scholarly journals The influence of the surveillance time interval on the risk of advanced neoplasia after non‐advanced adenoma removal

2021 ◽  
Author(s):  
Zaki Hamarneh ◽  
Charles Cock ◽  
Graeme P Young ◽  
Peter A Bampton ◽  
Robert Fraser ◽  
...  
Keyword(s):  
Advanced Adenoma ◽  
Time Interval ◽  
Advanced Neoplasia

scholarly journals Exploration of the Proteomic Landscape of Small Extracellular Vesicles in Serum as Biomarkers for Early Detection of Colorectal Neoplasia

2021 ◽  
Vol 11 ◽  
Author(s):  
Li-Chun Chang ◽  
Yi-Chiung Hsu ◽  
Han-Mo Chiu ◽  
Koji Ueda ◽  
Ming-Shiang Wu ◽  
...  
Keyword(s):  
Extracellular Vesicles ◽  
Normal Control ◽  
Early Stage ◽  
Colorectal Neoplasia ◽  
Enrichment Analysis ◽  
Functional Enrichment Analysis ◽  
Functional Enrichment ◽  
Data Matrix ◽  
Advanced Adenoma ◽  
Advanced Neoplasia

BackgroundPatient participation in colorectal cancer (CRC) screening via a stool test and colonoscopy is suboptimal, but participation can be improved by the development of a blood test. However, the suboptimal detection abilities of blood tests for advanced neoplasia, including advanced adenoma (AA) and CRC, limit their application. We aimed to investigate the proteomic landscape of small extracellular vesicles (sEVs) from the serum of patients with colorectal neoplasia and identify specific sEV proteins that could serve as biomarkers for early diagnosis.Materials and MethodsWe enrolled 100 patients including 13 healthy subjects, 12 non-AAs, 13 AAs, and 16 stage-I, 15 stage-II, 16 stage-III, and 15 stage-IV CRCs. These patients were classified as normal control, early neoplasia, and advanced neoplasia. The sEV proteome was explored by liquid chromatography-tandem mass spectrometry. Generalized association plots were used to integrate the clustering methods, visualize the data matrix, and analyze the relationship. The specific sEV biomarkers were identified by a decision tree via Orange3 software. Functional enrichment analysis was conducted by using the Ingenuity Pathway Analysis platform.ResultsThe sEV protein matrix was identified from the serum of 100 patients and contained 3353 proteins, of which 1921 proteins from 98 patients were finally analyzed. Compared with the normal control, subjects with early and advanced neoplasia exhibited a distinct proteomic distribution in the data matrix plot. Six sEV proteins were identified, namely, GCLM, KEL, APOF, CFB, PDE5A, and ATIC, which properly distinguished normal control, early neoplasia, and advanced neoplasia patients from each other. Functional enrichment analysis revealed that APOF+ and CFB+ sEV associated with clathrin-mediated endocytosis signaling and the complement system, which have critical implications for CRC carcinogenesis.ConclusionPatients with colorectal neoplasia had a distinct sEV proteome expression pattern in serum compared with those patients who were healthy and did not have neoplasms. Moreover, the six identified specific sEV proteins had the potential to discriminate colorectal neoplasia between early-stage and advanced neoplasia. Collectively, our study provided a six-sEV protein biomarker panel for CRC diagnosis at early or advanced stages. Furthermore, the implication of the sEV proteome in CRC carcinogenesis via specific signaling pathways was explored.

scholarly journals Risk stratification for advanced colorectal neoplasia based on the findings of the index and first surveillance colonoscopies

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245211
Author(s):  
Munenori Honda ◽  
Hideaki Naoe ◽  
Ryosuke Gushima ◽  
Hideaki Miyamoto ◽  
Masakuni Tateyama ◽  
...  
Keyword(s):  
High Risk ◽  
Risk Stratification ◽  
Retrospective Cohort ◽  
Colorectal Neoplasia ◽  
Advanced Adenoma ◽  
Time High Risk ◽  
Advanced Neoplasia ◽  
Advanced Colorectal Neoplasia ◽  
Surveillance Endoscopy ◽  
Subsequent Risk

Risk stratification by index colonoscopy is well established for first surveillance endoscopy, but whether the previous two colonoscopies affect the subsequent advanced neoplasias has not been established. Therefore, the subsequent risk based on the findings of the index and first surveillance colonoscopies were investigated. This retrospective, cohort study was conducted in two clinics and included participants who had undergone two or more colonoscopies after index colonoscopy. High-risk was defined as advanced adenoma (≥ 1 cm, or tubulovillous or villous histology, or high-grade dysplasia). Based on the findings of the index and first surveillance colonoscopies, patients were classified into four categories: category A (both colonoscopy findings were normal), category B (no high-risk findings both times), category C (one time high-risk finding), and category D (high-risk findings both times). The incidence of subsequent advanced neoplasia was examined in each category. A total of 13,426 subjects were included and surveyed during the study periods. The subjects in category D had the highest risk of advanced neoplasia (27.4%, n = 32/117). The subjects in category A had the lowest risk (4.0%, n = 225/5,583). The hazard ratio for advanced neoplasia of category D compared to category A was 9.90 (95% Confidence interval 6.82–14.35, P<0.001). Classification based on the findings of index and first surveillance colonoscopies more effectively stratifies the risk of subsequent advanced neoplasia, resulting in more proper allocation of colonoscopy resources after two consecutive colonoscopies.

Prevalence of adenomatous polyposis in a fecal immunochemical test-based colorectal cancer screening program and risk of advanced neoplasia during follow-up

Endoscopy ◽  
2021 ◽  
Author(s):  
Sabela Carballal ◽  
Ariadna Sánchez ◽  
Leticia Moreira ◽  
Jesús-Eduardo Cuellar Monterrubio ◽  
Julio Bernuy ◽  
...  
Keyword(s):  
Cumulative Incidence ◽  
Screening Program ◽  
Fecal Immunochemical Test ◽  
Colorectal Adenomas ◽  
Advanced Adenoma ◽  
Multivariable Logistic Regression Analysis ◽  
Crc Screening ◽  
Advanced Neoplasia ◽  
Immunochemical Test

Background and study aims: current guidelines recommend genetic counseling and intensive colonoscopy surveillance for patients with ≥10 colorectal adenomas based on scarce data. We investigated the prevalence of this condition in a FIT (fecal immunochemical test)-based colorectal (CRC) screening program and the incidence of metachronous lesions during follow-up. Patients and methods: we retrospectively included all FIT-positive participants with ≥10 adenomas at index colonoscopy between 2010 and 2018. Surveillance colonoscopies (SVC) were collected until 2019. Patients with inherited syndromes, serrated polyposis syndrome, total colectomy or lacking surveillance data, were excluded. Cumulative incidence of CRC and advanced neoplasia (AN) were analyzed by Kaplan-Meyer analysis. Risk factors of metachronous AN were investigated by multivariable logistic-regression analysis. Results: 215/9,582 (2.2%) participants had ≥10 adenomas. Germline genetic testing was performed in 92% of patients with ≥20 adenomas identifying 2 (3.3%) inherited syndromes. 3-year cumulative incidence of CRC and AN was 1%, and 16%, respectively. In 39 (24.2%) patients no polyps were found at first SVC. The presence of advanced adenoma was independently associated with a higher risk of AN at first SVC (OR: 3.91, 95% confident interval : 1.12-13.62; p=0.03). Beyond the first SVC, the risk of metachronous AN was lower. Conclusions: the prevalence of ≥10 adenomas in a FIT-based CRC screening program is 2.2% and a small proportion of inherited syndromes are detected even amongst those with ≥ 20 adenomas. Low rate of post-colonoscopy CRC is observed and the risk of AN beyond the first SVC tends to progressively decrease throughout successive follow-up.

Postcolonoscopy colorectal cancers in average-risk Korean subjects with a normal initial colonoscopy.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 526-526
Author(s):  
Han Hee Lee ◽  
Hyun Ho Choi ◽  
Chun-Hyun Lim ◽  
Hyung-Keun Kim ◽  
Sung Soo Kim ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Advanced Adenoma ◽  
Colorectal Cancers ◽  
Average Risk ◽  
Asian Countries ◽  
Technical Improvement ◽  
Advanced Neoplasia ◽  
Adenoma Detection ◽  
Advanced Adenomas

526 Background: There are relatively few studies regarding the incidence of postcolonoscopy colorectal cancer (PCCRC) in Asian countries. We evaluated the characteristics of PCCRC in average-risk Korean subjects. Methods: This study included subjects who were ≥ 50 years of age and had undergone a first completed colonoscopy between January 2001 and December 2004, at which no baseline adenoma had been detected, followed by a second colonoscopy 1–5 years later. The incidence and characteristics of advanced neoplasia in these subjects were assessed. Results: A total of 343 subjects underwent follow-up colonoscopy within 5 years. Seventy-three (21.3%) subjects were found to have at least one adenoma upon follow-up colonoscopy. Advanced adenoma was found in eight (2.3%) subjects, and non-advanced adenomas were found in 65 (19.0%). Five patients (1.5%) were diagnosed with invasive CRC following a normal colonoscopy. The putative reason for the PCCRCs was missed lesions in two (40.0%) and new cancer in three (60.0%) cases. Conclusions: The risk of advanced neoplasia (including PCCRCs) within 5 years after a normal baseline colonoscopy in our cohort was not low. Considering that 40% of PCCRCs were attributable to missed lesions, our results emphasize the need for technical improvement of colonoscopic examinations to improve adenoma detection.

scholarly journals The Addition of Other Fecal Biomarkers Does Not Improve the Diagnostic Accuracy of Immunochemical Fecal Occult Blood Test Alone in a Colorrectal Cancer Screening Cohort

2021 ◽  
Vol 8 ◽  
Author(s):  
Gonzalo Hijos-Mallada ◽  
Alberto Lué ◽  
Raul Velamazan ◽  
Nuria Saura ◽  
Carlos Abril ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Blood Test ◽  
Screening Program ◽  
Occult Blood ◽  
Advanced Adenoma ◽  
Fecal Occult Blood ◽  
Crc Screening ◽  
Advanced Neoplasia ◽  
Fecal Occult ◽  
Fecal Biomarkers

Background: Screening with fecal occult blood test reduces colorectal cancer (CRC) incidence and mortality, and is currently implemented in most countries. However, around 40% of screening colonoscopies are normal. Thus, strategies to avoid these colonoscopies are highly necessary. Adding other fecal biomarkers, such as fecal calprotectin (FC), lactoferrin, and transferrin may be useful, but evidence is scarce.Aims: To evaluate the diagnostic accuracy of fecal occult blood immunochemical test (FIT), FC, and a one-step combo card test for the simultaneous semi-qualitative detection of human hemoglobin (hHb), transferrin (hTf), calprotectin (hCp) and lactoferrin (hLf) in a CRC screening program population.Methods: Single-center, prospective observational study, enrolling patients included in a CRC screening program, referred for a colonoscopy due to a positive FIT test. Participants collected a stool sample prior to bowel preparation, and FIT, FC and the combo semi-qualitative tests were performed on the sample. Sensitivity, specificity, positive and negative predictive values and area under receiver operator curve (AUC) for diagnosis of advanced neoplasia, advanced adenoma and CRC were estimated for each biomarker and their combinations. The primary endpoint of the study was to assess whether these biomarkers could improve the diagnostic accuracy of FIT alone.Results: 336 consecutive patients (64% males) were recruited. Advanced neoplasia was found in 129/336 (38.4%) patients, and of these, 22/336 (6.5%) were diagnosed of CRC. 153/336 (45.5%) colonoscopies were completely normal. The AUC for the diagnosis of advanced neoplasia were 0.725 (95%CI 0.665–0.784) for FIT, 0.477 (95%CI 0.413–0.541) for FC and 0.732 (95%CI 0.674–0.791) for the combination of both (FIT + FC) quantitative tests. The AUCs for the combo test were 0.70 (95%CI 0.641–0.760) for hHb, 0.625 (95%CI 0.562–0.698) for hTf, 0.532 (95%CI 0.469–0.595) for hCp, 0.531 (95%CI 0.466–0.595 ) for hLf and 0.681 (95%CI 0.620–0.741) for the combination of the four biomarkers.Conclusion: In average-risk population, FIT appears to be the best fecal marker for the diagnosis of CRC and advanced adenoma. None of the other biomarkers explored or their combinations provided a better diagnostic accuracy. Only hTF showed an acceptable diagnostic accuracy. FC and hLF were not useful in this setting.

High incidence of advanced colorectal neoplasia during endoscopic surveillance in serrated polyposis syndrome

Endoscopy ◽  
2018 ◽  
Vol 51 (02) ◽  
pp. 142-151 ◽  
Author(s):  
Daniel Rodríguez-Alcalde ◽  
Sabela Carballal ◽  
Leticia Moreira ◽  
Luis Hernández ◽  
Lorena Rodríguez-Alonso ◽  
...  
Keyword(s):  
Cumulative Incidence ◽  
Colorectal Neoplasia ◽  
Endoscopic Surveillance ◽  
Advanced Adenoma ◽  
Polyposis Syndrome ◽  
Advanced Neoplasia ◽  
Increased Risk ◽  
Substantial Risk ◽  
Serrated Lesions ◽  
Serrated Lesion

Abstract Background Serrated polyposis syndrome (SPS) has been associated with an increased risk of colorectal cancer (CRC). Accordingly, intensive surveillance with annual colonoscopy is advised. The aim of this multicenter study was to describe the risk of advanced lesions in SPS patients undergoing surveillance, and to identify risk factors that could guide the prevention strategy. Methods From March 2013 to April 2015, 296 patients who fulfilled criteria I and/or III for SPS were retrospectively recruited at 18 centers. We selected patients in whom successful clearing colonoscopy had been performed and who underwent subsequent endoscopic surveillance. Advanced neoplasia was defined as CRC, advanced adenoma, or advanced serrated lesion that were ≥ 10 mm and/or with dysplasia. Cumulative incidence of advanced neoplasia was calculated and independent predictors of advanced neoplasia development were identified. Results In 152 SPS patients a total of 315 surveillance colonoscopies were performed (median 2, range 1 – 7). The 3-year cumulative incidence of CRC and advanced neoplasia were 3.1 % (95 % confidence interval [CI] 0 – 6.9) and 42.0 % (95 %CI 32.4 – 51.7), respectively. Fulfilling both I + III criteria and the presence of advanced serrated lesions at baseline colonoscopy were independent predictors of advanced neoplasia development (odds ratio [OR] 1.85, 95 %CI 1.03 – 3.33, P  = 0.04 and OR 2.62, 95 %CI 1.18 – 5.81, P  = 0.02, respectively). During follow-up, nine patients (5.9 %) were referred for surgery for invasive CRC (n = 4, 2.6 %) or because of polyp burden (n = 5, 3.3 %). After total colectomy, 17.9 % patients developed advanced neoplasia in the retained rectum. Conclusions Patients with SPS have a substantial risk of developing advanced neoplasia under endoscopic surveillance, whereas CRC incidence is low. Personalized endoscopic surveillance based on polyp burden and advanced serrated histology could help to optimize prevention in patients with SPS.

Focusing of Visuospatial Attention

2001 ◽  
Vol 15 (4) ◽  
pp. 256-274 ◽  
Author(s):  
Caterina Pesce ◽  
Rainer Bösel
Keyword(s):  
Reaction Times ◽  
Visual Space ◽  
Spatial Relation ◽  
Stimulus Onset ◽  
Visuospatial Attention ◽  
Task Demands ◽  
Time Interval ◽  
Behavioral Studies ◽  
Task Conditions ◽  
Simple Rt

Abstract In the present study we explored the focusing of visuospatial attention in subjects practicing and not practicing activities with high attentional demands. Similar to the studies of Castiello and Umiltà (e. g., 1990) , our experimental procedure was a variation of Posner's (1980) basic paradigm for exploring covert orienting of visuospatial attention. In a simple RT-task, a peripheral cue of varying size was presented unilaterally or bilaterally from a central fixation point and followed by a target at different stimulus-onset-asynchronies (SOAs). The target could occur validly inside the cue or invalidly outside the cue with varying spatial relation to its boundary. Event-related brain potentials (ERPs) and reaction times (RTs) were recorded to target stimuli under the different task conditions. RT and ERP findings showed converging aspects as well as dissociations. Electrophysiological results revealed an amplitude modulation of the ERPs in the early and late Nd time interval at both anterior and posterior scalp sites, which seems to be related to the effects of peripheral informative cues as well as to the attentional expertise. Results were: (1) shorter latency effects confirm the positive-going amplitude enhancement elicited by unilateral peripheral cues and strengthen the criticism against the neutrality of spatially nonpredictive peripheral cueing of all possible target locations which is often presumed in behavioral studies. (2) Longer latency effects show that subjects with attentional expertise modulate the distribution of the attentional resources in the visual space differently than nonexperienced subjects. Skilled practice may lead to minimizing attentional costs by automatizing the use of a span of attention that is adapted to the most frequent task demands and endogenously increases the allocation of resources to cope with less usual attending conditions.

Attention Deficit and Disruptive Behavior Disorder Symptoms

2001 ◽  
Vol 17 (1) ◽  
pp. 25-35 ◽  
Author(s):  
G. Leonard Burns ◽  
James A. Walsh ◽  
David R. Patterson ◽  
Carol S. Holte ◽  
Rita Sommers-Flanagan ◽  
...  
Keyword(s):  
Attention Deficit ◽  
Rating Scales ◽  
Behavior Disorder ◽  
Disruptive Behavior Disorder ◽  
Subjective Rating ◽  
Time Interval ◽  
Assessment Procedure ◽  
Frequency Count ◽  
Hyperactivity Disorder ◽  
Oppositional Defiant

Summary: Rating scales are commonly used to measure the symptoms of attention deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD). While these scales have positive psychometric properties, the scales share a potential weakness - the use of vague or subjective rating procedures to measure symptom occurrence (e. g., never, occasionally, often, and very often). Rating procedures based on frequency counts for a specific time interval (e. g., never, once, twice, once per month, once per week, once per day, more than once per day) are less subjective and provide a conceptually better assessment procedure for these symptoms. Such a frequency count procedure was used to obtain parent ratings on the ADHD, ODD, and CD symptoms in a normative (nonclinical) sample of 3,500 children and adolescents. Although the current study does not provide a direct comparison of the two types of rating procedures, the results suggest that the frequency count procedure provides a potentially more useful way to measure these symptoms. The implications of the results are noted for the construction of rating scales to measure the ADHD, ODD, and CD symptoms.

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