with stage III disease. Among of these, TCM is not necessary for patients with stage I disease, and postoperative patients with stage II disease should be recommended to take 2 years of TCM. For patients with stage III disease, adherence to medication of TCM during the 6-year follow-up is worthy of being recommended.
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Affiliation(s)
- Qi Shi
- Oncology Department of Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China
| | - Shanshan Liu
- Oncology Department of Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China
| | - Wen Li
- Oncology Department of Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China
| | - Shaoqi Zong
- Oncology Department of Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China
| | - Susu Han
- Oncology Department of Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China
| | - Wei Yang
- Oncology Department of Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China
| | - Hongjia Li
- Oncology Department of Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China
| | - Fenggang Hou
- Oncology Department of Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China
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193
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Chiu SYH, Chuang SL, Chen SLS, Yen AMF, Fann JCY, Chang DC, Lee YC, Wu MS, Chou CK, Hsu WF, Chiou ST, Chiu HM. Faecal haemoglobin concentration influences risk prediction of interval cancers resulting from inadequate colonoscopy quality: analysis of the Taiwanese Nationwide Colorectal Cancer Screening Program. Gut 2017; 66:293-300. [PMID: 26515543 PMCID: PMC5284478 DOI: 10.1136/gutjnl-2015-310256] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 10/04/2015] [Accepted: 10/11/2015] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Interval colorectal cancer (CRC) after colonoscopy may affect effectiveness and cost-effectiveness of screening programmes. We aimed to investigate whether and how faecal haemoglobin concentration (FHbC) of faecal immunochemical testing (FIT) affected the risk prediction of interval cancer (IC) caused by inadequate colonoscopy quality in a FIT-based population screening programme. DESIGN From 2004 to 2009, 29 969 subjects underwent complete colonoscopy after positive FIT in the Taiwanese Nationwide CRC Screening Program. The IC rate was traced until the end of 2012. The incidence of IC was calculated in relation to patient characteristics, endoscopy-related factors (such adenoma detection rate (ADR)) and FHbC. Poisson regression analysis was performed to assess the potential risk factors for colonoscopy IC. RESULTS One hundred and sixty-two ICs developed after an index colonoscopy and the estimated incidence was 1.14 per 1000 person-years of observation for the entire cohort. Increased risk of IC was most remarkable in the uptake of colonoscopy in settings with ADR lower than 15% (adjusted relative risk (aRR)=3.09, 95% CI 1.55 to 6.18) and then higher FHbC (μg Hb/g faeces) (100-149: aRR=2.55, 95% CI 1.52 to 4.29, ≥150: aRR=2.74, 95% CI 1.84 to 4.09) with adjustment for older age and colorectal neoplasm detected at baseline colonoscopy. Similar findings were observed for subjects with negative index colonoscopy. CONCLUSIONS Colonoscopy ICs arising from FIT-based population screening programmes were mainly influenced by inadequate colonoscopy quality and independently predicted by FHbC that is associated with a priori chance of advanced neoplasm. This finding is helpful for future modification of screening logistics based on FHbC.
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Affiliation(s)
- Sherry Yueh-Hsia Chiu
- Department of Health Care Management, College of Management, Chang Gung University, Tao-Yuan, Taiwan
| | - Shu-Ling Chuang
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Sam Li-Sheng Chen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Amy Ming-Fang Yen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Jean Ching-Yuan Fann
- Department of Health Industry Management, School of Healthcare Management, Kainan University, Tao-Yuan, Taiwan
| | - Dun-Cheng Chang
- Health Promotion Administration, Ministry of Health and Welfare, Taipei, Taiwan
| | - Yi-Chia Lee
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Shiang Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chu-Kuang Chou
- Division of Gastroenterology and Hepatology, Chia-Yi Christian Hospital, Chia-Yi, Taiwan
| | - Wen-Feng Hsu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Shu-Ti Chiou
- Health Promotion Administration, Ministry of Health and Welfare, Taipei, Taiwan.,Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Han-Mo Chiu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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194
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Aniwan S, Ratanachu Ek T, Pongprasobchai S, Limsrivilai J, Praisontarangkul OA, Pisespongsa P, Mairiang P, Sangchan A, Sottisuporn J, Wisedopas N, Kullavanijaya P, Rerknimitr R. The Optimal Cut-Off Level of The Fecal Immunochemical Test For Colorectal Cancer Screening in a Country with Limited Colonoscopy Resources: A Multi-Center Study from Thailand. Asian Pac J Cancer Prev 2017; 18:405-412. [PMID: 28345822 PMCID: PMC5454735 DOI: 10.22034/apjcp.2017.18.2.405] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Selecting the cut-off point for the fecal immunochemical test (FIT) for colorectal cancer (CRC) screening programs is of prime importance. The balance between the test performance for detecting advanced neoplasia and the available colonoscopy resources should be considered. We aimed to identify the optimal cut-off of FIT for advanced neoplasia in order to minimize colonoscopy burden. Methods: We conducted a multi-center study in 6 hospitals from diverse regions of Thailand. Asymptomatic participants, aged 50-75 years, were tested with one-time quantitative FIT (OC-SENSOR, Eiken Chemical Co.,Ltd., Tokyo, Japan) and all participants underwent colonoscopy. We assessed test performance in detecting advanced neoplasia (advanced adenoma and CRC) and measured the burden of colonoscopy with different cut-offs [25 (FIT25), 50 (FIT50), 100 (FIT100), 150 (FIT150), and 200 (FIT200)ng/ml]. Results: Among 1,479 participants, advanced neoplasia and CRC were found in 137 (9.3%) and 14 (0.9%), respectively. From FIT25 to FIT200, the positivity rate decreased from 18% to 4.9%. For advanced neoplasia, an increased cut-off decreased sensitivity from 42.3% to 16.8% but increased specificity from 84.2% to 96.3%. The increased cut-off increased the positive predictive value (PPV) from 21.5% to 31.5%. However, all cut-off points provided a high negative predictive value (NPV) (>90%). For CRC, the miss rate for FIT25 to FIT 150 was the same (n=3, 21%), whereas that with FIT200 increased to 35% (n=5). Conclusions: In a country with limited-colonoscopy resources, using FIT150 may be preferred because it offers both high PPV and NPV for advanced neoplasia detection. It could also decrease colonoscopy workload, while maintaining a CRC miss rate similar to those with lower cut-offs.
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Affiliation(s)
- Satimai Aniwan
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.
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195
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Galal YS, Amin TT, Alarfaj AK, Almulhim AA, Aljughaiman AA, Almulla AK, Abdelhai RA. Colon Cancer among Older Saudis: Awareness of Risk Factors and Early Signs, and Perceived Barriers to Screening. Asian Pac J Cancer Prev 2017; 17:1837-46. [PMID: 27221862 DOI: 10.7314/apjcp.2016.17.4.1837] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Colon cancer screening (CRCS) uptake is markedly affected by public awareness of the disease. This study was conducted to assess levels of knowledge of CRC, to explore the pattern of CRCS uptake and identify possible barriers to screening among Saudis older than 50 years of age and primary care providers (PCPs) in Al Hassa region, Saudi Arabia. MATERIALS AND METHODS This cross-sectional study was conducted in randomly selected primary health care (PHC) centers, 884 Saudis and 39 PCPs being enrolled for data collection. Structured interviews were conducted to obtain information regarding socio-demographic characteristics, personal information relevant to CRC, awareness about early signs/symptoms and risk factors, and barriers to CRCS. Also, a self- administered data collection form was used to assess barriers to CRCS from the physicians' perspectives. RESULTS More than 66% of participants were lacking knowledge about CRC. Participants with higher educational levels, having ever heard about CRC, and having relatives with CRC had a significantly higher awareness of the disease. The rate of reported CRCS was low (8.6%). After conducting a logistic regression analysis, it was observed that female gender (OR=0.28; 95% CI=0.14-0.57; P=0.001), being unmarried (OR=0.11; 95% CI=0.10-0.23; P=0.001), lower levels of education (OR=0.36; 95% CI=0.16-0.82; P=0.015), and having no relatives with CRC (OR=0.30; 95% CI=0.17-0.56; P=0.001) were significantly associated with a lower CRCS uptake. There was a significant difference between most of the perceived barriers to CRCS and gender. Exploratory factor analysis showed that personal fear (especially fear of the screening results and shyness) was the major factor that hindered CRCS with high loading Eigen value of 2.951, explaining 34.8% of the barriers of the included sample toward utilization of CRCS, followed by lack of awareness of both person and providers (high Eigen value of 2.132, and explaining 23.7% of the barriers). The most frequently cited barriers to CRCS from the physicians' perspectives were lack of public awareness, lack of symptoms and signs, and fear of painful procedures. CONCLUSIONS Poor levels of knowledge about CRC were found among older Saudis attending PHC centers in Al Hassa, Saudi Arabia. It is crucial to implement an organized national screening program in Saudi Arabia to increase public awareness.
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Affiliation(s)
- Yasmine Samir Galal
- Public Health and Community Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt E-mail :
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196
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Baghestani AR, Daneshvar T, Pourhoseingholi MA, Asadzade H. Survival of colorectal cancer patients in the presence of competing-risk. Asian Pac J Cancer Prev 2017; 15:6253-5. [PMID: 25124607 DOI: 10.7314/apjcp.2014.15.15.6253] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is considered to be a main cause of malignancy-related death in the world, being commonly diagnosed in both men and women. It is the third leading cause of cancer dependent death in the world and there are one million new cases diagnosed per year. In Iran the incidence of colorectal cancer has increased during the last 25 years and it is the fifth cause of cancer in men and the third in women. MATERIALS AND METHODS In this article we analyzed the survival of 475 colorectal patients of Taleghani hospital in Tehran with the semi-parametric competing-risks model. RESULTS There were 55% male cases and at the time of the diagnosis most of the patients were between 48 and 67 years old. The probability of a patient death from colorectal cancer with survival of more than 25 years was about 0.4. Body mass index, height, tumour site and gender had no influence. CONCLUSIONS According to these data and by using semi-parametric competing-risks method, we found out that only age at diagnosis has a significant effect on these patient survival time.
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Affiliation(s)
- Ahmad Reza Baghestani
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran E-mail :
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Tan W, Song ZZ, Xu Q, Qu X, Li Z, Wang Y, Yu Q, Wang S. Up-Regulated Expression of SPRY4-IT1 Predicts Poor Prognosis in Colorectal Cancer. Med Sci Monit 2017; 23:309-314. [PMID: 28099409 PMCID: PMC5267619 DOI: 10.12659/msm.898369] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background Long non-coding RNA SPRY4 intronic transcript 1 (lncRNA SPRY4-IT1) has been reported to be associated with the progression of several cancers, but its expression level in colorectal cancer (CRC) has rarely been reported. The purpose of this study was to estimate the clinical significance of SPRY4-IT1 in CRC. Material/Methods The relative expression levels of SPRY4-IT1 were detected by quantitative real-time polymerase chain reaction (qRT-PCR) in diseased tissues and the adjacent normal tissues of 106 CRC patients. Chi-square method was used to evaluate the association between SPRY4-IT1 expression and the clinical features. Additionally, we assessed the overall survival at different expression levels of SPRY4-IT1 using Kaplan-Meier method. The prognostic significance of SPRY4-IT1 was estimated by Cox regression analysis. Results Up-regulated level of SPRY4-IT1 was detected in pathologic tissues of CRC patients compared with adjacent normal tissues (P=0.000). The relative expression of SPRY4-IT1 was associated with the tumor size, the depth of invasion, lymph node invasion, distant invasion, and tumor stage (P<0.05). Patients with high expression of SPRY4-IT1 had poor overall survival compared with those with high level (39.3 vs. 49.3 months, log-rank test, P=0.016). Cox regression analysis showed that SPRY4-IT1 could act as an independent prognostic factor in CRC (HR=2.341, 95% CI=1.136–4.826, P=0.021). Conclusions SPRY4-IT1 might be associated with tumorigenesis and progression of CRC, and it may be a promising biomarker for prognosis in patients with CRC.
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Affiliation(s)
- Wenlong Tan
- Department of Biotechnology, Beijing Institute of Radiation Medicine, Beijing, China (mainland)
| | - Zi-Zheng Song
- II Department of Medical Oncology, PLA General Hospital, Beijing , China (mainland).,Department of Medical Oncology, Affiliated Hospital of Hebei University, Baoding, Hebei, China (mainland)
| | - Qunfang Xu
- Clinical Laboratory, Beijing Electric Power Hospital of Capital Medical University, Beijing, China (mainland)
| | - Xinyan Qu
- Department of Biotechnology, Beijing Institute of Radiation Medicine, Beijing, China (mainland)
| | - Zhen Li
- Department of Biotechnology, Beijing Institute of Radiation Medicine, Beijing, China (mainland)
| | - Yu Wang
- Clinical laboratory, Beijing Electric Power Hospital of Capital Medical University, Beijing, China (mainland)
| | - Qun Yu
- Department of Blood Products and Substitutes, Beijing Institute of Transfusion Medicine, Beijing, China (mainland)
| | - Shengqi Wang
- Department of Biotechnology, Beijing Institute of Radiation Medicine, Beijing, China (mainland)
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198
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Park YM, Kim HS, Park JJ, Baik SJ, Youn YH, Kim JH, Park H. A simple scoring model for advanced colorectal neoplasm in asymptomatic subjects aged 40-49 years. BMC Gastroenterol 2017; 17:7. [PMID: 28068908 PMCID: PMC5223374 DOI: 10.1186/s12876-016-0562-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 12/16/2016] [Indexed: 12/16/2022] Open
Abstract
Background Limited data are available for advanced colorectal neoplasm in asymptomatic individuals aged 40–49 years. We aimed to identify risk factors and develop a simple prediction model for advanced colorectal neoplasm in these persons. Methods Clinical data were collected on 2781 asymptomatic subjects aged 40–49 years who underwent colonoscopy for routine health examination. Subjects were randomly allocated to a development or validation set. Logistic regression analysis was used to determine predictors of advanced colorectal neoplasm. Results The prevalence of overall and advanced colorectal neoplasm was 20.2 and 2.5% respectively. Older age (45–49 years), male sex, positive serology of Helicobacter pylori, and high triglyceride and low high-density lipoprotein (HDL) levels were independently associated with an increased risk of advanced colorectal neoplasm. BMI (body mass index) was not significant in multivariable analysis. We developed a simple scoring model for advanced colorectal neoplasm (range 0–9). A cutoff of ≥4 defined 43% of subjects as high risk for advanced colorectal neoplasm (sensitivity, 79%; specificity, 58%; area under the receiver operating curve = 0.72) in the validation datasets. Conclusion Older age (45–49 years), male sex, positive serology of H. pylori, high triglyceride level, and low HDL level were identified as independent risk factors for advanced colorectal neoplasm.
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Affiliation(s)
- Yoo Mi Park
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 135-720, South Korea.,Health Promotion Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Hee Sun Kim
- Health Promotion Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jae Jun Park
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 135-720, South Korea.
| | - Su Jung Baik
- Health Promotion Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Hoon Youn
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 135-720, South Korea
| | - Jie-Hyun Kim
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 135-720, South Korea
| | - Hyojin Park
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 135-720, South Korea
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199
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NDRG4 stratifies the prognostic value of body mass index in colorectal cancer. Oncotarget 2016; 7:1311-22. [PMID: 26515606 PMCID: PMC4811462 DOI: 10.18632/oncotarget.6182] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 10/04/2015] [Indexed: 01/01/2023] Open
Abstract
NDRG4 is a novel candidate tumor suppressor and can inhibit PI3K/AKT signal which is related with energy balance and related carcinogenesis. In the present study, we investigated whether NDRG4 status could modify the association of obesity with clinical outcome of colorectal cancer. For this purpose, a hospital-based prospective study cohort of 226 colorectal cancer patients was involved. NDRG4 mRNA levels were determined by real-time PCR. Association of NDRG4 mRNA expression with disease-free and overall survival was studied first. Then, the association of obesity with clinical outcome was determined according to NDRG4 level. Multivariate Cox proportional hazards model was used to compute hazard ratio, adjusting for covariates including microsatellite instability, KRAS, BRAF and PIK3CA mutation. Results showed that NDRG4 mRNA expression was decreased in tumor specimens and significantly correlated with tumor differentiation, invasion and metastasis. Patients with tumor of reduced NDRG4 mRNA level had unfavorable disease-free and overall survival. Obesity was found to be adversely associated with disease-free and overall survival in tumors with reduced NDRG4 level, not in preserved NDRG4 level group, in both univariate and multivariate analysis. These data provided the first evidence that NDRG4 level in colorectal cancer could effectively stratify the prognostic value of obesity, which would better the understanding of the prognostic role of obesity in colorectal cancer. Our results also support the notion that the host-tumor interactions in colorectal cancer might influence tumor aggressiveness.
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Wang SJ, Cao YF, Yang ZQ, Jiang ZY, Cai B, Guo J, Zhang S, Zhang XL, Gao F. MicroRNA-93-5p increases multidrug resistance in human colorectal carcinoma cells by downregulating cyclin dependent kinase inhibitor 1A gene expression. Oncol Lett 2016; 13:722-730. [PMID: 28356951 PMCID: PMC5351191 DOI: 10.3892/ol.2016.5463] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Accepted: 09/30/2016] [Indexed: 01/05/2023] Open
Abstract
Multidrug resistance (MDR) impedes successful chemotherapy in colorectal carcinoma (CRC) and emerging evidence suggests that microRNAs (miRs) are involved in the development of MDR. In the present study, the role of miR-93-5p in the modulation of drug resistance in CRC was investigated using HCT-8 and MDR HCT-8/vincristine (VCR) cell lines. The results demonstrated upregulated expression of miR-93-5p and MDR protein 1 (MDR1) in HCT-8/VCR cells, compared with the parental HCT-8 cells. Furthermore, cyclin-dependent kinase inhibitor 1A (CDKN1A) was identified as a potential target of miR-93-5p using miR target analysis tools, including PicTar, TargetScan and miRanda. In addition, inhibition of miR-93-5p expression in HCT-8/VCR cells markedly downregulated MDR1 gene expression, upregulated CDKN1A gene expression and induced cell cycle arrest in G1. Conversely, the overexpression of miR-93-5p in HCT-8/VCR cells upregulated MDR1 gene expression, downregulated CDKN1A gene expression and promoted G1/S transition. Furthermore, the in vitro drug sensitivity assay performed suggested that downregulation of miR-93-5p enhanced the sensitivity of HCT-8/VCR cells to VCR, while the upregulation of miR-93-5p decreased the sensitivity of HCT-8 cells to VCR. In conclusion, the results of the present study suggest that miR-93-5p serves a role in the development of MDR through downregulating CDKN1A gene expression in CRC.
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Affiliation(s)
- Shi-Jun Wang
- Department of Colorectal and Anal Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Yun-Fei Cao
- Department of Colorectal and Anal Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Zu-Qing Yang
- Department of Colorectal and Anal Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Zhi-Yuan Jiang
- Department of Colorectal and Anal Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Bin Cai
- Department of Colorectal and Anal Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Jiao Guo
- Experimental Department, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Sen Zhang
- Department of Colorectal and Anal Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Xiao-Long Zhang
- Department of Colorectal and Anal Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Feng Gao
- Department of Colorectal and Anal Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
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