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Ghosh NK, Kumar A. Ultra-minimally invasive endoscopic techniques and colorectal diseases: Current status and its future. Artif Intell Gastrointest Endosc 2024; 5:91424. [DOI: 10.37126/aige.v5.i2.91424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 04/12/2024] [Accepted: 05/06/2024] [Indexed: 05/11/2024] Open
Abstract
Colorectal diseases are increasing due to altered lifestyle, genetic, and environmental factors. Colonoscopy plays an important role in diagnosis. Advances in colonoscope (ultrathin scope, magnetic scope, capsule) and technological gadgets (Balloon assisted scope, third eye retroscope, NaviAid G-EYE, dye-based chromoendoscopy, virtual chromoendoscopy, narrow band imaging, i-SCAN, etc.) have made colonoscopy more comfortable and efficient. Now in-vivo microscopy can be performed using confocal laser endomicroscopy, optical coherence tomography, spectroscopy, etc. Besides developments in diagnostic colonoscopy, therapeutic colonoscopy has improved to manage lower gastrointestinal tract bleeding, obstruction, perforations, resection polyps, and early colorectal cancers. The introduction of combined endo-laparoscopic surgery and robotic endoscopic surgery has made these interventions feasible. The role of artificial intelligence in the diagnosis and management of colorectal diseases is also increasing day by day. Hence, this article is to review cutting-edge developments in endoscopic principles for the management of colorectal diseases.
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Affiliation(s)
- Nalini Kanta Ghosh
- Department of Surgical Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India
| | - Ashok Kumar
- Department of Surgical Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India
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Zhuo L, Kong Y, Chen S, Ma Y, Cai T, Pan J, Wang X, Gao Y, Lu H, Li X, Zhao H, Mackay L, Dong W, Zhuo L, Dong D. Effect of sedated colonoscopy with different cost coverage on improving compliance with colorectal cancer screening in China. Front Oncol 2023; 13:1156237. [PMID: 37469417 PMCID: PMC10352912 DOI: 10.3389/fonc.2023.1156237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/19/2023] [Indexed: 07/21/2023] Open
Abstract
Background Colorectal cancer is the third most common cancer worldwide. Colonoscopy is the gold standard for colorectal cancer screening. However, the colonoscopy participation rate in China is much lower than that in Europe and the United States. As only non-sedated colonoscopies are offered in colorectal cancer screening programs in China, the absence of sedation may contribute to this gap. Methods To explore the effect of free and partially participant-paid sedated colonoscopy on improving colorectal screening participation, we conducted a cross-sectional study under the framework of the Cancer Screening Program in Urban China in Xuzhou from May 2017 to December 2020. The Quanshan district was set as the control group and provided free non-sedated colonoscopy, the Yunlong district was set as a partial cost coverage group and offered partially participant-paid sedated colonoscopy, and the Gulou district was set as the full cost coverage group and offered free sedation colonoscopies. Multivariate logistic regression was used for multivariate analysis of colonoscopy participation and colorectal lesion detection rates between the groups. Results From May 2017 to May 2020, 81,358 participants were recruited and completed questionnaire, 7,868 subjects who met high-risk conditions for CRC were invited to undergo colonoscopy. The colonoscopy participation rates in the control group, partially cost coverage, and full cost coverage groups were 17.33% (594/3,428), 25.66% (542/2,112), and 34.41% (801/2,328), respectively. Subjects in the partial and full cost coverage groups had 1.66-fold (95% CI: 1.48-1.86) and 2.49-fold (95% CI: 2.23-2.76) increased rates compared with those in the control group. The adjusted PARs for the partially and the full cost coverage group was 9.08 (95% CI: 6.88-11.28) and 18.97 (95% CI: 16.51-21.42), respectively. The detection rates of CAN in the control, partial-cost coverage, and full-cost coverage groups were 3.54% (21/594), 2.95% (16/542), and 5.12% (41/801), respectively. There were no significant differences in the detection rates between the group. However, sedated colonoscopy increases costs. Conclusion Sedated colonoscopy increased colonoscopy participation rates in both the partial and full cost-covered groups. A partial cost coverage strategy may be a good way to increase colorectal cancer participation rates and quickly establish a colorectal cancer screening strategy in underfunded areas.
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Affiliation(s)
- Lin Zhuo
- School of Public Health, Xuzhou Medical University, Xuzhou, China
- Department of Endocrinology, Peking University People′s Hospital, Beijing, China
| | - Yunxin Kong
- School of Public Health, Xuzhou Medical University, Xuzhou, China
- Cancer Prevention Office, Xuzhou Cancer Hospital, Xuzhou, China
| | - Siting Chen
- School of Management, Xuzhou Medical University, Xuzhou, China
| | - Yue Ma
- Cancer Prevention Office, Xuzhou Cancer Hospital, Xuzhou, China
- School of Management, Xuzhou Medical University, Xuzhou, China
| | - Ting Cai
- School of Management, Xuzhou Medical University, Xuzhou, China
| | - Jianqiang Pan
- School of Management, Xuzhou Medical University, Xuzhou, China
| | - Xiuying Wang
- Department of Nephrology, Xuzhou Central Hospital, Xuzhou, China
| | - Yihuan Gao
- School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Hang Lu
- School of Management, Xuzhou Medical University, Xuzhou, China
| | - Xinyue Li
- Department of Nephrology, Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, China
| | - Hongying Zhao
- Department of Medical Oncology, Xuzhou Cancer Hospital, Xuzhou, China
| | - Louisa Mackay
- School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Wendi Dong
- School of Clinical Medicine, Jiangsu University, Zhenjiang, China
| | - Lang Zhuo
- School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Dong Dong
- Cancer Prevention Office, Xuzhou Cancer Hospital, Xuzhou, China
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Shi H, Zeng H, Wang M, Jiang J, Sha S, Chen F, Wang Y, Cheng Y, Ma S, Liu X. Effectiveness of Water-Assisted Colonoscopy without Sedation in Patients with Ulcerative Colitis. Dig Dis 2023; 41:737-745. [PMID: 37369180 DOI: 10.1159/000531652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 05/24/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Studies have found that water-assisted colonoscopy (WAC) including water immersion colonoscopy (WIC) and water exchange colonoscopy (WEC) is superior to air insufflation colonoscopy (AIC) in terms of the cecal intubation rate. However, the application of WAC in ulcerative colitis (UC) has rarely been reported. This study aimed to explore the effectiveness of WAC without sedation in patients with UC. METHODS One hundred and seventy-two UC patients were randomly divided into the AIC group (n = 56), WIC group (n = 58), and WEC group (n = 58). The cecal intubation rate, abdominal pain score, operator difficulty, bowel cleanliness, insertion, and total time were compared. RESULTS The cecal intubation rate was higher in the WIC (91.4% vs. 75.0%; mean difference = 16.4%; 95% CI: 3.0-29.8%) and WEC (93.1% vs. 75.0%; mean difference = 18.1%; 95% CI: 5.0-31.2%) compared to the AIC group, while there was no difference between the WIC and WEC groups. The abdominal pain score and operator difficulty were lower in the WIC and WEC groups than in the AIC group, while there was no difference between the WIC and WEC groups. The bowel cleanliness during withdrawal was higher in the WIC and WEC groups than in the AIC group, while the WEC was superior to WIC. Compared with the AIC and WIC groups, the insertion time and total time were longer in the WEC group, and there was no difference in the AIC group and WIC group. CONCLUSION In comparison with AIC, WAC can increase the cecal intubation rate, reduce abdominal pain scores and improve bowel cleanliness in patients with UC.
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Affiliation(s)
- Haitao Shi
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Hong Zeng
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Mei Wang
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jiong Jiang
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Sumei Sha
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Fenrong Chen
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yan Wang
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yan Cheng
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shiyang Ma
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xin Liu
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Comparison of adenoma detection in different colorectal segments between deep-sedated and unsedated colonoscopy. Sci Rep 2022; 12:15356. [PMID: 36097050 PMCID: PMC9468171 DOI: 10.1038/s41598-022-19468-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 08/30/2022] [Indexed: 11/08/2022] Open
Abstract
To investigate if deep-sedated colonoscopy affects adenoma detection in certain colorectal segment. Review of colonoscopy reports, electronic images and medical records of individuals underwent screening colonoscopy with or without propofol sedation between October 2020 and March 2021 from seven hospitals in China. A total of 4500 individuals were analyzed. There was no significant difference in ADR between deep-sedated colonoscopy and unsedated colonoscopy [45.4% vs. 46.3%, P > 0.05]. The APP of deep-sedated colonoscopy was lower than unsedated colonoscopy (1.76 ± 0.81 vs. 2.00 ± 1.30, P < 0.05). Both average number of adenomas and luminal distention score of splenic flexure and descending colon were lower in deep-sedated colonoscopy (P < 0.05), and average number of adenomas was positively correlated with an improved distension score in splenic flexure and descending colon (splenic flexure r = 0.031, P < 0.05; descending colon r = 0.312, P < 0.05). Linear regression model showed deep-sedated colonoscopy significantly affected luminal distention of splenic flexure and descending colon as well as average number of adenomas detected in splenic flexure (P < 0.05). Deep-sedated colonoscopy decreased adenoma detection in splenic flexure and the luminal distention of splenic flexure and descending colon compared with unsedated colonoscopy.
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Shavakhi A, Khodadoostan M, Shariaat Nabavi SJ, Sadeghian S, Gholamrezaei A, Shavakhi A. Assessment of pain between sedated and unsedated colonoscopy: Double-blind randomized clinical trail. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2021; 26:36. [PMID: 34484368 PMCID: PMC8383995 DOI: 10.4103/jrms.jrms_828_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/27/2020] [Accepted: 02/02/2021] [Indexed: 12/12/2022]
Abstract
Background Colonoscopy plays a vital role for the diagnosis and treatment of colonic diseases but can be associated with anxiety and discomfort or pain. We tested whether unsedated colonoscopy impacts quality indicators and investigated predictors of pain during colonoscopy. Materials and Methods This randomized controlled trial was performed on candidates for elective colonoscopy at AL Zahra Hospital, Isfahan at 2018-2019. Balanced block randomization was used to allocate 275 cases into two groups. At finally, 124 patients in case and 122 patients in control group enrolled in analysis. Patients in the sedation group received midazolam with/out pethidine before colonoscopy. Pain intensity in rectal examination (PIREX), preprocedural anxiety, pain intensity during colonoscopy, hemodynamics, duration of colonoscopy, polyp detection rate, cecal intubation rate, bloating within 24 h after colonoscopy, and willingness to repeat colonoscopy were assessed and compared between two groups. Results Compared to the group with sedation, cecal intubation time was shorter and bloating was less frequent (7% vs. 16%, P = 0.02) in the unsedated group. There was no difference between the two groups regarding polyp detection rate, cecal detection rate, and willingness to repeat colonoscopy. Pain during rectal examination was significantly associated with pain during colonoscopy (P < 0.001, 95% confidence interval; 0.5-1.3). Conclusion The assessment of pain intensity during rectal examination may help to identify patients who can benefit from sedation during colonoscopy. Colonoscopy with sedation does not seem to have a negative impact on colonoscopy quality indicators, and may even reduce cecal intubation time and bloating following procedure.
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Affiliation(s)
- Ahmad Shavakhi
- Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahsa Khodadoostan
- Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Sina Sadeghian
- Department of Imaging and Radiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Gholamrezaei
- Translational Research Center in Gastrointestinal Disorders, Leuven, Belgium
| | - Alireza Shavakhi
- Department of Internal Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Shan K, Lu H, Zhang Z, Xie J, Xu L, Wang W, Hu C, Xu L. Impact of second forward-view examination on adenoma detection rate during unsedated colonoscopy: a randomized controlled trial. BMC Gastroenterol 2021; 21:213. [PMID: 33971824 PMCID: PMC8111781 DOI: 10.1186/s12876-021-01783-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 04/19/2021] [Indexed: 11/22/2022] Open
Abstract
Objectives Colorectal cancer on the right side of the colon has been suggested to be harder to detect by colonoscopy. The aim of this study was to evaluate whether a second forward-view examination of the right side of the colon could increase the adenoma detection rate (ADR) and/or polyp detection rate (PDR). Methods This was a single-centre randomized controlled trial. Patients undergoing colonoscopy were recruited and randomly assigned to the second forward-view examination (SFE) group, in which the right side of the colon was examined twice or the traditional colonoscopy (TC) group in which the colonoscopy was performed in a standard manner. The primary outcome was the ADR of right colon. The overall PDR and ADR, PDR of the right colon, per-adenoma miss rate of the right colon, and advanced lesion detection rate were also recorded and compared. Results A total of 392 patients were included in the study (SFE group 197 vs. TC group 195). The ADR and PDR of the right colon in the SFE group were significantly higher than those in the TC group (ADR 10.7% vs. 5.1%; P = 0.042); PDR 17.8% vs. 9.7%, P = 0.021). No significant difference was found in overall PDR/ADR, or advanced lesion detection rate between the two groups. Conclusions This prospective controlled study revealed that a second forward-view examination could modestly increase the ADR and PDR of the right colon during unsedated colonoscopies. This simple, safe and time-effective technique might be recommended for routine unsedated colonoscopy. Trial registration: Clinical Trials.gov, NCT03619122. Registered on 7/8/2018. Supplementary Information The online version contains supplementary material available at 10.1186/s12876-021-01783-9.
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Affiliation(s)
- Keshu Shan
- China Department of Gastroenterology, Ningbo First Hospital, 59 Liuting St, Ningbo, 315010, Zhejiang, China
| | - Hongpeng Lu
- China Department of Gastroenterology, Ningbo First Hospital, 59 Liuting St, Ningbo, 315010, Zhejiang, China
| | - Zhixin Zhang
- College of Medicine, Ningbo University, Ningbo, 315010, Zhejiang, China
| | - Jiarong Xie
- College of Medicine, Ningbo University, Ningbo, 315010, Zhejiang, China
| | - Lu Xu
- College of Medicine, Ningbo University, Ningbo, 315010, Zhejiang, China
| | - Weihong Wang
- China Department of Gastroenterology, Ningbo First Hospital, 59 Liuting St, Ningbo, 315010, Zhejiang, China
| | - Chunjiu Hu
- China Department of Gastroenterology, Ningbo First Hospital, 59 Liuting St, Ningbo, 315010, Zhejiang, China
| | - Lei Xu
- China Department of Gastroenterology, Ningbo First Hospital, 59 Liuting St, Ningbo, 315010, Zhejiang, China.
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Mamunes AP, Campisano F, Martin J, Scaglioni B, Mazomenos E, Valdastri P, Obstein KL. Magnetic flexible endoscope for colonoscopy: an initial learning curve analysis. Endosc Int Open 2021; 9:E171-E180. [PMID: 33532555 PMCID: PMC7834699 DOI: 10.1055/a-1314-9860] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 10/13/2020] [Indexed: 12/19/2022] Open
Abstract
Background and study aims Colonoscopy is a technically challenging procedure that requires extensive training to minimize discomfort and avoid trauma due to its drive mechanism. Our academic team developed a magnetic flexible endoscope (MFE) actuated by magnetic coupling under supervisory robotic control to enable a front-pull maneuvering mechanism, with a motion controller user interface, to minimize colon wall stress and potentially reduce the learning curve. We aimed to evaluate this learning curve and understand the user experience. Methods Five novices (no endoscopy experience), five experienced endoscopists, and five experienced MFE users each performed 40 trials on a model colon using 1:1 block randomization between a pediatric colonoscope (PCF) and the MFE. Cecal intubation (CI) success, time to cecum, and user experience (NASA task load index) were measured. Learning curves were determined by the number of trials needed to reach minimum and average proficiency-defined as the slowest average CI time by an experienced user and the average CI time by all experienced users, respectively. Results MFE minimum proficiency was achieved by all five novices (median 3.92 trials) and five experienced endoscopists (median 2.65 trials). MFE average proficiency was achieved by four novices (median 14.21 trials) and four experienced endoscopists (median 7.00 trials). PCF minimum and average proficiency levels were achieved by only one novice. Novices' perceived workload with the MFE significantly improved after obtaining minimum proficiency. Conclusions The MFE has a short learning curve for users with no prior experience-requiring relatively few attempts to reach proficiency and at a reduced perceived workload.
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Affiliation(s)
- Alexander P. Mamunes
- Division of Internal Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Federico Campisano
- Mechanical Engineering Department, Vanderbilt University, Nashville, Tennessee, United States
| | - James Martin
- STORM Lab UK, School of Electronic and Electrical Engineering, University of Leeds, Leeds, UK
| | - Bruno Scaglioni
- STORM Lab UK, School of Electronic and Electrical Engineering, University of Leeds, Leeds, UK
| | - Evangelos Mazomenos
- STORM Lab UK, School of Electronic and Electrical Engineering, University of Leeds, Leeds, UK
| | - Pietro Valdastri
- STORM Lab UK, School of Electronic and Electrical Engineering, University of Leeds, Leeds, UK
| | - Keith L. Obstein
- Mechanical Engineering Department, Vanderbilt University, Nashville, Tennessee, United States
- Division of Gastroenterology, Vanderbilt University Medical Center, Nashville, Tennessee, United States
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Zhao S, Deng XL, Wang L, Ye JW, Liu ZY, Huang B, Kan Y, Liu BH, Zhang AP, Li CX, Li F, Tong WD. The impact of sedation on quality metrics of colonoscopy: a single-center experience of 48,838 procedures. Int J Colorectal Dis 2020; 35:1155-1161. [PMID: 32300884 DOI: 10.1007/s00384-020-03586-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/04/2020] [Indexed: 02/04/2023]
Abstract
PURPOSE Investigation of the role of sedation during colonoscopy is meaningful as the advantages of colonoscopy performing with sedation are still controversial. METHODS Medical records of patients who underwent colonoscopy in our institution were retrospectively analyzed. The sedation rate, adenoma detection rate (ADR), polyp detection rate (PDR), cecal intubation rate (CIR), iatrogenic colonic perforation rate (ICP) were calculated. RESULTS A total of 48,838 colonoscopies (24,498 in males) dated from July 2007 to February 2017 were analyzed. The median age was 50 years (range 16-85 years). An overall sedation rate was 80.38%. The PDR was 26.77%, and was not statistically different between colonoscopy with or without sedation (26.67% vs 27.22, p = 0.474). ADR was 12.9% regardless of applying sedation or not (13.0% vs 12.44%, p = 0.337). The CIR was 87.42% in all examinations with an adjusted CIR of 90.34%, and was higher when performed with sedation than without sedation (88.92% vs 80.64%, p < 0.0001). Five cases (0.01%) of ICP were reported, all of which occurred in patients under sedation. CONCLUSIONS The use of sedation is associated with increased CIR, but ADR and PDR remain unchanged with or without sedation. However, perforation rate, albeit very low, is significantly higher in sedated patients.
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Affiliation(s)
- Song Zhao
- Department of General Surgery, Gastric and Colorectal Surgery division, Daping Hospital, Army Medical University, 10# Changjiangzhilu, Daping, Yuzhong District, Chongqing, 400042, China
| | - Xiao-Lian Deng
- Department of General Surgery, Gastric and Colorectal Surgery division, Daping Hospital, Army Medical University, 10# Changjiangzhilu, Daping, Yuzhong District, Chongqing, 400042, China
| | - Li Wang
- Department of General Surgery, Gastric and Colorectal Surgery division, Daping Hospital, Army Medical University, 10# Changjiangzhilu, Daping, Yuzhong District, Chongqing, 400042, China
| | - Jing-Wang Ye
- Department of General Surgery, Gastric and Colorectal Surgery division, Daping Hospital, Army Medical University, 10# Changjiangzhilu, Daping, Yuzhong District, Chongqing, 400042, China
| | - Zheng-Yong Liu
- Department of General Surgery, Gastric and Colorectal Surgery division, Daping Hospital, Army Medical University, 10# Changjiangzhilu, Daping, Yuzhong District, Chongqing, 400042, China
| | - Bin Huang
- Department of General Surgery, Gastric and Colorectal Surgery division, Daping Hospital, Army Medical University, 10# Changjiangzhilu, Daping, Yuzhong District, Chongqing, 400042, China
| | - Ying Kan
- Department of General Surgery, Gastric and Colorectal Surgery division, Daping Hospital, Army Medical University, 10# Changjiangzhilu, Daping, Yuzhong District, Chongqing, 400042, China
| | - Bao-Hua Liu
- Department of General Surgery, Gastric and Colorectal Surgery division, Daping Hospital, Army Medical University, 10# Changjiangzhilu, Daping, Yuzhong District, Chongqing, 400042, China
| | - An-Ping Zhang
- Department of General Surgery, Gastric and Colorectal Surgery division, Daping Hospital, Army Medical University, 10# Changjiangzhilu, Daping, Yuzhong District, Chongqing, 400042, China
| | - Chun-Xue Li
- Department of General Surgery, Gastric and Colorectal Surgery division, Daping Hospital, Army Medical University, 10# Changjiangzhilu, Daping, Yuzhong District, Chongqing, 400042, China
| | - Fan Li
- Department of General Surgery, Gastric and Colorectal Surgery division, Daping Hospital, Army Medical University, 10# Changjiangzhilu, Daping, Yuzhong District, Chongqing, 400042, China
| | - Wei-Dong Tong
- Department of General Surgery, Gastric and Colorectal Surgery division, Daping Hospital, Army Medical University, 10# Changjiangzhilu, Daping, Yuzhong District, Chongqing, 400042, China.
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Bagheri H, Mosallaei M, Bagherpour B, Khosravi S, Salehi AR, Salehi R. TFPI2 and NDRG4 gene promoter methylation analysis in peripheral blood mononuclear cells are novel epigenetic noninvasive biomarkers for colorectal cancer diagnosis. J Gene Med 2020; 22:e3189. [PMID: 32196834 DOI: 10.1002/jgm.3189] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/11/2020] [Accepted: 03/12/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND As a result of the growing prevalence of colorectal cancer (CRC), new screening and early detection methods are required. Among the novel biomarkers, DNA methylation has emerged as a high-potential diagnosis/screening molecular marker. The present study aimed to assess non-invasive early diagnosis of CRC by examining promoter methylation of TFPI2 and NDRG4 genes in peripheral blood mononuclear cells (PBMCs). METHODS Fifty CRC patients and 50 normal controls were recruited to the present study. Quantitative methylation of the promoter region of the TFPI2 and NDRG4 genes was analyzed in DNA extracted from PBMCs of all cases and control subjects using a methylation-quantification endonuclease-resistant DNA (MethyQESD) method. RESULTS The sensitivity and specificity of the TFPI2 gene for the diagnosis of CRC was 88% and 92%, respectively, and, for the NDRG4 gene, it was 86% and 92%, respectively. The methylation range for the TFPI2 gene was 43.93% and 11.56% in patients and controls, respectively, and, for the NDRG4 gene, it was 38.8% in CRC patients and 12.23% in healthy controls (p < 0.001). In addition, we observed that a higher percentage of methylation was correlated with the higher stage of CRC. CONCLUSIONS The results of the present study reveal that PBMCs are reliable sources of methylation analysis for CRC screening. Furthermore, the TFPI2 and NDRG4 genes provide sufficiently high sensitivity and specificity to be nominated for use in a novel noninvasive CRC screening method in PBMCs.
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Affiliation(s)
- Hadi Bagheri
- Department of Genetics and Molecular biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Meysam Mosallaei
- Department of Genetics and Molecular biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bahram Bagherpour
- Department of Genetics and Molecular biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Gerfa Namayesh Azmayesh (GENAZMA) Science & Research Institute, Isfahan, Iran
| | - Sharifeh Khosravi
- Department of Genetics and Molecular biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Reza Salehi
- Department of Genetics and Molecular biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rasoul Salehi
- Department of Genetics and Molecular biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Gerfa Namayesh Azmayesh (GENAZMA) Science & Research Institute, Isfahan, Iran
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