Clinical and Translational Gastroenterology最新文献

{"title":"Noninvasive Assessment of Vascular Endothelial Growth Factor and Prognosis in Gastric Cancer Through Radiomic Features.","authors":"Hao Feng, Kangneng Zhou, Qingyu Yuan, Zhiwei Liu, Taojun Zhang, Hao Chen, Benjamin Xu, Zepang Sun, Zhen Han, Hao Liu, Shitong Yu, Tao Chen, Guoxin Li, Wenlan Zhou, Jiang Yu, Weicai Huang, Yuming Jiang","doi":"10.14309/ctg.0000000000000802","DOIUrl":"10.14309/ctg.0000000000000802","url":null,"abstract":"<p><strong>Introduction: </strong>Gastric cancer (GC) is a leading cause of cancer-related deaths worldwide, with delayed diagnosis often limiting effective treatment options. This study introduces a novel, noninvasive radiomics-based approach using [18F] FDG PET/CT (fluorodeoxyglucose positron emission tomography/computed tomography) to predict vascular endothelial growth factor (VEGF) status and survival in patients with GC. The ability to noninvasively assess these parameters can significantly influence therapeutic decisions and outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective study involving patients diagnosed with GC, stratified into training, validation, and test groups. Each patient underwent a [18F] FDG PET/CT scan, and radiomic features were extracted using dedicated software. A Radiomics Score (RS) was calculated, serving as a predictor for VEGF status. Statistical analyses included logistic regression and Cox proportional hazards models to evaluate the predictive power of RS on survival outcomes.</p><p><strong>Results: </strong>The developed radiomics model demonstrated high predictive accuracy, with the RS formula achieving an area under the receiver operating characteristic curve of 0.861 in the training cohort and 0.857 in the validation cohort for predicting VEGF status. The model also identified RS as an independent prognostic factor for survival, where higher RS values correlated with poorer survival rates.</p><p><strong>Discussion: </strong>The findings underscore the potential of [18F] FDG PET/CT radiomics in transforming the management of GC by providing a noninvasive means to assess tumor aggressiveness and prognosis through VEGF status. This model could facilitate earlier and more tailored therapeutic interventions, potentially improving survival outcomes in a disease marked by typically late diagnosis and limited treatment success.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthy Lifestyle and Metabolic Dysfunction-Associated Steatotic Liver Disease: A Study of the Efficacy of Fatty Liver Regression.","authors":"Jingwei Wang, Jinli Zhao, Yueyuan Zhong, Chengyue He, Fen Hu","doi":"10.14309/ctg.0000000000000806","DOIUrl":"10.14309/ctg.0000000000000806","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity is the primary cause of metabolic dysfunction-associated steatotic liver disease (MASLD). Healthy lifestyle management has potential value in the treatment of MASLD.</p><p><strong>Methods: </strong>A total of 150 patients with MASLD diagnosed at the Health Management Center of our hospital were enrolled and randomly divided into a traditional treatment (control group, n = 75) and a healthy lifestyle group (observation group, n = 75). All patients underwent a 3-month intervention. Data on general information, body composition, glucose metabolism, lipid metabolism, and inflammatory factors were analyzed.</p><p><strong>Results: </strong>The difference in the change in fatty liver grade was statistically significant ( P < 0.05). There were statistically significant differences in treatment efficiency for physical conditions ( P < 0.05), including body fat mass, body mass index, body weight, waist circumference, and waist-to-hip ratio. In addition, there were statistically significant differences in treatment efficiency for scales such as the Diet Rating Scale, Emotional Stress Scale, and Global Physical Activity Questionnaire ( P < 0.05). Differences in treatment efficiency for body fat parameters, including percentage of body fat, visceral fat area, aspartate aminotransferase, and diastolic blood pressure, were also statistically significant ( P < 0.05). After treatment, statistically significant differences were observed in interferon-γ, insulin, low-density lipoprotein cholesterol, triglycerides, and tumor necrosis factor-α ( P < 0.05).</p><p><strong>Discussion: </strong>Our study indicates that a healthy lifestyle can effectively promote the reduction of fatty liver grade in patients with MASLD, demonstrating positive effects in improving lipid metabolism and inflammatory responses in these patients.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asymptomatic Inflammatory Bowel Disease Diagnosed During Colorectal Cancer Population Screening in Catalonia: Characteristics and Natural History.","authors":"Eduard Brunet-Mas, Anna Selva, Francesc Bas-Cutrina, Anna Brujats, Berta Caballol, Rebeca Font, Bàrbara Gómez, Carlos Gonzalez-Muñosa, David Busquets, David Monfort, Diana Patrícia Vera, Elisabet Maristany, Gemma Cirera, Gisela Torres, Jesús Castro-Poceiro, Joel Lopez, Laura Gonzalez-Gonzalez, Lucia Màrquez-Mosquera, Marta Gallach, Maria Esteve, Gemma Tremosa, Sandra Torra, Virginia Robles-Alonso, Pilar Garcia-Iglesias, Iago Rodríguez-Lago, Xavier Calvet","doi":"10.14309/ctg.0000000000000740","DOIUrl":"10.14309/ctg.0000000000000740","url":null,"abstract":"<p><strong>Introduction: </strong>Inflammatory bowel disease (IBD) is usually diagnosed when symptomatic. Prognosis and evolution of preclinical IBD is largely unknown. However, colorectal cancer screening programs (CRCSP) detect a subset of patients with IBD with no symptoms. The aim of this study was to describe the natural history of asymptomatic IBD diagnosed through CRCSP.</p><p><strong>Methods: </strong>An observational, longitudinal, and retrospective study was performed at 22 centers in Catalonia between January 2010 and December 2019 including patients with asymptomatic IBD detected in the CRCSP. Demographic data and IBD characteristics, evolution, and treatment were recorded. Descriptive statistics and Kaplan-Meier analysis were used for the analysis. Data were given separately for IBD, Crohn's disease (CD), ulcerative colitis (UC), and IBD unclassified (IBDU).</p><p><strong>Results: </strong>One hundred eighty-eight patients were included: 103 UC (54.8%), 60 CD (31.9%), and 25 IBDU (13.3%). Sixty-six (35.1%) were women, and the average age was 59.9 ± 5.9 years. Sixty-four patients (34.0%) developed symptoms after a median follow-up of 35.6 months. Diarrhea was the most frequent symptom for CD and IBDU (25.4% and 11.5%, respectively) and blood in stools for UC (21.4%). The median time to first symptom was 11.6 months. Treatment was prescribed in 135 patients (72.2%); mesalazine was the most prescribed drug (123 patients; 65.4%). Thirteen patients (6.9%) required biological treatment. None underwent surgery.</p><p><strong>Discussion: </strong>Around one-third of asymptomatic patients with IBD developed symptoms after a medium follow-up of 3 years. Only 6.9% required biological treatment, and none required surgery. Overall, prognosis of asymptomatic IBD seems better.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher rates of delay in starting advanced inflammatory bowel disease therapies linked to insurance delays, intravenous infusions, and lack of pharmacy support.","authors":"Sara Gottesman, Karen Xiao, Hang P Nguyen, Elizabeth Hernandez, Emily Saweris, Priyanka Jaganathan, Faraz Jafri, Jonathan Davis, Kimhouy Tong, Zhouwen Tang, Jill K J Gaidos, Linda A Feagins","doi":"10.14309/ctg.0000000000000808","DOIUrl":"https://doi.org/10.14309/ctg.0000000000000808","url":null,"abstract":"<p><strong>Background: </strong>Because biologic and small molecule therapy is expensive, payors have mandated pre-authorizations for these medications, often resulting in a lengthy approval process. The aims of this study are to assess the frequency of and risk factors for delays in starting advanced therapies assessing insurance, care team, and patient-related factors.</p><p><strong>Methods: </strong>Retrospective, multi-center study of adult inflammatory bowel disease patients with prescriptions for an advanced therapy in two geographically distinct academic gastroenterology practices; one with and the other without a dedicated pharmacist. A priori we defined a delay in starting therapy as >14 days between prescription and first dose. Logistic regression analysis was performed to assess for risk factors for delay.</p><p><strong>Results: </strong>A total of 388 patients were prescribed advanced therapies with 46.6% receiving their first dose within 14 days. Patients who were on time vs delayed were similar in baseline demographics, disease characteristics, and disease activity. After adjusting for confounders, three independent risk factors remained significant as predictors for delay; study site (OR=5.2, 95% CI 2.894, 9.333), intravenous drug delivery as opposed to subcutaneous or oral (OR=3.07, 95% CI 1.845, 5.099), and insurance denial (OR=2.72, 95% CI 1.082, 6.825).</p><p><strong>Conclusions: </strong>In a multicenter study, we found that a delay between prescription and administration of first dose of an advanced therapy is common, with >50% of patients having the first dose delayed by >2 weeks. Delays in starting therapy were significantly more likely if denied by insurance, given via IV induction, or at a study site without a dedicated pharmacist.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Associations Between Life's Essential 8 and Diarrhea and Constipation: Results from the 2005-2010 NHANES.","authors":"Xin Yang, Shengjie Ding, Jinlu Guo, Shuang Peng, Zhiqing Duan, Shi Liu","doi":"10.14309/ctg.0000000000000801","DOIUrl":"https://doi.org/10.14309/ctg.0000000000000801","url":null,"abstract":"<p><strong>Background and aims: </strong>Few studies have investigated the association between Life's Essential 8 (LE8) and abnormal bowel health. We aimed to investigate the relationship between LE8 and diarrhea and constipation in the adult population of the United States.</p><p><strong>Methods: </strong>This cross-sectional study, based on population data, utilized information from the National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and 2010. Diarrhea and constipation were classified based on Bristol Stool Form Scale and stool frequency. LE8 score is composed of four health behaviors (diet, physical activity, nicotine exposure, and sleep health) and four health factors (body mass index, blood lipids, blood glucose, and blood pressure) and is classified into low (0-49), moderate (50-79), and high (80-100) cardiovascular health (CVH) groups. Weighted logistic regression and restricted cubic splines were employed to analyze the relationship between the LE8 score and abnormal bowel health.</p><p><strong>Results: </strong>The study comprised 12,369 subjects aged 20 years or older, among whom 1,279 (9.7%) had constipation and 1,097 (7.6%) had diarrhea. After adjusting for potential confounders, we observed negative associations between LE8 scores and diarrhea (OR: 0.60, 95% CI: 0.39-0.93), whereas the association between LE8 scores and constipation was not statistically significant (OR: 0.82, 95% CI: 0.59-1.13). Additionally, health behavior scores and health factor scores are associated with constipation.</p><p><strong>Conclusions: </strong>Higher LE8 levels are associated with a lower incidence of diarrhea, but not constipation.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary Approach Improves Eradication Rate and Safety in Refractory Helicobacter pylori Infection.","authors":"Na Dai, Yu-Qin Zhao, Wen-Juan Wu, Zheng-Lin Shen, Yan-Hua Xu, Xiao-Yang Wu, Gui-Zhen Zhang, Lan Wang, Qing-Hua Wang","doi":"10.14309/ctg.0000000000000804","DOIUrl":"10.14309/ctg.0000000000000804","url":null,"abstract":"<p><strong>Introduction: </strong>Helicobacter pylori (HP) infection is prevalent worldwide and contributes to various gastrointestinal diseases. Eradication therapy is crucial in managing HP infection, but antibiotic resistance has led to refractory cases, complicating treatment outcomes and increasing the risk of adverse events. This study aimed to evaluate the effectiveness of a multidisciplinary approach, termed HP Multidisciplinary Team (MDT) Clinic, in improving eradication rates and safety in patients with refractory HP infection.</p><p><strong>Methods: </strong>Between November 2020 and November 2023, 153 patients with refractory HP infection were included, with 51 patients in the non-HP-MDT group and 102 patients in the HP-MDT group. The HP-MDT clinic provided personalized treatment plans, patient education, and follow-up. Genetic testing was conducted in selected cases to assess resistance patterns.</p><p><strong>Results: </strong>Patients attending the HP-MDT clinic showed significantly higher eradication rates compared with those in the non-HP-MDT group (80.39% vs 50.98%, P < 0.001). Logistic regression analysis confirmed that HP-MDT clinic attendance was independently associated with higher eradication rates (odds ratio: 4.43, 95% CI: 2.02 to 9.71, P < 0.001). Genetic testing revealed high rates of antibiotic resistance, particularly to clarithromycin (10/11, 90.91%) and metronidazole (11/11, 100%). Despite resistance, the HP-MDT approach achieved a high eradication rate of 92.31%. Adverse drug reactions occurred in 12.75% of patients in the HP-MDT group, predominantly mild gastrointestinal symptoms.</p><p><strong>Discussion: </strong>The HP-MDT clinic, integrating medical, pharmaceutical, and nursing expertise, significantly improved eradication rates and safety in patients with refractory HP infection. Personalized treatment plans, patient education, and genetic testing contributed to successful outcomes with minimal adverse events.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of the Second Forward View on the Detection Rate of Sessile Serrated Lesions in the Proximal Colon: A Single-Center Prospective Randomized Controlled Study.","authors":"Jiandi Wu, Qingqing Zhang, Xueyan Li, Tao Bai, Xiaohua Hou, Gangping Li, Jun Song","doi":"10.14309/ctg.0000000000000805","DOIUrl":"10.14309/ctg.0000000000000805","url":null,"abstract":"<p><strong>Introduction: </strong>The detection rate of proximal sessile serrated lesion (PSSLDR) is linked to the incidence and mortality of colorectal cancer. However, research on second forward view (SFV) examinations for PSSLDR remains limited. This first randomized controlled trial assessed the impact of the proximal SFV on the PSSLDR.</p><p><strong>Methods: </strong>Patients were randomized into 2 groups during proximal colonoscopy: standard colonoscopy (SC) and SFV. The SC group underwent a standard examination, whereas the SFV group underwent a second examination of the proximal colon (cecum to splenic flexure). The primary outcome was PSSLDR, with secondary outcomes, including the proximal polyp detection rate (PPDR), proximal adenoma detection rate (PADR), and lesion miss rate, compared between the 2 groups.</p><p><strong>Results: </strong>Among 246 patients (SC = 124; SFV = 122), SFV significantly improved the PSSLDR by 7.4% compared with SC (9.8% vs 2.4%, P = 0.017). SFV increased the PPDR by 20.2% (55.7% vs 35.5%, P = 0.002) and PADR by 12.7% (37.7% vs 25%, P = 0.039). Multivariate analysis revealed that sessile serrated lesions (odds ratio [OR] = 7.70, 95% confidence interval [CI] [1.58, 37.59]), inflammatory polyps (OR = 4.24, 95% CI [1.73, 10.39]), and lesion size (OR = 0.76, 95% CI [0.60, 0.96]) were associated with proximal missed lesions. The overall polyp miss rate was 52.9%, with miss rates of 61.0% for polyps <5 mm, 80% for sessile serrated lesions, and 42.2% for adenomas. Furthermore, 12.3% of patients experienced changes in surveillance intervals from SFV examination.</p><p><strong>Discussion: </strong>SFV examination of the proximal colon significantly improved the PSSLDR by 7.4%, PPDR by 20.2%, and PADR by 12.7%, while shortening the detection interval by 12.3%, making it a valuable and cost-effective addition to routine colonoscopy.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptom Burden After Acute Pancreatitis and Its Correlation With Exocrine Pancreatic Function: A Multicenter Prospective Study.","authors":"Joseph Bejjani, Stacey Culp, Melica Nikahd, Anna Evans Phillips, Vikesh Singh, Kristen M Roberts, Maisam Abu-El-Haija, Somashekar G Krishna, Mitchell L Ramsey, Ali Lahooti, Peter J Lee, Phil A Hart, Georgios I Papachristou","doi":"10.14309/ctg.0000000000000799","DOIUrl":"10.14309/ctg.0000000000000799","url":null,"abstract":"<p><strong>Introduction: </strong>Gastrointestinal (GI) symptoms and weight loss develop during and after acute pancreatitis (AP), but remain understudied. In this prospective, multicenter study, we aim to assess GI symptom burden and weight loss and their correlation with exocrine function up to 12 months post-AP.</p><p><strong>Methods: </strong>GI symptom burden, anthropometrics, and exocrine pancreatic function were systematically measured in adults (≥18 years) with AP at predefined intervals: hospitalization (enrollment), 3 months, and 12 months post-AP. Symptoms were evaluated using a 15-item tracker, including abdominal symptoms, stool characteristics, and activities of daily living, higher scores indicating greater symptom burden (range 0-45). Exocrine function was assessed with fecal elastase-1 (FE-1) levels.</p><p><strong>Results: </strong>GI symptoms were collected in 97 participants with 12-month follow-up. The median (interquartile range) GI-symptom score was 7 (3-12) with 55 participants (57%) experiencing at least one symptom frequently (often or almost always). In multivariable linear regression, younger age, lower Charlson Comorbidity Index, smoking, recurrent AP, and alcoholic or idiopathic etiologies were associated with significantly higher GI-symptom burden at 12 months. A significant negative correlation was found between GI symptoms and FE-1 levels during hospitalization ( ρ = -0.288; P = 0.015) and at 12 months ( ρ = -0.219; P = 0.046). Eighteen participants (18.6%) lost ≥10% body weight between hospitalization and 12 months, and had significantly lower median FE-1 levels at 12 months compared with the group without weight loss (166 vs 332 µg/g, P = 0.016).</p><p><strong>Discussion: </strong>This is the first study to prospectively assess GI-symptom burden and exocrine function post-AP. Lower exocrine pancreatic function at 12 months was associated with increased symptom burden and weight loss. These findings support further investigations to define and improve patient-reported outcomes post-AP. This study is registered with ClinicalTrials.gov , NCT03063398.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Levels of Evidence Supporting Recommendations in Gastroenterology.","authors":"Miyabi Saito, Amy Yu, Nneka N Ufere, Andrew Chan, Bharati Kochar","doi":"10.14309/ctg.0000000000000797","DOIUrl":"10.14309/ctg.0000000000000797","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to analyze gastrointestinal guidelines to assess the quality of evidence and strength of recommendation.</p><p><strong>Methods: </strong>We abstracted clinical practice guidelines and guidance statements from 4 American gastroenterology societies (American College of Gastroenterology, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy, and American Association for the Study of Liver Disease) and the US Multi-Society Task Force.</p><p><strong>Results: </strong>Of the 3,609 statements analyzed, only 13% were supported by high level of evidence. The number of statements published annually is increasing, but the level of evidence supporting recommendations is declining over time.</p><p><strong>Discussion: </strong>This analysis highlights the need for high quality research in gastroenterology to support the development of stronger evidence-based guideline statements.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics, Management, and Outcomes of Colitis-Associated Colorectal Cancer and the Comparison With Sporadic Colorectal Cancer in Taiwan.","authors":"Hsin-Yun Wu, Meng-Tzu Weng, Jen-Wei Chou, Hsu-Heng Yen, Chun-Chi Lin, Feng-Fan Chiang, Chen-Shuan Chung, Wei-Chen Lin, Chen-Wang Chang, Puo-Hsien Le, Chia-Jung Kuo, Ching-Pin Lin, Wen-Hung Hsu, Chiao-Hsiung Chuang, Tzung-Jiun Tsai, I-Che Feng, Shu-Chen Wei, Tien-Yu Huang","doi":"10.14309/ctg.0000000000000798","DOIUrl":"10.14309/ctg.0000000000000798","url":null,"abstract":"<p><strong>Introduction: </strong>We explored the clinical characteristics, treatment, and outcomes of colitis-associated colorectal cancer (CAC) and compared with sporadic colorectal cancer in Taiwan.</p><p><strong>Methods: </strong>In this retrospective study spanning 1987-2022, CACs diagnosed according to endoscopic and pathological reports from 14 tertiary centers were reported to our cohort. Clinical demographics, endoscopic findings, histological results, treatment modalities, and outcomes were analyzed. Sporadic colorectal cancer data were retrieved from the Cancer Registry Annual Report, Ministry of Health and Welfare, Taiwan.</p><p><strong>Results: </strong>We enrolled 65 patients with CAC (median age: 56 years; male: 66.2%). Distal colon was the most common tumor location (41.5%). Of patients with ulcerative colitis, 77.2% had extensive colitis, and 76.5% had Mayo endoscopic subscores of ≥2. Moreover, 50% of lesions were nonpolypoid with indistinct borders in 66.7%. Signet-ring cell subtype consisted of 12.3%. Surveillance colonoscopy adherence was 78.4%, yet 51.3% interval cancers occurred. Disease stage 0-4 distribution was 15%, 20%, 13.3%, 20%, and 31.7%, respectively. Endoscopic resection was feasible for 14%, whereas 67.7% required surgery. During follow-up (median: 21.5 months), we recorded 23.2% recurrence and 34.5% mortality. Lesions with indistinct borders were associated with adverse outcomes (adjusted odds ratio = 11.5 [1.35-98.16]). Colitis-associated rectal cancers, diagnosed later ( P < 0.001), had worse outcomes than sporadic rectal cancers.</p><p><strong>Discussion: </strong>This is the largest Asian CAC cohort study, emphasizing the need for stringent disease control, improving detection, and reducing interval cancers. Signet-ring cell subtype was prevalent. Rectal colitis-associated cancers were diagnosed later with poorer outcomes than sporadic rectal cancers.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}