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Khalid M, Deivasigamani S, V S, Rajendran S. An efficient colorectal cancer detection network using atrous convolution with coordinate attention transformer and histopathological images. Sci Rep 2024; 14:19109. [PMID: 39154091 PMCID: PMC11330491 DOI: 10.1038/s41598-024-70117-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Accepted: 08/13/2024] [Indexed: 08/19/2024] Open
Abstract
The second most common type of malignant tumor worldwide is colorectal cancer. Histopathology image analysis offers crucial data for the clinical diagnosis of colorectal cancer. Currently, deep learning techniques are applied to enhance cancer classification and tumor localization in histopathological image analysis. Moreover, traditional deep learning techniques might loss integrated information in the image while evaluating thousands of patches recovered from whole slide images (WSIs). This research proposes a novel colorectal cancer detection network (CCDNet) that combines coordinate attention transformer with atrous convolution. CCDNet first denoises the input histopathological image using a Wiener based Midpoint weighted non-local means filter (WMW-NLM) for guaranteeing precise diagnoses and maintain image features. Also, a novel atrous convolution with coordinate attention transformer (AConvCAT) is introduced, which successfully combines the advantages of two networks to classify colorectal tissue at various scales by capturing local and global information. Further, coordinate attention model is integrated with a Cross-shaped window (CrSWin) transformer for capturing tiny changes in colorectal tissue from multiple angles. The proposed CCDNet achieved accuracy rates of 98.61% and 98.96%, on the colorectal histological image and NCT-CRC-HE-100 K datasets correspondingly. The comparison analysis demonstrates that the suggested framework performed better than the most advanced methods already in use. In hospitals, clinicians can use the proposed CCDNet to verify the diagnosis.
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Affiliation(s)
- Majdi Khalid
- Department of Computer Science and Artificial Intelligence, College of Computing, Umm Al-Qura University, 21955, Makkah, Saudi Arabia
| | - Sugitha Deivasigamani
- Department of Computer Science and Engineering, University College of Engineering, A Constituent College of Anna University, Thirukkuvalai, Chennai, India
| | - Sathiya V
- Department of Computer Science and Engineering, Panimalar Engineering College, Chennai, 600123, India
| | - Surendran Rajendran
- Department of Computer Science and Engineering, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Chennai, 602105, Tamil Nadu, India.
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Liu XY, Kang B, Lv Q, Wang ZW. Phase angle is a predictor for postoperative complications in colorectal cancer. Front Nutr 2024; 11:1446660. [PMID: 39221167 PMCID: PMC11363711 DOI: 10.3389/fnut.2024.1446660] [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: 06/10/2024] [Accepted: 08/02/2024] [Indexed: 09/04/2024] Open
Abstract
Aim The aim of this study was to develop a validated nomogram to predict the risk of postoperative complications in colorectal cancer (CRC) patients by analyzing the factors that contribute to these complications. Methods We retrospectively collected clinical information on patients who underwent CRC surgery at a single clinical center from January 2021 to December 2021. Univariate and multivariate logistic regression analysis to identify independent risk factors for postoperative complications and to develop a predictive model. A receiver operating characteristic (ROC) curve was used to calculate the area under the curve (AUC) to assess the predicted probability. Calibration curve was drawn to compare the predicted probability of the nomogram with the actual probability, and decision curve analysis (DCA) was employed to evaluate the clinical utility of the nomogram. Results A total of 190 CRC patients were included in this study. We retrospectively collected baseline information, clinical information, surgical information, and nutrition-related indicators for all patients. Through multivariate logistic regression analysis, preoperative albumin (p = 0.041, OR = 0.906, 95% CI = 0.824-0.996), surgical time (p = 0.009, OR = 1.006, 95% CI = 1.001-1.010), waistline (p = 0.049, OR = 1.011, 95% CI = 1.002-1.020) and phase angle (PA) (p = 0.022, OR = 0.615, 95% CI = 0.405-0.933) were identified as independent risk factors for postoperative complications in CRC, and a nomogram prediction model was established using the above four variables. The AUC of 0.706 for the ROC plot and the high agreement between predicted and actual probabilities in the calibration curves suggested that the prediction model has good predictive power. The DCA also confirmed the good clinical performance of the nomogram. Conclusion This study developed a nomogram to predict the risk of postoperative complications in CRC patients, providing surgeons with a reliable reference to personalized patient management in the perioperative period and preoperative nutritional interventions.
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Affiliation(s)
- Xiao-Yu Liu
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Bing Kang
- Department of Clinical Nutrition, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Quan Lv
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zi-Wei Wang
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Jia L, Zhao H, Liu J. Meta-analysis of postoperative incision infection risk factors in colorectal cancer surgery. Front Surg 2024; 11:1415357. [PMID: 39193402 PMCID: PMC11347452 DOI: 10.3389/fsurg.2024.1415357] [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: 04/10/2024] [Accepted: 07/09/2024] [Indexed: 08/29/2024] Open
Abstract
Objective To evaluate the risk factors for postoperative incision infection in colorectal cancer, this meta-analysis aimed to identify key variables impacting infection incidence following colorectal cancer surgery. Methods Utilizing a meta-analytical approach, studies published from January 2015 to December 2022 were systematically collected and analyzed through the assessment of factors like body mass index, diabetes, albumin levels, malnutrition, and surgical duration. Results The meta-analysis of eleven high-quality studies revealed that elevated BMI, diabetes, low albumin levels, malnutrition, and extended surgical duration were associated with increased infection risk, while laparoscopic procedures showed potential for risk reduction. Conclusions This study underscores the significance of preoperative risk assessment and management in mitigating postoperative incision infections in colorectal cancer patients. The findings present actionable insights for clinicians to enhance patient prognoses and overall quality of life.
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Affiliation(s)
- Li Jia
- Department of Infection Control, People's Hospital of Dayi County, Chengdu, Sichuan Province, China
| | - Huacai Zhao
- Department of Urology, People's Hospital of Dayi County, Chengdu, Sichuan Province, China
| | - Jia Liu
- Department of Infection Control, Chengdu Fifth People’s Hospital, Chengdu, Sichuan Province, China
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Huang W, Feng Z, Ma M, Song F, Zeng S, Shao F, Yu X, Rong P, Chen J. Different impacts of adipose tissue dynamics on prognosis in patients with resectable locally advanced rectal cancer treated with and without neoadjuvant treatment. Front Oncol 2024; 14:1421651. [PMID: 39148902 PMCID: PMC11324464 DOI: 10.3389/fonc.2024.1421651] [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: 05/02/2024] [Accepted: 07/09/2024] [Indexed: 08/17/2024] Open
Abstract
Background Body composition is recognized to be associated with clinical outcomes in patients with locally advanced rectal cancer (LARC). This study aimed to determine the prognostic role of regional adipose tissue distribution in patients with resectable LARC treated with or without neoadjuvant chemoradiotherapy (nCRT). Methods This retrospective study included 281 consecutive patients who underwent radical surgery for LARC with or without preoperative nCRT between 2013 and 2019. Patients underwent contrast-enhanced CT scans before nCRT and before surgery. Visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue (aSAT), and gluteal subcutaneous adipose tissue (gSAT) were quantified on the CT images. The association of adipose tissue distribution with progression-free survival (PFS) was analyzed using Cox proportional hazards analysis. Results A total of 102 nCRT-treated and 179 primarily resected patients were included. During a median follow-up period of 24 months, 74 (26.3%) patients experienced local recurrence or metastasis. Multivariable analysis showed that VAT was associated with PFS in all patients (hazard ratio [HR] 1.28, 95% confidence interval [CI] 1.04-1.57; P = 0.021). This association was only maintained in primarily resected patients (HR 1.31, 95% CI 1.02-1.69; P = 0.037). For patients receiving preoperative nCRT, VAT was not significantly associated with PFS, while the dynamic change in gSAT (ΔgSAT) between nCRT and surgery was associated with PFS (HR 0.43, 95%CI 0.27-0.69, P = 0.001). Conclusion Visceral obesity is an adverse prognostic factor in patients with resectable LARC treated by primary resection, while increased gluteal subcutaneous adiposity during preoperative nCRT may indicate favorable clinical outcomes.
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Affiliation(s)
- Weiyan Huang
- Department of Radiology, The First Affiliated Hospital of Hainan Medical University, Haikou, China
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Zhichao Feng
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Mengtian Ma
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Fulong Song
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Shumin Zeng
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Fang Shao
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Xiaoping Yu
- Department of Diagnostic Radiology, Hunan Cancer Hospital, Changsha, China
| | - Pengfei Rong
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jianqiang Chen
- Department of Radiology, The First Affiliated Hospital of Hainan Medical University, Haikou, China
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Xu D, He Y, Liao C, Tan J. Identifying risk and prognostic factors for synchronous liver metastasis in small bowel adenocarcinoma: a predictive analysis using the SEER database. Front Surg 2024; 11:1437124. [PMID: 39136035 PMCID: PMC11317383 DOI: 10.3389/fsurg.2024.1437124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 07/19/2024] [Indexed: 08/15/2024] Open
Abstract
Background Small bowel adenocarcinoma (SBA) is a rare gastrointestinal malignancy with an increasing incidence and a high propensity for liver metastasis (LM). This study aimed to investigate the risk factors for synchronous LM and prognostic factors in patients with LM. Methods Utilizing the Surveillance, Epidemiology, and End Results (SEER) database, this study analyzed data from 2,064 patients diagnosed with SBA between 2010 and 2020. Logistic regression was used to determine risk factors for synchronous LM. A nomogram was developed to predict the risk of LM in SBA patients, and its predictive performance was assessed through receiver operating characteristic (ROC) curves and calibration curves. Kaplan-Meier and Cox regression analyses were conducted to evaluate survival outcomes for SBA patients with LM. Results Synchronous LM was present in 13.4% of SBA patients (n = 276). Six independent predictive factors for LM were identified, including tumor location, T stage, N stage, surgical intervention, retrieval of regional lymph nodes (RORLN), and chemotherapy. The nomogram demonstrated good discriminative ability, with an area under the curve (AUC) of 83.8%. Patients with LM had significantly lower survival rates than those without LM (P < 0.001). Survival analysis revealed that advanced age, tumor location in the duodenum, surgery, RORLN and chemotherapy were associated with cancer-specific survival (CSS) in patients with LM originating from SBA. Conclusions This study highlights the significant impact of LM on the survival of SBA patients and identifies key risk factors for its occurrence. The developed nomogram aids in targeted screening and personalized treatment planning.
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Affiliation(s)
- Duogang Xu
- Department of General Surgery, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, China
- Key Laboratory of Tumor Immunological Prevention and Treatment of Yunnan Province, Kunming, China
| | - Yulei He
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China
| | - Changkang Liao
- Department of General Surgery, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, China
- Key Laboratory of Tumor Immunological Prevention and Treatment of Yunnan Province, Kunming, China
| | - Jing Tan
- Department of General Surgery, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, China
- Key Laboratory of Tumor Immunological Prevention and Treatment of Yunnan Province, Kunming, China
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Florea MA, Eftimie LG, Glogojeanu RR, Hristu R, Stanciu GA, Costache M. Imaging of colorectal adenomas with pseudoinvasion and malignant polyps using two-photon excitation microscopy. Front Oncol 2024; 14:1394493. [PMID: 38947893 PMCID: PMC11211392 DOI: 10.3389/fonc.2024.1394493] [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: 03/01/2024] [Accepted: 05/20/2024] [Indexed: 07/02/2024] Open
Abstract
Introduction Although the incidence and mortality rates of colorectal cancer exhibit significant variability, it remains one of the most prevalent cancers worldwide. Endeavors to prevent colorectal cancer development focus on detecting precursor lesions during colonoscopy. The diagnosis of endoscopically resected polyps relies on hematoxylin and eosin staining examination. For challenging cases like adenomatous polyps with epithelial misplacement, additional diagnostic methods could prove beneficial. Methods This paper aims to underscore stromal changes observed in malignant polyps and polyps with pseudoinvasion, leveraging two-photon excitation microscopy (TPEM), a technique extensively employed in the medical field in recent years. Results and discussions Both the subjective and quantitative analysis of TPEM images revealed distinct distributions and densities of collagen at the invasion front in malignant polyps compared to areas of pseudoinvasion. TPEM holds potential in discerning true invasion in malignant polyps from pseudoinvasion, offering enhanced visualization of local stromal changes.
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Affiliation(s)
- Maria-Alexandra Florea
- Pathology Department, Central University Emergency Military Hospital, Bucharest, Romania
- Pathology Department, University of Medicine and Pharmacy, Carol Davila’, Bucharest, Romania
| | - Lucian George Eftimie
- Pathology Department, Central University Emergency Military Hospital, Bucharest, Romania
- Center for Microscopy-Microanalysis and Information Processing, National University of Science and Technology Politehnica Bucharest, Bucharest, Romania
- Department of Special Motricity and Medical Recovery, The National University of Physical Education and Sports, Bucharest, Romania
| | - Remus Relu Glogojeanu
- Department of Special Motricity and Medical Recovery, The National University of Physical Education and Sports, Bucharest, Romania
| | - Radu Hristu
- Center for Microscopy-Microanalysis and Information Processing, National University of Science and Technology Politehnica Bucharest, Bucharest, Romania
| | - George A. Stanciu
- Center for Microscopy-Microanalysis and Information Processing, National University of Science and Technology Politehnica Bucharest, Bucharest, Romania
| | - Mariana Costache
- Pathology Department, University of Medicine and Pharmacy, Carol Davila’, Bucharest, Romania
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Wang Z, Wang J, Pei J, Pan Y, Ding R. Sign of Neck Mass as the Chief Complaint: A Case Report and Literature Review About Thyroid Metastasis of Colorectal Cancer. Cancer Manag Res 2024; 16:575-583. [PMID: 38855326 PMCID: PMC11162220 DOI: 10.2147/cmar.s470045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 05/18/2024] [Indexed: 06/11/2024] Open
Abstract
Background Commonly, the thyroid gland is regarded as an organ with fewer metastatic diseases, and colorectal metastasis to the thyroid (CMT) is rarely reported, especially, with that the clinical sign of thyroid metastasis nidus is the chief complaint. The CMT occurs in advanced colorectal cancer and is associated with poor prognosis and short survival. Case Report In this case, we reported a patient with the sign of neck mass as the first manifestation of CMT. The patient underwent a partial thyroidectomy in June 2019, immunohistochemical findings of thyroid carcinoma suggested the possibility of adenocarcinoma of gastrointestinal tract. The patient underwent a colonoscopy in July 2019 and a colonic mass was found. Pathological examination diagnosed rectal adenocarcinoma. The patient underwent neoadjuvant chemotherapy, surgical treatment, postoperative adjuvant chemotherapy and targeted therapy. The patient died in June 2022. Conclusion The metastasis disease would not be ignored at all, when a patient complains at signs of neck mass. Further, the possibility of metastasis cancer should be considered once thyroid nodules occur in patients with colorectal cancer. Even though the biological characteristics and stage of the primary tumor have an important impact on the prognosis, positive standardized treatments can also be helpful.
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Affiliation(s)
- Zhaorui Wang
- Department of Emergency Surgery, Lu ‘an People’s Hospital, Lu ‘an Hospital Affiliated to Anhui Medical University, Lu ‘an, Anhui, 237000, People’s Republic of China
| | - Jingjing Wang
- Department of Emergency Surgery, Lu ‘an People’s Hospital, Lu ‘an Hospital Affiliated to Anhui Medical University, Lu ‘an, Anhui, 237000, People’s Republic of China
| | - Jing Pei
- Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, People’s Republic of China
| | - Yubo Pan
- Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, People’s Republic of China
| | - Rui Ding
- Department of Emergency Surgery, Lu ‘an People’s Hospital, Lu ‘an Hospital Affiliated to Anhui Medical University, Lu ‘an, Anhui, 237000, People’s Republic of China
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Peng J, Xu H, Huang S, Shi X, Wang P, Chen Q, Zhang W, Shi L, Peng Y, Yuan F, Tang X. Comparison of the burden of digestive diseases between China and the United States from 1990 to 2019. Front Public Health 2024; 12:1376406. [PMID: 38827620 PMCID: PMC11140071 DOI: 10.3389/fpubh.2024.1376406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/06/2024] [Indexed: 06/04/2024] Open
Abstract
Introduction China has experienced unprecedented transformations unseen in a century and is gradually progressing toward an emerging superpower. The epidemiological trends of digestive diseases in the United States (the US) have significant prescient effects on China. Methods We extracted data on 18 digestive diseases from the Global Burden of Diseases 2019 Data Resource. Linear regression analysis conducted by the JoinPoint software assessed the average annual percentage change of the burden. We performed subgroup analyses based on sex and age group. Results In 2019, there were 836.01 and 180.91 million new cases of digestive diseases in China and the US, causing 1558.01 and 339.54 thousand deaths. The age-standardized incidence rates of digestive diseases in China and the US were 58417.87/100,000 and 55018.65/100,000 respectively, resulting in age-standardized mortality rates of 81.52/100,000 and 60.88/100,000. The rates in China annually decreased by 2.149% for mortality and 2.611% for disability-adjusted life of year (DALY). The mortality and DALY rates of the US, respectively, had average annual percentage changes of -0.219 and -0.251. Enteric infections and cirrhosis and other chronic liver diseases accounted for the highest incidence and prevalence in both counties, respectively. The burden of multiple digestive diseases exhibited notable sex disparities. The middle-old persons had higher age-standardized prevalence rates. Conclusion China bore a greater burden of digestive diseases, and the evolving patterns were more noticeable. Targeted interventions and urgent measures should be taken in both countries to address the specific burden of digestive diseases based on their different epidemic degree.
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Affiliation(s)
- Jieyu Peng
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Huan Xu
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Shu Huang
- Department of Gastroenterology, Lianshui County People’s Hospital, Huaian, China
- Department of Gastroenterology, Lianshui People’s Hospital of Kangda College Affiliated to Nanjing Medical University, Huaian, China
| | - Xiaomin Shi
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Ping Wang
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Qi Chen
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Wei Zhang
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Lei Shi
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Yan Peng
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Fangfang Yuan
- Department of Intensive Care Unit, The 3rd Xiangya Hospital, Central South University, Changsha, China
| | - Xiaowei Tang
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
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Yang L, Cui X, Wu F, Chi Z, Xiao L, Wang X, Liang Z, Li X, Yu Q, Lin X, Gao C. The efficacy and safety of neoadjuvant chemoradiotherapy combined with immunotherapy for locally advanced rectal cancer patients: a systematic review. Front Immunol 2024; 15:1392499. [PMID: 38846948 PMCID: PMC11154111 DOI: 10.3389/fimmu.2024.1392499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 04/23/2024] [Indexed: 06/09/2024] Open
Abstract
Background Several studies have explored the effectiveness of PD-1/PD-L1 inhibitors combined with neoadjuvant chemoradiotherapy (nCRT) in the treatment of locally advanced rectal cancer(LARC), particularly in microsatellite stable(MSS) or mismatch repair proficient(pMMR) LARC patients. We undertook a single-arm systematic review to comprehensively evaluate the advantages and potential risks associated with the use of PD-1/PD-L1 inhibitors in conjunction with nCRT for patients diagnosed with locally advanced rectal cancer. Methods The PubMed, Embase, Cochrane Library, ClinicalTrials.gov, ASCO and ESMO were searched for related studies. The main outcomes were pathologic complete response (pCR), major pathological response (MPR), anal preservation, and adverse effects (AEs). Results Fourteen articles including 533 locally advanced rectal cancer (LARC) patients were analyzed. The pooled pCR, MPR, and anal preservation rates were 36%, 66% and 86%. Grade ≥3 adverse events occurred in 20%. Subgroup analysis showed that; dMMR/MSI-H had a pooled pCR (100%) and MPR (100%), pMMR/MSS had a pooled pCR (38%) and MPR (60%); the short-course radiotherapy and long-course radiotherapy had pooled pCR rates of 51% and 30%, respectively. The rates of pCR for the concurrent and sequential immuno-chemoradiotherapy subgroups at 30% and 40%, mirroring pCR rates for the PD-L1 and PD-1 inhibitor subgroups were 32% and 40%, respectively. Conclusion In cases of locally advanced rectal cancer, PD-1/PD-L1 inhibitors combined with neoadjuvant chemoradiotherapy have shown promising response rates and acceptable toxicity profiles. PD-1/PD-L1 inhibitors combined with neoadjuvant chemoradiotherapy hence has a positive outcome even in MSS LARC patients. Systematic Review Registration https://www.crd.york.ac.uk/prospero/#myprospero, identifier CRD42023465380.
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Affiliation(s)
- Lei Yang
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiujing Cui
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Fengpeng Wu
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zifeng Chi
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Linlin Xiao
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xuan Wang
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zezheng Liang
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiaoning Li
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Qiyao Yu
- Department of Research, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Xueqin Lin
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Chao Gao
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
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Bananzadeh A, Bahadori M, Mohammadianpanah M, Pakravan F, Shojaei-Zarghani S, Safarpour AR. Determinants of survival and recurrence in patients with stage I colorectal cancer. Front Surg 2024; 11:1377733. [PMID: 38817946 PMCID: PMC11138156 DOI: 10.3389/fsurg.2024.1377733] [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: 01/28/2024] [Accepted: 05/06/2024] [Indexed: 06/01/2024] Open
Abstract
Background Due to the novel advanced screening methods, the number of patients diagnosed with stage I colorectal cancer (CRC) is increasing. This retrospective cohort study aimed to identify recurrence and survival risk factors of patients with stage I CRC after surgery. Materials and methods Patients with stage I CRC were evaluated, and their demographic and clinicopathologic variables were recorded. The log-rank test assessed the association of variables with overall survival (OS), recurrence-free survival (RFS), local recurrence, and distant metastasis. Results The median overall survival period was 51 months. The recurrence rate was 13.7%: 7.2% local and 9.3% distant recurrence. One-, two-, three-, and five-year RFS were 92%, 89%, 87%, and 83%, respectively, and OS were 96%, 93%, 90%, and 89%, respectively. Local and distant recurrence rates were higher in patients with higher tumor grades. Additionally, RFS and OS were worse in patients with higher tumor grades, and perforation was associated with worse OS. Conclusions The determinants of survival and recurrence identified in the present study can be used to improve patient outcomes by early diagnosis and appropriate management of high-risk patients.
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Affiliation(s)
| | - Mahshid Bahadori
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Faramarz Pakravan
- Private Practice for Pelvic Floor, Continence Disorders and Coloproctology, Düsseldorf, Germany
| | | | - Ali Reza Safarpour
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Zhang N, Zhu L, Liu Y, Chen X, Zhang B, Wen C, Zhang H, Tang Q, Zhang M. Case report: Successful treatment of advanced colon cancer in an eighty-year-old man with long-term and multi-stage endoscopic minimally invasive therapy. Front Oncol 2024; 14:1367173. [PMID: 38444684 PMCID: PMC10914250 DOI: 10.3389/fonc.2024.1367173] [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: 01/12/2024] [Accepted: 01/18/2024] [Indexed: 03/07/2024] Open
Abstract
Background No previous studies have reported on the use of minimally invasive endoscopic therapy for colon cancer in older patients. Case presentation An 80-year-old man was admitted to our hospital with haematochezia and diagnosed with advanced colon cancer in 2018. Traditional surgical care was rejected by his family. We successfully treated the patient with multiple minimally invasive endoscopic therapies, such as argon plasma coagulation, from 2018 to 2021. Conclusion Invasive endoscopic therapy is a feasible way to treat colon cancer in older patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Mingqing Zhang
- Department of Gastroenterology, The 909th Hospital, School of Medicine, Xiamen University, Fujian, China
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Montalvan-Sanchez EE, Beas R, Karkash A, Godoy A, Norwood DA, Dougherty M. Delays in Colorectal Cancer Screening for Latino Patients: The Role of Immigrant Healthcare in Stemming the Rising Global Incidence of Colorectal Cancer. Gastroenterology Res 2024; 17:41-51. [PMID: 38463144 PMCID: PMC10923253 DOI: 10.14740/gr1697] [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: 01/05/2024] [Accepted: 02/01/2024] [Indexed: 03/12/2024] Open
Abstract
The significant global burden of colorectal cancer accentuates disparities in access to preventive healthcare in most low- and middle-income countries (LMICs) as well as large sections of underserved populations within high-income countries. The barriers to colorectal cancer screening in economically transitioning Latin America are multiple. At the same time, immigration from these countries to the USA continues to increase. This case highlights the delays in diagnosis experienced by a recent immigrant from a country with no established colorectal cancer screening program, to an immigrant population in the USA with similar poor screening coverage. We discuss common challenges faced by Latinos in their home countries and the USA, as well as strategies that could be implemented to improve screening coverage in US immigrant populations.
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Affiliation(s)
| | - Renato Beas
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Ahmad Karkash
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Ambar Godoy
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
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13
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Shevchenko I, Serban D, Dascalu AM, Tribus L, Alius C, Cristea BM, Suceveanu AI, Voiculescu D, Dumitrescu D, Bobirca F, Suceveanu AP, Georgescu DE, Serboiu CS. Factors Affecting the Efficiency of Near-Infrared Indocyanine Green (NIR/ICG) in Lymphatic Mapping for Colorectal Cancer: A Systematic Review. Cureus 2024; 16:e55290. [PMID: 38558607 PMCID: PMC10981778 DOI: 10.7759/cureus.55290] [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] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
As laparoscopy gained global popularity in oncologic surgery, the challenge of detecting lymph nodes spurred researchers to explore innovative techniques and approach the situation from a fresh perspective. While many proposed methods have faded into obscurity, the utilization of indocyanine green (ICG) in the surgical treatment of oncologic patients has continued to advance. The immense potential of this dye is widely acknowledged, yet its full extent and limitations in lymphatic mapping for colorectal cancer remain to be precisely determined. This article aims to assess the magnitude of its potential and explore the constraints based on insights from clinical studies published by pioneering researchers. A systematic review of the existing literature, comprising articles in English, was conducted using the Scopus, PubMed, and Springer Link databases. The search employed keywords such as "colorectal cancer" AND/OR "indocyanine green," "fluorescence" AND/OR "lymphatic mapping" AND/OR "lymph nodes." Initially identifying 129 articles, the application of selection criteria narrowed down the pool to 10 articles, which served as the primary sources of data for our review. Despite the absence of a standardized protocol for the application of ICG in colorectal cancer, particularly in the context of lymphatic mapping, the detection rates have exhibited considerable variation across studies. Nevertheless, all authors unanimously regarded this technique as beneficial and promising. Additionally, it is advocated as an adjunctive tool to enhance the accuracy of cancer staging. Near-infrared (NIR)-enhanced surgery holds the promise of transforming the landscape of oncologic surgery, emerging as a valuable tool for surgeons. However, the absence of a standardized technique and the subjective nature of result assessment impose limitations on the potential of this method. Consequently, it can be inferred that the establishment of a universally accepted protocol, encompassing parameters such as dose, concentration, technique, and site of administration of ICG, along with the optimal time needed for fluorescence visualization, would enhance the outcomes. Emphasizing the accurate selection of patients is crucial to prevent the occurrence of false-negative results.
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Affiliation(s)
- Irina Shevchenko
- Surgery, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
- General Surgery, Emergency University Hospital Bucharest, Bucharest, ROU
| | - Dragos Serban
- Surgery, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
- General Surgery, Emergency University Hospital Bucharest, Bucharest, ROU
| | - Ana Maria Dascalu
- Ophthalmology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Laura Tribus
- Gastroenterology, Faculty of Oral Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Catalin Alius
- Surgery, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
- General Surgery, Emergency University Hospital Bucharest, Bucharest, ROU
| | - Bogdan Mihai Cristea
- Anatomy, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Andra Iulia Suceveanu
- Gastroenterology, Faculty of Medicine, Ovidius University of Constanta, Constanta, ROU
- Gastroenterology, Clinical Emergency Hospital St Apostle Andrew, Constanta, ROU
| | - Daniel Voiculescu
- Surgery, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
- General Surgery, Emergency University Hospital Bucharest, Bucharest, ROU
| | - Dan Dumitrescu
- Surgery, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
- General Surgery, Emergency University Hospital Bucharest, Bucharest, ROU
| | - Florin Bobirca
- Surgery, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
- General Surgery, Clinic Hospital "Dr. Ioan Cantacuzino" Bucharest, Bucharest, ROU
| | - Adrian Paul Suceveanu
- Medicine, Faculty of Medicine, Ovidius University of Constanta, Constanta, ROU
- Gastroenterology, Clinical Emergency Hospital St Apostle Andrew, Constanta, ROU
| | - Dragos Eugen Georgescu
- Surgery, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Crenguta Sorina Serboiu
- Radiology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
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14
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Amin A, Cardoso SA, Suyambu J, Abdus Saboor H, Cardoso RP, Husnain A, Isaac NV, Backing H, Mehmood D, Mehmood M, Maslamani ANJ. Future of Artificial Intelligence in Surgery: A Narrative Review. Cureus 2024; 16:e51631. [PMID: 38318552 PMCID: PMC10839429 DOI: 10.7759/cureus.51631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2024] [Indexed: 02/07/2024] Open
Abstract
Artificial intelligence (AI) is the capability of a machine to execute cognitive processes that are typically considered to be functions of the human brain. It is the study of algorithms that enable machines to reason and perform mental tasks, including problem-solving, object and word recognition, and decision-making. Once considered science fiction, AI today is a fact and an increasingly prevalent subject in both academic and popular literature. It is expected to reshape medicine, benefiting both healthcare professionals and patients. Machine learning (ML) is a subset of AI that allows machines to learn and make predictions by recognizing patterns, thus empowering the medical team to deliver better care to patients through accurate diagnosis and treatment. ML is expanding its footprint in a variety of surgical specialties, including general surgery, ophthalmology, cardiothoracic surgery, and vascular surgery, to name a few. In recent years, we have seen AI make its way into the operating theatres. Though it has not yet been able to replace the surgeon, it has the potential to become a highly valuable surgical tool. Rest assured that the day is not far off when AI shall play a significant intraoperative role, a projection that is currently marred by safety concerns. This review aims to explore the present application of AI in various surgical disciplines and how it benefits both patients and physicians, as well as the current obstacles and limitations facing its seemingly unstoppable rise.
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Affiliation(s)
- Aamir Amin
- Cardiothoracic Surgery, Harefield Hospital, Guy's and St Thomas' NHS Foundation Trust, London, GBR
| | - Swizel Ann Cardoso
- Major Trauma Services, University Hospital Birmingham NHS Foundation Trust DC, Birmingham, GBR
| | - Jenisha Suyambu
- Medicine, University of Perpetual Help System Data - Jonelta Foundation School of Medicine, Las Piñas, PHL
| | | | - Rayner P Cardoso
- Medicine and Surgery, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Ali Husnain
- Radiology, Northwestern University, Lahore, PAK
| | - Natasha Varghese Isaac
- Medicine and Surgery, St John's Medical College Hospital, Rajiv Gandhi University of Health Sciences, Bengaluru, IND
| | - Haydee Backing
- Medicine, Universidad de San Martin de Porres, Lima, PER
| | - Dalia Mehmood
- Community Medicine, Fatima Jinnah Medical University, Lahore, PAK
| | - Maria Mehmood
- Internal Medicine, Shalamar Medical and Dental College, Lahore, PAK
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15
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Otto PO, Loft MK, Rafaelsen SR, Pedersen MRV. Diffusion-Weighted MRI as a Quantitative Imaging Biomarker in Colon Tumors. Cancers (Basel) 2023; 16:144. [PMID: 38201571 PMCID: PMC10778248 DOI: 10.3390/cancers16010144] [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: 11/24/2023] [Revised: 12/21/2023] [Accepted: 12/24/2023] [Indexed: 01/12/2024] Open
Abstract
PURPOSE To assess the use of quantitative diffusion-weighted MRI (DW-MRI) as a diagnostic imaging biomarker in differentiating between benign colon adenoma, early, and advanced cancer of the colon, as well as predicting lymph node involvement, and finally comparing mucinous-producing colon cancer with adenomas and non-mucinous colon cancer. METHOD Patients with a confirmed tumor on colonoscopy were eligible for inclusion in this study. Using a 3.0 Tesla MRI machine, the main tumor mean apparent diffusion coefficient (mADC) was obtained. Surgically resected tumor specimens served as an endpoint, except in mucinous colon cancers, which were classified based on T2 images. RESULTS A total of 152 patients were included in the study population. The mean age was 71 years. A statistically significant mADC mean difference of -282 × 10-6 mm2/s [-419--144 95% CI, p < 0.001] was found between colon adenomas and early colon cancer, with an AUC of 0.80 [0.68-0.93 95% CI] and an optimal cut off value of 1018 × 10-6 mm2/s. Only a small statistically significant difference (p = 0.039) in mADC was found between benign tumors and mucinous colon cancer. We found no statistical difference in mADC mean values between early and advanced colon cancer, and between colon cancer with and without lymph node involvement. CONCLUSION Quantitative DW-MRI is potentially useful for determining whether a colonic tumor is benign or malignant. Mucinous colon cancer shows less diffusion restriction when compared to non-mucinous colon cancer, a potential pitfall.
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Affiliation(s)
- Peter Obel Otto
- Department of Radiology, University Hospital of Southern Denmark, Beriderbakken 4, 7100 Vejle, Denmark
| | - Martina Kastrup Loft
- Department of Radiology, University Hospital of Southern Denmark, Beriderbakken 4, 7100 Vejle, Denmark
- Danish Colorectal Cancer Center South, Vejle Hospital, 7100 Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark
| | - Søren Rafael Rafaelsen
- Department of Radiology, University Hospital of Southern Denmark, Beriderbakken 4, 7100 Vejle, Denmark
- Danish Colorectal Cancer Center South, Vejle Hospital, 7100 Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark
| | - Malene Roland Vils Pedersen
- Department of Radiology, University Hospital of Southern Denmark, Beriderbakken 4, 7100 Vejle, Denmark
- Danish Colorectal Cancer Center South, Vejle Hospital, 7100 Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark
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16
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Saez de Gordoa K, Rodrigo-Calvo MT, Archilla I, Lopez-Prades S, Diaz A, Tarragona J, Machado I, Ruiz Martín J, Zaffalon D, Daca-Alvarez M, Pellisé M, Camps J, Cuatrecasas M. Lymph Node Molecular Analysis with OSNA Enables the Identification of pT1 CRC Patients at Risk of Recurrence: A Multicentre Study. Cancers (Basel) 2023; 15:5481. [PMID: 38001742 PMCID: PMC10670609 DOI: 10.3390/cancers15225481] [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: 10/13/2023] [Revised: 11/11/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
Early-stage colorectal carcinoma (CRC)-pT1-is a therapeutic challenge and presents some histological features related to lymph node metastasis (LNM). A significant proportion of pT1 CRCs are treated surgically, resulting in a non-negligible surgical-associated mortality rate of 1.5-2%. Among these cases, approximately 6-16% exhibit LNM, but the impact on survival is unclear. Therefore, there is an unmet need to establish an objective and reliable lymph node (LN) staging method to optimise the therapeutic management of pT1 CRC patients and to avoid overtreating or undertreating them. In this multicentre study, 89 patients with pT1 CRC were included. All histological features associated with LNM were evaluated. LNs were assessed using two methods, One-Step Nucleic Acid Amplification (OSNA) and the conventional FFPE plus haematoxylin and eosin (H&E) staining. OSNA is an RT-PCR-based method for amplifying CK19 mRNA. Our aim was to assess the performance of OSNA and H&E in evaluating LNs to identify patients at risk of recurrence and to optimise their clinical management. We observed an 80.9% concordance in LN assessment using the two methods. In 9% of cases, LNs were found to be positive using H&E, and in 24.7% of cases, LNs were found to be positive using OSNA. The OSNA results are provided as the total tumour load (TTL), defined as the total tumour burden present in all the LNs of a surgical specimen. In CRC, a TTL ≥ 6000 CK19 m-RNA copies/µL is associated with poor prognosis. Three patients had TTL > 6000 copies/μL, which was associated with higher tumour budding. The discrepancies observed between the OSNA and H&E results were mostly attributed to tumour allocation bias. We concluded that LN assessment with OSNA enables the identification of pT1 CRC patients at some risk of recurrence and helps to optimise their clinical management.
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Affiliation(s)
- Karmele Saez de Gordoa
- Pathology Department, Centre of Biomedical Diagnosis (CDB), Hospital Clinic, 08036 Barcelona, Spain; (K.S.d.G.); (M.T.R.-C.); (I.A.); (S.L.-P.); (A.D.)
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (M.P.); (J.C.)
| | - Maria Teresa Rodrigo-Calvo
- Pathology Department, Centre of Biomedical Diagnosis (CDB), Hospital Clinic, 08036 Barcelona, Spain; (K.S.d.G.); (M.T.R.-C.); (I.A.); (S.L.-P.); (A.D.)
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (M.P.); (J.C.)
| | - Ivan Archilla
- Pathology Department, Centre of Biomedical Diagnosis (CDB), Hospital Clinic, 08036 Barcelona, Spain; (K.S.d.G.); (M.T.R.-C.); (I.A.); (S.L.-P.); (A.D.)
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (M.P.); (J.C.)
| | - Sandra Lopez-Prades
- Pathology Department, Centre of Biomedical Diagnosis (CDB), Hospital Clinic, 08036 Barcelona, Spain; (K.S.d.G.); (M.T.R.-C.); (I.A.); (S.L.-P.); (A.D.)
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (M.P.); (J.C.)
| | - Alba Diaz
- Pathology Department, Centre of Biomedical Diagnosis (CDB), Hospital Clinic, 08036 Barcelona, Spain; (K.S.d.G.); (M.T.R.-C.); (I.A.); (S.L.-P.); (A.D.)
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (M.P.); (J.C.)
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain
- Department of Clinical Foundations, University of Barcelona (UB), 08036 Barcelona, Spain
| | - Jordi Tarragona
- Pathology Department, Hospital Arnau de Vilanova, 25198 Lleida, Spain;
| | - Isidro Machado
- Pathology Department, Instituto Valenciano de Oncología, Hospital Quirón-Salud Valencia, University of Valencia, 46010 Valencia, Spain;
- Centro de Investigación Biomédica en Red en Cancer (CIBERONC), 28029 Madrid, Spain
| | - Juan Ruiz Martín
- Pathology Department, Virgen de la Salud Hospital, 45071 Toledo, Spain;
| | - Diana Zaffalon
- Gastroenterology Department, Consorci Sanitari de Terrassa, 08227 Terrassa, Spain;
| | - Maria Daca-Alvarez
- Gastroenterology Department, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain;
| | - Maria Pellisé
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (M.P.); (J.C.)
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain
- Gastroenterology Department, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain;
| | - Jordi Camps
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (M.P.); (J.C.)
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain
- Cell Biology and Medical Genetics Unit, Department of Cell Biology, Physiology and Immunology, Faculty of Medicine, Autonomous University of Barcelona (UAB), 08193 Bellaterra, Spain
| | - Miriam Cuatrecasas
- Pathology Department, Centre of Biomedical Diagnosis (CDB), Hospital Clinic, 08036 Barcelona, Spain; (K.S.d.G.); (M.T.R.-C.); (I.A.); (S.L.-P.); (A.D.)
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (M.P.); (J.C.)
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain
- Department of Clinical Foundations, University of Barcelona (UB), 08036 Barcelona, Spain
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Giannas E, Kontovounisios C. The Antineoplastic Effect of Heparin on Colorectal Cancer: A Review of the Literature. J Clin Med 2023; 12:7173. [PMID: 38002785 PMCID: PMC10671867 DOI: 10.3390/jcm12227173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/04/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023] Open
Abstract
Heparin and derivatives are commonly used for thrombophylaxis in surgical colorectal cancer (CRC) patients. Recent studies have suggested that, besides its protective effect on the incidence of venous thromboembolism, heparin has an anti-cancer effect. The aim of this review was to explore the literature and report the antineoplastic effect of heparin and derivatives on CRC. MEDLINE and EMBASE databases were searched for relevant articles. Nineteen studies were included (n = 19). Fifteen were lab studies conducted in vivo or in vitro on CRC cell lines and/or mice (n = 15). Four were in vivo clinical studies (n = 4). CRC tumor growth was reduced by 78% in one study, (p < 0.01), while tumorigenesis was suppressed in heparin-treated mice in seven studies. A high dose of low molecular weight heparin for extended duration significantly reduced post-operative VEGF, suggesting that such a regime may inhibit tumor angiogenesis and distant metastasis. A randomized trial demonstrated the antineoplastic effect of nadroparin as the 6 month survival in palliative patients increased. Another study has reported that disease-free survival of CRC patients was not affected by a similar tinzaparin regime. The anti-cancer properties of heparin and derivatives are promising, especially in lab studies. Further clinical trials are needed to investigate the anti-cancer benefit of heparin on CRC.
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Affiliation(s)
- Emmanuel Giannas
- Department of Surgery and Cancer, Imperial College London, London SW7 2BX, UK;
- Department of General Surgery, Chelsea and Westminster Hospital, London SW10 9NH, UK
| | - Christos Kontovounisios
- Department of Surgery and Cancer, Imperial College London, London SW7 2BX, UK;
- Department of General Surgery, Chelsea and Westminster Hospital, London SW10 9NH, UK
- Department of Surgery, The Royal Marsden Hospital, London SW3 6JJ, UK
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18
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Jang HJ, Go JH, Kim Y, Lee SH. Deep Learning for the Pathologic Diagnosis of Hepatocellular Carcinoma, Cholangiocarcinoma, and Metastatic Colorectal Cancer. Cancers (Basel) 2023; 15:5389. [PMID: 38001649 PMCID: PMC10670046 DOI: 10.3390/cancers15225389] [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: 10/04/2023] [Revised: 11/01/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
Diagnosing primary liver cancers, particularly hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC), is a challenging and labor-intensive process, even for experts, and secondary liver cancers further complicate the diagnosis. Artificial intelligence (AI) offers promising solutions to these diagnostic challenges by facilitating the histopathological classification of tumors using digital whole slide images (WSIs). This study aimed to develop a deep learning model for distinguishing HCC, CC, and metastatic colorectal cancer (mCRC) using histopathological images and to discuss its clinical implications. The WSIs from HCC, CC, and mCRC were used to train the classifiers. For normal/tumor classification, the areas under the curve (AUCs) were 0.989, 0.988, and 0.991 for HCC, CC, and mCRC, respectively. Using proper tumor tissues, the HCC/other cancer type classifier was trained to effectively distinguish HCC from CC and mCRC, with a concatenated AUC of 0.998. Subsequently, the CC/mCRC classifier differentiated CC from mCRC with a concatenated AUC of 0.995. However, testing on an external dataset revealed that the HCC/other cancer type classifier underperformed with an AUC of 0.745. After combining the original training datasets with external datasets and retraining, the classification drastically improved, all achieving AUCs of 1.000. Although these results are promising and offer crucial insights into liver cancer, further research is required for model refinement and validation.
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Affiliation(s)
- Hyun-Jong Jang
- Department of Physiology, CMC Institute for Basic Medical Science, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea;
| | - Jai-Hyang Go
- Department of Pathology, Dankook University College of Medicine, Cheonan 31116, Republic of Korea;
| | - Younghoon Kim
- Department of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea;
| | - Sung Hak Lee
- Department of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea;
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19
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Asadnia A, Nazari E, Goshayeshi L, Zafari N, Moetamani-Ahmadi M, Goshayeshi L, Azari H, Pourali G, Khalili-Tanha G, Abbaszadegan MR, Khojasteh-Leylakoohi F, Bazyari M, Kahaei MS, Ghorbani E, Khazaei M, Hassanian SM, Gataa IS, Kiani MA, Peters GJ, Ferns GA, Batra J, Lam AKY, Giovannetti E, Avan A. The Prognostic Value of ASPHD1 and ZBTB12 in Colorectal Cancer: A Machine Learning-Based Integrated Bioinformatics Approach. Cancers (Basel) 2023; 15:4300. [PMID: 37686578 PMCID: PMC10486397 DOI: 10.3390/cancers15174300] [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: 08/01/2023] [Revised: 08/22/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
Introduction: Colorectal cancer (CRC) is a common cancer associated with poor outcomes, underscoring a need for the identification of novel prognostic and therapeutic targets to improve outcomes. This study aimed to identify genetic variants and differentially expressed genes (DEGs) using genome-wide DNA and RNA sequencing followed by validation in a large cohort of patients with CRC. Methods: Whole genome and gene expression profiling were used to identify DEGs and genetic alterations in 146 patients with CRC. Gene Ontology, Reactom, GSEA, and Human Disease Ontology were employed to study the biological process and pathways involved in CRC. Survival analysis on dysregulated genes in patients with CRC was conducted using Cox regression and Kaplan-Meier analysis. The STRING database was used to construct a protein-protein interaction (PPI) network. Moreover, candidate genes were subjected to ML-based analysis and the Receiver operating characteristic (ROC) curve. Subsequently, the expression of the identified genes was evaluated by Real-time PCR (RT-PCR) in another cohort of 64 patients with CRC. Gene variants affecting the regulation of candidate gene expressions were further validated followed by Whole Exome Sequencing (WES) in 15 patients with CRC. Results: A total of 3576 DEGs in the early stages of CRC and 2985 DEGs in the advanced stages of CRC were identified. ASPHD1 and ZBTB12 genes were identified as potential prognostic markers. Moreover, the combination of ASPHD and ZBTB12 genes was sensitive, and the two were considered specific markers, with an area under the curve (AUC) of 0.934, 1.00, and 0.986, respectively. The expression levels of these two genes were higher in patients with CRC. Moreover, our data identified two novel genetic variants-the rs925939730 variant in ASPHD1 and the rs1428982750 variant in ZBTB1-as being potentially involved in the regulation of gene expression. Conclusions: Our findings provide a proof of concept for the prognostic values of two novel genes-ASPHD1 and ZBTB12-and their associated variants (rs925939730 and rs1428982750) in CRC, supporting further functional analyses to evaluate the value of emerging biomarkers in colorectal cancer.
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Affiliation(s)
- Alireza Asadnia
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad 91779-48564, Iran; (A.A.); (N.Z.); (M.M.-A.); (H.A.); (G.P.); (G.K.-T.); (F.K.-L.); (E.G.); (M.K.); (S.M.H.)
- Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad 91886-17871, Iran; (M.R.A.); (M.S.K.)
- Basic Sciences Research Institute, Mashhad University of Medical Sciences, Mashhad 13944-91388, Iran;
| | - Elham Nazari
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran 19839-69411, Iran;
| | - Ladan Goshayeshi
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad 91779-48564, Iran;
- Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad 91779-48954, Iran;
| | - Nima Zafari
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad 91779-48564, Iran; (A.A.); (N.Z.); (M.M.-A.); (H.A.); (G.P.); (G.K.-T.); (F.K.-L.); (E.G.); (M.K.); (S.M.H.)
| | - Mehrdad Moetamani-Ahmadi
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad 91779-48564, Iran; (A.A.); (N.Z.); (M.M.-A.); (H.A.); (G.P.); (G.K.-T.); (F.K.-L.); (E.G.); (M.K.); (S.M.H.)
- Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad 91886-17871, Iran; (M.R.A.); (M.S.K.)
| | - Lena Goshayeshi
- Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad 91779-48954, Iran;
| | - Haneih Azari
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad 91779-48564, Iran; (A.A.); (N.Z.); (M.M.-A.); (H.A.); (G.P.); (G.K.-T.); (F.K.-L.); (E.G.); (M.K.); (S.M.H.)
| | - Ghazaleh Pourali
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad 91779-48564, Iran; (A.A.); (N.Z.); (M.M.-A.); (H.A.); (G.P.); (G.K.-T.); (F.K.-L.); (E.G.); (M.K.); (S.M.H.)
| | - Ghazaleh Khalili-Tanha
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad 91779-48564, Iran; (A.A.); (N.Z.); (M.M.-A.); (H.A.); (G.P.); (G.K.-T.); (F.K.-L.); (E.G.); (M.K.); (S.M.H.)
| | - Mohammad Reza Abbaszadegan
- Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad 91886-17871, Iran; (M.R.A.); (M.S.K.)
- Basic Sciences Research Institute, Mashhad University of Medical Sciences, Mashhad 13944-91388, Iran;
| | - Fatemeh Khojasteh-Leylakoohi
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad 91779-48564, Iran; (A.A.); (N.Z.); (M.M.-A.); (H.A.); (G.P.); (G.K.-T.); (F.K.-L.); (E.G.); (M.K.); (S.M.H.)
- Basic Sciences Research Institute, Mashhad University of Medical Sciences, Mashhad 13944-91388, Iran;
| | - MohammadJavad Bazyari
- Department of Medical Biotechnology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad 91779-48564, Iran;
| | - Mir Salar Kahaei
- Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad 91886-17871, Iran; (M.R.A.); (M.S.K.)
| | - Elnaz Ghorbani
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad 91779-48564, Iran; (A.A.); (N.Z.); (M.M.-A.); (H.A.); (G.P.); (G.K.-T.); (F.K.-L.); (E.G.); (M.K.); (S.M.H.)
| | - Majid Khazaei
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad 91779-48564, Iran; (A.A.); (N.Z.); (M.M.-A.); (H.A.); (G.P.); (G.K.-T.); (F.K.-L.); (E.G.); (M.K.); (S.M.H.)
- Basic Sciences Research Institute, Mashhad University of Medical Sciences, Mashhad 13944-91388, Iran;
| | - Seyed Mahdi Hassanian
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad 91779-48564, Iran; (A.A.); (N.Z.); (M.M.-A.); (H.A.); (G.P.); (G.K.-T.); (F.K.-L.); (E.G.); (M.K.); (S.M.H.)
- Basic Sciences Research Institute, Mashhad University of Medical Sciences, Mashhad 13944-91388, Iran;
| | | | - Mohammad Ali Kiani
- Basic Sciences Research Institute, Mashhad University of Medical Sciences, Mashhad 13944-91388, Iran;
| | - Godefridus J. Peters
- Department of Biochemistry, Medical University of Gdansk, 80-211 Gdansk, Poland;
- Cancer Center Amsterdam, Amsterdam U.M.C., VU University Medical Center (VUMC), Department of Medical Oncology, 1081 HV Amsterdam, The Netherlands
| | - Gordon A. Ferns
- Brighton & Sussex Medical School, Department of Medical Education, Falmer, Brighton, Sussex BN1 9PH, UK;
| | - Jyotsna Batra
- Faculty of Health, School of Biomedical Sciences, Queensland University of Technology (QUT), Brisbane, QLD 4059, Australia;
| | - Alfred King-yin Lam
- Pathology, School of Medicine and Dentistry, Gold Coast Campus, Griffith University, Gold Coast, QLD 4222, Australia;
| | - Elisa Giovannetti
- Cancer Center Amsterdam, Amsterdam U.M.C., VU University Medical Center (VUMC), Department of Medical Oncology, 1081 HV Amsterdam, The Netherlands
- Cancer Pharmacology Lab, AIRC Start Up Unit, Fondazione Pisana per La Scienza, 56017 Pisa, Italy
| | - Amir Avan
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad 91779-48564, Iran; (A.A.); (N.Z.); (M.M.-A.); (H.A.); (G.P.); (G.K.-T.); (F.K.-L.); (E.G.); (M.K.); (S.M.H.)
- Department of Medical Biotechnology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad 91779-48564, Iran;
- Faculty of Health, School of Biomedical Sciences, Queensland University of Technology (QUT), Brisbane, QLD 4059, Australia;
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Chlorogiannis DD, Verras GI, Tzelepi V, Chlorogiannis A, Apostolos A, Kotis K, Anagnostopoulos CN, Antzoulas A, Davakis S, Vailas M, Schizas D, Mulita F. Tissue classification and diagnosis of colorectal cancer histopathology images using deep learning algorithms. Is the time ripe for clinical practice implementation? PRZEGLAD GASTROENTEROLOGICZNY 2023; 18:353-367. [PMID: 38572457 PMCID: PMC10985751 DOI: 10.5114/pg.2023.130337] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 05/20/2023] [Indexed: 04/05/2024]
Abstract
Colorectal cancer is one of the most prevalent types of cancer, with histopathologic examination of biopsied tissue samples remaining the gold standard for diagnosis. During the past years, artificial intelligence (AI) has steadily found its way into the field of medicine and pathology, especially with the introduction of whole slide imaging (WSI). The main outcome of interest was the composite balanced accuracy (ACC) as well as the F1 score. The average reported ACC from the collected studies was 95.8 ±3.8%. Reported F1 scores reached as high as 0.975, with an average of 89.7 ±9.8%, indicating that existing deep learning algorithms can achieve in silico distinction between malignant and benign. Overall, the available state-of-the-art algorithms are non-inferior to pathologists for image analysis and classification tasks. However, due to their inherent uniqueness in their training and lack of widely accepted external validation datasets, their generalization potential is still limited.
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Affiliation(s)
| | | | - Vasiliki Tzelepi
- Department of Pathology, School of Medicine, University of Patras, Patras, Greece
| | | | - Anastasios Apostolos
- First Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece
| | - Konstantinos Kotis
- Intelligent Systems Lab, Department of Cultural Technology and Communication, University of the Aegean, Mytilene, Greece
| | | | - Andreas Antzoulas
- Department of Surgery, General University Hospital of Patras, Patras, Greece
| | - Spyridon Davakis
- Upper Gastrointestinal and General Surgery Unit, First Department of Surgery, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Michail Vailas
- Upper Gastrointestinal and General Surgery Unit, First Department of Surgery, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Dimitrios Schizas
- Upper Gastrointestinal and General Surgery Unit, First Department of Surgery, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Francesk Mulita
- Department of Surgery, General University Hospital of Patras, Patras, Greece
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