How can colorectal neoplasms be treated during colonoscopy?

AIM: For many physicians who ordinarily treat patients with colonic diseases, colonoscopy is considered a prime study interest. Developments in colonoscopic equipment and methods have led to a large number of endoscopic diagnoses and treatment for colorectal neoplasms. The purpose of this investigation is to evaluate the efficacy and outcomes of endoscopic treatment for colorectal neoplastic lesions.METHODS: From September 1999 to May 2003, 11 447 consecutive colonoscopic examinations in 9 864 patients were gathered; totaling 5 502 endoscopic treatments for colorectal neoplasms. Macroscopic characteristics of the neoplasms were classified into protruded (n = 3 953), sessile (n = 1 402), lateral spreading tumor (n = 139) and depressed lesions (n = 8). Snare polypectomy was conducted in 3 984 lesions, hot forcep removal in 1 368 lesions, and endoscopic mucosal resection in 150 lesions.RESULTS: Histological diagnoses were 4 596 neoplastic lesions (4 376 adenomas and 220 adenocarcinomas) and 906 non-neoplastic lesions (891 hyperplastic and 15 inflammatory polyps). For the adenocarcinoma group, 31 instances involved submucosal invasion or resection margin, who received further operations, while 13 surgical specimens discovered no residual tumors. Three perforations and 96 bleedings were found following endoscopic treatment. No procedure-related mortality was found and no recurrent malignancy was found after 1456 mo follow-up.CONCLUSION: To lower the incidence and mortality of colorectal cancer, endoscopic treatment for colorectalneoplasms is a simple and safe procedure.

Fusobacterium nucleatum colonization is associated with decreased survival of helicobacter pylori-positive gastric cancer patients

BACKGROUND An increased amount of Fusobacterium nucleatum(F.nucleatum)is frequently detected in the gastric cancer-associated microbiota of the Taiwan Residents population.F.nucleatum is known to exert cytotoxic effects and play a role in the progression of colorectal cancer,though the impact of F.nucleatum colonization on gastric cancer cells and patient prognosis has not yet been examined.AIM To identify F.nucleatum-dependent molecular pathways in gastric cancer cells and to determine the impact of F.nucleatum on survival in gastric cancer.METHODS Coculture of F.nucleatum with a gastric cancer cell line was performed,and changes in gene expression were investigated.Genes with significant changes in expression were identified by RNA sequencing.Pathway analysis was carried out to determine deregulated cellular functions.A cohort of gastric cancer patients undergoing gastrectomy was recruited,and nested polymerase chain reaction was performed to detect the presence of F.nucleatum in resected cancer tissues.Statistical analysis was performed to determine whether F.nucleatum colonization affects patient survival.RESULTS RNA sequencing and subsequent pathway analysis revealed a drastic interferon response induced by a high colonization load.This response peaked within 24 h and subsided after 72 h of incubation.In contrast,deregulation of actin and its regulators was observed during prolonged incubation under a low colonization load,likely altering the mobility of gastric cancer cells.According to the clinical specimen analysis,approximately one-third of the gastric cancer patients were positive for F.nucleatum,and statistical analysis indicated that the risk for colonization increases in late-stage cancer patients.Survival analysis demonstrated that F.nucleatum colonization was associated with poorer outcomes among patients also positive for Helicobacter pylori(H.pylori).CONCLUSION F.nucleatum colonization leads to deregulation of actin dynamics and likely changes cancer cell mobility.Cohort analysis demonstrated that F.nucleatum colonization leads to poorer prognosis in H.pylori-positive patients with late-stage gastric cancer.Hence,combined colonization of F.nucleatum and H.pylori is a predictive biomarker for poorer survival in late-stage gastric cancer patients treated with gastrectomy.

Routine blood tests to predict liver fibrosis in chronic hepatitis C

AIM: To verify the usefulness of FibroQ for predicting fi brosis in patients with chronic hepatitis C, compared with other noninvasive tests. METHODS: This retrospective cohort study included 237 consecutive patients with chronic hepatitis C who had undergone percutaneous liver biopsy before treatment. FibroQ, aspartate aminotransferase (AST)/alanine aminotransferase ratio (AAR), AST to platelet ratioindex, cirrhosis discriminant score, age-platelet index (API), Pohl score, FIB-4 index, and Lok's model were calculated and compared. RESULTS: FibroQ, FIB-4, AAR, API and Lok's model results increased significantly as fibrosis advanced (analysis of variance test: P < 0.001). FibroQ trended to be superior in predicting signifi cant fi brosis score in chronic hepatitis C compared with other noninvasive tests. CONCLUSION: FibroQ is a simple and useful test for predicting signifi cant fi brosis in patients with chronic hepatitis C.