Comparative detection of syndecan-2 methylation in preoperative and postoperative stool DNA in patients with colorectal cancer

BACKGROUND Early detection of colorectal cancer(CRC)is essential to reduce cancer-related morbidity and mortality.Stool DNA(sDNA)testing is an emerging method for early CRC detection.Syndecan-2(SDC2)methylation is a potential biomarker for the sDNA testing.Aberrant DNA methylation is an early epigenetic event during tumorigenesis and can occur in the normal colonic mucosa during aging,which can compromise the sDNA test results.METHODS In this prospective study,we enrolled 151 patients with CRC who underwent curative surgical resection between September 2016 and May 2020.Preoperative stool samples were collected from 123 patients and postoperative samples were collected from 122 patients.A total of 104 samples were collected from both preoperative and postoperative patients.Aberrant promoter methylation of SDC2 in sDNA was assessed using linear target enrichment quantitative methylation-specific real-time polymerase chain reaction.Clinicopathological parameters were analyzed using the results of SDC2 methylation.RESULTS Detection rates of SDC2 methylation in the preoperative and postoperative stool samples were 88.6%and 19.7%,respectively.Large tumor size(3 cm,P=0.019)and advanced T stage(T3–T4,P=0.033)were positively associated with the detection rate of SDC2 methylation before surgery.Female sex was associated with false positives after surgery(P=0.030).Cycle threshold(CT)values were significantly decreased postoperatively compared with preoperative values(P<0.001).The postoperative negative conversion rate for preoperatively methylated SDC2 was 79.3%(73/92).CONCLUSION Our results suggested that the SDC2 methylation test for sDNA has acceptable sensitivity and specificity.However,small size and early T stage tumors are associated with a low detection rate of SDC2 methylation.As the cycle threshold values significantly decreased after surgery,SDC2 methylation test for sDNA might have a diagnostic value for CRC.

Different risk factors for advanced colorectal neoplasm in young adults

AIM: To compare the risk of developing advanced colorectal neoplasm(ACRN) according to age in Koreans.METHODS: A total of 70428 Koreans from an occupational cohort who underwent a colonoscopy between 2003 and 2012 at Kangbuk Samsung Hospital were retrospectively selected. We evaluated and compared odds ratios(OR) for ACRN between the young-adults(YA < 50 years) and in the older-adults(OA ≥ 50 years). ACRN was defined as an adenoma ≥ 10 mm in diameter, adenoma with any component of villous histology, high-grade dysplasia, or invasive cancer.RESULTS: In the YA group, age(OR = 1.08, 95%CI: 1.06-1.09), male sex(OR = 1.26, 95%CI: 1.02-1.55), current smoking(OR = 1.37, 95%CI: 1.15-1.63), family history of colorectal cancer(OR = 1.46, 95%CI: 1.01-2.10), diabetes mellitus related factors(OR = 1.27, 95%CI: 1.06-1.54), obesity(OR = 1.23, 95%CI: 1.03-1.47), CEA(OR = 1.04, 95%CI: 1.01-1.09) and low-density lipoprotein-cholesterol(OR = 1.01, 95%CI: 1.01-1.02) were related with an increased risk of ACRN. However, age(OR = 1.08, 95%CI: 1.06-1.09), male sex(OR = 2.12, 95%CI: 1.68-2.68), current smoking(OR = 1.38, 95%CI: 1.12-1.71), obesity(OR = 1.34, 95%CI: 1.09-1.65) and CEA(OR = 1.05, 95%CI: 1.01-1.09) also increased the risk of ACRN in the OA group.CONCLUSION: The risks of ACRN differed based on age group. Different colonoscopic screening strategies are appropriate for particular subjects with risk factors for ACRN, even in subjects younger than 50 years.

Acute idiopathic pancreatitis in pregnancy:A case study

Acute pancreatitis during pregnancy is a rare event,and can be associated with high maternal mortality and fetal loss.Gallstone disease is thought to be the most common causative factor of acute pancreatitis,but,in many cases,the cause remains unclear.We report a case of a 36-year-old woman at 35 wk of gestation,who presented with severe pain confined to the upper abdomen and radiating to the back.The patient was diagnosed with acute idiopathic pancreatitis,which was managed conservatively;she recovered within several days and then delivered a healthy baby.Therefore it is important to consider acute pancreatitis when a pregnant woman presents with upper abdominal pain,nausea and vomiting in order to improve fetal and maternal outcomes for patients with acute pancreatitis.

Chronic alcohol consumption potentiates the development of diabetes through pancreatic β-cell dysfunction

Chronic ethanol consumption is well established as a major risk factor for type-2 diabetes(T2D), which is evidenced by impaired glucose metabolism and insulin resistance. However, the relationships between alcoholconsumption and the development of T2 D remain controversial. In particular, the direct effects of ethanol consumption on proliferation of pancreatic β-cell and the exact mechanisms associated with ethanolmediated β-cell dysfunction and apoptosis remain elusive. Although alcoholism and alcohol consumption are prevalent and represent crucial public health problems worldwide, many people believe that low-tomoderate ethanol consumption may protect against T2 D and cardiovascular diseases. However, the J- or U-shaped curves obtained from cross-sectional and large prospective studies have not fully explained the relationship between alcohol consumption and T2 D. This review provides evidence for the harmful effects of chronic ethanol consumption on the progressive development of T2 D, particularly with respect to pancreatic β-cell mass and function in association with insulin synthesis and secretion. This review also discusses a conceptual framework for how ethanolproduced peroxynitrite contributes to pancreatic β-cell dysfunction and metabolic syndrome.