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Supply and quality of colonoscopy according to the characteristics of gastroenterologists in the French population-based colorectalcancer screening program

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World Journal of Gastroenterology 2023年第9期29卷 1492-1508页

作者： AkoïKoïvogui Catherine Vincelet Gaëlle Abihsera Hamou Ait-Hadad Hélène Delattre Tu Le Trung Agnès Bernoux Rachel Carroll Jérôme Nicolet Site de Seine-Saint-Denis Centre Régional de Coordination des Dépistages des Cancers en Ile-de-France(CRCDC-IDF)Bondy 93146France Site des Yvelines Centre Régional de Coordination des Dépistages des Cancers en Ile-de-France(CRCDC-IDF)Le Chesnay Cedex 78153France Site du Val-de-Marne Centre Régional de Coordination des Dépistages des Cancers en Ile-de-France(CRCDC-IDF)Joinville-le-Pont 94340France Site de Seine-et-Marne Centre Régional de Coordination des Dépistages des Cancers en Ile-de-France(CRCDC-IDF)Lieusaint 77763France Site des Hauts-de-Seine Centre Régional de Coordination des Dépistages des Cancers en Ile-de-France(CRCDC-IDF)Nanterre 92000France site du Val-d’Oise Centre Régional de Coordination des Dépistages des Cancers en Ile-de-France(CRCDC-IDF)Cergy Saint-Christophe 95800France Site de l’Essonne Centre Régional de Coordination des Dépistages des Cancers en Ile-de-France(CRCDC-IDF)Fontenay-Les-Briis 91640France Siège Paris Centre Régional de Coordination des Dépistages des Cancers en Ile-de-France(CRCDC-IDF)Paris 75015France

BACKGROUND Since its complete roll-out in 2009,the French colorectal cancer screening program(CRCSP)experienced 3 major constraints[use of a less efficient Guaiac-test(gFOBT),stopping the supply of Fecal-Immunochemical-Test kits(FIT),and suspension of the program due to the coronavirus disease 2019(COVID-19)]affecting its *** To describe the impact of the constraints in terms of changes in the quality of screeningcolonoscopy(Quali-Colo).METHODS This retrospective cohort study included screening-colonoscopies performed by gastroenterologists between Jan-2010 and Dec-2020 in people aged 50-74 living in Ile-de-France(France).The changes in Quali-colo(Proportion of colonoscopies performed beyond 7 mo(Colo_7 mo),Frequency of serious adverse events(SAE)and Colonoscopy detection rate)were described in a cohort of Gastroenterologists who performed at least one colonoscopy over each of the four periods defined according to the chronology of the constraints[gFOBT:Normal progress of the CRCSP using gFOBT(2010-2014);FIT:Normal progress of the CRCSP using FIT(2015-2018);STOP-FIT:Year(2019)during which the CRCSP experienced the cessation of the supply of test kits;COVID:program suspension due to the COVID-19 health crisis(2020)].The link between each dependent variable(Colo_7 mo;SAE occurrence,neoplasm detection rate)and the predictive factors was analyzed in a two-level multivariate hierarchical *** The 533 gastroenterologists(cohort)achieved 21509 screening colonoscopies over gFOBT period,38352 over FIT,7342 over STOP-FIT and 7995 over COVID *** frequency of SAE did not change between periods(gFOBT:0.3%;FIT:0.3%;STOP-FIT:0.3%;and COVID:0.2%;P=0.10).The risk of Colo_7 mo doubled between FIT[adjusted odds ratio(aOR):1.2(1.1;1.2)]and STOPFIT[aOR:2.4(2.1;2.6)];then,decreased by 40%between STOP-FIT and COVID[aOR:2.0(1.8;2.2)].Regardless of the period,this Colo_7 mo’s risk was twice as high for screening colonoscopy performed in a public hospital[aOR:2.

关键词： Colorectal cancer screening Screening colonoscopy Faecal immunochemical test Guaiac faecal occult blood test Quality of colonoscopy Severity of tumor lesions

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Non-guided self-learning program for high-proficiency optical diagnosis of diminutive and small colorectal lesions: A single-endoscopist pilot study

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World Journal of Gastroenterology 2019年第10期25卷 1278-1287页

作者： Marco Bustamante-Balén Carla Satorres Lorena Puchades Belén Navarro Natalia García-Morales Noelia Alonso Marta Ponce Lidia Argüello Vicente Pons-Beltrán gastrointestinal Endoscopy Research Group Gastrointestinal Endoscopy UnitDigestive Diseases DepartmentLa Fe Polytechnic University Hospital Digestive Diseases Department La Fe Polytechnic University Hospital gastrointestinal Endoscopy Unit Digestive Diseases DepartmentLa Fe Polytechnic University Hospital

BACKGROUND The implementation of optical diagnosis(OD) of diminutive colorectal lesions in clinical practice has been hampered by differences in performance between community and academic settings. One possible cause is the lack of a standardized learning tool. Since the factors related to better learning are not well described, strong evidence upon which a consistent learning tool could be designed is lacking. We hypothesized that a self-designed learning program may be enough to achieve competency in OD of diminutive lesions of the *** To assess the accuracy of OD of diminutive lesions in real colonoscopies after application of a self-administered learning *** This was a single-endoscopist prospective pilot study, in which an experienced endoscopist followed a self-designed, self-administered learning program in OD of colorectal lesions. An assessment phase divided in two halves with a 6-mo period in between without performance of OD was developed in a populationbased colorectal cancer screening program. The accomplishment of the Preservation and Incorporation of Valuable Endoscopic Innovations criteria and performance measures were calculated overall and in the two halves of the assessment phase, assessing their response to the 6-mo stopping period. The evolution of performance through blocks of 50 lesions was also *** Overall, 152 patients and 522 lesions(≤ 5 mm: 399, and 6-9 mm: 123) were included. The negative predictive value for the OD of adenoma in rectosigmoid lesions diagnosed with high confidence was 91.7% [95% confidence interval(CI):87.3-96.6]. The proportion of agreement on surveillance interval between OD and pathological diagnosis was higher than 95%. Overall accuracy for diminutive lesions diagnosed with high confidence was 89.5%(95%CI: 86.3-92.7). The overall accuracy of OD was similar in the two halves of the assessment phase [90.1(95%CI: 85.6-94.7) vs 88.2(95%CI: 87.9-95.9)]. All the other performance parameters we

关键词： Optical diagnosis Accuracy Learning Polyp Colonoscopy Education

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Health economic evaluation on population-based Helicobacter pylori eradication and endoscopic screening for gastric cancer prevention

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Chinese Journal of Cancer Research 2023年第6期35卷 595-605页

作者： Zhiqiang Hu Zongchao Liu Wenqing Li Weicheng You Kaifeng Pan State Key Laboratory of Holistic Integrative Management of gastrointestinal cancers Beijing Key Laboratory of Carcinogenesis and Translational ResearchDepartment of Cancer EpidemiologyPeking University Cancer Hospital&InstituteBeijing 100142China Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing) Department of Cancer EpidemiologyPeking University Cancer Hospital&InstituteBeijing 100142China

Gastric cancer is a global public health burden, nearly one million new cases are diagnosed per year worldwide, of which 44% of cases occur in China. The prognosis of gastric cancer varies remarkably by the stage of cancer, and most of the patients in China are diagnosed at advanced stages, resulting in poor prognoses. Effective strategies to reduce the burden of gastric cancer include primary prevention through testing and treatment of Helicobacter pylori(H. pylori) and secondary prevention by screening and early detection. Although many countries have issued management guidelines and consensus reports concerning these strategies, the limited availability of healthcare resources often precludes their widespread implementation. Therefore, assessing the costs, benefits, and harms of population-based intervention measures through health economic evaluation is necessary for informed health policy decisions. Accordingly, we synthesize management approaches from different countries on H. pylori eradication and endoscopic screening, and also summarize recent advancements in health economic evaluations on population-based preventive strategies. The goal of the review is to provide empirical evidence supporting optimal resource allocation, maximizing benefits for the population, and ultimately reducing the burden of gastric cancer.

关键词： Gastric cancer endoscopic screening Helicobacter pylori health economic evaluation

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Association between COX-2-1195G>A polymorphism and gastrointestinal cancer risk: A meta-analysis

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World Journal of Gastroenterology 2017年第12期23卷 2234-2245页

作者： Xiao-Wei Zhang Jun Li Yu-Xing Jiang Yu-Xiang Chen Department of gastrointestinal and Vascular Surgery Deyang People's Hospital Department of General Surgery and Center for Minimal Invasive gastrointestinal Surgery Southwest Hospital Third Military Medical University

AIM To perform a meta-analysis to investigate the association between cyclooxygenase-2(COX-2)-1195G>A gene polymorphism and gastrointestinal cancers. METHODS Publications related to the COX-2-1195G>A gene polymorphism and gastrointestinal cancers published before July 2016 were retrieved from Pub Med, EMBASE, Web of Science, China Biological Medicine Database, China National Knowledge Infrastructure, and CQVIP Database. Meta-analysis was performed using Stata11.0 software. The strength of the association was evaluated by calculating the combined odds ratios(ORs) and the corresponding 95%CIs. The retrieved publications were excluded or included one by one for sensitivity analysis. In addition, the funnel plot, Begg's rank correlation test, and Egger's linear regression method were applied to analyse whether the included publications had publication bias. RESULTS A total of 24 publications related to the COX-2-1195G>A gene polymorphism were included, including 28 studies involving 11043 cases and 18008 controls. The meta-analysis results showed that the COX-2-1195G>A gene polymorphism significantly correlated with an increased risk of gastrointestinal cancers, particularly gastric cancer(A vs G: OR = 1.35; AA/AG vs GG: OR = 1.54; AA vs GG/AG: OR = 1.43; AA vs GG: OR = 1.80; AG vs GG: OR = 1.35). Compared to the Caucasian population in America and Europe, the COX-2-1195G>A gene polymorphism in the Asian population(A vs G: OR = 1.30; AA/AG vs GG: OR= 1.50; AA vs GG/AG: OR = 1.35; AA vs GG: OR = 1.71; AG vs GG: OR = 1.37) significantly increased gastrointestinal cancer risk. The sensitivity analysis(P A gene polymorphism might be a potential risk factor for gastrointestinal cancers. Further validation by a large homogeneous study is warranted.

关键词： COX-2 -1195G>A Polymorphism Meta-analysis gastrointestinal cancer

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MicroRNA-320a suppresses tumor progression by targeting PBX3 in gastric cancer and is downregulated by DNA methylation

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World Journal of gastrointestinal Oncology 2019年第10期11卷 842-856页

作者： Yong-Shuang Li Ying Zou Dong-Qiu Dai Department of gastrointestinal Surgery the Fourth Affiliated Hospital of China Medical University

BACKGROUND Ectopic expression of miRNAs promotes tumor development and ***(miR)-320a is downregulated in many cancers,including gastric cancer(GC).However,the mechanism underlying its downregulation and the role of miR-320a in GC are *** To determine expression and biological functions of miR-320a in GC and investigate the underlying molecular *** Quantitative real-time polymerase chain reaction(PCR)was used to determine expression of miR-320a in GC cell lines and ***7.1,miRDB,and *** were used to predict the possible targets of miR-320a,and a dual luciferase assay was used to confirm the *** blotting was used to detect the protein levels of pre-B-cell leukemia homeobox 3(PBX3)in GC cells and tissue *** Counting Kit-8 proliferation,Transwell,wound healing,and apoptosis assays were performed to analyze the biological functions of miR-320a in GC ***-specific PCR was used to analyze the methylation level of the miR-320a promoter CpG islands.5-Aza-2’-deoxycytidine(5-Aza-CdR)and trichostatin A(TSA)were used to treat GC *** miR-320a expression was lower in GC cell lines and tissues than in the normal gastric mucosa cell line GES-1 and matched adjacent normal ***-320a overexpression suppressed GC cell proliferation,invasion and migration,and induced ***3 was a target of miR-320a in *** methylation level of the miR-320a promoter CpG islands was elevated and this was partly reversed by 5-Aza-CdR and *** miR-320a acts as a tumor suppressor and inhibits malignant behavior of GC cells,partly by targeting *** methylation is an important mechanism associated with low expression of miR-320a.

关键词： Gastric cancer miRNA-320a DNA methylation Pre-B-cell leukemia homeobox 3 Tumor suppressor

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Dopamine and cyclic adenosine monophosphate-regulated phosphoprotein with an apparent Mr of 32000 promotes colorectal cancer growth

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World Journal of gastrointestinal Oncology 2023年第11期15卷 1936-1950页

作者： Kuan He Chao-Zheng Xie Ya Li Zhen-Zhou Chen Shi-Hao Xu Si-Qi Huang Jian-Guo Yang Zheng-QiangWei Xu-Dong Peng gastrointestinal Surgery The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400000China gastrointestinal Surgery The Third Affiliated Hospital of Chongqing Medical UniversityChongqing 400000China

BACKGROUND Dopamine and cyclic adenosine monophosphate(cAMP)-regulated phosphop-rotein with an apparent Mr of 32000(DARPP-32)is a protein that is involved in regulating dopamine and cAMP signaling pathways in the ***,recent studies have shown that DARPP-32 is also expressed in other tissues,including colorectal cancer(CRC),where its function is not well *** To explore the effect of DARPP-32 on CRC *** The expression levels of DARPP-32 were assessed in CRC tissues using both quantitative polymerase chain reaction and immunohistochemistry *** proliferative capacity of CRC cell lines was evaluated with Cell Counting Kit-8 and 5-ethynyl-2’-deoxyuridine assays,while apoptosis was measured by flow *** migratory and invasive potential of CRC cell lines were deter-mined using wound healing and transwell chamber *** vivo studies involved monitoring the growth rate of xenograft ***,the underlying molecular mechanism of DARPP-32 was investigated through RNA-sequencing and western blot *** DARPP-32 was frequently upregulated in CRC and associated with abnormal clinicopathological features in *** of DARPP-32 was shown to promote cancer cell proliferation,migration,and invasion and reduce ***-32 knockdown resulted in the opposite functional ***,DARPP-32 may regulate the phosphoinositide 3-kinase(PI3K)/AKT signaling pathway in order to carry out its biological *** DARPP-32 promotes CRC progression via the PI3K/AKT signaling pathway.

关键词： Colorectal cancer Dopamine and cyclic adenosine monophosphate-regulated phosphoprotein with an apparent Mr of 32000 Proliferation Migration Phosphoinositide 3-kinase Akt

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Endoscopy vs surgery in the treatment of early gastric cancer:Systematic review

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World Journal of Gastroenterology 2015年第46期21卷 13177-13187页

作者： André Kondo Eduardo Guimaraes Hourneaux de Moura Wanderley Marques Bernardo Osmar Kenji Yagi Diogo Turiani Hourneaux de Moura Eduardo Turiani Hourneaux de Moura José Gon?alves Pereira Bravo Kendi Yamazaki Paulo Sakai gastrointestinal Endoscopy Division Department of GastroenterologyHospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo Guidelines program Coordinator Brazilian Medical Association (AMB) gastrointestinal Surgery Division Sao Paulo State Cancer Institute (ICESP)Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo

AIM: To report a systematic review,establishing the available data to an unpublished 2a strength of evidence,better handling clinical ***: A systematic review was performed using MEDLINE,EMBASE,Cochrane,LILACS,Scopus and CINAHL databases. Information of the selected studies was extracted on characteristics of trial participants,inclusion and exclusion criteria,interventions(mainly,mucosal resection and submucosal dissection vs surgical approach) and outcomes(adverse events,different survival rates,mortality,recurrence and complete resection rates). To ascertain the validity of eligible studies,the risk of bias was measured using the Newcastle-Ottawa Quality Assessment Scale. The analysis of the absolute risk of the outcomes was performed using the software Rev Man,by computingrisk differences(RD) of dichotomous variables. Data on RD and 95%CIs for each outcome were calculated using the Mantel-Haenszel test and inconsistency was qualified and reported in χ2 and the Higgins method(I2). Sensitivity analysis was performed when heterogeneity was higher than 50%,a subsequent assay was done and other findings were ***: Eleven retrospective cohort studies were selected. The included records involved 2654 patients with early gastric cancer that filled the absolute or expanded indications for endoscopic resection. Threeyear survival data were available for six studies(n = 1197). There were no risk differences(RD) after endoscopic and surgical treatment(RD = 0.01,95%CI:-0.02-0.05,P = 0.51). Five-year survival data(n = 2310) showed no difference between the two groups(RD = 0.01,95%CI:-0.01-0.03,P = 0.46). Recurrence data were analized in five studies(1331 patients) and there was no difference between the approaches(RD = 0.01,95%CI:-0.00-0.02,P = 0.09). Adverse event data were identified in eight studies(n = 2439). A significant difference was detected(RD =-0.08,95%CI:-0.10--0.05,P < 0.05),demonstrating better results with endoscopy. Mortality data were

关键词： Gastric cancer Endoscopy Gastroscopy Gastrectomy Surgery Systematic review

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Colonoscopy plays an important role in detecting colorectal neoplasms in patients with gastric neoplasms

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World Journal of gastrointestinal Oncology 2024年第1期16卷 133-143页

作者： Xu-Rui Liu Ze-Lin Wen Fei Liu Zi-Wei Li Xiao-Yu Liu Wei Zhang Dong Peng Department of gastrointestinal Surgery The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China Department of gastrointestinal Surgery Yongchuan Hospital of Chongqing Medical UniversityChongqing 402160China

BACKGROUND Gastric cancer(GC)and colorectal cancer(CRC)are the fifth and third most common cancer worldwide,***,GC is reported to have a potential predictive value for CRC,especially for advanced *** To evaluate the necessity of colonoscopy for gastric neoplasm(GN)*** Four databases,including PubMed,EMBASE,the Cochrane Library,and Ovid,were used to perform the search strategy on May 2,*** prevalence of colorectal neoplasms(CRN)and baseline characteristics were compared between the neoplasm group and the control *** variables are expressed as the mean difference and standard *** of categorical variables in the two groups are expressed as odds ratios(OR)and 95%confidence intervals(95%CIs).Subgroup analysis according to different kinds of GNs was conducted for more in-depth *** results of this study are represented by forest *** bias was evaluated by a funnel *** data analyses were performed by STATA SE 16.0 *** A total of 3018 patients with GNs and 3905 healthy controls(age and sex matched)were enrolled for *** comparing the prevalence of CRNs between the two groups,CRNs were detected significantly more frequently in GN patients than in controls(OR=1.69,95%CI=1.28 to 2.23,I^(2)=85.12%,P=0.00),especially in patients with GC(OR=1.80,95%CI=1.49 to 2.18,I^(2)=25.55%,P<0.1).Moreover,other risk factors including age(OR=1.08,95%CI=1.00 to 1.17,I^(2)=90.13%,P=0.00)and male sex(OR=2.31,95%CI=1.26 to 4.22,I^(2)=87.35%,P=0.00),were related to the prevalence of *** patients in the GN group,body mass index(BMI,OR=0.88,95%CI=0.80 to 0.98,I^(2)=0.00%,P=0.92)and smoking(OR=1.03,95%CI=1.01 to 1.05,I^(2)=0.00%,P=0.57)were protective and risk factors for CRNs,*** Patients are recommended to undergo colonoscopy when diagnosed with GNs,especially GC patients with a low BMI and a history of smoking.

关键词： Gastric neoplasm Gastric cancer Colorectal neoplasm Colonoscopy

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Gut Bacterial and Lactobacilli Communities of Weaning Piglets in Response to Mannan Oligosaccharide and Sugar Beet Pulp In vitro Fermentation

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Journal of Integrative Agriculture 2012年第1期11卷 122-133页

作者： HANG Su-qin ZHU Wei-yun Laboratory of gastrointestinal Microbiology Nanjing Agricultural UniversityNanjing 210095P.R.China

Microbiota in the gastrointestinal tract （GIT） of piglets during weaning transition can experience a sharp change which could result in growth reduction and diarrhea of weaned piglets. Dietary manipulations can play an important role in attenuating such changes caused by weaning stress. Therefore, ileal and colonic contents of weaned piglets were used as inocula, mannan oligosaccharide （MOS） or sugar beet pulp （SBP） was supplied as single energy sources to investigate effects of MOS or SBP on the shifts of gastro-intestinal microflora and lactobacilli populations. The universal bacteria- and lactobacilli-specific PCR/denaturing gradient gel electrophoresis （DGGE）, cloning and sequencing techniques were used. DGGE profiles of the universal bacteria showed that great changes were found in the position, numbers and intensity of dominant bands after fermentation. The similarity of bacterial community between ileum and colon was increased to 85-97% by MOS or SBP treatment after fermentation from the similarity with 20% before fermentation. MOS treatment significantly increased the bacterial diversity and band number in both ileal and colonic fermentation （P〈0.05）. SBP treatment significantly increased the bacterial diversity and band number in colon （P〈0.05）. It implies that some species were enriched by the addition of MOS or SBP to increase the similarity and diversity of bacterial community in weaned piglets. Five specific bands appearing in MOS or SBP treatment group after fermentation were cloned and sequenced, the changes of species related to Prevotella and Ruminococcus were observed. Two bands related to uncultured bacterium with 98% similarity were detected by MOS or SBP treatment. However, there were no effects on the similarity, diversity index and lactobacilli species revealed by MOS or SBP treatment. These results imply that MOS or SBP could have beneficial effects on the weaning piglets by stablizing microbiota in the GIT microflora.

关键词： mannan oligosaccharide (MOS) sugar beet pulp (SBP) bacterial communities lactobacilli weaning piglets

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prognostic significance of pretreatment serum carcinoembryonic antigen levels in gastric cancer with pathological lymph node-negative: A large sample singlecenter retrospective study

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World Journal of Gastroenterology 2017年第48期23卷 8562-8569页

作者： Jun Xiao Zai-Sheng Ye Sheng-Hong Wei Yi Zeng Zhen-Meng Lin Yi Wang Wen-Hao Teng Lu-Chuan Chen Department of gastrointestinal Surgery Fujian Cancer Hospital and Fujian Medical University Cancer Hospital

AIM To assess whether elevated serum carcinoembryonic antigen(CEA) is in the inferior prognosis for pathological lymph node-negative(p N_0) gastric cancer(GC) patients who underwent D_2 *** About 469 p N0 GC patients,who received D^2 radical gastrectomy were retrospectively analyzed. The X-tile plots cut-off point for CEA were 30.02 ng/m L using minimum P-value from log-rank χ~2 statistics,and p N_0 GC patients were assigned to two groups: those more than 30.02 ng/m L(n = 48;CEA-high group) and those less than 30.02 ng/m L(n = 421;CEA-low group). Clinicopathologic characteristics were compared usingPearson's χ2 or Fisher's exact tests,and survival curves were so manufactured using the Kaplan-Meier method. Univariate and multivariate analysis were carried out using the logistic regression *** The percentage of vessel carcinoma embolus(31.35% vs 17.1%) and advanced GC(T_(2-4b))(81.25% vs 65.32%) were higher in CEA-high group than CEA-low group. The CEA-positive patients had a significantly poorer prognosis than the CEA-nagetive patients in terms of overall survival(57.74% vs 90.69%,P 0.05). Multivariate survival analysis showed that CEA(OR = 4.924),and T category(OR = 2.214) were significant prognostic factors for stage p N0 GC(all P < 0.05). Besides,only T category(OR = 1.962) was an independent hazard factor in the CEA-high group(P < 0.05).CONCLUSION Those pretreatment serum CEA levels over 30.02 ng/m L on behalf of worse characteristics and unfavourable tumor behavior,and a poor prognosis for a nearly doubled risk of mortality in GC patients.

关键词： Carcinoembryonic antigen Gastric cancer Pathological lymph node-negative X-tile plots 5-year survial rate

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