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Original Articles
The impact of the COVID-19 pandemic on clinical practices related to colorectal cancer and colonoscopy in South Korea: a nationwide population-based study
Jin Young Yoon, Moon Hyung Lee, Min Seob Kwak, Jae Myung Cha
Received May 10, 2024  Accepted September 21, 2024  Published online November 29, 2024  
DOI: https://doi.org/10.5217/ir.2024.00066    [Epub ahead of print]
AbstractAbstract PDF
Background/Aims
Despite of the coronavirus disease 2019 (COVID-19) pandemic, there is little data regarding its impact on colorectal cancer (CRC)-related clinical practice. This study aimed to assess the changes in its impact during the COVID-19 pandemic.
Methods
This was a retrospective national population-based study using the Health Insurance Review and Assessment database from January 2019 to December 2021. The number of patients in 2020 and 2021 was compared with those in 2019 for the diagnostic and therapeutic colonoscopy, CRC-related operation, and any treatment for CRC.
Results
The annual number of patients undergoing diagnostic colonoscopies decreased by 6.9% in 2020 but increased 8.1% in 2021, compared to those in 2019; number of patients undergoing therapeutic colonoscopies increased by 6.0% and 37.7% in 2020 and 2021, respectively; number of patients operated for CRC decreased by 4.2% in 2020 and increased by 2.3% in 2021. The number of patients treated for CRC decreased by 2.8% in 2020 and increased by 4.4% in 2021. Diagnostic and therapeutic colonoscopies and any CRC-related treatment decreased by 43.8%, 37.5%, and 11.3% in March 2020, during the first surge of COVID-19, but increased by 26.0%, 58.1%, and 9.5% in June 2021, respectively. CRC-related operations decreased by 24.1% in April 2020 and increased by 12.6% in August 2021.
Conclusions
Negative impact of the COVID-19 pandemic on clinical practices related to CRC completely recovered within second year. It could be considered for the development of an optimal strategy on CRC management in response to the pandemic-driven crisis.
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IBD
Ulcerative colitis-associated neoplasms often harbor poor prognostic histologic components with low detection by biopsy
Ryoya Sakakibara, Shinya Sugimoto, Kaoru Takabayashi, Hiroki Kiyohara, Yusuke Wakisaka, Yuta Kaieda, Miho Kawaida, Yusuke Yoshimatsu, Tomohisa Sujino, Naoki Hosoe, Motohiko Kato, Masayuki Shimoda, Yohei Mikami, Yasushi Iwao, Takanori Kanai
Intest Res 2024;22(4):428-438.   Published online May 7, 2024
DOI: https://doi.org/10.5217/ir.2024.00006
AbstractAbstract PDFPubReaderePub
Background/Aims
Poorly differentiated adenocarcinoma, signet-ring cell carcinoma, and mucinous adenocarcinoma (por/sig/muc), which are considered to be histologic subtypes with a poor prognosis, occur more frequently with colitis-associated cancer than with sporadic tumors. However, their invasiveness and manifestations are unclear. This study aimed to determine the prevalence of the por/sig/muc component in ulcerative colitis-associated neoplasms (UCANs) and its association with invasiveness and to clarify its clinicohistologic and endoscopic features.
Methods
This retrospective observational study included patients diagnosed with ulcerative colitis-associated high-grade dysplasia or adenocarcinoma from 1997 to 2022 who were divided according to the presence or absence of a por/sig/muc component.
Results
Thirty-five patients had UCAN with a por/sig/muc component and 66 had UCAN without this component. The 5-year survival rate was significantly lower in the por/sig/muc group than in the tub group (67% vs. 96%, P= 0.001), which was attributed to disease above stage III and depth to below the subserosa. Biopsy-based diagnosis before resection detected a por/sig/muc component in only 40% of lesions (14/35). Lesions with a por/sig/muc component were prevalent even in the early stages: stage 0 (4/36, 11%), I (8/20, 40%), II (7/12, 58%), III (10/14, 71%), and IV (6/8, 75%).
Conclusions
This is the first investigation that shows UCANs with a por/sig/muc component tended to be deeply invasive and were often not recognized preoperatively. Endoscopists should be aware that UCAN often has a por/sig/muc component that is not always recognized on biopsy, and the optimal treatment strategy needs to be carefully considered.
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Colorectal neoplasia
Unraveling molecular similarities between colorectal polyps and colorectal cancer: a systems biology approach
Mehran Radak, Hossein Fallahi
Intest Res 2024;22(2):199-207.   Published online February 6, 2024
DOI: https://doi.org/10.5217/ir.2023.00162
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Colorectal cancer (CRC) and colorectal polyps are intimately linked, with polyps acting as precursors to CRC. Understanding the molecular mechanisms governing their development is crucial for advancing diagnosis and treatment. Employing a systems biology approach, we investigated the molecular similarities between polyp and CRC.
Methods
We analyzed gene expression profiles, protein-protein interactions, transcription factors, and gene ontology to identify common differentially expressed genes (DEGs) and unravel shared molecular pathways.
Results
Our analysis revealed 520 commonly dysregulated genes in polyps and CRC, serving as potential biomarkers and pivotal contributors to disease progression. Gene ontology analysis elucidated distinct biological processes associated with upregulated and downregulated DEGs in both conditions, highlighting common pathways, including signal transduction, cell adhesion, and positive regulation of cell proliferation. Moreover, protein-protein interaction networks shed light on subnetworks involved in rRNA processing, positive regulation of cell proliferation, mRNA splicing, and cell division. Transcription factor analysis identified major regulators and differentially expressed transcription factors in polyp and CRC. Notably, we identified common differentially expressed transcription factors, including ZNF217, NR3C1, KLF5, GATA6, and STAT3, with STAT3 and NR3C1 exhibiting increased expression.
Conclusions
This comprehensive analysis enriches our understanding of the molecular mechanisms underlying polyp formation and CRC development, providing potential targets for further investigation and therapeutic intervention. Our findings contribute substantively to crafting personalized strategies for refining the diagnosis and treatment of polyps and CRC.

Citations

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  • Stool Glycoproteomics Signatures of Pre-Cancerous Lesions and Colorectal Cancer
    Janine Soares, Mariana Eiras, Dylan Ferreira, Daniela A. R. Santos, Marta Relvas-Santos, Beatriz Santos, Martina Gonçalves, Eduardo Ferreira, Renata Vieira, Luís Pedro Afonso, Lúcio Lara Santos, Mário Dinis-Ribeiro, Luís Lima, José Alexandre Ferreira
    International Journal of Molecular Sciences.2024; 25(7): 3722.     CrossRef
  • 3,224 View
  • 146 Download
  • 1 Web of Science
  • 1 Crossref
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Reviews
Colorectal neoplasia
Screening and surveillance for hereditary colorectal cancer
Hee Man Kim, Tae Il Kim
Intest Res 2024;22(2):119-130.   Published online February 6, 2024
DOI: https://doi.org/10.5217/ir.2023.00112
AbstractAbstract PDFPubReaderePub
Hereditary colorectal cancer is a type of cancer that is caused by a genetic mutation. Individuals with a family history of colorectal cancer, or who have a known hereditary syndrome, are at an increased risk of developing the disease. Screening and surveillance are important tools for managing the risk of hereditary colorectal cancer. Screening involves a combination of tests that can detect precancerous or cancerous changes in the colon and rectum. Surveillance involves regular follow-up examinations to monitor disease progression and to identify new developments. The frequency and type of screening and surveillance tests may vary depending on an individual’s risk factors, genetic profile, and medical history. However, early detection and treatment of hereditary colorectal cancer can significantly improve patient outcomes and reduce mortality rates. By implementing comprehensive screening and surveillance strategies, healthcare providers can help individuals at risk of hereditary colorectal cancer to receive timely interventions and make informed decisions about their health. Specific examples of screening and surveillance tests for hereditary colorectal cancer include colonoscopy, genetic testing, and imaging tests. In this review article, we will discuss detailed screening and surveillance of hereditary colorectal cancer.

Citations

Citations to this article as recorded by  
  • Efficacy of Oral Sulfate Tablet and 2 L-Polyethylene Glycol with Ascorbic Acid for Bowel Preparation: A Prospective Randomized KASID Multicenter Trial
    Yunho Jung, Hyun Gun Kim, Dong-Hoon Yang, Hyoun Woo Kang, Jae Jun Park, Dong Hoon Baek, Jaeyoung Chun, Tae-Geun Gweon, Hyeon Jeong Goong, Min Seob Kwak, Hyun Jung Lee, Soo-Kyung Park, Jong Hoon Lee
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Influence of Lifestyles on Polyp Burden and Cancer Development in Hereditary Colorectal Cancer Syndromes
    Hye Kyung Hyun, Ji Soo Park, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim
    Journal of Gastroenterology and Hepatology.2024;[Epub]     CrossRef
  • 3,152 View
  • 200 Download
  • 2 Web of Science
  • 2 Crossref
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Colorectal neoplasia
Pathogenesis and biomarkers of colorectal cancer by epigenetic alteration
Chang Kyo Oh, Young-Seok Cho
Intest Res 2024;22(2):131-151.   Published online February 1, 2024
DOI: https://doi.org/10.5217/ir.2023.00115
AbstractAbstract PDFPubReaderePub
Colorectal cancer (CRC) ranks third in cancer incidence and stands as the second leading cause of cancer-related deaths globally. CRC tumorigenesis results from a cumulative set of genetic and epigenetic alterations, disrupting cancer-regulatory processes like cell proliferation, metabolism, angiogenesis, cell death, invasion, and metastasis. Key epigenetic modifications observed in cancers encompass abnormal DNA methylation, atypical histone modifications, and irregularities in noncoding RNAs, such as microRNAs and long noncoding RNAs. The advancement in genomic technologies has positioned these genetic and epigenetic shifts as potential clinical biomarkers for CRC patients. This review concisely covers the fundamental principles of CRC-associated epigenetic changes, and examines in detail their emerging role as biomarkers for early detection, prognosis, and treatment response prediction.

Citations

Citations to this article as recorded by  
  • The role of suppressor of cytokine signaling 3 in inflammatory bowel disease and its associated colorectal cancer
    Pengfei Zhang, Bing Pei, Chengxue Yi, Francis Atim Akanyibah, Fei Mao
    Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease.2025; 1871(2): 167578.     CrossRef
  • miR-3065-5p and miR-26a-5p as Clinical Biomarkers in Colorectal Cancer: A Translational Study
    Berenice Carbajal-López, Antonio Daniel Martínez-Gutierrez, Eduardo O. Madrigal-Santillán, Germán Calderillo-Ruiz, José Antonio Morales-González, Jossimar Coronel-Hernández, Joey Lockhart, Oliver Millan-Catalan, Monica G. Mendoza-Rodriguez, Leonardo S. Li
    Cancers.2024; 16(21): 3649.     CrossRef
  • Influence of Lifestyles on Polyp Burden and Cancer Development in Hereditary Colorectal Cancer Syndromes
    Hye Kyung Hyun, Ji Soo Park, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim
    Journal of Gastroenterology and Hepatology.2024;[Epub]     CrossRef
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  • 194 Download
  • 3 Web of Science
  • 3 Crossref
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Original Articles
Risk of malignancies and chemopreventive effect of statin, metformin, and aspirin in Korean patients with ulcerative colitis: a nationwide population-based study
Eun Hye Oh, Ye-Jee Kim, Minju Kim, Seung Ha Park, Tae Oh Kim, Sang Hyoung Park
Received June 3, 2023  Accepted September 14, 2023  Published online November 9, 2023  
DOI: https://doi.org/10.5217/ir.2023.00062    [Epub ahead of print]
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
We investigated the incidences of overall and site-specific malignancies and chemopreventive effects of statin, metformin, and aspirin in patients with ulcerative colitis.
Methods
We collected data using the Health Insurance Review and Assessment claims database from January 2007 to April 2020.
Results
The overall malignancy risk among the 35,189 ulcerative colitis patients was similar to that of the general population (standardized incidence ratio, 0.94; 95% confidence interval, 0.88–1.00). In male patients, standardized incidence ratios were high for thyroid cancer and low for stomach cancer, colorectal cancer, liver cancer, and lung cancer. Concurrently, standard incidence ratios were high for liver cancer and central nervous system cancer in female patients. While 122 cases of colorectal cancer occurred in the study patients, the standardized incidence ratio was 0.83 (95% confidence interval, 0.69–0.99). Treatment for ulcerative colitis was not associated with an increased adjusted hazard ratio, while comorbidities increased it for all malignancies. Treatment for ulcerative colitis was associated with an increased adjusted hazard ratio, while comorbidities did not increase it for colorectal cancer. After adjusting for age, sex, comorbidities, and ulcerative colitis treatment, statins showed a dose-dependent chemopreventive effect for all malignancies (P=0.002), while metformin and aspirin did not show any.
Conclusions
In ulcerative colitis patients, standardized incidence ratios for all malignancies and colorectal cancer did not increase. Adjusted hazard ratios for all malignancies increased with comorbidities and those for colorectal cancer with ulcerative colitis treatment. Statins have a dose-dependent chemopreventive effect for all malignancies.
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Colorectal neoplasia
The elderly population are more vulnerable for the management of colorectal cancer during the COVID-19 pandemic: a nationwide, population-based study
Hong Sun Kang, Seung Hoon Jeon, Su Bee Park, Jin Young Youn, Min Seob Kwak, Jae Myung Cha
Intest Res 2023;21(4):500-509.   Published online August 29, 2023
DOI: https://doi.org/10.5217/ir.2023.00004
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
The impact of coronavirus disease 2019 (COVID-19) on the management of colorectal cancer (CRC) may worse in elderly population, as almost all COVID-19 deaths occurred in the elderly patients. This study aimed to evaluate the impact of COVID-19 on CRC management in the elderly population.
Methods
The numbers of patients who underwent colonoscopy, who visited hospitals or operated for CRC in 2020 and 2021 (COVID-19 era) were compared with those in 2019, according to 3 age groups (≥70 years, 50–69 years, and ≤49 years), based on the nationwide, population-based database (2019–2021) in South Korea.
Results
The annual volumes of colonoscopy and hospital visits for CRC in 2020 were more significantly declined in the old age group than in the young age group (both P<0.001). In addition, the annual volume of patients operated for CRC numerically more declined in old age group than in young age group. During the first surge of COVID-19 (March and April 2020), old age patients showed statistically significant declines for the monthly number of colonoscopies (–46.5% vs. –39.3%, P<0.001), hospital visits (–15.4% vs. –7.9%, P<0.001), CRC operations (–33.8% vs. –0.7%, P<0.05), and colonoscopic polypectomies (–41.8% vs. –38.0%, P<0.001) than young age patients, compared with those of same months in 2019.
Conclusions
Elderly population are more vulnerable for the management of CRC during the COVID-19 pandemic. Therefore, the elderly population are more carefully cared for in the management of CRC during the next pandemic.

Citations

Citations to this article as recorded by  
  • To overcome medical gap in screening and surveillance of colorectal cancer during the COVID-19 pandemic
    Yoo Min Han
    Intestinal Research.2023; 21(4): 418.     CrossRef
  • 2,284 View
  • 197 Download
  • 1 Web of Science
  • 1 Crossref
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IBD
Risks of colorectal cancer and biliary cancer according to accompanied primary sclerosing cholangitis in Korean patients with ulcerative colitis: a nationwide population-based study
Eun Hye Oh, Ye-Jee Kim, Minju Kim, Seung Ha Park, Tae Oh Kim, Sang Hyoung Park
Intest Res 2023;21(2):252-265.   Published online December 2, 2022
DOI: https://doi.org/10.5217/ir.2022.00092
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
We conducted a nationwide population-based study to investigate incidence rates of colorectal and biliary cancers according to accompanying primary sclerosing cholangitis in Korean ulcerative colitis patients.
Methods
We used the Health Insurance Review and Assessment claim database from January 2007 to April 2020. Standardized incidence ratios of colorectal and biliary cancers in ulcerative colitis patients were calculated.
Results
Among 35,189 newly diagnosed ulcerative colitis patients, 1,224 patients were diagnosed with primary sclerosing cholangitis. During the study period, 122 and 52 patients were diagnosed with colorectal and biliary cancers, respectively. Incidences of colorectal cancer were not higher in ulcerative colitis patients than those in the general population (standardized incidence ratios, 0.83; 95% confidence interval, 0.69–0.99), regardless of accompanied primary sclerosing cholangitis (standardized incidence ratio, 0.73; 95% confidence interval, 0.24–1.71). While incidences of biliary cancer were not higher in ulcerative colitis patients than those in the general population (standardized incidence ratio, 1.14; 95% confidence interval, 0.80–1.58), these were much higher with accompanied primary sclerosing cholangitis (standardized incidence ratio, 10.07; 95% confidence interval, 5.75–16.36). Cumulative incidences of colorectal and biliary cancers increased in patients who were diagnosed with ulcerative colitis at an older age.
Conclusions
In Korean ulcerative colitis patients, colorectal cancer incidences were not higher than those in the general population regardless of accompanied primary sclerosing cholangitis. However, biliary cancer incidences were much higher in ulcerative colitis patients with primary sclerosing cholangitis than in those without, or in the general population.

Citations

Citations to this article as recorded by  
  • Treatment of primary sclerosing cholangitis combined with inflammatory bowel disease
    You Sun Kim, Edward H. Hurley, Yoojeong Park, Sungjin Ko
    Intestinal Research.2023; 21(4): 420.     CrossRef
  • Are the risks of colorectal cancer and biliary cancer really increased if patients with ulcerative colitis have primary sclerosing cholangitis?
    Jung Wook Lee, Won Moon
    Intestinal Research.2023; 21(2): 171.     CrossRef
  • 3,393 View
  • 331 Download
  • 2 Web of Science
  • 2 Crossref
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Review
Cancer
Endoscopic diagnosis and treatment of early colorectal cancer
Seung Wook Hong, Jeong-Sik Byeon
Intest Res 2022;20(3):281-290.   Published online July 26, 2022
DOI: https://doi.org/10.5217/ir.2021.00169
AbstractAbstract PDFPubReaderePub
Early colorectal cancer refers to cancer in the colorectum that is confined to the mucosa or submucosa and does not invade the muscularis propria, irrespective of lymph node or distant metastasis. As the number of persons undergoing screening colonoscopy increases, the proportion of patients diagnosed with precancerous colorectal lesions and early colorectal cancer also increases. In the last decade, innovative optical technologies for endoscopic diagnosis have been introduced and endoscopic treatment techniques such as endoscopic submucosal dissection have provided major breakthroughs in the management of early colorectal cancer. With these remarkable developments, endoscopic treatment has established itself as an alternative to surgical resection in the treatment of early colorectal cancer. This review will discuss the endoscopic diagnosis and treatment of early colorectal cancer. Furthermore, the unmet needs in this field and the latest research addressing those issues will be summarized.

Citations

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  • Case report: Successful treatment of advanced colon cancer in an eighty-year-old man with long-term and multi-stage endoscopic minimally invasive therapy
    Nana Zhang, Lulu Zhu, Yan Liu, Xiaolong Chen, Bifang Zhang, Chunhong Wen, Huayu Zhang, Qinglin Tang, Mingqing Zhang
    Frontiers in Oncology.2024;[Epub]     CrossRef
  • Prediction of Lymph Node Metastasis in T1 Colorectal Cancer Using Artificial Intelligence with Hematoxylin and Eosin-Stained Whole-Slide-Images of Endoscopic and Surgical Resection Specimens
    Joo Hye Song, Eun Ran Kim, Yiyu Hong, Insuk Sohn, Soomin Ahn, Seok-Hyung Kim, Kee-Taek Jang
    Cancers.2024; 16(10): 1900.     CrossRef
  • Influence of Certification Program on Treatment Quality and Survival for Rectal Cancer Patients in Germany: Results of 13 Certified Centers in Collaboration with AN Institute
    Mihailo Andric, Jessica Stockheim, Mirhasan Rahimli, Sara Al-Madhi, Sara Acciuffi, Maximilian Dölling, Roland Siegfried Croner, Aristotelis Perrakis
    Cancers.2024; 16(8): 1496.     CrossRef
  • Screening and surveillance for hereditary colorectal cancer
    Hee Man Kim, Tae Il Kim
    Intestinal Research.2024; 22(2): 119.     CrossRef
  • The Usefulness of Vitamin K-Dependent Proteins in the Diagnosis of Colorectal Carcinoma
    Mirela-Georgiana Perné, Adela-Viviana Sitar-Tăut, Olga Hilda Orășan, Vasile Negrean, Călin Vasile Vlad, Teodora-Gabriela Alexescu, Mircea Vasile Milaciu, Lorena Ciumărnean, Răzvan Dan Togănel, Gabriel Emil Petre, Ioan Șimon, Alexandra Crăciun
    International Journal of Molecular Sciences.2024; 25(9): 4997.     CrossRef
  • Strategies to improve screening colonoscopy quality for the prevention of colorectal cancer
    Joo Hye Song, Eun Ran Kim
    The Korean Journal of Internal Medicine.2024; 39(4): 547.     CrossRef
  • Patient and procedural factors associated with true histology rates in patients undergoing colonoscopy with computer-aided detection of polyps
    Aasma Shaukat, David R. Lichtenstein, Daniel C. Chung, Caitlyn Seidl, Yeli Wang, Emma E. Navajas, Daniel R. Colucci, Shrujal Baxi, William R. Brugge
    Gastrointestinal Endoscopy.2024; 100(6): 1090.     CrossRef
  • Short‐term morbidity and mortality after right hemicolectomy: an update of national performance in the Netherlands
    J. M. L. Sijmons, A. A. J. Grüter, B. R. Toorenvliet, R. A. E. M. Tollenaar, J. W. T. Dekker, P. J. Tanis, J. B. Tuynman
    Colorectal Disease.2024; 26(11): 1983.     CrossRef
  • Efficacy of Oral Sulfate Tablet and 2 L-Polyethylene Glycol with Ascorbic Acid for Bowel Preparation: A Prospective Randomized KASID Multicenter Trial
    Yunho Jung, Hyun Gun Kim, Dong-Hoon Yang, Hyoun Woo Kang, Jae Jun Park, Dong Hoon Baek, Jaeyoung Chun, Tae-Geun Gweon, Hyeon Jeong Goong, Min Seob Kwak, Hyun Jung Lee, Soo-Kyung Park, Jong Hoon Lee
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Olfactomedin 4 produces dysplasia but suppresses metastasis of colon cancer
    Hyun Woo Ma, Jung Min Kim, Da Hye Kim, I Seul Park, Ji Hyung Kim, Ki Cheong Park, Dong Hyuk Seo, Jae Hyeon Kim, Xiumei Che, Tae Il Kim, Jae Hee Cheon, Seung Won Kim
    Cancer Gene Therapy.2023; 30(5): 694.     CrossRef
  • Past, present, and future of Intestinal Research
    Jae Hee Cheon
    Intestinal Research.2023; 21(1): 1.     CrossRef
  • Chasm between Public Perceptions and Epidemiological Data on Colorectal Cancer
    Su Bee Park, Min Seob Kwak, Jin Young Yoon, Jae Myung Cha
    Gut and Liver.2023; 17(3): 449.     CrossRef
  • Technique, sedation, and clinical outcome of endoscopic submucosal dissection for rectal tumor with involvement of dentate line: A retrospective cohort study
    Yoon Kyoo Noh, Jun Lee, Seong Jung Kim
    Saudi Journal of Gastroenterology.2023; 29(6): 365.     CrossRef
  • Նորագույն էնդոսկոպիկ մեթոդների դերը հաստ աղու նորագոյացությունների ախտորոշման և բուժման մեջ
    Ն. Գ. Զալինյան, Ա. Մ. Խալաթյան, Ս. Ա. Խաչատրյան, Մ. Ա. Նալբանդյան, Տ. Է. Ստեփանյան, Գ. Ն. Թամամյան, Կ. Դ. Մանուկյան
    Medical Science of Armenia.2023; : 11.     CrossRef
  • Effectiveness and Safety of Endoscopic Submucosal Dissection for Colorectal Neoplasm in Patients with High Charlson Comorbidity Index Score: A HASID Multicenter Study
    Dong-Hyun Kim, Yong-Wook Jung, Byung-Chul Jin, Hyung-Hoon Oh, Hyo-Yeop Song, Seong-Jung Kim, Dae-Seong Myung, Sang-Wook Kim, Jun Lee, Geom-Seog Seo, Young-Eun Joo, Hyun-Soo Kim
    Journal of Clinical Medicine.2023; 12(19): 6255.     CrossRef
  • The tumor suppressive effect and apoptotic mechanism of TRAIL gene‐containing recombinant NDV in TRAIL‐resistant colorectal cancer HT‐29 cells and TRAIL‐nonresistant HCT116 cells, with each cell bearing a mouse model
    Bo‐Kyoung Jung, Yong Hee An, Sung Hoon Jang, Gyoungah Ryu, Saet‐byel Jung, Seonhee Kim, Cuk‐Seong Kim, Hyun Jang
    Cancer Medicine.2023; 12(20): 20380.     CrossRef
  • Clinical characteristics and risk factors related to polyposis recurrence and advanced neoplasm development among patients with non-hereditary colorectal polyposis
    Jihun Jang, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim
    Intestinal Research.2023; 21(4): 510.     CrossRef
  • Summary and comparison of recently updated post-polypectomy surveillance guidelines
    Yoon Suk Jung
    Intestinal Research.2023; 21(4): 443.     CrossRef
  • Wide-field endoscope accessory for multiplexed fluorescence imaging
    Gaoming Li, Miki Lee, Tse-Shao Chang, Joonyoung Yu, Haijun Li, Xiyu Duan, Xiaoli Wu, Sangeeta Jaiswal, Shuo Feng, Kenn R. Oldham, Thomas D. Wang
    Scientific Reports.2023;[Epub]     CrossRef
  • Endoscopic characterization of neoplastic and non-neoplastic lesions in inflammatory bowel disease: systematic review in the era of advanced endoscopic imaging
    Andrea Cassinotti, Marco Parravicini, Thomas P. Chapman, Marco Balzarini, Lorenzo Canova, Simone Segato, Valentina Zadro, Simon Travis, Sergio Segato
    Therapeutic Advances in Gastroenterology.2023;[Epub]     CrossRef
  • Prediction of disease recurrence or residual disease after primary endoscopic resection of pT1 colorectal cancer—results from a large nationwide Danish study
    Ilze Ose, Katarina Levic, Lau Caspar Thygesen, Orhan Bulut, Thue Bisgaard, Ismail Gögenur, Tine Plato Kuhlmann
    International Journal of Colorectal Disease.2023;[Epub]     CrossRef
  • 4,950 View
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Original Articles
Colorectal neoplasia
Postgastrectomy gastric cancer patients are at high risk for colorectal neoplasia: a case control study
Tae-Geun Gweon, Kyu-Tae Yoon, Chang Hyun Kim, Jin-Jo Kim
Intest Res 2021;19(2):239-246.   Published online November 13, 2020
DOI: https://doi.org/10.5217/ir.2020.00009
AbstractAbstract PDFPubReaderePub
Background/Aims
Several studies have shown that colorectal neoplasms (CRN) including colorectal cancer (CRC) may be prevalent in patients with gastric cancer. However, in most of these studies, colonoscopy to investigate the prevalence of CRN was performed prior to surgery. We aimed to investigate whether CRN was more prevalent in postgastrectomy gastric cancer patients than in healthy individuals.
Methods
We reviewed the medical records of those patients within a cohort of gastric cancer patients with gastrectomy who underwent colonoscopy between 2016 and 2017. Controls age- and sex-matched with gastric cancer patients at a 2:1 ratio were identified among those who underwent colonoscopy at a health-promotion center. The frequencies of CRN, advanced CRN (ACRN), and CRC among patients with gastrectomy were compared with those in the control subjects. A total of 744 individuals (gastric cancer, 248; control, 496) were included.
Results
The rates of CRN and ACRN in the gastric cancer group were higher than those in the healthy individuals (CRN, 47.6% vs. 34.7%, P< 0.001; ACRN, 16.9% vs. 10.9%, P= 0.020). The rate of CRC was comparable between the 2 groups (2.0% vs. 0.6%, P= 0.125). Multivariate analysis identified previous gastrectomy for gastric cancer and male sex as significant risk factors for (A)CRN.
Conclusions
CRN and ACRN were more prevalent in patients who underwent surgery for gastric cancer than in the control group. Regular surveillance colonoscopy at appropriate intervals is indicated after gastrectomy.

Citations

Citations to this article as recorded by  
  • Effect of bowel preparation completion time on bowel cleansing efficacy: Prospective randomized controlled trial of different bowel preparation completion times precolonoscopy
    Hye Min Kim, Hyo Suk Kim, Young Eun An, Jae Hyuck Chang, Tae Ho Kim, Chang Whan Kim, Tae‐Geun Gweon
    Digestive Endoscopy.2024;[Epub]     CrossRef
  • Calcium, Vitamin D, and Colorectal Cancer
    Young-Jo Wi, Soo-Young Na
    The Korean Journal of Gastroenterology.2023; 82(2): 47.     CrossRef
  • Comparison of 2 L Polyethylene Glycol Plus Ascorbic Acid and 4 L Polyethylene Glycol in Elderly Patients Aged 60–79: A Prospective Randomized Study
    Sung Hoon Jung, Chul-Hyun Lim, Tae-Geun Gweon, Jinsu Kim, Jung Hwan Oh, Kyu-Tae Yoon, Jee Young An, Jeong‑Seon Ji, Hwang Choi
    Digestive Diseases and Sciences.2022; 67(10): 4841.     CrossRef
  • Colonoscopy Insertion in Patients with Gastrectomy: Does Position Impact Cecal Intubation Time?
    Jae Hyun Kim, Youn Jung Choi, Hye Jung Kwon, Gyu Man Oh, Kyoungwon Jung, Sung Eun Kim, Won Moon, Moo In Park, Seun Ja Park
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    American Journal of Gastroenterology.2022; 117(11): 1877.     CrossRef
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Inflammatory bowel diseases
Advanced neoplasia detection using chromoendoscopy and white light colonoscopy for surveillance in patients with inflammatory bowel disease
Kyeong Ok Kim, Michael V. Chiorean
Intest Res 2020;18(4):438-446.   Published online October 26, 2020
DOI: https://doi.org/10.5217/ir.2019.00090
AbstractAbstract PDFPubReaderePub
Background/Aims
Chromoendoscopy (CE) has been shown to be superior to white light endoscopy (WLE) for neoplasia detection in inflammatory bowel disease (IBD). We aimed to compare the yield of CE and WLE for the detection of overall neoplasia and advanced neoplasia in IBD.
Methods
Patients who underwent surveillance colonoscopy from 1999 to 2017 were identified from our IBD database. CE procedures were compared with their respective WLE controls in a paired comparison, and frequency of all neoplasia, advanced neoplasia, and serrated neoplasia was assessed for both targeted and random biopsies.
Results
A total of 290 procedures performed in 98 individuals were identified with a median follow-up 4 years (median 3 colonoscopies/patient). CE and WLE were performed in 159 and 131 episodes, respectively. CE detected neoplasia in 40.9% of colonoscopies versus 23.7% with WLE (P= 0.002). In addition, CE detected more advanced neoplasia (18.2% vs. 6.1%, P= 0.002) and serrated lesions (14.5% vs. 6.1%, P= 0.022). Significantly fewer samples were obtained per procedure with CE (14.9 ± 9.7 vs. 20.9 ± 11.1, P< 0.001). Cancer was diagnosed in 2 cases.
Conclusions
CE has a higher detection rate than WLE for advanced neoplasia and serrated lesions in patients with IBD under surveillance. Further prospective studies evaluating the impact of CE on decreasing the risk of interval cancer and colectomy in IBD patients are warranted.

Citations

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    Caroline Tanadi, Kevin Tandarto, Maureen Miracle Stella, Kenny Wijaya Sutanto, Mario Steffanus, Riki Tenggara, Muhammad Begawan Bestari
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    Roberto Gabbiadini, Ferdinando D’Amico, Alessandro De Marco, Maria Terrin, Alessandra Zilli, Federica Furfaro, Mariangela Allocca, Gionata Fiorino, Silvio Danese
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    Kyeong Ok Kim, Eun Young Kim, Yoo Jin Lee, Hyun Seok Lee, Eun Soo Kim, Yun Jin Chung, Byung Ik Jang, Sung Kook Kim, Chang Heon Yang
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    Olga Maria Nardone, Marietta Iacucci
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    金良 肖
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    Lisa Amsberg, Ulrike Schempf, Dörte Wichmann
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  • 10 Crossref
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Colorectal neoplasia
Factors associated with the survival of colorectal cancer in Mexico
Carlos Quezada-Gutiérrez, María Teresa Álvarez-Bañuelos, Jaime Morales-Romero, Clara Luz Sampieri, Raúl Enrique Guzmán-García, Evangelina Montes-Villaseñor
Intest Res 2020;18(3):315-324.   Published online May 19, 2020
DOI: https://doi.org/10.5217/ir.2019.09179
AbstractAbstract PDFPubReaderePub
Background/Aims
Colorectal cancer (CRC) is a public health problem. In Mexico, there have been no recent studies conducted on survival in terms of this pathology or on the influence of prognostic factors. The study aims to determine the probability of survival in patients with CRC presence of low levels of schooling and a rural population, adjusted for clinical stage and type of treatment.
Methods
A retrospective study was conducted in a cohort of 305 patients with CRC treated at State Cancer Center, located in Veracruz-Mexico; the follow-up period of 60 months (2012–2016). The survival probability was calculated using the Kaplan-Meier estimator and the log-rank test with 95% confidence intervals (CIs). Prognostic factors were determined using hazard ratio (HR) multivariate Cox regression analysis.
Results
Overall survival was 40% at 60 months. Subjects in the age group ≥ 65 years had a low survival rate of 28% (P= 0.026) and an advanced clinical stage of 22% (P< 0.001). Of the patients with bone metastasis, none survived longer than 5 years (P= 0.008). With respect to the unfavorable prognostic factors identified in the multivariate analysis, a decreased level of schooling was associated with an HR of 7.6 (95% CI, 1.1–54.7), advanced clinical stage was associated with an HR of 2.1 (95% CI, 1.2–4.0), and the presence of metastasis had an HR of 1.8 (95% CI, 1.1–2.9).
Conclusions
Poor prognostic factors include an advanced clinical stage, the presence of metastasis and a low level of schooling. These findings confirm the importance of screening for early diagnosis, diminishing the barriers to accessing treatment and prospectively monitoring the population.

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Review
Novel biomarkers for the diagnosis and prognosis of colorectal cancer
Hyung-Hoon Oh, Young-Eun Joo
Intest Res 2020;18(2):168-183.   Published online November 30, 2019
DOI: https://doi.org/10.5217/ir.2019.00080
AbstractAbstract PDFPubReaderePub
Colorectal cancer (CRC) is among the most common malignancies and remains a major cause of cancer-related death worldwide. Despite recent advances in surgical and multimodal therapies, the overall survival of advanced CRC patients remains very low. Cancer progression, including invasion and metastasis, is a major cause of death among CRC patients. The underlying mechanisms of action resulting in cancer progression are beginning to unravel. The reported molecular and biochemical mechanisms that might contribute to the phenotypic changes in favor of carcinogenesis include apoptosis inhibition, enhanced tumor cell proliferation, increased invasiveness, cell adhesion perturbations, angiogenesis promotion, and immune surveillance inhibition. These events may contribute to the development and progression of cancer. A biomarker is a molecule that can be detected in tissue, blood, or stool samples to allow the identification of pathological conditions such as cancer. Thus, it would be beneficial to identify reliable and practical molecular biomarkers that aid in the diagnostic and therapeutic processes of CRC. Recent research has targeted the development of biomarkers that aid in the early diagnosis and prognostic stratification of CRC. Despite that, the identification of diagnostic, prognostic, and/or predictive biomarkers remains challenging, and previously identified biomarkers might be insufficient to be clinically applicable or offer high patient acceptability. Here, we discuss recent advances in the development of molecular biomarkers for their potential usefulness in early and less-invasive diagnosis, treatment, and follow-up of CRC.

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Close layer
Original Articles
Colorectal neoplasia
Microvascular density under magnifying narrow-band imaging endoscopy in colorectal epithelial neoplasms
Takahiro Gonai, Keisuke Kawasaki, Shotaro Nakamura, Shunichi Yanai, Risaburo Akasaka, Kunihiko Sato, Yousuke Toya, Kensuke Asakura, Jun Urushikubo, Yasuko Fujita, Makoto Eizuka, Noriyuki Uesugi, Tamotsu Sugai, Takayuki Matsumoto
Intest Res 2020;18(1):107-114.   Published online November 4, 2019
DOI: https://doi.org/10.5217/ir.2019.00061
AbstractAbstract PDFPubReaderePub
Background/Aims
Magnifying endoscopic classification systems, such as the Japan narrow-band imaging (NBI) Expert Team (JNET) classification, have been widely used for predicting the histologic diagnosis and invasion depth of colorectal epithelial tumors. However, disagreement exists among observers regarding magnifying endoscopic diagnosis, because these classification systems are subjective. We herein investigated the utility of endoscopic microvascular density (eMVD) calculated from magnifying NBI endoscopic images in colorectal tumors.
Methods
We reviewed magnifying NBI endoscopic images from 169 colorectal epithelial tumors (97 adenomas, 72 carcinomas/high-grade dysplasias) resected endoscopically or surgically. The eMVD on magnifying NBI endoscopic images was evaluated using image-editing software, and relationships between eMVD and clinical, endoscopic, and pathological findings were retrospectively analyzed.
Results
The eMVD in carcinomas (0.152 ± 0.079) was significantly higher than that in adenomas (0.119 ± 0.059, P< 0.05). The best cutoff value for distinguishing carcinoma from adenoma was 0.133. Sensitivity, specificity, and accuracy were 56.9%, 67.0%, and 62.7%, respectively. In addition, JNET type 2B tumors showed significantly higher eMVD (0.162 ± 0.079) compared to type 2A tumors (0.111 ± 0.050, P< 0.05).
Conclusions
The eMVD as determined by magnifying NBI endoscopy is considered to be a possible objective indicator for differentiating colorectal carcinomas from adenomas.

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Colorectal neoplasia
Parthenolide inhibits transforming growth factor β1-induced epithelial-mesenchymal transition in colorectal cancer cells
Shi Mao Zhu, Yong Ran Park, Seung Yong Seo, In Hee Kim, Soo Teik Lee, Sang Wook Kim
Intest Res 2019;17(4):527-536.   Published online August 23, 2019
DOI: https://doi.org/10.5217/ir.2019.00031
AbstractAbstract PDFPubReaderePub
Background/Aims
Transforming growth factor-β1 (TGF-β1) induction of epithelial-mesenchymal transition (EMT) is one of the mechanisms by which colorectal cancer (CRC) cells acquire migratory and invasive capacities, and subsequently metastasize. Parthenolide (PT) expresses multiple anti-cancer and anti-inflammatory activities that inhibit nuclear factor κB by targeting the IκB kinase complex. In the present study, we aimed to investigate whether PT can inhibit TGF-β1-induced EMT in CRC cell lines.
Methods
HT-29 and SW480 cell lines were used in the experiment. Cell viability was detected by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and sub-G1 analysis was measured by flow cytometry. The induction of EMT by TGF-β1 and inhibition of the process by PT was analyzed by phase contrast microscopy, wounding healing, cellular migration and invasion assays, and Western blotting.
Results
TGF-β1 inhibits HT-29 cell proliferation, but has no effect on SW480 cell proliferation; different concentrations of TGF-β1 did not induce apoptosis in HT-29 and SW480 cells. PT attenuates TGF-β1-induced elongated, fibroblast-like shape changing in cells. PT inhibits TGF-β1-induced cell migration and cell invasion. In addition, other EMT markers such as β-catenin, Vimentin, Snail, and Slug were suppressed by PT, while E-cadherin was increased by PT.
Conclusions
Our findings show that PT inhibits TGF-β1-induced EMT by suppressing the expression of the mesenchymal protein and increasing expression of the epithelial protein. These findings suggest a novel approach for CRC treatment by suppression of TGF-β1-induced EMT.

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Review
Colorectal neoplasia
Prevalence and risk factors of colorectal cancer in Asia
Martin CS Wong, Hanyue Ding, Jingxuan Wang, Paul SF Chan, Junjie Huang
Intest Res 2019;17(3):317-329.   Published online May 20, 2019
DOI: https://doi.org/10.5217/ir.2019.00021
AbstractAbstract PDFPubReaderePub
Globally, colorectal cancer (CRC) is a substantial public health burden, and it is increasingly affecting populations in Asian countries. The overall prevalence of CRC is reported to be low in Asia when compared with that in Western nations, yet it had the highest number of prevalent cases. This review described the prevalence of CRC in Asia according to the International Agency for Research on Cancer from World Health Organization (WHO) database and summarized its major risk factors. Non-modifiable factors include genetic factors, ethnicity, age, gender, family history and body height; smoking, alcohol drinking, weight, Westernized diet, physical inactivity, chronic diseases and microbiota were involved in environmental factors. These risk factors were separately discussed in this review according to published literature from Asian countries. CRC screening has been playing an important role in reducing its disease burden. Some recommendations on its screening practices have been formulated in guidelines for Asia Pacific countries.

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Original Articles
Colorectal neoplasia
Development and validation of a scoring system for advanced colorectal neoplasm in young Korean subjects less than age 50 years
Ji Yeon Kim, Sungkyoung Choi, Taesung Park, Seul Ki Kim, Yoon Suk Jung, Jung Ho Park, Hong Joo Kim, Yong Kyun Cho, Chong Il Sohn, Woo Kyu Jeon, Byung Ik Kim, Kyu Yong Choi, Dong Il Park
Intest Res 2019;17(2):253-264.   Published online November 20, 2018
DOI: https://doi.org/10.5217/ir.2018.00062
AbstractAbstract PDFPubReaderePub
Background/Aims
Colorectal cancer incidence among patients aged ≤50 years is increasing. This study aimed to develop and validate an advanced colorectal neoplasm (ACRN) screening model for young adults aged <50 years in Korea.
Methods
This retrospective cross-sectional study included 59,575 consecutive asymptomatic Koreans who underwent screening colonoscopy between 2003 and 2012 at a single comprehensive health care center. Young Adult Colorectal Screening (YCS) score was developed as an optimized risk stratification model for ACRN using multivariate analysis and was internally validated. The predictive power and diagnostic performance of YCS score was compared with those of Asia-Pacific Colorectal Screening (APCS) and Korean Colorectal Screening (KCS) scores.
Results
41,702 and 17,873 subjects were randomly allocated into the derivation and validation cohorts, respectively, by examination year. ACRN prevalence was 0.9% in both cohorts. YCS score comprised sex, age, alcohol, smoking, obesity, glucose metabolism abnormality, and family history of CRC, with score ranges of 0 to 10. In the validation cohort, ACRN prevalence was 0.6% in the low-risk tier (score, 0–4), 1.5% in the moderate-risk tier (score, 5–7), and 3.4% in the high-risk tier (score, 8–10). ACRN risk increased 2.5-fold (95%CI, 1.8–3.4) in the moderate-risk tier and 5.8-fold (95%CI, 3.4–9.8) in the high-risk tier compared with the low-risk tier. YCS score identified better balanced accuracy (53.9%) than APCS (51.5%) and KCS (50.7%) scores and had relatively good discriminative power (area under the curve=0.660).
Conclusions
YCS score based on clinical and laboratory risk factors was clinically effective and beneficial for predicting ACRN risk and targeting screening colonoscopy in adults aged <50 years.

Citations

Citations to this article as recorded by  
  • Performance of the Asia–Pacific Colorectal Screening score in stratifying the risk of advanced colorectal neoplasia: A meta‐analysis and systematic review
    Mai Ngoc Luu, Nhi Ai Trinh, Truc Le Thanh Tran, Thinh Phuong Dang, Toru Hiyama, Duc Trong Quach
    Journal of Gastroenterology and Hepatology.2024; 39(6): 1000.     CrossRef
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    MN Luu, DT Quach
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    Kai Gao, Huyi Jin, Yi Yang, Jiayu Li, Yuanliang He, Ruiyao Zhou, Wanting Zhang, Xiangrong Gao, Zongming Yang, Mengling Tang, Jianbing Wang, Ding Ye, Kun Chen, Mingjuan Jin
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    Deborah Jael Herrera, Wessel van de Veerdonk, Daiane Maria Seibert, Moges Muluneh Boke, Claudia Gutiérrez-Ortiz, Nigus Bililign Yimer, Karen Feyen, Allegra Ferrari, Guido Van Hal
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    Yoon Suk Jung
    Precision and Future Medicine.2021; 5(2): 69.     CrossRef
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    The Ewha Medical Journal.2021; 44(4): 122.     CrossRef
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    Ala I Sharara, Ali El Mokahal, Ali H Harb, Natalia Khalaf, Fayez S Sarkis, Mustapha M El-Halabi, Nabil M Mansour, Ahmad Malli, Robert Habib
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    Genevieve Breau, Ursula Ellis
    Cancer Control.2020;[Epub]     CrossRef
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Colorectal neoplasia
Association of visceral adiposity and insulin resistance with colorectal adenoma and colorectal cancer
In Sub Jung, Cheol Min Shin, Sung Jae Park, Young Soo Park, Hyuk Yoon, Hyun Jin Jo, Nayoung Kim, Dong Ho Lee
Intest Res 2019;17(3):404-412.   Published online November 12, 2018
DOI: https://doi.org/10.5217/ir.2018.00072
AbstractAbstract PDFPubReaderePub
Background/Aims
To examine whether visceral adiposity serves as a risk factor for colorectal cancer (CRC) and colorectal adenomas.
Methods
Two hundred healthy subjects, 200 patients with colorectal adenoma, and 151 patients with CRC (46 with early-stage and 105 with advanced-stage cancers) were enrolled at a tertiary referral hospital. All subjects underwent colonoscopy, and had laboratory data, and computed tomography (CT) scan available for abdominal fat measurement. An abdominal CT scan taken 1 to 4 years (mean interval, 20.6 months) before the diagnosis of CRC was also available in the 42 CRC patients.
Results
The mean areas of visceral adipose tissue (VAT) areas in the control, adenoma, early- and advanced-stage CRC groups were 94.6, 116.8, 110.4, and 99.7 cm2 , respectively (P<0.001). The risk of adenoma positively correlated with VAT area and the visceral-to-total fat ratio (P for trend <0.01), but the risk of CRC did not (P>0.05). The risk of both adenoma and CRC positively correlated with fasting plasma glucose levels (P for trend <0.05). In patients with early-stage cancer (n=17), VAT area decreased when the CT scan at diagnosis was compared with that taken before the diagnosis of CRC, but superficial adipose tissue area did not, so visceral-to-total fat ratio significantly decreased (46.6% vs. 50.7%, respectively, P=0.018)
Conclusions
VAT area is related to the risk of colorectal adenoma. However, VAT decreases from the early stages of CRC. Impaired fasting glucose has a role in colorectal carcinogenesis.

Citations

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Endoscopy
The current capacity and quality of colonoscopy in Korea
Jae Ho Choi, Jae Myung Cha, Jin Young Yoon, Min Seob Kwak, Jung Won Jeon, Hyun Phil Shin
Intest Res 2019;17(1):119-126.   Published online October 10, 2018
DOI: https://doi.org/10.5217/ir.2018.00060
AbstractAbstract PDFPubReaderePub
Background/Aims
Little is known for the capacity and quality of colonoscopy, and adherence to colonoscopy surveillance guidelines in Korea. This study aimed to investigate the present and potential colonoscopic capacity, colonoscopic quality, and adherence to colonoscopy surveillance guidelines in Korea.
Methods
We surveyed representative endoscopists of 72 endoscopy units from June to August 2015, using a 36-item questionnaire regarding colonoscopic capacity, quality, and adherence to colonoscopy surveillance guidelines of each hospitals.
Results
Among the 62 respondents who answered the questionnaire, 51 respondents were analyzed after exclusion of 11 incomplete answers. Only 1 of 3 of endoscopy units can afford to perform additional colonoscopies in addition to current practice, and the potential maximum number of colonoscopies per week was only 42. The quality of colonoscopy was variable as reporting of quality indicators of colonoscopy were considerably variable (29.4%–94.1%) between endoscopy units. Furthermore, there are substantial gaps in the adherence to colonoscopy surveillance guidelines, as concordance rate for guideline recommendation was less than 50% in most scenarios.
Conclusions
The potential capacity and quality of colonoscopy in Korea was suboptimal. Considering suboptimal reporting of colonoscopic quality indicators and low adherence rate for colonoscopy surveillance guidelines, quality improvement of colonoscopy should be underlined in Korea.

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  • Comparison of Synergistic Sedation with Midazolam and Propofol Versus Midazolam and Pethidine in Colonoscopies: A Prospective, Randomized Controlled Study
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Colorectal neoplasia
Clinical significance of carcinoembryonic antigen in peritoneal fluid detected during operation in stage I–III colorectal cancer patients
Jae Hyun Kim, Seunghun Lee, Seung Hyun Lee, Byung Kwon Ahn, Sung Uhn Baek, Won Moon, Seun Ja Park
Intest Res 2018;16(3):467-474.   Published online July 27, 2018
DOI: https://doi.org/10.5217/ir.2018.16.3.467
AbstractAbstract PDFPubReaderePub
<b>Background/Aims</b><br/>

Early diagnosis of peritoneal metastases in patients with colorectal cancer (CRC) can influence patient prognosis. The aim of this study was to identify the clinical significance of carcinoembryonic antigen (CEA) in peritoneal fluid detected during operation in stage I–III CRC patients.

Methods

Between April 2009 and April 2015, we reviewed medical records from a total of 60 stage I–III CRC patients who had peritoneal fluid collected during operation. Patients who had positive cytology in the assessment of peritoneal fluid were excluded. We evaluated the values of CEA in peritoneal fluid (pCEA) to predict the long-term outcomes of these patients using Kaplan-Meier curves and Cox regression models.

Results

The median follow-up duration was 37 months (interquartile range, 21–50 months). On receiver operating characteristic analysis, pCEA had the largest area under the curve (0.793; 95% confidence interval, 0.635–0.950; P=0.001) with an optimal cutoff value of 26.84 (sensitivity, 80.0%; specificity, 76.6%) for predicting recurrence. The recurrence rate was 8.1% in patients with low pCEA (<26.84 ng/mL, n=37), and 52.2% in patients with high pCEA (≥26.84 ng/mL, n=23). In multivariate Cox regression analysis, high pCEA (≥26.84 ng/mL) was a risk factor for poor cancer-free survival (CFS) in stage I–III patients.

Conclusions

In this study, we determined that high pCEA (≥26.84 ng/mL) detected during operation was helpful for the prediction of poor CFS in patients with stage I–III CRC.

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Focused Review: Colorectal Cancers
Colorectal neoplasia
Serrated neoplasia pathway as an alternative route of colorectal cancer carcinogenesis
Soon Young Kim, Tae Il Kim
Intest Res 2018;16(3):358-365.   Published online July 27, 2018
DOI: https://doi.org/10.5217/ir.2018.16.3.358
AbstractAbstract PDFPubReaderePub

In the past two decades, besides conventional adenoma pathway, a subset of colonic lesions, including hyperplastic polyps, sessile serrated adenoma/polyps, and traditional serrated adenomas have been suggested as precancerous lesions via the alternative serrated neoplasia pathway. Major molecular alterations of sessile serrated neoplasia include BRAF mutation, high CpG island methylator phenotype, and escape of cellular senescence and progression via methylation of tumor suppressor genes or mismatch repair genes. With increasing information of the morphologic and molecular features of serrated lesions, one major challenge is how to reflect this knowledge in clinical practice, such as pathologic and endoscopic diagnosis, and guidelines for treatment and surveillance.

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Colorectal neoplasia
Impact of microbiota in colorectal carcinogenesis: lessons from experimental models
Linda Chia-Hui Yu, Shu-Chen Wei, Yen-Hsuan Ni
Intest Res 2018;16(3):346-357.   Published online July 27, 2018
DOI: https://doi.org/10.5217/ir.2018.16.3.346
AbstractAbstract PDFPubReaderePub

A role of gut microbiota in colorectal cancer (CRC) growth was first suggested in germ-free rats almost 50 years ago, and the existence of disease-associated bacteria (termed pathobionts) had becoming increasingly evident from experimental data of fecal transplantation, and microbial gavage or monoassociation. Altered bacterial compositions in fecal and mucosal specimens were observed in CRC patients compared to healthy subjects. Microbial fluctuations were found at various cancer stages; an increase of bacterial diversity was noted in the adenoma specimens, while a reduction of bacterial richness was documented in CRC samples. The bacterial species enriched in the human cancerous tissues included Escherichia coli, Fusobacterium nucleatum, and enterotoxigenic Bacteroides fragilis. The causal relationship of gut bacteria in tumorigenesis was established by introducing particular bacterial strains in in situ mouse CRC models. Detailed experimental protocols of bacterial gavage and the advantages and caveats of different experimental models are summarized in this review. The microbial genotoxins, enterotoxins, and virulence factors implicated in the mechanisms of bacteria-driven tumorigenesis are described. In conclusion, intestinal microbiota is involved in colon tumorigenesis. Bacteria-targeting intervention would be the next challenge for CRC.

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Colorectal neoplasia
Intestinal microbiota, chronic inflammation, and colorectal cancer
Chan Hyuk Park, Chang Soo Eun, Dong Soo Han
Intest Res 2018;16(3):338-345.   Published online July 27, 2018
DOI: https://doi.org/10.5217/ir.2018.16.3.338
AbstractAbstract PDFPubReaderePub

In addition to genetic and epigenetic factors, various environmental factors, including diet, play important roles in the development of colorectal cancer (CRC). Recently, there is increasing interest in the intestinal microbiota as an environmental risk factor for CRC, because diet also influences the composition of the intestinal microbiota. The human intestinal microbiota comprises about 100 trillion microbes. This microbiome thrives on undigested dietary residues in the intestinal lumen and produces various metabolites. It is well known that the dietary risk factors for CRC are mediated by dysbiosis of the intestinal microbiota and their metabolites. In this review, we describe the bacterial taxa associated with CRC, including Fusobacterium nucleatum, enterotoxigenic Bacteroides fragilis, Escherichia coli, and butyrate-producing bacteria. We also discuss the host-diet interaction in colorectal carcinogenesis.

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Colorectal neoplasia
Genetic and epigenetic alterations of colorectal cancer
Sung Noh Hong
Intest Res 2018;16(3):327-337.   Published online July 27, 2018
DOI: https://doi.org/10.5217/ir.2018.16.3.327
AbstractAbstract PDFPubReaderePub

Colorectal cancer (CRC) arise from multi-step carcinogenesis due to genetic mutations and epigenetic modifications of human genome. Genetic mutations and epigenetic modifications were originally established as 2 independent mechanisms contributing to colorectal carcinogenesis. However, recent evidences demonstrate that there are interactions between these 2 mechanisms. Genetic mutations enable disruption of epigenetic controls while epigenetic modifications can initiate genomic instability and carcinogenesis. This review summarized genetic mutations and epigenetic modifications in colorectal carcinogenesis and molecular classification of CRC subtype based on genetic or epigenetic biomarkers for treatment response and prognosis. Molecular subtypes of CRC will permit the implementation of precision medicine with better outcome of management for CRC.

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Statement
IBD
Predicting outcomes to optimize disease management in inflammatory bowel disease in Japan: their differences and similarities to Western countries
Taku Kobayashi, Tadakazu Hisamatsu, Yasuo Suzuki, Haruhiko Ogata, Akira Andoh, Toshimitsu Araki, Ryota Hokari, Hideki Iijima, Hiroki Ikeuchi, Yoh Ishiguro, Shingo Kato, Reiko Kunisaki, Takayuki Matsumoto, Satoshi Motoya, Masakazu Nagahori, Shiro Nakamura, Hiroshi Nakase, Tomoyuki Tsujikawa, Makoto Sasaki, Kaoru Yokoyama, Naoki Yoshimura, Kenji Watanabe, Miiko Katafuchi, Mamoru Watanabe, Toshifumi Hibi
Intest Res 2018;16(2):168-177.   Published online April 30, 2018
DOI: https://doi.org/10.5217/ir.2018.16.2.168
AbstractAbstract PDFPubReaderePub

Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), is a chronic inflammatory disease of the gastrointestinal tract, with increasing prevalence worldwide. IBD Ahead is an international educational program that aims to explore questions commonly raised by clinicians about various areas of IBD care and to consolidate available published evidence and expert opinion into a consensus for the optimization of IBD management. Given differences in the epidemiology, clinical and genetic characteristics, management, and prognosis of IBD between patients in Japan and the rest of the world, this statement was formulated as the result of literature reviews and discussions among Japanese experts as part of the IBD Ahead program to consolidate statements of factors for disease prognosis in IBD. Evidence levels were assigned to summary statements in the following categories: disease progression in CD and UC; surgery, hospitalization, intestinal failure, and permanent stoma in CD; acute severe UC; colectomy in UC; and colorectal carcinoma and dysplasia in IBD. The goal is that this statement can aid in the optimization of the treatment strategy for Japanese patients with IBD and help identify high-risk patients that require early intervention, to provide a better long-term prognosis in these patients.

Citations

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    Ashwin N. Ananthakrishnan
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    Hiromu Morikubo, Takayoshi Nagahama, Katsuhiko Nagai, Hajime Yamazaki, Taku Kobayashi
    Inflammatory Intestinal Diseases.2024; 9(1): 260.     CrossRef
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    Yanfang Liu, Choo Hua Goh, Hong Qiu, Kuan-Chih Huang, Hsingwen Chung, Carine Saadoun
    Annals of Pharmacotherapy.2023; 57(9): 1053.     CrossRef
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    Kunio Asonuma, Taku Kobayashi, Masaru Nakano, Shintaro Sagami, Hiroki Kiyohara, Mao Matsubayashi, Hiromu Morikubo, Yusuke Miyatani, Shinji Okabayashi, Hajime Yamazaki, Yuichiro Kuroki, Toshifumi Hibi
    Inflammatory Bowel Diseases.2022; 28(2): 200.     CrossRef
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    Motoi Uchino, Hiroki Ikeuchi, Keisuke Hata, Tomohiro Minagawa, Yuki Horio, Ryuichi Kuwahara, Shiro Nakamura, Kenji Watanabe, Masayuki Saruta, Toshimitsu Fujii, Taku Kobayashi, Ken Sugimoto, Fumihito Hirai, Motohiro Esaki, Sakiko Hiraoka, Katsuyoshi Matsuo
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    Pier Paolo Mainenti, Fabiana Castiglione, Antonio Rispo, Ettore Laccetti, Salvatore Guarino, Valeria Romeo, Anna Testa, Leonardo Pace, Simone Maurea
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    Eun Mi Song, Ho-Su Lee, Ye-Jee Kim, Eun Hye Oh, Nam Seok Ham, Jeongseok Kim, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Jong Lyul Lee, Yong Sik Yoon, Chang Sik Yu, Suk-Kyun Yang
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    Mônica Cristina Lopes do Carmo, Isabela Mateus Martins, Ana Elisa Ramos Magalhães, Mário Roberto Maróstica Júnior, Juliana Alves Macedo
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    Toshifumi Hibi, Satoshi Motoya, Toshifumi Ashida, Souken Sai, Yukinori Sameshima, Shiro Nakamura, Atsuo Maemoto, Masahiro Nii, Barbara A Sullivan, Robert A. Gasser Jr, Yasuo Suzuki
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Original Articles
Colorectal neoplasia
An analysis of dietary fiber and fecal fiber components including pH in rural Africans with colorectal cancer
Mohammed Faruk, Sani Ibrahim, Ahmed Adamu, Abdulmumini Hassan Rafindadi, Yahaya Ukwenya, Yawale Iliyasu, Abdullahi Adamu, Surajo Mohammed Aminu, Mohammed Sani Shehu, Danladi Amodu Ameh, Abdullahi Mohammed, Saad Aliyu Ahmed, John Idoko, Atara Ntekim, Aishatu Maude Suleiman, Khalid Zahir Shah, Kasimu Umar Adoke
Intest Res 2018;16(1):99-108.   Published online January 18, 2018
DOI: https://doi.org/10.5217/ir.2018.16.1.99
AbstractAbstract PDFSupplementary MaterialPubReaderePub
<b>Background/Aims</b><br/>

Colorectal cancer (CRC) is now a major public health problem with heavy morbidity and mortality in rural Africans despite the lingering dietary fiber-rich foodstuffs consumption. Studies have shown that increased intake of dietary fiber which contribute to low fecal pH and also influences the activity of intestinal microbiota, is associated with a lowered risk for CRC. However, whether or not the apparent high dietary fiber consumption by Africans do not longer protects against CRC risk is unknown. This study evaluated dietary fiber intake, fecal fiber components and pH levels in CRC patients.

Methods

Thirty-five subjects (CRC=21, control=14), mean age 45 years were recruited for the study. A truncated food frequency questionnaire and modified Goering and Van Soest procedures were used.

Results

We found that all subjects consumed variety of dietary fiber-rich foodstuffs. There is slight preponderance in consumption of dietary fiber by the control group than the CRC patients. We also found a significant difference in the mean fecal neutral detergent fiber, acid detergent fiber, hemicellulose, cellulose and lignin contents from the CRC patients compared to the controls (P<0.05). The CRC patients had significantly more fecal pH level than the matched apparently healthy controls (P=0.017).

Conclusions

The identified differences in the fecal fiber components and stool pH levels between the 2 groups may relate to CRC incidence and mortality in rural Africans. There is crucial need for more hypothesis-driven research with adequate funding on the cumulative preventive role of dietary fiber-rich foodstuffs against colorectal cancer in rural Africans “today.”

Citations

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    Anna M. Malinowska, Malgorzata Majcher, Guido JEJ. Hooiveld, Hanna Przydatek, Marta Szaban, Agata Kurowiecka, Marcin Schmidt
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    Caroline Young, Henry M. Wood, Ramakrishnan Ayloor Seshadri, Pham Van Nang, Carlos Vaccaro, Luis Contreras Melendez, Mayilvahanan Bose, Mai Van Doi, Tamara Alejandra Piñero, Camilo Tapia Valladares, Julieta Arguero, Alba Fuentes Balaguer, Kelsey N. Thomps
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    Andreana N. Holowatyj, Aishatu Suleiman Maude, Halimatu Sadiya Musa, Ahmed Adamu, Sani Ibrahim, Adamu Abdullahi, Muhammad Manko, Sirajo Mohammed Aminu, Abdullahi Mohammed, John Idoko, Yahaya Ukwenya, John Carpten, Paulette D. Chandler, Heather Hampel, Moh
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Endoscopy
Clinical outcomes of surveillance colonoscopy for patients with sessile serrated adenoma
Sung Jae Park, Hyuk Yoon, In Sub Jung, Cheol Min Shin, Young Soo Park, Na Young Kim, Dong Ho Lee
Intest Res 2018;16(1):134-141.   Published online January 18, 2018
DOI: https://doi.org/10.5217/ir.2018.16.1.134
AbstractAbstract PDFPubReaderePub
<b>Background/Aims</b><br/>

Sessile serrated adenomas (SSAs) are known to be precursors of colorectal cancer (CRC). The proper interval of follow-up colonoscopy for SSAs is still being debated. We sought to determine the proper interval of colonoscopy surveillance in patients diagnosed with SSAs in South Korea.

Methods

We retrospectively reviewed the medical records of patients diagnosed with SSAs who received 1 or more follow-up colonoscopies. The information reviewed included patient baseline characteristics, SSA characteristics, and colonoscopy information.

Results

From January 2007 to December 2011, 152 SSAs and 8 synchronous adenocarcinomas were identified in 138 patients. The mean age of the patients was 62.2 years and 60.1% patients were men. SSAs were located in the right colon (i.e., from the cecum to the hepatic flexure) in 68.4% patients. At the first follow-up, 27 SSAs were identified in 138 patients (right colon, 66.7%). At the second follow-up, 6 SSAs were identified in 65 patients (right colon, 66.7%). At the 3rd and 4th follow-up, 21 and 11 patients underwent colonoscopy, respectively, and no SSAs were detected. The total mean follow-up duration was 33.9 months. The mean size of SSAs was 8.1±5.0 mm. SSAs were most commonly found in the right colon (126/185, 68.1%). During annual follow-up colonoscopy surveillance, no cancer was detected.

Conclusions

Annual colonoscopy surveillance is not necessary for identifying new CRCs in all patients diagnosed with SSAs. In addition, the right colon should be examined more carefully because SSAs occur more frequently in the right colon during initial and follow-up colonoscopies.

Citations

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    Duk Hwan Kim
    Journal of Digestive Cancer Research.2023; 11(1): 30.     CrossRef
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    Shahzaib Anwar, Charles Cock, Joanne Young, Graeme P Young, Rosie Meng, Kalindra Simpson, Michelle Coats, Junming Huang, Peter Bampton, Robert Fraser, Erin L Symonds
    Journal of Gastroenterology and Hepatology.2021; 36(6): 1620.     CrossRef
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    Xinwei Hua, Polly A. Newcomb, Jessica Chubak, Rachel C. Malen, Rebecca Ziebell, Aruna Kamineni, Lee-Ching Zhu, Melissa P. Upton, Michelle A. Wurscher, Sushma S. Thomas, Hana Newman, Sheetal Hardikar, Andrea N. Burnett-Hartman
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    Andrea N. Burnett-Hartman, Jessica Chubak, Xinwei Hua, Rebecca Ziebell, Aruna Kamineni, Lee-Ching Zhu, Melissa P. Upton, Rachel C. Malen, Sheetal Hardikar, Polly A. Newcomb
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    Ji Hyung Nam, Hyoun Woo Kang
    Intestinal Research.2018; 16(3): 502.     CrossRef
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Is methylation analysis of SFRP2, TFPI2, NDRG4, and BMP3 promoters suitable for colorectal cancer screening in the Korean population?
Soo-Kyung Park, Hae Lim Baek, Junghee Yu, Ji Yeon Kim, Hyo-Joon Yang, Yoon Suk Jung, Kyu Yong Choi, Hungdai Kim, Hyung Ook Kim, Kyung Uk Jeong, Ho-Kyung Chun, Kyungeun Kim, Dong Il Park
Intest Res 2017;15(4):495-501.   Published online October 23, 2017
DOI: https://doi.org/10.5217/ir.2017.15.4.495
AbstractAbstract PDFPubReaderePub
<b>Background/Aims</b><br/>

Colorectal cancer (CRC) screening using stool DNA was recently found to yield good detection rates. A multi-target stool DNA test (Cologuard®, Exact Sciences), including methylated genes has been recently approved by the U.S. Food and Drug Administration. The aim of this study was to validate these aberrantly methylated genes as stool-based DNA markers for detecting CRC and colorectal advanced adenoma (AA) in the Korean population.

Methods

A single-center study was conducted in 36 patients with AA; 35 patients with CRC; and 40 endoscopically diagnosed healthy controls using CRC screening colonoscopy. The methylation status of the SFRP2, TFPI2, NDRG4, and BMP3 promoters was investigated blindly using bisulfate-modified stool DNA obtained from 111 participants. Methylation status was investigated by methylation-specific polymerase chain reaction.

Results

Methylated SFRP2, TFPI2, NDRG4, and BMP3 promoters were detected in 60.0%, 31.4%, 68.8%, and 40.0% of CRC samples and in 27.8%, 27.8%, 27.8%, and 33.3% of AA samples, respectively. The sensitivities obtained using 4 markers to detect CRC and AA were 94.3% and 72.2%, respectively. The specificity was 55.0%.

Conclusions

Our results demonstrate that the SFRP2, TFPI2, NDRG4, and BMP3 promoter methylation analysis of stool sample DNA showed high sensitivity but low specificity for detecting CRC and AA. Because of the low specificity, 4 methylated markers might not be sufficient for CRC screening in the Korean population. Further large-scale studies are required to validate the methylation of these markers in the Asian population and to find new markers for the Asian population.

Citations

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Close layer
Clinical characteristics of patients with serrated polyposis syndrome in Korea: comparison with Western patients
Eun Ran Kim, Jaryong Jeon, Jin Hee Lee, Yoon Jung Lee, Sung Noh Hong, Dong Kyung Chang, Young-Ho Kim
Intest Res 2017;15(3):402-410.   Published online June 12, 2017
DOI: https://doi.org/10.5217/ir.2017.15.3.402
AbstractAbstract PDFPubReaderePub
<b>Background/Aims</b><br/>

Serrated polyposis syndrome (SPS) has been shown to increase the risk of colorectal cancer (CRC). However, little is known about the characteristics of Asian patients with SPS. This study aimed to identify the clinicopathological features and risk of CRC in Korean patients with SPS as well as the differences between Korean and Western patients based on a literature review.

Methods

This retrospective study included 30 patients with SPS as defined by World Health Organization classification treated at Samsung Medical Center, Korea, between March 1999 and May 2011.

Results

Twenty patients (67%) were male. The median patient age at diagnosis was 56 years (range, 39–76 years). A total of 702 polyps were identified during a median follow-up of 43 months (range, 0–149 months). Serrated polyps were noted more frequently in the distal colon (298/702, 55%). However, large serrated polyps and serrated adenomas were mainly distributed throughout the proximal colon (75% vs. 25% and 81% vs. 19%, respectively); 73.3% had synchronous adenomatous polyps. The incidence of CRC was 10% (3/30 patients), but no interval CRC was detected. A total of 87% of the patients underwent esophagogastroduodenoscopy and 19.2% had significant lesions.

Conclusions

The phenotype of SPS in Korean patients is different from that of Western patients. In Korean patients, SPS is more common in men, there were fewer total numbers of serrated adenoma/polyps, and the incidence of CRC was lower than that in Western patients. Korean patients tend to more frequently have abnormal gastric lesions. However, the prevalence of synchronous adenomatous polyps is high in both Western and Korean patients.

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Current practices in endoscopic submucosal dissection for colorectal neoplasms: a survey of indications among Korean endoscopists
Tae Jun Kim, Eun Ran Kim, Sung Noh Hong, Young-Ho Kim, Dong Kyung Chang
Intest Res 2017;15(2):228-235.   Published online April 27, 2017
DOI: https://doi.org/10.5217/ir.2017.15.2.228
AbstractAbstract PDFSupplementary MaterialPubReaderePub
<b>Background/Aims</b><br/>

The indications for colorectal endoscopic submucosal dissection (ESD) vary in clinical practice. To establish colorectal ESD as a standard treatment, standard indications are essential. For establishing standard indications for colorectal ESD, we surveyed the preferences and criteria of endoscopists for colorectal ESD in their practices.

Methods

A multiple-choice questionnaire was sent to 27 members of the Korean Society of Gastrointestinal Endoscopy/ESD group. The indications of endoscopists for selecting ESD as a treatment for colorectal tumors ≥2 cm in diameter were surveyed.

Results

On the basis of the preprocedural assessment of histology, adenoma with high-grade dysplasia, mucosal cancer, and shallow submucosa invasive cancer were included in the indication for ESD. Based on gross morphology, laterally spreading tumor (LST) granular nodular mixed type, LST-nongranular (LST-NG) flat elevated type, and LST-NG pseudodepressed type were included. On the basis of the pit pattern by Kudo classification, types III, IV, and V-I were included. Based on the narrow band imaging pattern by Sano classification, types II and III-a were included. Other lesions, such as sporadic localized tumors in chronic inflammation and local residual early carcinoma after endoscopic resection, were also included in the indication for ESD.

Conclusions

The indications of Korean endoscopists for colorectal ESD are broader than those in recent guidelines, and tend to include more benign-looking tumors. To find the appropriate indications for colorectal ESD, systematic data collection and analysis are required to reach a consensus in a timely manner.

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