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Palma R, Andrisani G, Fanello G, Lauro A, Panetta C, Eberspacher C, Di Matteo FM, Vaccari S, Zorzetti N, D’Andrea V, Pontone S. Endocuff Vision-Assisted Resection for Difficult Colonic Lesions-Preliminary Results of a Multicenter, Prospective Randomized Pilot Study. J Clin Med 2023; 12:4980. [PMID: 37568382 PMCID: PMC10420096 DOI: 10.3390/jcm12154980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 07/21/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
Background-Screening programs for colorectal cancer are implemented due to their ability to reduce mortality. The Endocuff Vision is a new endoscopic device that significantly improves the adenoma detection rate. The primary outcome was to assess the efficacy of ECV in improving stability and reducing operation time during difficult colon polypectomies in a multicenter randomized prospective study. Methods-In a randomized multicenter pilot study, two groups of patients who underwent difficult polypectomies with and without the assistance of Endocuff Vision were compared. Demographics and clinical characteristics of patients were obtained, and polyps' size, morphology, site, and access (SMSA); polypectomy time; and endoscope stability were evaluated. Results-From October 2016 to April 2020, 32 patients were enrolled. In total, 12 patients underwent Endocuff Vision polypectomy, and 20 patients underwent standard polypectomy by using a computer-generated random number table. No statistical differences were found in clinical characteristics, SMSA, and polypectomy time. The most interesting findings were the positive correlations between shaking and SMSA (r = 0.55, p = 0.005) and shaking and polypectomy time (r = 0.745, p < 0.0001). Conclusion-Endocuff Vision seems to be adequately stable during difficult endoscopic resection procedures. The new parameter proposed that shaking is strongly correlated to the stability of the endoscope, the difficulty of the resection (SMSA), and the polypectomy time.
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Affiliation(s)
- Rossella Palma
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (R.P.); (A.L.); (C.P.); (C.E.); (S.V.); (N.Z.); (V.D.)
| | - Gianluca Andrisani
- Digestive Endoscopy Unit, Campus Bio-Medico, University of Rome, 00185 Rome, Italy; (G.A.); (F.M.D.M.)
| | - Gianfranco Fanello
- UOC Gastroenterologia ed Endoscopia Digestiva, Azienda Ospedaliera “San Giovanni-Addolorata”, 00184 Rome, Italy;
| | - Augusto Lauro
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (R.P.); (A.L.); (C.P.); (C.E.); (S.V.); (N.Z.); (V.D.)
| | - Cristina Panetta
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (R.P.); (A.L.); (C.P.); (C.E.); (S.V.); (N.Z.); (V.D.)
| | - Chiara Eberspacher
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (R.P.); (A.L.); (C.P.); (C.E.); (S.V.); (N.Z.); (V.D.)
| | - Francesco Maria Di Matteo
- Digestive Endoscopy Unit, Campus Bio-Medico, University of Rome, 00185 Rome, Italy; (G.A.); (F.M.D.M.)
| | - Samuele Vaccari
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (R.P.); (A.L.); (C.P.); (C.E.); (S.V.); (N.Z.); (V.D.)
| | - Noemi Zorzetti
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (R.P.); (A.L.); (C.P.); (C.E.); (S.V.); (N.Z.); (V.D.)
| | - Vito D’Andrea
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (R.P.); (A.L.); (C.P.); (C.E.); (S.V.); (N.Z.); (V.D.)
| | - Stefano Pontone
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (R.P.); (A.L.); (C.P.); (C.E.); (S.V.); (N.Z.); (V.D.)
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Pattarajierapan S, Takamaru H, Khomvilai S. Difficult colorectal polypectomy: Technical tips and recent advances. World J Gastroenterol 2023; 29:2600-2615. [PMID: 37213398 PMCID: PMC10198056 DOI: 10.3748/wjg.v29.i17.2600] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/24/2023] [Accepted: 04/12/2023] [Indexed: 05/23/2023] Open
Abstract
Colonoscopy has been shown to be an effective modality to prevent colorectal cancer (CRC) development. CRC reduction is achieved by detecting and removing adenomas, which are precursors of CRC. Most colorectal polyps are small and do not pose a significant challenge for trained and skilled endoscopists. However, up to 15% of polyps are considered “difficult”, potentially causing life-threatening complications. A difficult polyp is defined as any polyp that is challenging for the endoscopist to remove owing to its size, shape, or location. Advanced polypectomy techniques and skills are required to resect difficult colorectal polyps. There were various polypectomy techniques for difficult polyps such as endoscopic mucosal resection (EMR), underwater EMR, Tip-in EMR, endoscopic submucosal dissection (ESD), or endoscopic full-thickness resection. The selection of the appropriate modality depends on the morphology and endoscopic diagnosis. Several technologies have been developed to aid endoscopists in performing safe and effective polypectomies, especially complex procedures such as ESD. These advances include video endoscopy system, equipment assisting in advanced polypectomy, and closure devices/techniques for complication management. Endoscopists should know how to use these devices and their availability in practice to enhance polypectomy performance. This review describes several useful strategies and tips for managing difficult colorectal polyps. We also propose the stepwise approach for difficult colorectal polyps.
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Affiliation(s)
- Sukit Pattarajierapan
- Surgical Endoscopy Colorectal Division, Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Hiroyuki Takamaru
- Endoscopy Division, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Supakij Khomvilai
- Surgical Endoscopy Colorectal Division, Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
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Tziatzios G, Gkolfakis P, Papadopoulos V, Papanikolaou IS, Fuccio L, Facciorusso A, Ebigbo A, Gölder SK, Probst A, Messmann H, Triantafyllou K. Modified endoscopic mucosal resection techniques for treating precancerous colorectal lesions. Ann Gastroenterol 2021; 34:757-769. [PMID: 34815641 PMCID: PMC8596214 DOI: 10.20524/aog.2021.0647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 04/24/2021] [Indexed: 11/13/2022] Open
Abstract
Endoscopic mucosal resection (EMR) is a technique allowing efficacious and minimally invasive resection of precancerous lesions across the entire gastrointestinal tract. However, conventional EMR, involving injection of fluid into the submucosal space, is imperfect, given the high rate of recurrence of post-endoscopic resection adenoma, especially after piecemeal resection. In light of these observations, modifications of the technique have been proposed to overcome the weakness of conventional EMR. Some of them were designed to maximize the chance of en bloc resection—cap-assisted EMR, underwater EMR, tip-in EMR, precutting, assisted by ligation device—while others were designed to minimize the complications (cold EMR). In this review, we present their modes of action and summarize the evidence regarding their efficacy and safety.
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Affiliation(s)
- Georgios Tziatzios
- Hepatogastroenterology Unit, Second Department of Internal Medicine-Propaedeutic, Medical School, National and Kapodistrian University of Athens, "Attikon" University General Hospital, Athens, Greece (Georgios Tziatzios, Ioannis S. Papanikolaou, Konstantinos Triantafyllou)
| | - Paraskevas Gkolfakis
- Department of Gastroenterology Hepatopancreatology and Digestive Oncology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium (Paraskevas Gkolfakis)
| | - Vasilios Papadopoulos
- Department of Gastroenterology, Koutlimbaneio & Triantafylleio General Hospital, Larissa, Greece (Vasilios Papadopoulos)
| | - Ioannis S Papanikolaou
- Hepatogastroenterology Unit, Second Department of Internal Medicine-Propaedeutic, Medical School, National and Kapodistrian University of Athens, "Attikon" University General Hospital, Athens, Greece (Georgios Tziatzios, Ioannis S. Papanikolaou, Konstantinos Triantafyllou)
| | - Lorenzo Fuccio
- Gastroenterology Unit, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy (Lorenzo Fuccio)
| | - Antonio Facciorusso
- Gastroenterology Unit, Department of Surgical and Medical Sciences, University of Foggia, Italy (Antonio Facciorusso)
| | - Alanna Ebigbo
- Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany (Alanna Ebigbo, Stefan Karl Gölder, Andreas Probst, Helmut Messmann)
| | - Stefan Karl Gölder
- Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany (Alanna Ebigbo, Stefan Karl Gölder, Andreas Probst, Helmut Messmann)
| | - Andreas Probst
- Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany (Alanna Ebigbo, Stefan Karl Gölder, Andreas Probst, Helmut Messmann)
| | - Helmut Messmann
- Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany (Alanna Ebigbo, Stefan Karl Gölder, Andreas Probst, Helmut Messmann)
| | - Konstantinos Triantafyllou
- Hepatogastroenterology Unit, Second Department of Internal Medicine-Propaedeutic, Medical School, National and Kapodistrian University of Athens, "Attikon" University General Hospital, Athens, Greece (Georgios Tziatzios, Ioannis S. Papanikolaou, Konstantinos Triantafyllou)
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Abdalla S, Meillat H, Fillol C, Zuber K, Manceau G, Dubray V, Beyer-Berjot L, Lefevre JH, Selvy M, Benoist S, Micelli Lupinacci R. Ileocecal Valve Sparing Resection for the Treatment of Benign Cecal Polyps Unsuitable for Polypectomy. JSLS 2021; 25:JSLS.2021.00023. [PMID: 34316245 PMCID: PMC8280722 DOI: 10.4293/jsls.2021.00023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Not all benign-appearance polyps are amenable to endoscopic removal and colectomy is required in some cases. This study aims to compare the early outcomes of cecal wedge resection with ileocecal valve sparring versus standard right colectomy in patients with endoscopically unresectable cecal polyps referred for surgery. Methods: From Apr 2010 to Aug 2019, all consecutive patients who underwent cecal wedge resection or right colectomy in ten European centers for a presumed endoscopically benign polyp unsuitable for endoscopic resection were retrospectively analyzed. The primary endpoint was morbidity. Secondary endpoints were operative time and length of hospital stay. Results: One hundred and ten patients were included: 25 patients underwent cecal wedge resection and 85 a right colectomy. There were 56 men (51%) and 90% of the procedures were performed laparoscopically. 29 lesions were located at the appendix orifice (26.4%). Mortality was nil. There were no significant differences between both procedures for morbidity rate (20% versus 24.7%) or reoperation (4% versus 4.7%). Cecal wedge was related to shorter operative time (63 min versus 150 min, P = .008) and shorter hospital stay (5 days versus 6 days, P = .049). Only 1 patient had a salvage right colectomy after cecal wedge for a pTis adenoma. Conclusions: For benign-appearance cecal polyps unsuitable for endoscopic ablation, cecal wedge resection is safe and should be considered as an attractive alternative to right colectomy.
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Affiliation(s)
| | | | | | - Kevin Zuber
- Fondation Ophtalmologique Rothschild, Paris, France
| | | | - Vincent Dubray
- Université de Lille, Service de Chirurgie Digestive et Générale, Hôpital Claude Huriez, CHU de Lille, 59037 Lille, France
| | | | - Jérémie H Lefevre
- Sorbonne Université, Department of Digestive Surgery, AP-HP, Hôpital St Antoine, 75012 Paris, France
| | - Marie Selvy
- Service de Chirurgie Digestive, CHU Estaing, 63100 Clermont-Ferrand, France
| | - Stéphane Benoist
- Service de Chirurgie Digestive et Oncologique, CHU Bicêtre, 94270 Le Kremlin-Bicêtre, France
| | - Renato Micelli Lupinacci
- Service de Chirurgie Digestive et Oncologique, Hôpital Ambroise Paré, 92104 Boulogne-Billancourt, France
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Yang D, Aihara H, Perbtani YB, Wang AY, Aadam AA, Tomizawa Y, Hwang JH, Zou B, Natov NS, Siegel A, Khoshknab MP, Khashab MA, Ngamruengphong S, Khara HS, Diehl DL, Maniere T, Andrawes S, Benias P, Kumta NA, Ramay F, Kim RE, Samarasena J, Chang K, Hashimoto R, Tharian B, Inamdar S, Lan G, Sethi A, Nosler MJ, Tabash A, Othman MO, Draganov PV. Safety and efficacy of endoscopic submucosal dissection for rectal neoplasia: a multicenter North American experience. Endosc Int Open 2019; 7:E1714-E1722. [PMID: 31803823 PMCID: PMC6887644 DOI: 10.1055/a-1010-5663] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 08/16/2019] [Indexed: 02/07/2023] Open
Abstract
Background and aims Rectal lesions traditionally represent the first lesions approached during endoscopic submucosal dissection (ESD) training in the West. We evaluated the safety and efficacy of rectal ESD in North America. Methods This is a multicenter retrospective analysis of rectal ESD between January 2010 and September 2018 in 15 centers. End points included: rates of en bloc resection, R0 resection, adverse events, comparison of pre- and post-ESD histology, and factors associated with failed resection. Results In total, 171 patients (median age 63 years; 56 % men) underwent rectal ESD (median size 43 mm). En bloc resection was achieved in 141 cases (82.5 %; 95 %CI 76.8-88.2), including 24 of 27 (88.9 %) with prior failed endoscopic mucosal resection (EMR). R0 resection rate was 74.9 % (95 %CI 68.4-81.4). Post-ESD bleeding and perforation occurred in 4 (2.3 %) and 7 (4.1 %), respectively. Covert submucosal invasive cancer (SMIC) was identified in 8.6 % of post-ESD specimens. There was one case (1/120; 0.8 %) of recurrence at a median follow-up of 31 weeks; IQR: 19-76 weeks). Older age and higher body mass index (BMI) were predictors of failed R0 resection, whereas submucosal fibrosis was associated with a higher likelihood of both failed en bloc and R0 resection. Conclusion Rectal ESD in North America is safe and is associated with high en bloc and R0 resection rates. The presence of submucosal fibrosis was the main predictor of failed en bloc and R0 resection. ESD can be considered for select rectal lesions, and serves not only to establish a definitive tissue diagnosis but also to provide curative resection for lesions with covert advanced disease.
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Affiliation(s)
- Dennis Yang
- Division of Gastroenterology and Hepatology, University of Florida, Gainesville, FL, USA,Corresponding author Dennis Yang, MD 1329 SW 16th StreetRoom #5252GainesvilleFL 32608USA+1-352-627-9002
| | - Hiroyuki Aihara
- Division of Gastroenterology and Hepatology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Yaseen B. Perbtani
- Division of Gastroenterology and Hepatology, University of Florida, Gainesville, FL, USA
| | - Andrew Y. Wang
- Division of Gastroenterology and Hepatology, University of Virginia, Charlottesville, VA, USA
| | - Abdul Aziz Aadam
- Division of Gastroenterology and Hepatology, Northwestern University Medical Center, Chicago, IL, USA
| | - Yutaka Tomizawa
- Division of Gastroenterology and Hepatology, University of Washington, Seattle, WA, USA
| | - Joo Ha Hwang
- Division of Gastroenterology and Hepatology, University of Washington, Seattle, WA, USA
| | - Baiming Zou
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - Nikola S. Natov
- Division of Gastroenterology and Hepatology, University of Virginia, Charlottesville, VA, USA
| | - Amanda Siegel
- Division of Gastroenterology and Hepatology, Northwestern University Medical Center, Chicago, IL, USA
| | | | - Mouen A. Khashab
- Division of Gastroenterology and Hepatology, Johns Hopkins Medicine, Baltimore, MD, USA
| | | | - Harshit S. Khara
- Division of Gastroenterology and Hepatology, Geisinger Health System, Danville, PA, USA
| | - David L. Diehl
- Division of Gastroenterology and Hepatology, Geisinger Health System, Danville, PA, USA
| | - Thibaut Maniere
- Division of Gastroenterology and Hepatology, Universite de Sherbrooke, Sherbrook, QC, Canada
| | - Sherif Andrawes
- Division of Gastroenterology and Hepatology, Northwell Health, Staten Island, NY, USA
| | - Petros Benias
- Division of Gastroenterology and Hepatology, Northwell Health, Staten Island, NY, USA
| | - Nikhil A. Kumta
- Division of Gastroenterology, Mount Sinai Hospital, New York, NY, USA
| | - Fariha Ramay
- Division of Gastroenterology and Hepatology, University of Maryland, Baltimore, MD, USA
| | - Raymond E. Kim
- Division of Gastroenterology and Hepatology, University of Maryland, Baltimore, MD, USA
| | - Jason Samarasena
- Division of Gastroenterology and Hepatology, University of California Irvine, Irvine, CA, USA
| | - Kenneth Chang
- Division of Gastroenterology and Hepatology, University of California Irvine, Irvine, CA, USA
| | - Rintaro Hashimoto
- Division of Gastroenterology and Hepatology, University of California Irvine, Irvine, CA, USA
| | - Benjamin Tharian
- Division of Gastroenterology and Hepatology, University of Arkansas Medical Sciences, Little Rock, AR, USA
| | - Sumant Inamdar
- Division of Gastroenterology and Hepatology, University of Arkansas Medical Sciences, Little Rock, AR, USA
| | - Gloria Lan
- Division of Gastroenterology and Hepatology, New York Presbyterian Hospital, New York, NY, USA
| | - Amrita Sethi
- Division of Gastroenterology and Hepatology, New York Presbyterian Hospital, New York, NY, USA
| | | | - Abdalaziz Tabash
- Division of Gastroenterology and Hepatology, Baylor University Medical Center, Houston, TX, USA
| | - Mohamed O. Othman
- Division of Gastroenterology and Hepatology, Baylor University Medical Center, Houston, TX, USA
| | - Peter V. Draganov
- Division of Gastroenterology and Hepatology, University of Florida, Gainesville, FL, USA
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Yamamoto T, Suzuki S, Kusano C, Yakabe K, Iwamoto M, Ikehara H, Gotoda T, Moriyama M. Histological outcomes between hot and cold snare polypectomy for small colorectal polyps. Saudi J Gastroenterol 2017; 23:246-252. [PMID: 28721979 PMCID: PMC5539679 DOI: 10.4103/sjg.sjg_598_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND/AIM To compare the complete resection rate of hot and cold snare polypectomy for small colorectal polyps. PATIENTS AND METHODS We retrospectively reviewed the medical records of 233 consecutive patients with 461 colorectal polyps up to 10 mm in diameter that were treated by hot or cold snare polypectomy between April 2014 and August 2016. Lesions treated by hot snare polypectomy (n = 137) and cold snare polypectomy (n = 324) were compared. The histological complete resection rates were evaluated between the two groups. We analyzed the relationship between factors for complete resection and clinical factors using multivariate analysis. RESULTS There was a significantly higher complete resection rate in hot snare polypectomy than in cold snare polypectomy (70.5% vs. 47.3%; P < 0.001). In the analysis of subgroups categorized according to polyp size, the complete resection rate for hot snare polypectomy was significantly higher than that for cold snare polypectomy among polyps ≥6 mm (69.0% vs. 43.5%; P < 0.001). Among polyps ≤5 mm, no significant difference regarding the complete resection rate was observed between the methods (81.3% vs. 53.4%; P = 0.057). There was no significant difference in the incidence of adverse events between the two groups. Multivariate analysis revealed that using hot snare polypectomy (odds ratio 3.03; P < 0.001), small lesion size (odds ratio 1.57; P = 0.049), and lesion location in the left colon (odds ratio 1.73; P = 0.007) were independent factors for complete resection. CONCLUSION Hot snare polypectomy provides a higher complete resection rate than does cold snare polypectomy for larger (6-10 mm) subcentimeter colorectal polyps.
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Affiliation(s)
- Toshiki Yamamoto
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Sho Suzuki
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan,Department of Gastroenterology, Yuri-Kumiai General Hospital, Akita, Japan,Address for correspondence: Dr. Sho Suzuki, Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan. E-mail:
| | - Chika Kusano
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan,Department of Gastroenterology, Yuri-Kumiai General Hospital, Akita, Japan
| | - Kyoko Yakabe
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Maho Iwamoto
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Hisatomo Ikehara
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Takuji Gotoda
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Mitsuhiko Moriyama
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
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Lu HY, Lin RT, Zhou GX, Yu TM, Liu ZJ. Critical Role of p53 and K-ras in the Diagnosis of Early Colorectal Cancer: a One-year, Single-center Analysis. Int J Med Sci 2017; 14:1154-1162. [PMID: 29104470 PMCID: PMC5666547 DOI: 10.7150/ijms.20538] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 08/07/2017] [Indexed: 12/18/2022] Open
Abstract
Background: Colorectal cancer (CRC) is strongly associated with colorectal polyps, which has become the third most common cancer in China. In the present study, we revealed the susceptible population and risk factors of colorectal polyps, and analyzed the expression of Ki-67, p53 and K-ras in the intestinal mucosa of patients with colorectal polyps in order to explore their significance in the detection and prognosis of CRC at an early stage. Materials and Methods: Total 801 cases of colorectal polyps were collected during endoscopic resection including endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). Expression of Ki-67, p53 and K-ras in the intestinal mucosa was detected by immunohistochemistry and quantitative real-time polymerase chain reaction (qRT-PCR), respectively. Histological analysis was performed by Hematoxylin and eosin (HE) staining. Categorical variables were compared by one-way ANOVA, Pearson test, Spearman test, Kruskal-Wallis test and analysis of regression. Results: Of all patients with colorectal polyps, 90.76% of patients (n = 727) were ≥ 50 years old. 530 cases (66.17%) were males compared with 271 females (33.83%) in all 801 cases. More importantly, 1.03% patients (n = 7) underwent polypectomy and histological examination was confirmed to be the early stage of CRC. The expression of p53 was found to be significantly decreased, while K-ras was increased in tumor tissues of CRC compared with that in hyperplastic polyps and healthy controls. Conclusions: 1.03% patients (n = 7) underwent polypectomy was confirmed to be the early stage of CRC. Histological analysis for expression of p53 and K-ras can guarantee to screen the early stage of CRC.
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Affiliation(s)
- Hui-Ying Lu
- Department of Gastroenterology, The Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China
| | - Ri-Tian Lin
- Department of Gastroenterology, The Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China
| | - Guang-Xi Zhou
- Department of Gastroenterology, The Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China
| | - Tian-Ming Yu
- Department of Gastroenterology, The Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China
| | - Zhan-Ju Liu
- Department of Gastroenterology, The Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China
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