AIM: To estimate the prevalence of colorectal cancer (CRC) in patients with long lasting colonic symptoms undergoing total colonoscopy; and to establish clinical features predicting its occurrence. METHODS: This prosp...AIM: To estimate the prevalence of colorectal cancer (CRC) in patients with long lasting colonic symptoms undergoing total colonoscopy; and to establish clinical features predicting its occurrence. METHODS: This prospective study was carried out in Imam Hospital, Tabriz University of medical sciences, Iran. Continuous patients with long lasting lower gastrointestinal tract symptoms who had the criteria of a colonoscopy were included. The endoscopist visualized the caecum documented by a photo and/or a specimen from terminal ileum. RESULTS: Four hundred and eighty consecutive symptomatic patients [mean age (SD): 42.73 (16.21)] were included. The prevalence of colorectal neoplasia was 15.3% (34 subjects) and 37.7% (181 subjects) had a completely normal colon. Adenomatous polyps were detected in 56 (11.7%) patients, in 12.3% of men and 10.9% of women. The mean age of the patients with a polyp was significantly higher than the others (49.53 ± 14.16 vs 41.85 ± 16.26, P = 0.001). Most of the adenomatous polyps were left sided and tubular; only 22.5% of polyps were more than 10 mm. Cancer was detected in 16 (3.6%) of our study population, which was mostly right sided (57.2%). The mean age of patients with cancer was significantly higher than the others (60.25 ± 8.26 vs 42.13 ± 16.08, P < 0.005) and higher than patients with polyps [60.25 (8.26) vs 49.53 (1.91) (P < 0.0005)]. None of the symptoms (diarrhea, abdominal pain, rectal bleeding, constipation, altering diarrhea and constipation, history of cancer, known irritable bowel disease, history of polyp and fissure or family history of cancer) were predictors for cancer or polyps, but the age of the patient and unexplainedanemia independently predicted cancer. CONCLUSION: Less advanced patterns and smaller sizes of adenomas in Iran is compatible with other data from Asia and the Middle East, but in contrast to western countries. Prevalence of colonic neoplasia in our community seems to be lower than that in western population. Colonic symptoms are not predictors for polyps or cancer but unexplained anemia and elder age can predict CRC.展开更多
AIM:To investigate the rates of polyp detection in a mixed risk population using standard definition (SDC) vs high definition colonoscopes (HDC).METHODS:This was a retrospective cohort comparative study of 3 colonosco...AIM:To investigate the rates of polyp detection in a mixed risk population using standard definition (SDC) vs high definition colonoscopes (HDC).METHODS:This was a retrospective cohort comparative study of 3 colonoscopists who each consecutively performed 150 SDC (307,200 pixel) and 150 HDC (792,576 pixels) in a community teaching hospital.RESULTS:A total of 900 colonoscopies were evaluated (mean age 56,46.8% men),450 with each resolution.Polyps of any type were detected in 46.0% of patients using SDC and 43.3% with HDC (P=0.42).There was no significant difference between the overall number of polyps,HDC (397) and SDC (410),detected among all patients examined,(P=0.73).One or more adenomatous polyps were detected in 24.2% of patients with HDC and 24.9% of patients with SDC colonoscopy (P=0.82).There was no significant difference between HDC (M=0.41) and SDC (M=0.42) regarding adenomatous polyp (P=0.88) or advanced adenoma (P=0.56) detection rate among all patients examined.CONCLUSION:HDC did not improve yield of adenomatous polyp,advanced adenoma or overall polyp detection in a population of individuals with mixed risk for colorectal cancer.展开更多
920331 Alterations of ulex europaeusagglutinin-I receptor in human colorectalbenign and malignant tumors.HAN Bing(韩兵),et al.Digest Dis Instit,Hubei Med Coll,
Fundic gland polyps are now commonly recognized during endoscopy. These polyps are benign, often multiple and usually detected in the gastric body and fundus. In the past, these polyps were sometimes associated with f...Fundic gland polyps are now commonly recognized during endoscopy. These polyps are benign, often multiple and usually detected in the gastric body and fundus. In the past, these polyps were sometimes associated with familial adenomatous polyposis. In recent years, it has become evident that increasing numbers of these polyps are being detected during endoscopic studies, particularly in patients treated with proton pump inhibitors for prolonged periods. In some, dysplastic changes in these polyps have also been reported. Recent studies have suggested that there may be no increase in risk of colon cancer with long-term proton pump inhibitor therapy. While temporarily reassuring, ongoing vigilance, particularly in those genetically predisposed to colon cancer, is still warranted.展开更多
Colorectal cancer(CRC)is the second leading cause of cancer related deaths in the United States.There are significant differences in CRC incidence and mortality by race with the highest burden occurring among blacks.T...Colorectal cancer(CRC)is the second leading cause of cancer related deaths in the United States.There are significant differences in CRC incidence and mortality by race with the highest burden occurring among blacks.The underlying factors contributing to CRC disparities are multiple and complex.Studies have suggested that a higher prevalence of putative risk factors for CRC,limited access to healthcare services,lower utilization of healthcare resources and increased biological susceptibilities contribute to this disparity by race.This article reviews the factors associated with the disproportionally higher burden of CRC among blacks;addresses the controversies regarding the age to begin CRC screening and the screening modality to use for blacks;and proffers solutions to eliminate CRC disparity by race.展开更多
A high risk population consisting of 3034 people with history of rectal polyps or ulcers were screened for colorectal neoplasia with Reverse Passive Hemagglutination Fecal Occult Blood Test (RPHA FOB) and 60 cm fibero...A high risk population consisting of 3034 people with history of rectal polyps or ulcers were screened for colorectal neoplasia with Reverse Passive Hemagglutination Fecal Occult Blood Test (RPHA FOB) and 60 cm fiberoptic colonoscopy. Among 2553 subjects (84.1%)who completed both tests, 11 cases of colorectal malignancies and 465 cases of polyps were detected.Using colonoscopic finding and histopathological examination as the 'gold standard' of diagnosis, results showed that FOB positivity of polyps was related to their size, macroscopic appearance and surface features but no correlation between bleeding of polyps and their location, numbers, pathological types were found. In this study the sensitivity of RPHA in screening of colorectal malignancy was 63.6% (7/11), while that for polyps was only 21.1% (98/465) . For screening of colorectal neoplasia (cancer+polyps) the overall sensitivity and specificity of RPHA FOB were 22.1% and 82.4%, the positive and negative predictive values were 22.3% and 82.2% respectively. Amoug 465 polyps there were 195 adenomas, further analysis showed that villous and tubulovillous adenomas had higher intestinal bleeding rate (FOB positive)than tubular type (45.5%,30.0% and 17.8% respectively, X2=5.8, p=0.05). The results indicate that although the sensitivity of RPHA FOB in screening for colorectal polyps was generally low, but about 40% (8/21) of villous and tubulovillous adenoma which present higher tendency of malignant transformation can be detected by RPHA FOB as a screening Procedure. So the authors suggest that screening of colorectal neoplasia be not only a procedure of secondary prevention but also a measure of primary prevention for colorectal cancer.Accepted March 22, 1994展开更多
AIM: To assess the prevalence of colorectal neoplasms (adenomas, advanced adenomas and colorectal cancers) among Israeli military and commercial airline pilots.
2009199 Analysis of prognostic factors in 300 colorectal cancer patients with liver metastases.FANG Hua(方桦),et al.Dept Med Oncol,Cancer Hop,CAMS,Beijing 100021.Chin J Oncol,2009;31(3):220-222.
基金Liver and Gastrointestinal Diseases Research Center, Tabriz University of medical sciences, East Azerbaijan, Iran
文摘AIM: To estimate the prevalence of colorectal cancer (CRC) in patients with long lasting colonic symptoms undergoing total colonoscopy; and to establish clinical features predicting its occurrence. METHODS: This prospective study was carried out in Imam Hospital, Tabriz University of medical sciences, Iran. Continuous patients with long lasting lower gastrointestinal tract symptoms who had the criteria of a colonoscopy were included. The endoscopist visualized the caecum documented by a photo and/or a specimen from terminal ileum. RESULTS: Four hundred and eighty consecutive symptomatic patients [mean age (SD): 42.73 (16.21)] were included. The prevalence of colorectal neoplasia was 15.3% (34 subjects) and 37.7% (181 subjects) had a completely normal colon. Adenomatous polyps were detected in 56 (11.7%) patients, in 12.3% of men and 10.9% of women. The mean age of the patients with a polyp was significantly higher than the others (49.53 ± 14.16 vs 41.85 ± 16.26, P = 0.001). Most of the adenomatous polyps were left sided and tubular; only 22.5% of polyps were more than 10 mm. Cancer was detected in 16 (3.6%) of our study population, which was mostly right sided (57.2%). The mean age of patients with cancer was significantly higher than the others (60.25 ± 8.26 vs 42.13 ± 16.08, P < 0.005) and higher than patients with polyps [60.25 (8.26) vs 49.53 (1.91) (P < 0.0005)]. None of the symptoms (diarrhea, abdominal pain, rectal bleeding, constipation, altering diarrhea and constipation, history of cancer, known irritable bowel disease, history of polyp and fissure or family history of cancer) were predictors for cancer or polyps, but the age of the patient and unexplainedanemia independently predicted cancer. CONCLUSION: Less advanced patterns and smaller sizes of adenomas in Iran is compatible with other data from Asia and the Middle East, but in contrast to western countries. Prevalence of colonic neoplasia in our community seems to be lower than that in western population. Colonic symptoms are not predictors for polyps or cancer but unexplained anemia and elder age can predict CRC.
基金Supported by Cleveland Clinic Florida Institution Review Committee
文摘AIM:To investigate the rates of polyp detection in a mixed risk population using standard definition (SDC) vs high definition colonoscopes (HDC).METHODS:This was a retrospective cohort comparative study of 3 colonoscopists who each consecutively performed 150 SDC (307,200 pixel) and 150 HDC (792,576 pixels) in a community teaching hospital.RESULTS:A total of 900 colonoscopies were evaluated (mean age 56,46.8% men),450 with each resolution.Polyps of any type were detected in 46.0% of patients using SDC and 43.3% with HDC (P=0.42).There was no significant difference between the overall number of polyps,HDC (397) and SDC (410),detected among all patients examined,(P=0.73).One or more adenomatous polyps were detected in 24.2% of patients with HDC and 24.9% of patients with SDC colonoscopy (P=0.82).There was no significant difference between HDC (M=0.41) and SDC (M=0.42) regarding adenomatous polyp (P=0.88) or advanced adenoma (P=0.56) detection rate among all patients examined.CONCLUSION:HDC did not improve yield of adenomatous polyp,advanced adenoma or overall polyp detection in a population of individuals with mixed risk for colorectal cancer.
文摘920331 Alterations of ulex europaeusagglutinin-I receptor in human colorectalbenign and malignant tumors.HAN Bing(韩兵),et al.Digest Dis Instit,Hubei Med Coll,
文摘Fundic gland polyps are now commonly recognized during endoscopy. These polyps are benign, often multiple and usually detected in the gastric body and fundus. In the past, these polyps were sometimes associated with familial adenomatous polyposis. In recent years, it has become evident that increasing numbers of these polyps are being detected during endoscopic studies, particularly in patients treated with proton pump inhibitors for prolonged periods. In some, dysplastic changes in these polyps have also been reported. Recent studies have suggested that there may be no increase in risk of colon cancer with long-term proton pump inhibitor therapy. While temporarily reassuring, ongoing vigilance, particularly in those genetically predisposed to colon cancer, is still warranted.
文摘Colorectal cancer(CRC)is the second leading cause of cancer related deaths in the United States.There are significant differences in CRC incidence and mortality by race with the highest burden occurring among blacks.The underlying factors contributing to CRC disparities are multiple and complex.Studies have suggested that a higher prevalence of putative risk factors for CRC,limited access to healthcare services,lower utilization of healthcare resources and increased biological susceptibilities contribute to this disparity by race.This article reviews the factors associated with the disproportionally higher burden of CRC among blacks;addresses the controversies regarding the age to begin CRC screening and the screening modality to use for blacks;and proffers solutions to eliminate CRC disparity by race.
文摘A high risk population consisting of 3034 people with history of rectal polyps or ulcers were screened for colorectal neoplasia with Reverse Passive Hemagglutination Fecal Occult Blood Test (RPHA FOB) and 60 cm fiberoptic colonoscopy. Among 2553 subjects (84.1%)who completed both tests, 11 cases of colorectal malignancies and 465 cases of polyps were detected.Using colonoscopic finding and histopathological examination as the 'gold standard' of diagnosis, results showed that FOB positivity of polyps was related to their size, macroscopic appearance and surface features but no correlation between bleeding of polyps and their location, numbers, pathological types were found. In this study the sensitivity of RPHA in screening of colorectal malignancy was 63.6% (7/11), while that for polyps was only 21.1% (98/465) . For screening of colorectal neoplasia (cancer+polyps) the overall sensitivity and specificity of RPHA FOB were 22.1% and 82.4%, the positive and negative predictive values were 22.3% and 82.2% respectively. Amoug 465 polyps there were 195 adenomas, further analysis showed that villous and tubulovillous adenomas had higher intestinal bleeding rate (FOB positive)than tubular type (45.5%,30.0% and 17.8% respectively, X2=5.8, p=0.05). The results indicate that although the sensitivity of RPHA FOB in screening for colorectal polyps was generally low, but about 40% (8/21) of villous and tubulovillous adenoma which present higher tendency of malignant transformation can be detected by RPHA FOB as a screening Procedure. So the authors suggest that screening of colorectal neoplasia be not only a procedure of secondary prevention but also a measure of primary prevention for colorectal cancer.Accepted March 22, 1994
文摘AIM: To assess the prevalence of colorectal neoplasms (adenomas, advanced adenomas and colorectal cancers) among Israeli military and commercial airline pilots.
文摘2009199 Analysis of prognostic factors in 300 colorectal cancer patients with liver metastases.FANG Hua(方桦),et al.Dept Med Oncol,Cancer Hop,CAMS,Beijing 100021.Chin J Oncol,2009;31(3):220-222.