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Original Articles
Tumor
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
Intest Res 2025;23(1):85-95.   Published online November 29, 2024
DOI: https://doi.org/10.5217/ir.2024.00066
AbstractAbstract PDFSupplementary MaterialPubReaderePub
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
  • 3,534 View
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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
  • Identification of Genetic Factors Related With Nonhereditary Colorectal Polyposis and Its Recurrence Through Genome‐Wide Association Study
    Jung Hyun Ji, Su Hyun Lee, Chan Il Jeon, Jihun Jang, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Sun Ha Jee, Tae Il Kim
    Journal of Gastroenterology and Hepatology.2024;[Epub]     CrossRef
  • 3,536 View
  • 206 Download
  • 3 Web of Science
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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
  • 4,517 View
  • 207 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.

Citations

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  • Thyroid disorders and inflammatory bowel disease: an association present in adults but also in children and adolescents
    Valeria Calcaterra, Francesca Penagini, Virginia Rossi, Luisa Abbattista, Alice Bianchi, Massimiliano Turzi, Lucia Cococcioni, Gianvincenzo Zuccotti
    Frontiers in Endocrinology.2025;[Epub]     CrossRef
  • 2,748 View
  • 370 Download
  • 1 Web of Science
  • 1 Crossref
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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
  • 2,534 View
  • 199 Download
  • 1 Web of Science
  • 1 Crossref
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Review
IBD
Does caffeine have a double-edged sword role in inflammation and carcinogenesis in the colon?
Emiko Mizoguchi, Takayuki Sadanaga, Toshiyuki Okada, Takanori Minagawa, Jun Akiba
Intest Res 2023;21(3):306-317.   Published online April 20, 2023
DOI: https://doi.org/10.5217/ir.2022.00118
AbstractAbstract PDFPubReaderePub
Caffeine (1,3,7-trimethylxanthine, also abbreviated to CAF) is a natural chemical with stimulant effects and is commonly included in many drinks and foods, including coffee, tea, cola, energy drinks, cocoa, chocolates, and so on. Our group previously reported that oral administration of CAF efficiently suppressed the development of intestinal inflammation in a dextran sulfate sodium (DSS)-induced murine acute colitis model by suppressing the expression of chitinase 3-like 1, one of the mammalian chitinases without enzymatic activity. Chitinases are hydrolytic enzymes that break down chitin, a polymer of N-acetylglucosamine, and chitinase-like proteins have no enzymatic activity with preserving chitin-binding ability. CAF binds a cleft of the chitinase active site and plays a role as a pan-chitinase inhibitor. Although CAF showed an anti-inflammatory effect in the above model, oral administration of low-dose CAF with 10% sucrose showed potentially neoplastic effects in colonic epithelial cells in a DSS-induced murine chronic colitis model. In this review, we would like to discuss the pros and cons of coffee/CAF in colonic inflammation and neoplasia with an example of pathological finding.

Citations

Citations to this article as recorded by  
  • Evaluation of the effect of roasting and digestion on biological activity of compounds of coffee extracts - in vitro assessment of the bioavailability, cytoprotective properties and modulation of inflammatory response
    Joanna Grzelczyk, Grażyna Budryn, Dominik Szwajgier, Ewa Baranowska-Wójcik, Małgorzata Zakłos-Szyda
    Food Chemistry.2024; 460: 140648.     CrossRef
  • Recently Updated Role of Chitinase 3-like 1 on Various Cell Types as a Major Influencer of Chronic Inflammation
    Emiko Mizoguchi, Takayuki Sadanaga, Linda Nanni, Siyuan Wang, Atsushi Mizoguchi
    Cells.2024; 13(8): 678.     CrossRef
  • Comprehensive evaluation of Capsosiphon fulvescens water extract: Assessing its effects on intestinal barrier integrity and inflammation in vitro and in vivo
    Yu Rim Kim, Soo-yeon Park, Ji Yeon Kim
    Journal of Functional Foods.2024; 123: 106563.     CrossRef
  • Dose–Response Associations Between Diet and Risk of Rheumatoid Arthritis: A Meta-Analysis of Prospective Cohort Studies
    Yuanyuan Dong, Darren Greenwood, James Webster, Chinwe Uzokwe, Jinhui Tao, Laura Hardie, Janet Cade
    Nutrients.2024; 16(23): 4050.     CrossRef
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  • 4 Web of Science
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Original Article
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
  • 3,655 View
  • 334 Download
  • 2 Web of Science
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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

Citations to this article as recorded by  
  • Artificial Intelligence Models May Aid in Predicting Lymph Node Metastasis in Patients with T1 Colorectal Cancer
    Ji Eun Baek, Hahn Yi, Seung Wook Hong, Subin Song, Ji Young Lee, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Namkug Kim, Jeong-Sik Byeon
    Gut and Liver.2025; 19(1): 69.     CrossRef
  • 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
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    International Journal of Colorectal Disease.2023;[Epub]     CrossRef
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Original Article
IBD
Incidence rates for hospitalized infections, herpes zoster, and malignancies in patients with ulcerative colitis in Japan: an administrative health claims database analysis
Katsuyoshi Matsuoka, Kanae Togo, Noritoshi Yoshii, Masato Hoshi, Shoko Arai
Intest Res 2023;21(1):88-99.   Published online March 11, 2022
DOI: https://doi.org/10.5217/ir.2021.00154
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background/Aims
Patients with ulcerative colitis (UC) are at an increased risk of certain infections and malignancies compared with the general population. Incidence rates (IRs) of hospitalized infections, herpes zoster (HZ), and malignancies in patients with UC, stratified by treatment, in Japan were estimated.
Methods
This retrospective study identified patients with UC treated with corticosteroids, immunosuppressants, or tumor necrosis factor inhibitors (TNFi) from 2 administrative databases (Japan Medical Data Center [JMDC] and Medical Data Vision [MDV]). IRs (unique patients with events per 100 patient‐years) were estimated for hospitalized infections, HZ, and malignancies, between June 2010 and May 2018.
Results
Among 6,033 MDV patients with UC receiving corticosteroids, immunosuppressants, or TNFi, IRs (95% confidence intervals) were: hospitalized infections, 1.73 (1.52–1.93); HZ, 1.00 (0.85–1.16), and malignancies, 1.48 (1.29–1.66). Among 958 JMDC patients with UC receiving corticosteroids, immunosuppressants, or TNFi, IRs (95% confidence intervals) were: HZ, 1.82 (1.27–2.37) and malignancies, 1.35 (0.87–1.82). In both cohorts, IRs of malignancies were generally similar among patients receiving immunosuppressants, TNFi, or combination therapy (immunosuppressants and TNFi); this was also true for IRs of hospitalized infections and HZ in the MDV cohort. IRs of hospitalized infections, HZ, and malignancies were higher in patients receiving calcineurin inhibitors compared with immunosuppressants or TNFi, in both cohorts.
Conclusions
IRs of hospitalized infections, HZ, and malignancies among patients with UC were generally similar regardless of UC treatment, except for calcineurin inhibitors.

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Reviews
Microbiota
The role of microbiome in colorectal carcinogenesis and its clinical potential as a target for cancer treatment
Sang Hoon Kim, Yun Jeong Lim
Intest Res 2022;20(1):31-42.   Published online May 21, 2021
DOI: https://doi.org/10.5217/ir.2021.00034
AbstractAbstract PDFPubReaderePub
The role of gut microbiome-intestinal immune complex in the development of colorectal cancer and its progression is well recognized. Accordingly, certain microbial strains tend to colonize or vanish in patients with colorectal cancer. Probiotics, prebiotics, and synbiotics are expected to exhibit both anti-tumor effects and chemopreventive effects during cancer treatment through mechanisms such as xenometabolism, immune interactions, and altered eco-community. Microbial modulation can also be safely used to prevent complications during peri-operational periods of colorectal surgery. A deeper understanding of the role of intestinal microbiota as a target for colorectal cancer treatment will lead the way to a better prognosis for colorectal cancer patients.

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Microbiota
Gut microbiome and checkpoint inhibitor colitis
Kanika Sehgal, Sahil Khanna
Intest Res 2021;19(4):360-364.   Published online December 1, 2020
DOI: https://doi.org/10.5217/ir.2020.00116
AbstractAbstract PDFPubReaderePub
Immune checkpoint inhibitor therapies such as ipilimumab, are increasingly being used as a treatment option for a variety of cancers, including metastatic melanoma and have demonstrated effectively a prolonged survival. These agents have an immunological mode of action that predisposes patients to a number of immune-related adverse events, colitis being one of the most commonly encountered complications. The pathogenesis for the development of colitis is unclear, and there is a growing consensus that the ecosystem of the gastrointestinal microbiota plays a significant role. Based on this suspected connection, studies are being carried out to explore the changes in the microbiota in patients on these medications who develop colitis. Conceivably, the modulation of the gut microbiota could offer a therapeutic benefit. Fecal microbiota transplantation is one therapeutic option that is currently being investigated, though there are still more data needed to evaluate its efficacy. In this review, we recapitulate the mechanisms of action of immune checkpoint inhibitors, their adverse events, with a focus on colitis and the role gut microbiota are suspected to play, and finally discuss the microbiota modulation therapies being investigated.

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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.

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    Hye Min Kim, Hyo Suk Kim, Young Eun An, Jae Hyuck Chang, Tae Ho Kim, Chang Whan Kim, Tae‐Geun Gweon
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    Gastrointestinal Endoscopy.2024;[Epub]     CrossRef
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    Young-Jo Wi, Soo-Young Na
    The Korean Journal of Gastroenterology.2023; 82(2): 47.     CrossRef
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    Digestive Diseases and Sciences.2022; 67(10): 4841.     CrossRef
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    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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    Seong-Jung Kim, Jun Lee, Dae Youb Baek, Jun Hyung Lee, Ran Hong
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    Peter P. Stanich, Dareen Elgindi, Elena Stoffel, Erika Koeppe, Ajay Bansal, Rachel Stetson, Debra L. Collins, Dana Farengo Clark, Eve Karloski, Beth Dudley, Randall E. Brand, Michael J. Hall, Yana Chertock, Brian A. Sullivan, Charles Muller, Alice Hinton,
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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.

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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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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
IBD
Endoscopic molecular imaging in inflammatory bowel disease
Nam Seok Ham, Seung-Jae Myung
Intest Res 2021;19(1):33-44.   Published online April 20, 2020
DOI: https://doi.org/10.5217/ir.2019.09175
AbstractAbstract PDFPubReaderePub
Molecular imaging is a technique for imaging the processes occurring in a living body at a molecular level in real-time, combining molecular cell biology with advanced imaging technologies using molecular probes and fluorescence. Gastrointestinal endoscopic molecular imaging shows great promise for improving the identification of neoplasms, providing characterization for patient stratification and assessing the response to molecular targeted therapy. In inflammatory bowel disease, endoscopic molecular imaging can be used to assess disease severity and predict therapeutic response and prognosis. Endoscopic molecular imaging is also able to visualize dysplasia in the presence of background inflammation. Several preclinical and clinical trials have evaluated endoscopic molecular imaging; however, this area is just beginning to evolve, and many issues have not been solved yet. In the future, it is expected that endoscopic molecular imaging will be of increasing interest among clinicians as a new technology for the identification and evaluation of colorectal neoplasm and colitis-associated cancer.

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Original Article
Inflammatory bowel diseases
Safety of tumor necrosis factor inhibitor use in patients with concomitant malignancy
Hiep Phan, Rick A. Weideman, Daisha J. Cipher, Linda A. Feagins
Intest Res 2020;18(3):282-288.   Published online April 7, 2020
DOI: https://doi.org/10.5217/ir.2019.09140
AbstractAbstract PDFPubReaderePub
Background/Aims
Safety for tumor necrosis factor inhibitors (TNFi) in cancer has been focused on risk of incident malignancies, but studies on prognostic effects have been scarce. We determined survival and recurrence rates at 1, 2, and 5 years after cancer diagnosis in patients with and without concurrent TNFi use.
Methods
Chart reviews were performed between 1996 and 2015 at the VA North Texas Healthcare System. Cases were patients with inflammatory disease, concomitant malignancy, and TNFi use while controls were patients with inflammatory disease, concomitant malignancy but no TNFi use. Cases and controls were matched for type of malignancy. Analysis was performed with log-rank tests on Kaplan-Meier curves.
Results
Thirty-six cases and 72 controls were identified. For cases, survival at 1, 2, and 5 years were 32 (89%), 31 (86%), and 29 (81%) compared to 63 (90%), 61 (87%), and 51 (73%) for the control group (P=0.985). For cases, recurrence rates at 1, 2, and 5 years were 3 (8%), 5 (14%), and 6 (17%) compared to 2 (3%), 5 (7%), and 7 (10%) for the control group (P=0.158).
Conclusions
Our findings suggest TNFi may be safely used in select inflammatory disease patients with concurrent cancer if therapy is needed for proper disease control. However, case-by-case consideration in conjunction with an oncologist is recommended while considering the apparent safety of TNFi for patients suffering from active inflammatory diseases despite having a concomitant malignancy.

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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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Original Article
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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Focused Review
Colorectal neoplasia
Nutritional issues in patients with cancer
Duk Hwan Kim
Intest Res 2019;17(4):455-462.   Published online October 14, 2019
DOI: https://doi.org/10.5217/ir.2019.00076
AbstractAbstract PDFPubReaderePub
Cancer is a catabolic inflammatory disease that causes patients to often experience weight loss, or even cachexia in severe cases. Undernourishment in patients with cancer impairs the quality of life and therapeutic response, further leading to poor prognosis. Active and frequent nutritional screening and assessment using valid tools are important for fast and appropriate nutritional intervention. Additionally, a suitable individualized nutritional intervention strategy should be established based on the nutritional assessment result. In general, nutritional intervention begins with nutritional counseling of patients diagnosed with cancer, and a well-planned nutritional counseling improves the treatment adherence and nutritional status. When planning nutritional supplementation for cancer patients, specific nutrients, including amino acids and fatty acids, should be considered. However, there has been no consistent result showing that any particular nutrient significantly improves the prognosis of cancer patients. Hence, continuous attention from clinical physicians is needed to plan nutritional improvement in patients with cancer.

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Original Article
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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Close layer
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
    Journal of Gastroenterology and Hepatology.2024;[Epub]     CrossRef
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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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    Nature Reviews Gastroenterology & Hepatology.2023; 20(5): 271.     CrossRef
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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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    Han Hee Lee
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    Tomotaka Ugai, Naoko Sasamoto, Hwa-Young Lee, Mariko Ando, Mingyang Song, Rulla M. Tamimi, Ichiro Kawachi, Peter T. Campbell, Edward L. Giovannucci, Elisabete Weiderpass, Timothy R. Rebbeck, Shuji Ogino
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    Marta Puzzono, Alessandro Mannucci, Simone Grannò, Raffaella Alessia Zuppardo, Andrea Galli, Silvio Danese, Giulia Martina Cavestro
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    Journal of Gastroenterology and Hepatology.2020; 35(1): 43.     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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  • Change in abdominal obesity after colon cancer surgery – effects of left-sided and right-sided colonic resection
    Younes Kays Mohammed Ali, Troels Gammeltoft Dolin, Janus Damm Nybing, Jakob Lykke, Frederik Hvid Linden, Erik Høgh-Schmidt, Thorkild I. A. Sørensen, Jesper Frank Christensen, Yousef J. W. Nielsen, Jim Stenfatt Larsen, Sten Madsbad, Julia Sidenius Johansen
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    欣然 王
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Endoscopy
Clinicopathological feature and treatment outcome of patients with colorectal laterally spreading tumors treated by endoscopic submucosal dissection
Young-Hoon Jeong, Jun Lee, Sang-Wook Kim, Geom-Seog Seo, Hyun-Soo Kim, Young-Eun Joo
Intest Res 2019;17(1):127-134.   Published online October 10, 2018
DOI: https://doi.org/10.5217/ir.2018.00075
AbstractAbstract PDFPubReaderePub
Background/Aims
Endoscopic submucosal dissection (ESD) is an advanced technique that can be used to treat precancerous and early colorectal neoplasms by facilitating en bloc resection regardless of tumor size. In our study, we investigated the clinicopathological feature and the treatment outcome of patients with colorectal laterally spreading tumors (LSTs) that were treated by ESD.
Methods
The study enrolled all of 210 patients with colorectal LSTs who underwent ESD. Clinical outcomes were analyzed by retrospectively reviewing medical records.
Results
A cancerous pit pattern (Vi/Vn) was more common in pseudo-depressed (PD) subtype than in flat elevated (FE) subtype. The incidence of adenocarcinoma in the PD subtype and nodular mixed (NM) subtypes was significantly higher than in the homogenous (HG) subtype and FE subtype. The en bloc and R0 resection rates were 89.0% and 85.7%, respectively. The bleeding and perforation rates were 5.2% and 1.9%, respectively. The mean procedure time was much longer in the PD subtype than in the FE subtype. The en bloc resection rate was significantly higher in the NM subtype than in the HG subtype. However, there were no statistically significant differences in mean procedure time, en bloc resection rate, R0 resection rate, bleeding rate, or perforation rate between LST-granular and LST-nongranular types.
Conclusions
These results indicate that ESD is acceptable for treating colorectal LSTs concerning en bloc resection, curative resection, and risk of complications. Careful consideration is required for complete resection of the PD subtype and NM subtype because of their higher malignant potential.

Citations

Citations to this article as recorded by  
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    Feng Gu, Wei Jiang, Jingyi Zhu, Lei Ma, Boyuan He, Huihong Zhai
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    Seong-Jung Kim, Su Young Kim, Jun Lee
    Surgical Endoscopy.2022; 36(8): 6243.     CrossRef
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    Si-lin Huang, Wen-xin Tan, Qun Peng, Wen-hua Zhang, Hai-tao Qing, Qiang Zhang, Jun Wu, Liang-dou Lin, Zhi-bin Lu, Yu Chen, Wei-guang Qiao
    Surgical Endoscopy.2021; 35(10): 5430.     CrossRef
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    Eun Hye Oh, Nayoung Kim, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Chang Sik Yu, Jin Cheon Kim, Jeong-Sik Byeon
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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.

Citations

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    Ga Hee Kim, Yeong Chan Lee, Tae Jun Kim, Sung Noh Hong, Dong Kyung Chang, Young-Ho Kim, Dong-Hoon Yang, Chang Mo Moon, Kyunga Kim, Hyun Gun Kim, Eun-Ran Kim
    World Journal of Gastrointestinal Oncology.2024; 16(1): 51.     CrossRef
  • Factors Affecting Adherence to National Colorectal Cancer Screening: A 12-Year Longitudinal Study Using Multi-Institutional Pooled Data in Korea
    Dae Sung Kim, Jeeyoung Hong, Kihyun Ryu, Sang Hyuk Lee, Hwanhyi Cho, Jehyeong Yu, Jieun Lee, Jong-Yeup Kim
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
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    Joo Hye Song, Eun Ran Kim
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    Jennifer Pham, Geraldine Laven-Law, Erin L. Symonds, Molla M. Wassie, Charles Cock, Jean M. Winter
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    Chonnam Medical Journal.2024; 60(3): 192.     CrossRef
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    Bomi Park, Eun Young Her, Kyeongmin Lee, Fatima Nari, Jae Kwan Jun, Kui Son Choi, Mina Suh
    Cancer Research and Treatment.2023; 55(3): 910.     CrossRef
  • Sessile serrated lesions in patients with adenoma on index colonoscopy do not increase metachronous advanced adenoma risk
    Seung Wook Hong, Jeongseok Kim, Ji Young Lee, Jong‐Soo Lee, Hye‐Sook Chang, Hye Won Park, Gwang‐Un Kim, Jiyoung Yoon, Byong Duk Ye, Jeong‐Sik Byeon, Seung‐Jae Myung, Suk‐Kyun Yang, Jaewon Choe, Dong‐Hoon Yang
    Digestive Endoscopy.2022; 34(4): 850.     CrossRef
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    Sung Noh Hong, Chang Kyun Lee, Jong Pil Im, Chang Hwan Choi, Jeong-Sik Byeon, Young-Seok Cho, Sung-Ae Jung, Tae Il Kim, Yoon Tae Jeen
    Gastrointestinal Endoscopy.2022; 95(3): 500.     CrossRef
  • Effect of colorectal cancer screening on long‐term survival of colorectal cancer patients: Results of the Korea National Cancer Screening Program
    Xuan Quy Luu, Kyeongmin Lee, Jae Kwan Jun, Mina Suh, Kyu‐Won Jung, Kui Son Choi
    International Journal of Cancer.2022; 150(12): 1958.     CrossRef
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    Dong Yang, Yuqin Li, Haibo Sun, Chuan He, Geng Chen, Zhuo Zhao, Tongyu Tang, Amosy M'Koma
    Gastroenterology Research and Practice.2022; 2022: 1.     CrossRef
  • Risk of Metachronous Colorectal Advanced Neoplasia and Cancer in Patients With 3–4 Nonadvanced Adenomas at Index Colonoscopy: A Systematic Review and Meta-Analysis
    Suyeon Park, Seong Ran Jeon, Hyun Gun Kim, Yunho Jung, Min-Seob Kwak, Su Young Kim, Jong Wook Kim, Seung-Joo Nam, Eun Hye Oh, Seon-Young Park, Soo-Kyung Park, Jeong-Sik Byeon, Sun-Jin Boo, Dong Hoon Baek, Soon Man Yoon, Jaeyoung Chun, Jooyoung Lee, Miyoun
    American Journal of Gastroenterology.2022; 117(4): 588.     CrossRef
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    Kyeongmin Lee, Haejoo Seo, Sunho Choe, Seung-Yong Jeong, Ji Won Park, Mina Suh, Aesun Shin, Kui Son Choi, Filipe Prazeres
    PLOS ONE.2021; 16(2): e0247252.     CrossRef
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    Jae Gon Lee, Dong Soo Han, Young-Eun Joo, Dae-Seong Myung, Dong Il Park, Seul Ki Kim, Yunho Jung, Won Hyun Lee, Eun Soo Kim, Joon Seok Yoon, Chang Soo Eun
    The Korean Journal of Internal Medicine.2021; 36(Suppl 1): S35.     CrossRef
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Colorectal neoplasia
Rates of metachronous adenoma after curative resection for left-sided or right-sided colon cancer
Yuk Fai Lam, Wai Kay Seto, Teresa Tong, Ka Shing Cheung, Oswens Lo, Ivan FN Hung, Wai Lun Law, Wai K Leung
Intest Res 2018;16(4):619-627.   Published online October 10, 2018
DOI: https://doi.org/10.5217/ir.2018.00013
AbstractAbstract PDFPubReaderePub
Background/Aims
We determined the rates of metachronous colorectal neoplasm in colorectal cancer (CRC) patients after resection for right (R)-sided or left (L)-sided cancer.
Methods
Consecutive CRC patients who had undergone surgical resection for curative intent in our hospital between 2001 and 2004 were identified. R-sided colonic cancers refer to cancer proximal to splenic flexure whereas L-sided cancers include rectal cancers. Patients were included only if they had a clearing colonoscopy performed either before or within 6 months after the operation. Findings of surveillance colonoscopy performed up to 5 years after colonic resection were included in the analysis.
Results
Eight hundred and sixty-three CRC patients underwent curative surgical resection during the study period. Three hundred and twenty-seven patients (107 R-sided and 220 L-sided) fulfilled the inclusion criteria and had at least 1 postoperative surveillance colonoscopy performed. The proportion of patients who had polyp and adenoma on surveillance colonoscopy was significantly higher among patients with L-sided than R-sided cancers (polyps: 30.9% vs. 19.6%, P=0.03; adenomas: 25.5% vs. 13.1%, P=0.01). The mean number of adenoma per patient on surveillance colonoscopy was also higher for patients with L-sided than R-sided tumors (0.52; 95% confidence interval [CI], 0.37–0.68 vs. 0.22; 95% CI, 0.08–0.35; P<0.01). Multivariate analysis showed that L-sided cancers, age, male gender and longer follow-up were independent predictors of adenoma detection on surveillance colonoscopy.
Conclusions
Patients with Lsided cancer had a higher rate of metachronous polyps and adenoma than those with R-sided cancer on surveillance colonoscopy.

Citations

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  • The absolute number of small and diminutive adenomas with high-grade dysplasia is substantially higher compared with large adenomas: a retrospective pooled study
    Jiancheng Zhang, Huajun Sun, Fei Xiong, Shan Lei, Guanyu Zhou, Xun Xiao, Lin Liu, Pu Wang
    Frontiers in Oncology.2024;[Epub]     CrossRef
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    D. Suraci, E. Baria, L. Tirloni, J. L. Lagarto, S. Buccianti, C. Agostini, S. Pillozzi, L. Antonuzzo, A. Taddei, R. Cicchi
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    Beatrice Salmaso, Melania Scarpa, Valerio Pellegrini, Astghik Stepanyan, Roberta Salmaso, Andromachi Kotsafti, Federico Scognamiglio, Dario Gregori, Giorgio Rivella, Ottavia De Simoni, Giulia Becherucci, Silvia Negro, Chiara Vignotto, Gaya Spolverato, Ces
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    Kwangwoo Nam, Jeong Eun Shin
    The Korean Journal of Internal Medicine.2021; 36(2): 305.     CrossRef
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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.

Citations

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    Journal of Oncology.2021; 2021: 1.     CrossRef
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Focused Review: Colorectal Cancer
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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