AIM: To investigate the phenotype of inflammatory bowel disease associated with primary sclerosing cholangitis (PSC-IBD). METHODS: Data from 75 PSC-IBD patients evaluated in our tertiary center between 1963 and 2006 w...AIM: To investigate the phenotype of inflammatory bowel disease associated with primary sclerosing cholangitis (PSC-IBD). METHODS: Data from 75 PSC-IBD patients evaluated in our tertiary center between 1963 and 2006 were collected and compared to 150 IBD patients without PSC, matched for sex, birth date, IBD diagnosis date and initial disease location regarding ileal, different colonic segments, and rectum, respectively. RESULTS: While PSC-IBD patients received more 5-aminosalicylates (8.7 years/patient vs 2.9 years/ patient, P < 0.001), they required less immuno-suppressors (24% vs 46% at 10 years; P < 0.001) and less intestinal resection (10% vs 44% at 10 years, P < 0.001). The 25-year cumulative rate of colectomy was 25.1% in PSC-IBD and 37.3% in controls (P = 0.004). The 25-year cumulative rate of colorectal cancer was 23.4% in PSC-IBD vs 0% in controls (P = 0.002). PSC was the only independent risk factor for the development of colorectal cancer (OR = 10.8; 95% CI, 3.7-31.3). Overall survival rate without liver transplantation was reduced in PSC-IBD patients (67% vs 91% in controls at 25 years, P = 0.001).CONCLUSION: This study confirms that patients with PSC-IBD have a particular disease phenotype independent of the initial disease location. Although their disease is less active and they use more 5-aminosalicylates, they present a higher risk of colorectal cancer.展开更多
AIM:To explore the potential risk factors related to gastrointestinal cancer in northern China.METHODS:A total of 3314 cases of gastrointestinal cancer(esophageal,gastric,pancreatic and biliary) and 2223 controls(incl...AIM:To explore the potential risk factors related to gastrointestinal cancer in northern China.METHODS:A total of 3314 cases of gastrointestinal cancer(esophageal,gastric,pancreatic and biliary) and 2223 controls(including healthy individuals,glioma and thyroid cancer) were analyzed by case-control study.Multivariable logistic regression analysis was applied to evaluate the association between different cancers and hepatitis B surface antigen,sex,age,blood type,diabetes,or family history of cancer.RESULTS:Type 2 diabetes was significantly associated with gastric,biliary and pancreatic cancer with an OR of 2.0-3.0.Blood type B was significantly associated with esophageal cancer [odd ratio(OR) = 1.53,95% confidence interval(CI) = 1.10-2.14] and biliary cancer(OR = 1.49,95% CI = 1.09-2.05).The prevalence of type 2 diabetes was significantly higher in gastric,biliary and pancreatic cancers compared with other groups,with ORs ranging between 2.0 and 3.0.Family history of cancer was strongly associated with gastrointestinal compared with other cancers.CONCLUSION:Blood type B individuals are susceptible to esophageal and biliary cancer.Type 2 diabetes is significantly associated with gastric,biliary and especially pancreatic cancer.展开更多
Objective： To evaluate the efficacy and safety of cetuximab combined with chemotherapy in colorectal cancer （CRC）. Methods： 35 cases of CRC were retrospectively analyzed. Efficacy and adverse events were observed....Objective： To evaluate the efficacy and safety of cetuximab combined with chemotherapy in colorectal cancer （CRC）. Methods： 35 cases of CRC were retrospectively analyzed. Efficacy and adverse events were observed. Results： 29 cases of CRC were evaluated by RECIST criteria, showing 7 PR （partial response, 24.1%） and 15 SD （stable disease, 51.8%）, disease control rate （DC） was 75.9%. Subgroup analysis showed response rate （RR） of 36.4% and DC of 91% in the 1st line therapy, RR of 20% and DC of 70% in the 2rid line therapy, RR of 12.5% and DC of 62.5% in heavily pre-treated cases. Rash appeared in 74.3% of patients （grade 3 was 8.6%）, and the severity was relevant with disease control rate （DC）. Neutropenia of grade 3/4 was 14.3%, and infusion related reaction （IRR） of grade 3 happened in 1 case （2.9%）. Conclusion： Cetuximab combined with chemotherapy is safe and effective for patients with metastatic colorectal cancer. The combination therapy shows high DC, especially in 1st line therapy. Severity of rash may predict efficacy.展开更多
AIM： To identity the factors influencing colorectal cancer （CRC） screening behavior and willingness among Chinese outpatients.METHODS： An outpatient-based face-to-face survey was conducted from August 18 to Septem...AIM： To identity the factors influencing colorectal cancer （CRC） screening behavior and willingness among Chinese outpatients.METHODS： An outpatient-based face-to-face survey was conducted from August 18 to September 7, 2010 in Changhai Hospital. A total of 1200 consecutive patients aged ≥ 18 years were recruited for interview. The patient＇s knowledge about CRC and screening was pre-measured as a predictor variable, and other pre- dictors included age, gender, educational level, month- ly household income and health insurance status. The relationship between these predictors and screening behavior, screening willingness and screening approach were examined using Pearson＇s 2 test and logistic regression analyses.RESULTS： Of these outpatients, 22.5% had undergone CRC screening prior to this study. Patients who had participated in the screening were more likely to have good knowledge about CRC and screening （OR： 5.299, 95% CI： 3.415-8.223）, have health insurance （OR： 1.996, 95% CI： 1.426-2.794） and older in age. Higher income, however, was found to be a barrier to the screening （OR： 0.633, 95% CI： 0.467-0.858）. An analysis of screening willingness showed that 37.5% of the patients would voluntarily participated in a screen at the recommended age, but 41.3% would do so under doctor＇s advice. Screening willingness was positively correlated with the patient＇s knowledge sta- tus. Patients with higher knowledge levels would like to participate in the screening （OR： 4.352, 95% CI： 3.008-6.298）, and they would select colonoscopy as a screening approach （OR： 3.513, 95% CI： 2.290-5.389）. However, higher income level was, again, a bar- rier to colonoscopic screening （OR： 0.667, 95% CI： 0.505-0.908）. CONCLUSION： Patient＇s level of knowledge and in-ome should be taken into consideration when conducting a feasible CRC screening.展开更多
A 53-year old previously healthy male underwent a screening colonoscopy for detection of a potential colorectal neoplasm. The terminal ileum was intubated and a mass was noted. Examination of the colon was normal. The...A 53-year old previously healthy male underwent a screening colonoscopy for detection of a potential colorectal neoplasm. The terminal ileum was intubated and a mass was noted. Examination of the colon was normal. The biopsy of the ileal mass was consistent with an adenocarcinoma arising from the terminal ileum. His father who had never been previously ill from gastrointestinal disease died of natural causes, but was found to have Crohn's disease postmortem. The patient underwent exploratory laparotomy and a right hemicolectomy with a 30 cm section of terminal ileum in continuity. Findings were consistent with ileal adenocarcinoma in the setting of Crohn's disease. The patient made an uneventful recovery. The pathology was stage 1 adenocarcinoma. This is a unique case in that on a screening colonoscopy, a favorable ileal adenocarcinoma was discovered in the setting of asymptomatic, undiagnosed ileal Crohn's disease in a patient whose father had Crohn's disease diagnosed postmortem.展开更多
AIM: To explore the associations of polymorphisms of lipopolysaccharide binding protein (LBP), cluster of differentiation 14 (CD14), toll-like receptor 4 (TLR-4), interleukin-6 (IL-6) and tumor necrosis factor α (TNF...AIM: To explore the associations of polymorphisms of lipopolysaccharide binding protein (LBP), cluster of differentiation 14 (CD14), toll-like receptor 4 (TLR-4), interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) with the colorectal carcinoma (CRC) risk in Han Chinese. METHODS: Polymorphisms of LBP (rs1739654, rs223 2596, rs2232618), CD14 (rs77083413, rs4914), TLR-4 (rs5030719), IL-6 (rs13306435) and TNF-α (rs35131721) were genotyped in 479 cases of sporadic colorectal carcinoma and 486 healthy controls of Han Chinese in a case-control study. Single-nucleotide polymorphisms (SNPs) between cases and controls were analyzed by unconditional logistic regression. RESULTS: GA and GG genotypes of LBP rs2232596 were associated with a significantly increased risk ofCRC [odds ratio (OR) = 1.51, 95% confidence interval (CI) 1.15-1.99, P = 0.003; OR = 2.49, 95% CI 1.16-5.38, P = 0.016, respectively]. A similar association was also observed for the CG genotype of CD14 rs4914 (OR= 1.69, 95% CI 1.20-2.36, P = 0.002). In addition, a combination of polymorphisms in LBP rs2232596 and CD14 rs4914 led to a 3.4-fold increased risk of CRC (OR = 3.44, 95% CI 1.94-6.10, P = 0.000). CONCLUSION: This study highlights the LBP rs2232596 and CD14 rs4914 polymorphisms as biomarkers for elevated CRC susceptibility in the Chinese Han population.展开更多
OBJECTIVE To investigate the clinical characteristics of melanosis of the colon （MC） and its correlation with polypus and carcinoma of the large intestine. METHODS Clinical feature and colonoscopic findings of 156 M...OBJECTIVE To investigate the clinical characteristics of melanosis of the colon （MC） and its correlation with polypus and carcinoma of the large intestine. METHODS Clinical feature and colonoscopic findings of 156 MC patients were retrospectively analyzed. Final diagnosis of MC case was made after colonoscopic and pathological examination, and data of the case history was recorded. RESULTS The overall detection rate of MC was 1.12%, with 0.46% in males, 0.66% in females. An 82.69% of the patients suffered various constipations and had a history of taking cathartics. The clinical manifestation of total-colon melanosis occurred in 83.97% of the patients. There was no significant difference between the rate of concomitant polypus （27.56%） in the MC patients and the detection rate of polypus in the patients who underwent a synchronous colonoscopy （χ^2 = 1.205, P = 0.298）. Also there was no significant difference between the detection rate of carcinoma of the large intestine （8.97%） in MC patients and the detection rate of the same disease in the patients who underwent synchronous colonoscopy （χ^2 = 0.268, P = 0.604）. A logistic regression analysis has shown that the older the age of MC patients is, the more opportunities of MC and the concomitant polypus would occur. CONCLUSION MC may be related to constipations and a long-term administration of cathartics, among which total-colon melanosis ranks first in the cases. There is an earlier age of onset in the females, with a higher detection rate. The older the age of the patients is, the higher the detection rate of MC is, and the more possibility the onset of the concomitant polypus.展开更多
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 coh...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.展开更多
文摘AIM: To investigate the phenotype of inflammatory bowel disease associated with primary sclerosing cholangitis (PSC-IBD). METHODS: Data from 75 PSC-IBD patients evaluated in our tertiary center between 1963 and 2006 were collected and compared to 150 IBD patients without PSC, matched for sex, birth date, IBD diagnosis date and initial disease location regarding ileal, different colonic segments, and rectum, respectively. RESULTS: While PSC-IBD patients received more 5-aminosalicylates (8.7 years/patient vs 2.9 years/ patient, P < 0.001), they required less immuno-suppressors (24% vs 46% at 10 years; P < 0.001) and less intestinal resection (10% vs 44% at 10 years, P < 0.001). The 25-year cumulative rate of colectomy was 25.1% in PSC-IBD and 37.3% in controls (P = 0.004). The 25-year cumulative rate of colorectal cancer was 23.4% in PSC-IBD vs 0% in controls (P = 0.002). PSC was the only independent risk factor for the development of colorectal cancer (OR = 10.8; 95% CI, 3.7-31.3). Overall survival rate without liver transplantation was reduced in PSC-IBD patients (67% vs 91% in controls at 25 years, P = 0.001).CONCLUSION: This study confirms that patients with PSC-IBD have a particular disease phenotype independent of the initial disease location. Although their disease is less active and they use more 5-aminosalicylates, they present a higher risk of colorectal cancer.
基金Supported by The National Basic Research Program,973 Pro-gram No. 2010CB912802 and No. 2006CB910700the China National Science Foundation,No. 81071953,No. 30890033 and No. 30620120433+1 种基金the Chinese Academy of Sciences No.KSCX1-YW-R-40the 44 Postdoctoral Fund of China,No.20080441314
文摘AIM:To explore the potential risk factors related to gastrointestinal cancer in northern China.METHODS:A total of 3314 cases of gastrointestinal cancer(esophageal,gastric,pancreatic and biliary) and 2223 controls(including healthy individuals,glioma and thyroid cancer) were analyzed by case-control study.Multivariable logistic regression analysis was applied to evaluate the association between different cancers and hepatitis B surface antigen,sex,age,blood type,diabetes,or family history of cancer.RESULTS:Type 2 diabetes was significantly associated with gastric,biliary and pancreatic cancer with an OR of 2.0-3.0.Blood type B was significantly associated with esophageal cancer [odd ratio(OR) = 1.53,95% confidence interval(CI) = 1.10-2.14] and biliary cancer(OR = 1.49,95% CI = 1.09-2.05).The prevalence of type 2 diabetes was significantly higher in gastric,biliary and pancreatic cancers compared with other groups,with ORs ranging between 2.0 and 3.0.Family history of cancer was strongly associated with gastrointestinal compared with other cancers.CONCLUSION:Blood type B individuals are susceptible to esophageal and biliary cancer.Type 2 diabetes is significantly associated with gastric,biliary and especially pancreatic cancer.
文摘Objective： To evaluate the efficacy and safety of cetuximab combined with chemotherapy in colorectal cancer （CRC）. Methods： 35 cases of CRC were retrospectively analyzed. Efficacy and adverse events were observed. Results： 29 cases of CRC were evaluated by RECIST criteria, showing 7 PR （partial response, 24.1%） and 15 SD （stable disease, 51.8%）, disease control rate （DC） was 75.9%. Subgroup analysis showed response rate （RR） of 36.4% and DC of 91% in the 1st line therapy, RR of 20% and DC of 70% in the 2rid line therapy, RR of 12.5% and DC of 62.5% in heavily pre-treated cases. Rash appeared in 74.3% of patients （grade 3 was 8.6%）, and the severity was relevant with disease control rate （DC）. Neutropenia of grade 3/4 was 14.3%, and infusion related reaction （IRR） of grade 3 happened in 1 case （2.9%）. Conclusion： Cetuximab combined with chemotherapy is safe and effective for patients with metastatic colorectal cancer. The combination therapy shows high DC, especially in 1st line therapy. Severity of rash may predict efficacy.
文摘AIM： To identity the factors influencing colorectal cancer （CRC） screening behavior and willingness among Chinese outpatients.METHODS： An outpatient-based face-to-face survey was conducted from August 18 to September 7, 2010 in Changhai Hospital. A total of 1200 consecutive patients aged ≥ 18 years were recruited for interview. The patient＇s knowledge about CRC and screening was pre-measured as a predictor variable, and other pre- dictors included age, gender, educational level, month- ly household income and health insurance status. The relationship between these predictors and screening behavior, screening willingness and screening approach were examined using Pearson＇s 2 test and logistic regression analyses.RESULTS： Of these outpatients, 22.5% had undergone CRC screening prior to this study. Patients who had participated in the screening were more likely to have good knowledge about CRC and screening （OR： 5.299, 95% CI： 3.415-8.223）, have health insurance （OR： 1.996, 95% CI： 1.426-2.794） and older in age. Higher income, however, was found to be a barrier to the screening （OR： 0.633, 95% CI： 0.467-0.858）. An analysis of screening willingness showed that 37.5% of the patients would voluntarily participated in a screen at the recommended age, but 41.3% would do so under doctor＇s advice. Screening willingness was positively correlated with the patient＇s knowledge sta- tus. Patients with higher knowledge levels would like to participate in the screening （OR： 4.352, 95% CI： 3.008-6.298）, and they would select colonoscopy as a screening approach （OR： 3.513, 95% CI： 2.290-5.389）. However, higher income level was, again, a bar- rier to colonoscopic screening （OR： 0.667, 95% CI： 0.505-0.908）. CONCLUSION： Patient＇s level of knowledge and in-ome should be taken into consideration when conducting a feasible CRC screening.
文摘A 53-year old previously healthy male underwent a screening colonoscopy for detection of a potential colorectal neoplasm. The terminal ileum was intubated and a mass was noted. Examination of the colon was normal. The biopsy of the ileal mass was consistent with an adenocarcinoma arising from the terminal ileum. His father who had never been previously ill from gastrointestinal disease died of natural causes, but was found to have Crohn's disease postmortem. The patient underwent exploratory laparotomy and a right hemicolectomy with a 30 cm section of terminal ileum in continuity. Findings were consistent with ileal adenocarcinoma in the setting of Crohn's disease. The patient made an uneventful recovery. The pathology was stage 1 adenocarcinoma. This is a unique case in that on a screening colonoscopy, a favorable ileal adenocarcinoma was discovered in the setting of asymptomatic, undiagnosed ileal Crohn's disease in a patient whose father had Crohn's disease diagnosed postmortem.
基金Supported by The Nationgal Natural Science Foundation of China,No.30571924
文摘AIM: To explore the associations of polymorphisms of lipopolysaccharide binding protein (LBP), cluster of differentiation 14 (CD14), toll-like receptor 4 (TLR-4), interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) with the colorectal carcinoma (CRC) risk in Han Chinese. METHODS: Polymorphisms of LBP (rs1739654, rs223 2596, rs2232618), CD14 (rs77083413, rs4914), TLR-4 (rs5030719), IL-6 (rs13306435) and TNF-α (rs35131721) were genotyped in 479 cases of sporadic colorectal carcinoma and 486 healthy controls of Han Chinese in a case-control study. Single-nucleotide polymorphisms (SNPs) between cases and controls were analyzed by unconditional logistic regression. RESULTS: GA and GG genotypes of LBP rs2232596 were associated with a significantly increased risk ofCRC [odds ratio (OR) = 1.51, 95% confidence interval (CI) 1.15-1.99, P = 0.003; OR = 2.49, 95% CI 1.16-5.38, P = 0.016, respectively]. A similar association was also observed for the CG genotype of CD14 rs4914 (OR= 1.69, 95% CI 1.20-2.36, P = 0.002). In addition, a combination of polymorphisms in LBP rs2232596 and CD14 rs4914 led to a 3.4-fold increased risk of CRC (OR = 3.44, 95% CI 1.94-6.10, P = 0.000). CONCLUSION: This study highlights the LBP rs2232596 and CD14 rs4914 polymorphisms as biomarkers for elevated CRC susceptibility in the Chinese Han population.
文摘OBJECTIVE To investigate the clinical characteristics of melanosis of the colon （MC） and its correlation with polypus and carcinoma of the large intestine. METHODS Clinical feature and colonoscopic findings of 156 MC patients were retrospectively analyzed. Final diagnosis of MC case was made after colonoscopic and pathological examination, and data of the case history was recorded. RESULTS The overall detection rate of MC was 1.12%, with 0.46% in males, 0.66% in females. An 82.69% of the patients suffered various constipations and had a history of taking cathartics. The clinical manifestation of total-colon melanosis occurred in 83.97% of the patients. There was no significant difference between the rate of concomitant polypus （27.56%） in the MC patients and the detection rate of polypus in the patients who underwent a synchronous colonoscopy （χ^2 = 1.205, P = 0.298）. Also there was no significant difference between the detection rate of carcinoma of the large intestine （8.97%） in MC patients and the detection rate of the same disease in the patients who underwent synchronous colonoscopy （χ^2 = 0.268, P = 0.604）. A logistic regression analysis has shown that the older the age of MC patients is, the more opportunities of MC and the concomitant polypus would occur. CONCLUSION MC may be related to constipations and a long-term administration of cathartics, among which total-colon melanosis ranks first in the cases. There is an earlier age of onset in the females, with a higher detection rate. The older the age of the patients is, the higher the detection rate of MC is, and the more possibility the onset of the concomitant polypus.
基金Supported by A Research Grant of Center for Translational Molecular Medicine, The Netherlands, to van Turenhout STGrant of Nycomed B.V., Hoofddorp to "the Amsterdam Gut-club", The Netherlands+1 种基金The Netherlands Organization for Health Research and Development, ZonMW, No. 50-50115-98-060,project 63000004The original trial was registered under IS-RCTN57917442 at Current Controlled Trials (www.controlled-trials.com)
文摘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.
