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Development and validation of a prediction model for early screening of people at high risk for colorectal cancer 被引量:2
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作者 Ling-Li Xu Yi Lin +3 位作者 Li-Yuan Han Yue Wang Jian-Jiong Li Xiao-Yu Dai 《World Journal of Gastroenterology》 SCIE CAS 2024年第5期450-461,共12页
BACKGROUND Colorectal cancer(CRC)is a serious threat worldwide.Although early screening is suggested to be the most effective method to prevent and control CRC,the current situation of early screening for CRC is still... BACKGROUND Colorectal cancer(CRC)is a serious threat worldwide.Although early screening is suggested to be the most effective method to prevent and control CRC,the current situation of early screening for CRC is still not optimistic.In China,the incidence of CRC in the Yangtze River Delta region is increasing dramatically,but few studies have been conducted.Therefore,it is necessary to develop a simple and efficient early screening model for CRC.AIM To develop and validate an early-screening nomogram model to identify individuals at high risk of CRC.METHODS Data of 64448 participants obtained from Ningbo Hospital,China between 2014 and 2017 were retrospectively analyzed.The cohort comprised 64448 individuals,of which,530 were excluded due to missing or incorrect data.Of 63918,7607(11.9%)individuals were considered to be high risk for CRC,and 56311(88.1%)were not.The participants were randomly allocated to a training set(44743)or validation set(19175).The discriminatory ability,predictive accuracy,and clinical utility of the model were evaluated by constructing and analyzing receiver operating characteristic(ROC)curves and calibration curves and by decision curve analysis.Finally,the model was validated internally using a bootstrap resampling technique.RESULTS Seven variables,including demographic,lifestyle,and family history information,were examined.Multifactorial logistic regression analysis revealed that age[odds ratio(OR):1.03,95%confidence interval(CI):1.02-1.03,P<0.001],body mass index(BMI)(OR:1.07,95%CI:1.06-1.08,P<0.001),waist circumference(WC)(OR:1.03,95%CI:1.02-1.03 P<0.001),lifestyle(OR:0.45,95%CI:0.42-0.48,P<0.001),and family history(OR:4.28,95%CI:4.04-4.54,P<0.001)were the most significant predictors of high-risk CRC.Healthy lifestyle was a protective factor,whereas family history was the most significant risk factor.The area under the curve was 0.734(95%CI:0.723-0.745)for the final validation set ROC curve and 0.735(95%CI:0.728-0.742)for the training set ROC curve.The calibration curve demonstrated a high correlation between the CRC high-risk population predicted by the nomogram model and the actual CRC high-risk population.CONCLUSION The early-screening nomogram model for CRC prediction in high-risk populations developed in this study based on age,BMI,WC,lifestyle,and family history exhibited high accuracy. 展开更多
关键词 colorectal cancer early screening model High-risk population Nomogram model Questionnaire survey Dietary habit Living habit
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Clinical significance of peripheral blood UL16 and DR-70 for the early diagnosis and prognostic evaluation of colorectal cancer
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作者 Zhi-Ping Zong Chen Wu 《World Journal of Gastrointestinal Oncology》 SCIE 2024年第9期3832-3838,共7页
BACKGROUND Early diagnosis of colorectal cancer(CRC)is of great significance to improve the survival rate and quality of life of patients,but early diagnosis of CRC requires more sensitive techniques.Peripheral blood ... BACKGROUND Early diagnosis of colorectal cancer(CRC)is of great significance to improve the survival rate and quality of life of patients,but early diagnosis of CRC requires more sensitive techniques.Peripheral blood UL16-binding protein 2(ULBP2)and human fibrinogen degradation products(DR-70)are the main indicators for the diagnosis of malignant tumors.AIM To assess ULBP2 and DR-70 potential for the early diagnosis and prognostic evaluation of CRC to provide a reference.METHODS This study involved 60 patients with early-stage CRC(CRC group),50 patients with benign colorectal tumors(benign group),and 50 healthy patients(control group)enrolled at the Affiliated Hospital of Jiangnan University and Jiangsu Province Official Hospital between January,2020 and January,2022.ULBP2 and DR-70 levels in the blood were determined and differences among the three groups and early diagnostic values for CRC were determined.Patients with CRC were divided into the good prognosis and poor prognosis groups,and ULBP2 and DR-70 levels in the blood and diagnostic values were compared.RESULTS ULBP2 and DR-70 serum levels were significantly higher in the CRC group than in the control and benign groups(P<0.05);however,no significant differences were observed between the benign and control groups(P>0.05).Among the 60 patients with CRC followed up for two years,two died(3.33%)and 15 exhibited tumor metastasis,progression,or recurrence(25.00%).ULBP2 and DR-70 serum levels were significantly higher in the poor prognosis group than in the good prognosis group(P<0.05).A receiver operating characteristic curve was plotted.Area under the curve,sensitivity,and specificity of serum ULBP2 with DR-70 for the early diagnosis of CRC were higher than those of the single serum indices(P<0.05)in both the good and poor prognosis groups.CONCLUSION ULBP2 and DR-70 serum levels were significantly high in patients with early-stage CRC.They improved the diagnostic rate of early-stage CRC and predicted patient prognosis,thereby showing clinical application potential. 展开更多
关键词 ULBP2 DR-70 colorectal cancer early diagnosis PROGNOSIS
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Colorectal cancer screening:The value of early detection and modern challenges
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作者 Jian Li Zhi-Peng Li +1 位作者 Wen-Jie Ruan Wei Wang 《World Journal of Gastroenterology》 SCIE CAS 2024年第20期2726-2730,共5页
The screening of colorectal cancer(CRC)is pivotal for both the prevention and treatment of this disease,significantly improving early-stage tumor detection rates.This advancement not only boosts survival rates and qua... The screening of colorectal cancer(CRC)is pivotal for both the prevention and treatment of this disease,significantly improving early-stage tumor detection rates.This advancement not only boosts survival rates and quality of life for patients but also reduces the costs associated with treatment.However,the adoption of CRC screening methods faces numerous challenges,including the technical limitations of both noninvasive and invasive methods in terms of sensitivity and specificity.Moreover,socioeconomic factors such as regional disparities,economic conditions,and varying levels of awareness affect screening uptake.The coronavirus disease 2019 pandemic further intensified these challenges,leading to reduced screening participation and increased waiting periods.Additionally,the growing prevalence of early-onset CRC necessitates innovative screening approaches.In response,research into new methodologies,including artificial intelligence-based systems,aims to improve the precision and accessibility of screening.Proactive measures by governments and health organizations to enhance CRC screening efforts are underway,including increased advocacy,improved service delivery,and international cooperation.The role of technological innovation and global health collaboration in advancing CRC screening is undeniable.Technologies such as artificial intelligence and gene sequencing are set to revolutionize CRC screening,making a significant impact on the fight against this disease.Given the rise in early-onset CRC,it is crucial for screening strategies to continually evolve,ensuring their effectiveness and applicability. 展开更多
关键词 colorectal cancer early detection Economic implications Noninvasive tests Quality of life Survival rates Therapeutic modalities Technical challenges
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Serum ferritin and the risk of early-onset colorectal cancer
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作者 Adam L Urback Kylee Martens +5 位作者 Hannah Stowe McMurry Emerson Y Chen Caitlin Citti Anil Sharma Adel Kardosh Joseph J Shatzel 《World Journal of Gastrointestinal Oncology》 SCIE 2024年第8期3496-3506,共11页
BACKGROUND The incidence of early-onset colorectal cancer(EO-CRC)is rising in the United States,and is often diagnosed at advanced stages.Low serum ferritin is often incidentally discovered in young adults,however,the... BACKGROUND The incidence of early-onset colorectal cancer(EO-CRC)is rising in the United States,and is often diagnosed at advanced stages.Low serum ferritin is often incidentally discovered in young adults,however,the indication for endoscopy in EO-CRC is unclear.AIM To compare serum ferritin between patients with EO-CRC and healthy controls(HCs),and examine the association of serum ferritin in EO-CRC with patient-and disease-specific characteristics.METHODS A retrospective study of patients<50 years with newly-diagnosed EO-CRC was conducted from 1/2013-12/2023.Patients were included if serum ferritin was measured within 2 years prior to 1 year following CRC histologic diagnosis.To supplement the analysis,a cohort of HCs meeting similar inclusion and exclusion criteria were identified for comparison.A sensitivity analysis including only patients with serum ferritin obtained at or before diagnosis was separately performed to minimize risk of confounding.RESULTS Among 85 patients identified with EO-CRC(48 females),the median serum ferritin level was 26 ng/mL(range<1-2759 ng/mL).Compared to HCs(n=80211),there were a higher proportion of individuals with EO-CRC with serum ferritin<20 ng/mL(female 65%,male 40%)versus HCs(female 32.1%,male 7.2%)age 29-39 years(P=0.002 and P<0.00001,respectively).Stage IV disease was associated with significantly higher serum ferritin compared to less advanced stages(P<0.001).Serum ferritin obtained before or at the time of diagnosis was lower than levels obtained after diagnosis.Similar findings were confirmed in the sensitivity analysis.CONCLUSION Severe iron deficiency may indicate an increased risk of EO-CRC,particularly at earlier stages.Further studies defining the optimal serum ferritin threshold and routine incorporation of serum ferritin in screening algorithms is essential to develop more effective screening strategies for EO-CRC. 展开更多
关键词 early-ONSET Young-onset colorectal cancer Age FERRITIN Iron deficiency
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Research Progress in Early-onset Colorectal Cancer
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作者 Jing Li Haoyuan Guo +1 位作者 Jing Yu Zhibo Gai 《Journal of Clinical and Nursing Research》 2024年第6期201-205,共5页
Colorectal cancer used to be a common disease among middle-aged and elderly people.In recent years,the incidence of colorectal cancer(Early-onset colorectal cancer,EOCRC)under 50 years old has increased year by year.D... Colorectal cancer used to be a common disease among middle-aged and elderly people.In recent years,the incidence of colorectal cancer(Early-onset colorectal cancer,EOCRC)under 50 years old has increased year by year.Different from the traditional late-onset colon cancer(LOCRC),the diagnosis stage of EOCRC is mostly in the late stage,with poor cell differentiation and poor diagnosis,and there is a layer of consensus and guidance on the diagnosis,treatment or screening of EOCRC at presentation.Therefore,fully understanding the disease characteristics and risk exposure factors of EOCRC is helpful to guide early screening and treatment,which ultimately reduces the mortality of EOCRC.In this review article,we summarized the epidemiology,physiology,risk exposure factors and pathological diagnosis of EOCRC,and discussed the diagnosis and treatment prospect of EOCRC. 展开更多
关键词 early-onset colorectal cancer Epidemiological investigation PHYLOGENY Exposure factors Pathological prognosis
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Early colorectal cancer screening–no time to lose
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作者 Ying Wang Zheng-Long Wu +2 位作者 Yi-Gang Wang Hui Wang Xiao-Yuan Jia 《World Journal of Gastroenterology》 SCIE CAS 2024年第23期2959-2963,共5页
In this editorial,we comment on the article entitled“Stage at diagnosis of colorectal cancer through diagnostic route:Who should be screened?”by Agatsuma et al.Colorectal cancer(CRC)is emerging as an important healt... In this editorial,we comment on the article entitled“Stage at diagnosis of colorectal cancer through diagnostic route:Who should be screened?”by Agatsuma et al.Colorectal cancer(CRC)is emerging as an important health issue as its incidence continues to rise globally,adversely affecting the quality of life.Although the public has become more aware of CRC prevention,most patients lack screening awareness.Some poor lifestyle practices can lead to CRC and symptoms can appear in the early stages of CRC.However,due to the lack of awareness of the disease,most of the CRC patients are diagnosed already at an advanced stage and have a poor prognosis. 展开更多
关键词 colorectal cancer The immunochemical fecal occult blood test Diagnostic route cancer screening Stage at diagnosis
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Importance of diet and intestinal microbiota in the prevention of colorectal cancer-colonoscopy early screening diagnosis
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作者 Miljana Z Jovandaric 《World Journal of Gastrointestinal Oncology》 SCIE 2024年第8期3428-3435,共8页
Colorectal cancer is a term used to describe colon and rectal cancer,which is the third most common type of cancer.A MEDLINE and PubMed search resulted in the inclusion of manuscripts written in the last 10 years,usin... Colorectal cancer is a term used to describe colon and rectal cancer,which is the third most common type of cancer.A MEDLINE and PubMed search resulted in the inclusion of manuscripts written in the last 10 years,using keywords relevant to the topic of the manuscript.By analyzing the aim of the searched studies and manuscripts,adequate articles were included that described the stated problem.The frequency of colorectal cancer varies with climate,nutrition,and many other factors,primarily endogenous,hereditary,intestinal microbiome,as well as external factors,such as exposure of the individual to stress,and bad eating habits.Colon cancer and rectal cancer or colorectal cancer in general in the early stages of the disease,may not show symptoms or are barely noticeable.Colorectal cancer symptoms will most often not develop until the disease has progressed to stage 2 or beyond.Regular screening tests for colon or rectal cancer,especially colonoscopy,are recommended as part of a regular checkup for people aged 50 years or younger who are at high risk due to a family history of the disease or other cancers.Diet and colonoscopy as an early screening method play an important role in the prevention of colorectal cancer. 展开更多
关键词 colorectal cancer CAUSES SYMPTOMS Screening Diet and colonoscopy
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Early diagnostic strategies for colorectal cancer
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作者 Shi-Cai Liu Han Zhang 《World Journal of Gastroenterology》 SCIE CAS 2024年第33期3818-3822,共5页
At present,cancer is still an important factor threatening human health.Colorectal cancer(CRC)is one of the top three most common cancers worldwide and one of the deadliest malignancies in humans.The latest data showe... At present,cancer is still an important factor threatening human health.Colorectal cancer(CRC)is one of the top three most common cancers worldwide and one of the deadliest malignancies in humans.The latest data showed that CRC incidence and mortality rank third and second,respectively,among global malignancies.Early and accurate diagnosis is crucial to reduce the morbidity,mortality and improve survival of patients with CRC,but the current early diagnostic methods have limitations.The effectiveness and compliance of diagnostic methods have a certain impact on whether people choose screening.In this editorial,we explore strategies for the early diagnosis of CRC,including stool-based,blood-based,direct visualization,and imaging examinations. 展开更多
关键词 colorectal cancer Diagnostic markers COLONOSCOPY Fecal immunochemical test Fecal occult blood test Circulating tumor cells Circulating tumor DNA
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Barriers in early detection of colorectal cancer and exploring potential solutions
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作者 Maryam Aleissa Ernesto Raul Drelichman +1 位作者 Vijay K Mittal Jasneet Singh Bhullar 《World Journal of Clinical Oncology》 2024年第7期811-817,共7页
This editorial discusses the literature review article by Tonini and Zanni,the paper was published in January 2024,and the authors provided very interesting conclusions regarding existing barriers to the early diagnos... This editorial discusses the literature review article by Tonini and Zanni,the paper was published in January 2024,and the authors provided very interesting conclusions regarding existing barriers to the early diagnosis of colon cancer.Many cancers do not have identifiable precursors,or there are currently no screening tests to find them.Therefore,these cancers do not have preventive screening options.Early detection is crucial for reducing mortality rates by identifying cancer at an earlier stage through screening,as opposed to no screening.Colorectal cancer develops from precancerous lesions,which can be detected early and potentially prevented and cured.Early detection leads to improved survival rates,decreased complications,and reduced healthcare expenses.This editorial provides a brief description of the biology of colon cancer,emphasizing the contrast in outcomes between early detection and late detection.We also describe screening programs around the globe and examine the barriers in each program.Finally,we explore potential future solutions to enhance inclusion in screening programs and improve patient compliance. 展开更多
关键词 Colon cancer Rectal cancer early detection
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Non-participation of asymptomatic candidates in screening protocols reduces early diagnosis and worsens prognosis of colorectal cancer 被引量:1
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作者 Sergio Pérez-Holanda 《World Journal of Gastroenterology》 SCIE CAS 2024年第26期3198-3200,共3页
The Agatsuma et al’s study shows that despite the evidence of the benefits of an early colorectal cancer(CRC)diagnosis,through screening in asymptomatic subjects,up to 50%of candidates reject this option and many of ... The Agatsuma et al’s study shows that despite the evidence of the benefits of an early colorectal cancer(CRC)diagnosis,through screening in asymptomatic subjects,up to 50%of candidates reject this option and many of those affected are diagnosed later,in advanced stages.The efficacy of screening programs has been well-established for several years,which reduces the risk of CRC morbidity and mortality,without taking into account the test used for screening,or other tools.Nevertheless,a significant proportion of patients remain unscreened,so understanding the factors involved,as well as the barriers of the population to adherence is the first step to possibly modify the participation rate.These barriers could include a full range of social and political aspects,especially the type of financial provision of each health service.In Japan,health services are universal,and this advantageous situation makes it easier for citizens to access to these services,contributing to the detection of various diseases,including CRC.Interestingly,the symptomatic CRC group had a lower early-stage diagnosis rate than the patients detected during follow-up for other comorbidities,and symptomatic and cancer screening groups showed similar early-stage diagnosis. 展开更多
关键词 colorectal neoplasms cancer registry Diagnostic route cancer screening Stage at diagnosis
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Molecular genetics of early-onset colorectal cancer 被引量:1
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作者 Olivia Marx Marc Mankarious Gregory Yochum 《World Journal of Biological Chemistry》 2023年第2期13-27,共15页
Early-onset colorectal cancer(EOCRC)has been rising in global prevalence and incidence over the past several decades.Environmental influences,including generational lifestyle changes and rising obesity,contribute to t... Early-onset colorectal cancer(EOCRC)has been rising in global prevalence and incidence over the past several decades.Environmental influences,including generational lifestyle changes and rising obesity,contribute to these increased rates.While the rise in EOCRC is best documented in western countries,it is seen throughout the world,although EOCRC may have distinct genetic mutations in patients of different ethnic backgrounds.Pathological and molecular characterizations show that EOCRC has a distinct presentation compared with later-onset colorectal cancer(LOCRC).Recent studies have identified DNA,RNA,and protein-level alterations unique to EOCRC,revealing much-needed biomarkers and potential novel therapeutic targets.Many molecular EOCRC studies have been performed with Caucasian and Asian EOCRC cohorts,however,studies of other ethnic backgrounds are limited.In addition,certain molecular characterizations that have been conducted for LOCRC have not yet been repeated in EOCRC,including high-throughput analyses of histone modifications,mRNA splicing,and proteomics on large cohorts.We propose that the complex relationship between cancer and aging should be considered when studying the molecular underpinnings of EOCRC.In this review,we summarize current EOCRC literature,focusing on sporadic molecular alterations in tumors,and their clinical implications.We conclude by discussing current challenges and future directions of EOCRC research efforts. 展开更多
关键词 early-onset colorectal cancer Later-onset colorectal cancer Mutations ONCOGENES Molecular characteristics TRANSCRIPTOMICS
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Epidemiology and early screening strategies for colorectal cancer in China 被引量:5
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作者 Yong Yang Zhaoya Gao +4 位作者 An Huang Jingyi Shi Zhuang Sun Haopeng Hong Jin Gu 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2023年第6期606-617,共12页
China ranks the first worldwide in the number of new colorectal cancer(CRC) cases and CRC-related deaths. The increasing incidence of early-onset CRC in recent years highlights the challenges related to CRC screening ... China ranks the first worldwide in the number of new colorectal cancer(CRC) cases and CRC-related deaths. The increasing incidence of early-onset CRC in recent years highlights the challenges related to CRC screening and prevention. High-quality colonoscopy is the universally used gold standard for CRC screening. Risk assessment combined with a two-step screening strategy based on colonoscopy and non-invasive examinations was proven to be highly effective. However, systematic use of well-established risk factors associated with CRC, beyond age, could better identify those who might harbor advanced colorectal neoplasia, improve the diagnostic yield of current screening modalities, and optimize the selection of individuals who might benefit most from preventive strategies.“Personalization” and “Standardization” are the future development directions of CRC screening, from the initiation of screening in those at high risk for CRC to follow-up after treatment, which are the key to ensure the screening efficiency. 展开更多
关键词 colorectal cancer EPIDEMIOLOGY early screening REVIEW
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Early-onset colorectal cancer:A review of current knowledge 被引量:6
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作者 Margarida R Saraiva Isadora Rosa Isabel Claro 《World Journal of Gastroenterology》 SCIE CAS 2023年第8期1289-1303,共15页
Colorectal cancer(CRC)is one of the most prevalent malignancies worldwide.Although most prevalent among older people,its incidence above 50 years old has been decreasing globally in the last decades,probably as a resu... Colorectal cancer(CRC)is one of the most prevalent malignancies worldwide.Although most prevalent among older people,its incidence above 50 years old has been decreasing globally in the last decades,probably as a result of better screening.Paradoxically,its incidence in patients below 50 years old[early-onset CRC(EO-CRC)]has been increasing,for reasons not yet fully understood.EOCRC’s increasing incidence is genre independent but shows racial disparities and has been described to occur worldwide.It follows a birth-cohort effect which probably reflects a change in exposure to CRC risk factors.Its incidence is predicted to double until 2030,which makes EO-CRC a serious public health issue.Both modifiable and non-modifiable risk factors have been identified-some are potential targets for preventive measures.EO-CRC is often diagnosed at advanced stages and histological features associated with poor prognosis have been described.EO-CRC presents some distinctive features:Microsatellite instability is common,but another subtype of tumours,both microsatellite and chromosome stable also seems relevant.There are no age-specific treatment protocols and studies on EO-CRC survival rates have shown conflicting data.Due to the higher germline pathological mutations found in EO-CRC patients,an accurate genetic risk evaluation should be performed.In this review,we summarize the current evidence on epidemiological,clinical,histopathological and molecular features of EO-CRC and discuss the contribution of genetics and lifestyle risk factors.We further comment on screening strategies and specific dimensions to consider when dealing with a younger cancer patient. 展开更多
关键词 colorectal cancer early-ONSET ADENOCARCINOMA HEREDITARY Birth-cohort effect Risk factors
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Diagnostic value of matrix metalloproteinases 2, 7 and 9 in urine for early detection of colorectal cancer
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作者 Liu Peng Xin Zhang +2 位作者 Man-Li Zhang Tao Jiang Peng-Jun Zhang 《World Journal of Gastrointestinal Surgery》 2023年第5期931-939,共9页
BACKGROUND A noninvasive biomarker with high diagnostic performance is urgently needed for the early diagnosis of colorectal cancer(CRC).AIM To evaluate the diagnostic value of matrix metalloproteinases(MMPs)2,7 and 9... BACKGROUND A noninvasive biomarker with high diagnostic performance is urgently needed for the early diagnosis of colorectal cancer(CRC).AIM To evaluate the diagnostic value of matrix metalloproteinases(MMPs)2,7 and 9 in urine for CRC.METHODS Of 59 healthy controls,47 patients with colon polyps and 82 patients with CRC were included in this study.Carcinoembryonic antigen(CEA)in serum and MMP2,MMP7,and MMP9 in urine were detected.The combined diagnostic model of the indicators was established by binary logistic regression.The receiver operating characteristic curve(ROC)of the subjects was used to evaluate the independent and combined diagnostic value of the indicators.RESULTS The MMP2,MMP7,MMP9,and CEA levels in the CRC group differed significantly from levels in the healthy controls(P<0.05).The levels of MMP7,MMP9,and CEA also differed significantly between the CRC group and the colon polyps group(P<0.05).The area under the curve(AUC)distinguishing between the healthy control and the CRC patients using the joint model with CEA,MMP2,MMP7 and MMP9 was 0.977,and the sensitivity and specificity were 95.10%and 91.50%,respectively.For early-stage CRC,the AUC was 0.975,and the sensitivity and specificity were 94.30%and 98.30%,respectively.For advanced stage CRC,the AUC was 0.979,and the sensitivity and specificity were 95.70%and 91.50%,respectively.Using CEA,MMP7 and MMP9 to jointly established a model distinguishing the colorectal polyp group from the CRC group,the AUC was 0.849,and the sensitivity and specificity were 84.10%and 70.20%,respectively.For early-stage CRC,the AUC was 0.818,and the sensitivity and specificity were 76.30%and 72.30%,respectively.For advanced stage CRC,the AUC was 0.875,and the sensitivity and specificity were 81.80%and 72.30%,respectively.CONCLUSION MMP2,MMP7 and MMP 9 may exhibit diagnostic value for the early detection of CRC and may serve as auxiliary diagnostic markers for CRC. 展开更多
关键词 colorectal cancer early detection Matrix metalloproteinases URINE BIOMARKER
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Significance of carcinoembryonic antigen detection in the early diagnosis of colorectal cancer:A systematic review and metaanalysis
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作者 Rui Wang Qin Wang Pan Li 《World Journal of Gastrointestinal Surgery》 SCIE 2023年第12期2907-2918,共12页
BACKGROUND Colorectal cancer(CRC)is a prevalent malignant tumor involving adenomas that develop into malignant lesions.Carcinoembryonic antigen(CEA)is a non-specific serum biomarker upregulated in CRC.The concentratio... BACKGROUND Colorectal cancer(CRC)is a prevalent malignant tumor involving adenomas that develop into malignant lesions.Carcinoembryonic antigen(CEA)is a non-specific serum biomarker upregulated in CRC.The concentration of CEA is modulated by tumor stage and grade,tumor site in the colon,ploidy status,and patient smoking status.This study aimed to evaluate current evidence regarding the diagnostic power of CEA levels in the early detection of CRC recurrence in adults.AIM To evaluate current evidence regarding the diagnostic power of CEA levels in the early detection of CRC recurrence in adults.METHODS A systematic search was performed using four databases:MEDLINE,Cochrane Trials,EMBASE,and the Web of Science.The inclusion criteria were as follows:Adult patients aged≥18 years who had completed CRC curative treatment and were followed up postoperatively;reporting the number of CRC recurrences as an outcome;and randomized,clinical,cohort,and case-control study designs.Studies that were not published in English and animal studies were excluded.The following data were extracted by three independent reviewers:Study design,index tests,follow-up,patient characteristics,and primary outcomes.All statistical analyses were performed using the RevMan 5.4.1.RESULTS A total of 3232 studies were identified,with 73 remaining following the elimination of duplicates.After screening on predetermined criteria,12 studies were included in the final analysis.At a reference standard of 5 mg/L,CEA detected only approximately half of recurrent CRCs,with a pooled sensitivity of 59%(range,33%–83%)and sensitivity of 89%(range,58%–97%).CONCLUSION CEA is a significant marker for CRC diagnosis.However,it has insufficient sensitivity and specificity to be used as a single biomarker of early CRC recurrence,with an essential proportion of false negatives. 展开更多
关键词 Carcinoembryonic antigen colorectal cancer Reference standard Sensitivity and specificity Curative carcinoembryonic antigen treatment
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Approach to early-onset colorectal cancer:Clinicopathological,familial,molecular and immunohistochemical characteristics 被引量:3
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作者 Jose Perea Edurne Alvaro +8 位作者 Yolanda Rodríguez Cristina Gravalos Eva Sánchez-Tomé Barbara Rivera Francisco Colina Pablo Carbonell Rogelio González-Sarmiento Manuel Hidalgo Miguel Urioste 《World Journal of Gastroenterology》 SCIE CAS CSCD 2010年第29期3697-3703,共7页
AIM:To characterize clinicopathological and familial features of early-onset colorectal cancer(CRC) and compare features of tumors with and without microsatellite instability(MSI).METHODS:Forty-five patients with CRC ... AIM:To characterize clinicopathological and familial features of early-onset colorectal cancer(CRC) and compare features of tumors with and without microsatellite instability(MSI).METHODS:Forty-five patients with CRC aged 45 or younger were included in the study.Clinical information,a three-generation family history,and tumor samples were obtained.MSI status was analyzed and mismatch repair genes were examined in the MSI families.Tumors were included in a tissue microarray and an immunohistochemical study was carried out with a panel of selected antibodies.RESULTS:Early onset CRC is characterized by advanced stage at diagnosis,right colon location,low-grade of differentiation,mucin production,and presence of polyps.Hereditary forms represent at least 21% of cases.Eighty-one percent of patients who died during followup showed a lack of expression of cyclin E,which could be a marker of poor prognosis.β-catenin expression was normal in a high percentage of tumors.CONCLUSION:Early-onset CRC has an important familial component,with a high proportion of tumors showing microsatellite stable.Cyclin E might be a poor prognosis factor. 展开更多
关键词 early onset colorectal cancer Microsatellite instability Lynch syndrome Microsatellite stable colorectal cancer
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Early-onset colorectal cancer:Current insights and future directions 被引量:1
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作者 Claudia Wing-Kwan Wu Rashid N Lui 《World Journal of Gastrointestinal Oncology》 SCIE 2022年第1期230-241,共12页
Early-onset colorectal cancer(EOCRC)has seen an alarming rise worldwide over the past two decades.The reason for this global trend is poorly understood.EOCRC appears to have its own unique clinical and molecular featu... Early-onset colorectal cancer(EOCRC)has seen an alarming rise worldwide over the past two decades.The reason for this global trend is poorly understood.EOCRC appears to have its own unique clinical and molecular features when compared with late-onset colorectal cancer.Younger patients appear to have more distal or rectal disease,a more advanced stage of disease at presentation,and more unfavorable histological features.Identifying risk factors for EOCRC is the first step in mitigating the rising burden of this disease.Here we summarize several noteworthy biological factors and environmental exposures that are postulated to be responsible culprits.This can hopefully translate in clinical practice to the development of better risk stratification tool for identifying highrisk individuals for early colorectal cancer screening,and identifying areas needed for further research to curb this rising trend. 展开更多
关键词 early-onset colorectal cancer Young-onset colorectal cancer Risk factors Environmental exposures MICROBIOME GENETICS
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Early-onset colorectal cancer:A sporadic or inherited disease? 被引量:13
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作者 Vittoria Stigliano Lupe Sanchez-Mete +1 位作者 Aline Martayan Marcello Anti 《World Journal of Gastroenterology》 SCIE CAS 2014年第35期12420-12430,共11页
Colorectal cancer is the third most common cancer diagnosed worldwide. Although epidemiology data show a marked variability around the world, its overall incidence rate shows a slow but steady decrease, mainly in deve... Colorectal cancer is the third most common cancer diagnosed worldwide. Although epidemiology data show a marked variability around the world, its overall incidence rate shows a slow but steady decrease, mainly in developed countries. Conversely, early-onset colorectal cancer appears to display an opposite trend with an overall prevalence in United States and European Union ranging from 3.0% and 8.6%. Colorectal cancer has a substantial proportion of familial cases. In particular, early age at onset is especially suggestive of hereditary predisposition. The clinicopathological and molecular features of colorectal cancer cases show a marked heterogeneity not only between early- and late-onset cases but also within the early-onset group. Two distinct subtypes of early-onset colorectal cancers can be identified: a &#x0201c;sporadic&#x0201d; subtype, usually without family history, and an inherited subtype arising in the context of well defined hereditary syndromes. The pathogenesis of the early-onset disease is substantially well characterized in the inherited subtype, which is mainly associated to the Lynch syndrome and occasionally to other rare mendelian diseases, whereas in the &#x0201c;sporadic&#x0201d; subtype the origin of the disease may be attributed to the presence of various common/rare genetic variants, so far largely unidentified, displaying variable penetrance. These variants are thought to act cumulatively to increase the risk of colorectal cancer, and presumably to also anticipate its onset. Efforts are ongoing in the attempt to unravel the intricate genetic basis of this &#x0201c;sporadic&#x0201d; early-onset disease. A better knowledge of molecular entities and pathways may impact on family-tailored prevention and clinical management strategies. 展开更多
关键词 early-onset colorectal cancer Epidemiology Hereditary syndrome Lynch syndrome MUTYH-associated polyposis
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Early-onset colorectal cancer:A separate subset of colorectal cancer 被引量:4
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作者 Irene Osorio Silla Daniel Rueda +3 位作者 Yolanda Rodríguez Juan Luis García Felipe de la Cruz Vigo José Perea 《World Journal of Gastroenterology》 SCIE CAS 2014年第46期17288-17296,共9页
Colorectal cancer(CRC)has a great impact on the world population.With increasing frequency,CRC is described according to the presenting phenotype,based on its molecular characteristics.Classification of CRC tumors acc... Colorectal cancer(CRC)has a great impact on the world population.With increasing frequency,CRC is described according to the presenting phenotype,based on its molecular characteristics.Classification of CRC tumors according to their genetic and/or epigenetic alterations is not only important for establishing the molecular bases of the disease,but also for predicting patient outcomes and developing more individualized treatments.Early-onset CRC is a heterogeneous disease,with a strong familial component,although the disease is sporadic in an important proportion of cases.Different molecular alterations appear to contribute to the apparent heterogeneity of the early-onset population and subgroups can be distinguished with distinct histopathologic and familial characteristics.Moreover,compared with late-onset CRC,there are characteristicsthat suggest that early-onset CRC may have a different molecular basis.The purpose of this review was to analyze the current state of knowledge about earlyonset CRC with respect to clinicopathologic,familial and molecular features.Together,these features make it increasingly clear that this subset of CRC may be a separate disease,although it has much in common with late-onset CRC. 展开更多
关键词 Chromosomal instability CpG island methylator phenotype early-onset colorectal cancer Lynch syndrome Microsatellite instability
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Study on the Early Detection and Clinico—pathologic Staging of Colorectal Cancer in China 被引量:1
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作者 ZHENGShu CAIShanrong 等 《The Chinese-German Journal of Clinical Oncology》 CAS 2002年第2期68-71,共4页
Objective To confirm an effective and practicable screening model for early detection of colorectal cancer (CRC) , and to modify an acceptable and reasonable staging of CRC for predicting prognosis and to define the t... Objective To confirm an effective and practicable screening model for early detection of colorectal cancer (CRC) , and to modify an acceptable and reasonable staging of CRC for predicting prognosis and to define the therapeutic strategy.Methods Data from 3 case-control studies have been used for selecting the high risk factors of CRC to optimize Sequencing Screening Model (SSM) . The fieldwork recalls have been utilized to compare the sensitivity, specificity and Youden Index between the SSM and the optimized one. The 1722 individuals have been used to evaluate the Optimized Sequencing Screening Model (OPSM). From 1980 to 1995, 1334 cases of CRC pathologically confirmed have been analyzed for 3-, 5- and 10-year survival rates. All tests were performed at the 0.05 level of significances. Statistical analysis was conducted by using the SPSS 10.0 statistic software.Results A simple questionnaire and RPHA-FOB test as the screening model for early detecting CRC had been proved as an optimized screening model. The sensitivity, specificity and Youden Index of the optimized model were higher than those of SSM. From the 1722 individuals 4 Dukes A and 5 Dukes B CRC were screened out. Analysis of the 3-, 5- and 10-year survival rates revealed that there were statistically significant differences between serosa and extraserosa. The 3-, 5- and 10-year survival rates were 0.91? 展开更多
关键词 colorectal cancer early detection clinico-pathologic staging
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