Intestinal Research

Original Article

Tumor

Impact of stool transplantation and metformin on polyp reduction and inflammation in an APC Min mouse model: Yeon Ji Kim, Jiwon Lee, Eunmi Lee, Seun Ja Park, Jae Hyun Kim; Intest Res 2025;23(3):382-389. Published online May 19, 2025; DOI: https://doi.org/10.5217/ir.2025.00011

Abstract PDF PubReader ePub: Background/Aims
Familial adenomatous polyposis is a hereditary condition characterized by numerous adenomatous polyps in the colon and rectum, significantly increasing colorectal cancer risk. Current management strategies, such as prophylactic colectomy, are invasive and have long-term consequences, highlighting the need for alternative therapies. This study aimed to evaluate whether stool transplantation and metformin therapy synergistically reduce polyp formation and inflammation.
Methods
APC Min mice were divided into 4 groups: control, anti-control (antibiotic pretreatment), stool (stool transplantation), and stool+metformin. Polyp burden, bacterial abundance, inflammatory cytokines (interleukin [IL]-6, tumor necrosis factor [TNF]-α, IL-10), and tumorigenic markers (NF-κB, Cox2, c-myc, β-catenin) were assessed using messenger RNA (mRNA) and protein analyses of intestinal tissues, along with serum and fecal microbiota evaluations.
Results
Stool transplantation combined with metformin significantly reduced bacterial abundance and polyp burden. The anti-control group showed similar reductions, suggesting suppression of gut microbiota re-establishment. TNF-α and IL-10 levels remained unchanged, but a significant increase in IL-6 was observed in the stool+metformin group’s intestinal tissues, indicating localized immune activation. Intestinal Cox2 mRNA expression was reduced in the combination group, correlating with polyp suppression. Protein levels of NF-κB, Cox2, and β-catenin showed no significant changes in vivo, while in vitro experiments revealed a decrease in NF-κB and an increase in Cox2, suggesting complex regulation of inflammation-related pathways.
Conclusions
Stool transplantation combined with metformin reduces polyp burden in APC Min mice through gut microbiota modulation and localized immune activation. These findings support the therapeutic potential of this combination treatment for familial adenomatous polyposis.

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Review

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

Abstract PDF PubReader ePub

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

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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.2025; 40(2): 433. 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
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Journal of Korean Medical Science.2024;[Epub] CrossRef

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Original Articles

Colorectal neoplasia

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; Intest Res 2023;21(4):510-517. Published online May 31, 2023; DOI: https://doi.org/10.5217/ir.2022.00139

Abstract PDF PubReader ePub

Background/Aims
Patients with more than 10 cumulative polyps might involve a greater genetic risk of colorectal neoplasia development. However, few studies have investigated the risk factors of polyposis recurrence and development of advanced neoplasms among patients with non-hereditary colorectal polyposis.
Methods
This study included patients (n=855) with 10 or more cumulative polyps diagnosed at Severance Hospital from January 2012 to September 2021. Patients with known genetic mutations related to polyposis, known hereditary polyposis syndromes, insufficient information, total colectomy, and less than 3 years of follow-up were excluded. Finally, 169 patients were included for analysis. We collected clinical data, including colonoscopy surveillance results, and performed Cox regression analyses of risk factors for polyposis recurrence and advanced neoplasm development.
Results
The 169 patients were predominantly male (84.02%), with a mean age of 64.19±9.92 years. The mean number of adenomas on index colonoscopy was 15.33±8.47. Multivariable analysis revealed history of cancer except colon cancer (hazard ratio [HR], 2.23; 95% confidence interval [CI], 1.23–4.01), current smoking (HR, 2.39; 95% CI, 1.17–4.87), and detection of many polyps (≥15) on index colonoscopy (HR, 2.05; 95% CI, 1.21–3.50) were significant risk factors for recurrence of polyposis. We found no statistically significant risk factors for advanced neoplasm development during surveillance among our cohort.
Conclusions
The presence of many polyps (≥15) on index colonoscopy, history of cancer except colon cancer, and current smoking state were significant risk factors for polyposis recurrence among patients with non-hereditary colorectal polyposis.

Citations

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Prognosis of Korean patients with familial adenomatous polyposis who did not undergo colectomy: a retrospective study
Min Kwan Kwon, Jin Hee Noh, Ji Yong Ahn, Woochang Lee, Seok-Byung Lim, Yong Sang Hong, Seung Wook Hong, Sung Wook Hwang, Sang Hyoung Park, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Dong-Hoon Yang
Clinical Endoscopy.2026; 59(2): 254. 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.2025; 40(2): 433. 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.2025; 40(2): 482. CrossRef
Machine learning in colorectal polyp surveillance: A paradigm shift in post-endoscopic mucosal resection follow-up
Vasily Isakov
World Journal of Gastroenterology.2025;[Epub] CrossRef
Screening and surveillance for hereditary colorectal cancer
Hee Man Kim, Tae Il Kim
Intestinal Research.2024; 22(2): 119. CrossRef

5,429 View
318 Download
5 Web of Science
5 Crossref

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

Abstract PDF PubReader ePub

<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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Mechelle Loughrey, Mary Forry, Roberta Horgan, Aisling Hegarty
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Ira Upadhye, Husam Al Maliki, Victoria Cuthill, Andrew Latchford, Kevin Monahan
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Risk of Colorectal Cancer in Serrated Polyposis Syndrome: A Systematic Review and Meta-analysis
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Clinical Gastroenterology and Hepatology.2022; 20(3): 622. CrossRef
Synchronized early gastric cancer occurred in a patient with serrated polyposis syndrome: A case report
Ying-Ze Ning, Guan-Yi Liu, Xiao-Long Rao, Yong-Chen Ma, Long Rong
World Journal of Clinical Cases.2022; 10(8): 2644. CrossRef
Usefulness of narrow-band imaging for the detection of remnant sessile-serrated adenoma (SSA) tissue after endoscopic resection: the KASID multicenter study
Yunho Jung, Jung Rock Moon, Seong Ran Jeon, Jae Myung Cha, Hyo-Joon Yang, Suyeon Park, Yumi Ahn, Jeong-Sik Byeon, Hyun Gun Kim
Surgical Endoscopy.2021; 35(9): 5217. CrossRef
Serrated Polyposis Syndrome with a Synchronous Colon Adenocarcinoma Treated by an Endoscopic Mucosal Resection
Sang Hoon Lee, Sung Joon Lee, Sung Chul Park, Seung-Joo Nam, Myeong Ho Kang, Tae Suk Kim, Seung Koo Lee
The Korean Journal of Gastroenterology.2020; 76(3): 159. CrossRef

10,060 View
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