The application of ultra-wide-field fundus autofluorescence in early metastatic choroidal tumor screening

I am Dr.Ke Yao,from Eye Center,the Second Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou,China.I write to present three cases with metastatic choroidal tumor using an ultra-wide-field scanning laser ophthalmoscope.

Role of different examination methods in colorectal cancer screening:Insights and future directions

Colorectal cancer is a malignant tumor with the third and second highest incidence and mortality rates worldwide,and its mortality rate is increasing annually.Colorectal cancer evolves gradually over a long period of time.The evolving process from colorectal adenoma to colorectal cancer takes approximately 10-15 years,providing a sufficiently long"window period"for early screening and diagnosis of colorectal cancer.The recurrence and mortality rates can be controlled at a low level with an early intervention.Metaxas et al summarized existing screening methods and their applicable scope in a recent publication.Moreover,they provide suggestions on how to improve adherence.This editorial provides a commentary on their article and discuss the roles of different screening methods in the early screening of colorectal cancer.

Similar fecal immunochemical test results in screening and referral colorectal cancer

AIM: To improve the interpretation of fecal immunochemical test (FIT) results in colorectal cancer (CRC) cases from screening and referral cohorts. METHODS: In this comparative observational study, two prospective cohorts of CRC cases were compared. The first cohort was obtained from 10 322 average risk subjects invited for CRC screening with FIT, of which, only subjects with a positive FIT were referred for colonoscopy. The second cohort was obtained from 3637 subjects scheduled for elective colonoscopy with a positive FIT result. The same FIT and positivity threshold (OC sensor; ≥ 50 ng/mL) was used in both cohorts. Colonoscopy was performed in all referral subjects and in FIT positive screening subjects. All CRC cases were selected from both cohorts. Outcome measurements were mean FIT results and FIT scores per tissue tumor stage (T stage). RESULTS: One hundred and eighteen patients with CRC were included in the present study: 28 cases obtained from the screening cohort (64% male; mean age 65 years, SD 6.5) and 90 cases obtained from the referral cohort (58% male; mean age 69 years, SD 9.8). The mean FIT results found were higher in the referral cohort (829 ± 302 ng/mLvs 613 ± 368 ng/mL,P = 0.02). Tissue tumor stage (T stage) distribution was dif-ferent between both populations [screening population: 13 (46%) T1, eight (29%) T2, six (21%) T3, one (4%) T4 carcinoma; referral population: 12 (13%) T1, 22 (24%) T2, 52 (58%) T3, four (4%) T4 carcinoma], and higher T stage was significantly associated with higher FIT results (P < 0.001). Per tumor stage, no significant difference in mean FIT results was observed (screening vs referral: T1 498 ± 382 ng/mL vs 725 ± 374 ng/mL, P = 0.22; T2 787 ± 303 ng/mL vs 794 ± 341 ng/mL, P = 0.79; T3 563 ± 368 ng/mLvs 870 ± 258 ng/mL,P = 0.13; T4 not available). After correction for T stage in logistic regression analysis, no significant differences in mean FIT results were observed between both types of cohorts (P = 0.10). CONCLUSION: Differences in T stage distribution largely explain differences in FIT results between screening and referral cohorts. Therefore, FIT results should be reported according to T stage.

A melatonin-based targetable fluorescent probe for screening of tumor cells and real-time imaging of glutathione fluctuations in tumor cells

Glutathione(GSH)is a key maintainer of cellular redox balance and plays an important role in many physiological effects.For example,GSH has been widely implicated in cancer initiation,progression and metastasis.Moreover,the concentrations of GSH in tumor cells can influence drug resistance.Given the serious harmfulness of cancer and the important roles of GSH in cancer,it has great significance to devel-opment probes for screening of tumor cells and real-time monitoring of GSH fluctuations in tumor cells.However,no targetable probe for reversible imaging of GSH in tumor cells has been reported.Herein,we constructed a melatonin-based targetable and reversible fluorescent probe(GR-MT)for screening of tumor cells and real-time imaging of GSH fluctuations in tumor cells.The probe uses coumarin as the skeleton,Michael addition reaction as the reaction mechanism,and melatonin as the targeted groups of tumor cells.The experimental results demonstrate this probe has many advantages including high selec-tivity,satisfactory sensitivity,excellent reversible ability,rapid reaction speed,and outstanding targetabil-ity of tumor cells.Therefore,this study provides a promising tool for tumor cells screening and real-time detection of GSH fluctuations in specific tumor cells.

Asymptomatic pancreatic lesions: New insights and clinical implications

Despite great efforts in experimental and clinical research, the prognosis of pancreatic cancer (PC) has not changed significantly for decades. Detection of pre-invasive lesions or early-stage PC with small resectable cancers in asymptomatic individuals remains one of the most promising approaches to substantially improve the overall outcome of PC. Therefore, screening programs have been proposed to identify curable lesions especially in individuals with a familial or genetic predisposition for PC. In this regard, Canto et al recently contributed an important article comparing computed tomography, magnetic resonance imaging, and endoscopic ultrasound for the screening of 216 asymptomatic high-risk individuals (HRI). Pancreatic lesions were detected in 92 of 216 asymptomatic HRI (42.6%). The high diagnostic yield in this study raises several questions that need to be answered of which two will be discussed in detail in this commentary: First: which imaging test should be performed? Second and most importantly: what are we doing with incidentally detected pancreatic lesions? Which ones can be observed and which ones need to be resected?