Digestion最新文献

{"title":"Annual Trends in the Diagnosis of Autoimmune Gastritis over 11 Years at a Single Facility in Japan.","authors":"Kaoru Nakano, Toshiaki Hirasawa, Ayaka Takasu, Yuka Higashi, Souya Nunobe, Masayuki Shimoda, Kengo Takeuchi, Hiroshi Kawachi","doi":"10.1159/000544812","DOIUrl":"10.1159/000544812","url":null,"abstract":"<p><strong>Introduction: </strong>Autoimmune gastritis (AIG), a type of chronic atrophic gastritis, is characterized by positive anti-parietal cell antibodies and mucosal atrophy predominantly in the corpus. In Japan, AIG has garnered increasing attention owing to the recent decline in Helicobacter pylori (HP) infection rates, leading to the proposal of diagnostic criteria. These criteria encompass serological test results, endoscopic findings, and histological findings, emphasizing the need for collaboration between endoscopists and pathologists to make an accurate diagnosis. In the present study, we aimed to clarify the annual number of patients with AIG diagnosed over the past 11 years and analyze their endoscopic and histological characteristics.</p><p><strong>Methods: </strong>We retrospectively reviewed patients with AIG newly diagnosed at our institution between 2013 and 2023. Patients were categorized into the \"prior endoscopically diagnosed group\" (ED group) and the \"prior pathologically diagnosed group\" (PD group). The annual trend in AIG diagnosis was analyzed, and clinicopathological characteristics were compared between the groups.</p><p><strong>Results: </strong>In total, 118 patients were diagnosed with AIG during the study period. The number of diagnoses increased after 2018, when a focused effort to identify AIG began, peaking in 2021 with 32 cases. All patients diagnosed before 2018 belonged to the ED group, but subsequent years saw increases in both groups of patients. The PD group had significantly more cases of coexisting gastric carcinoma (86.3% vs. 26.9%, p < 0.001) or HP-associated gastritis (72.4% vs. 32.8%, p = 0.002) than the ED group, whereas the ED group frequently exhibited typical endoscopic findings, such as atrophic gastritis predominantly in the corpus and adherent mucus.</p><p><strong>Conclusion: </strong>Accurate diagnosis of AIG requires familiarity with the diagnostic criteria by endoscopists and pathologists. In cases complicated by gastric carcinoma or HP-associated gastritis, endoscopic findings alone may not suffice for diagnosis, underscoring the critical role of pathologists in interpreting histological findings.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"395-405"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585036","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":"Dynamic Observation of Colonic Lesions, Commensal Microbiome, and Mycobiome Variations in Trinitrobenzene Sulfonic Acid-Induced Experimental Crohn's Disease in Rats.","authors":"Jingui Li, Mingjiang Liu, Huiwen Wang, Junjie Huang, Yuying Huai, Chenglong Yu, Guoqing Fang, Minxia Zhang, Ruonan Bo, Kai Fan, Jingui Li","doi":"10.1159/000543337","DOIUrl":"10.1159/000543337","url":null,"abstract":"<p><strong>Introduction: </strong>Crohn's disease (CD) is an inflammatory bowel disease characterized by chronic inflammation of the entire digestive lining. Although the pathogenesis of CD remains unclear, multiple factors, especially altered microbiota, are among its causes.</p><p><strong>Methods: </strong>In this study, an experimental CD model was established by trinitrobenzene sulfonic acid (TNBS) enema. Then the dynamic changes of colonic tissue lesions, tight junctions, inflammation response, and oxidative stress are respectively tested by hematoxylin and eosin staining, immunofluorescence staining, and commercial kits. 16S rRNA and ITS sequencing of colonic feces were applied to analyze the composition and diversity of the microbiome and mycobiome for lasting 5 weeks.</p><p><strong>Results: </strong>As a result, despite TNBS being applied only once time, the stimuli-caused injury reached a peak in the second week (the most severe period), after which symptoms began to gradually return to the normal stage. Additionally, consistent with the TNBS-caused colonic damage, deaths were also concentrated within 2 weeks after modeling, with only one death occurring in the subsequent period despite ongoing inflammation and other typical symptoms. In terms of gut bacteria, microbiome diversity decreased significantly while mycobiome diversity increased, along with the enrichment of harmful microbiota and shrinkage of probiotic microorganisms.</p><p><strong>Conclusion: </strong>Therefore, the data suggested that TNBS-induced CD can be roughly divided into two phases: the acute inflammatory phase (weeks 1-2) and the chronic inflammatory phase (weeks 3-5). However, the microbiome and mycobiome dysbiosis did not return to normal within the trial period. Hence, our findings may facilitate a better comprehension of the dynamic progress of experimental TNBS-induced CD.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"365-379"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398660","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 Efficacy and Safety of Treatments for Exocrine Pancreatic Insufficiency: A Systematic Literature Review.","authors":"Paula Chu, Jasmina Mioc, Peter O'Donovan, Owen Henry","doi":"10.1159/000541326","DOIUrl":"10.1159/000541326","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Exocrine pancreatic insufficiency (EPI) is caused by multiple clinical conditions such as cystic fibrosis and chronic pancreatitis (CP). Standard management of EPI includes pancreatic enzyme replacement therapy (PERT) along with consultation with a dietitian. While PERTs have been on the market for several decades, newer publications on their clinical efficacy and safety raised the need for a comprehensive review of the literature. We aimed to identify the available evidence on the clinical efficacy and safety of treatments for EPI to understand the current treatment landscape and unmet need in patients with EPI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic literature review (SLR) was conducted in Embase, Medline, and Evidence-Based Medicine databases from 2010 to 2022; conference proceedings from 2020 to 2022 were also searched. Articles were screened independently by two reviewers at abstract and full-text stage against predefined eligibility criteria.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We identified 26 journal publications and two conference abstracts, reporting on 22 randomized control trials, four observational studies, and two single-arm interventional studies. The most reported treatment was pancrelipase, specifically Creon® (n = 12). Fourteen studies reported coefficient of fat absorption (CFA) results. Across studies, patients experienced a considerable increase in CFA post-initiation of treatment regardless of intervention or timepoint. Mean change in CFA ranged from 7.5% in patients with CP who received placebo to 36% in patients with CP treated with Creon®. Ten studies reported coefficient of nitrogen absorption (CNA). Where reported, pancrelipase (including Creon®) increased CNA levels in EPI patients compared to placebo. Only one study compared PERT brands head-to-head: no significant differences were reported in the CNA-72 h values (Creon® 82.0% [SE: 1.2] vs. Zenpep® 80.9% [SE: 1.2]). Loss of body weight and low body mass index (BMI) are important features of EPI. Overall, treatment with PERT increased BMI and body weight, or limited their decline, with increases ranging from 0.1 to 6.1 kg. Based on the 18 studies that reported safety outcomes, PERT was considered safe and well tolerated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This SLR confirmed that PERT is an effective and tolerable treatment option for patients with EPI. However, nutritional parameters and health-related quality of life data were sparsely reported, and future clinical trials should look to incorporate these data given their importance in clinical practice and patient outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Exocrine pancreatic insufficiency (EPI) is caused by multiple clinical conditions such as cystic fibrosis and chronic pancreatitis (CP). Standard management of EPI includes pancreatic enzyme replacement therapy (PERT) along with consultation with a dietitian. While PERTs have been on the market for several decades, newer publ","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"45-61"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening Colonoscopy to Reduce the Incidence and Mortality of Colorectal Cancer.","authors":"Naoya Tada, Naoto Tamai, Kazuki Sumiyama","doi":"10.1159/000542113","DOIUrl":"10.1159/000542113","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is a major concern because of its increasing incidence and mortality worldwide. Therefore, effective screening strategies are necessary to reduce its incidence.</p><p><strong>Summary: </strong>In addition to fecal immunochemical tests and computed tomography colonography, screening colonoscopy is expected to significantly contribute to the reduction of CRC. However, the timing of colonoscopy for CRC screening is not well-defined because of the lack of sufficient data. Additionally, the effectiveness of colonoscopy is affected by various factors known as quality indicators (QIs), such as the performance of the endoscopist; therefore, there are concerns regarding quality assurance. The adenoma detection rate (ADR) is a well-known QI of colonoscopy. Substantial evidence has suggested that improving the ADR could reduce the incidence and mortality of postcolonoscopy CRC.</p><p><strong>Key messages: </strong>Recent technological advancements have led to the development of image-enhanced endoscopy and the incorporation of artificial intelligence, and their ability to improve the ADR has been assessed. This review focused on screening colonoscopies and QIs and their ability to improve the ADR and incidence and mortality of CRC.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"100-106"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497009","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":"Surveillance and Endoscopic Resection of Ulcerative Colitis-Associated Neoplasia: A Japanese Perspective.","authors":"Yu Hashimoto, Syota Tomaru, Yuki Itoi, Keigo Sato, Hiroko Hosaka, Hirohito Tanaka, Shiko Kuribayashi, Yoji Takeuchi, Toshio Uraoka","doi":"10.1159/000543250","DOIUrl":"10.1159/000543250","url":null,"abstract":"<p><strong>Background: </strong>Patients with a long history of ulcerative colitis (UC) are at risk of developing a serious complication known as UC-associated neoplasia (UCAN). Because the treatment strategy for UCAN greatly differs from that for sporadic tumors, UCAN needs to be distinguished from sporadic tumors. This article provides an overview of the current status and future challenges regarding the surveillance colonoscopy (SC) and endoscopic submucosal dissection (ESD) of neoplastic lesions in patients with UC.</p><p><strong>Summary: </strong>To reduce the risk of associated mortality, the current guidelines recommend initiating SC using chromoendoscopy with high-definition colonoscopy 8-10 years after the confirmation of a UC diagnosis. However, the endoscopic diagnosis of UCAN is occasionally challenging and requires a stepwise approach using multiple endoscopic modalities. The worldwide consensus is that a diagnosis of high-grade dysplasia or higher is an indication for proctocolectomy. Although the management of low-grade dysplasia (LGD) remains controversial, the SCENIC consensus statement recommends the complete removal of \"endoscopically resectable\" LGD, followed by monitoring. ESD was developed in Japan, allows for the removal of complex gastrointestinal lesions, facilitates the treatment of LGD, and enables precise pathological evaluations to differentiate between UCAN and sporadic tumors and to determine the grade of dysplasia in UCAN. Close endoscopic surveillance should follow complete endoscopic resection. A Japanese expert consensus meeting recommended the performance of follow-up SC 6-12 months after complete resection with ESD.</p><p><strong>Key messages: </strong>The roles of ESD for UCAN are to treat LGD and to enable the histopathological examination of complete excisional biopsy specimens to differentiate between UCAN and sporadic tumors and grade the dysplasia of UCAN. In future, prospective cohort studies are needed to better assess the clinical outcomes of ESD in patients with UC.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"146-152"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406222","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":"KIF4A Facilitates Oxaliplatin Resistance and Stemness in Colon Cancer by Boosting Glucose Metabolism.","authors":"Jianping Wang, Cheng Cai, Xia Zhang, Chenyang Ge, Shicheng Zhou, Zhekang Jin, Kangfu Dai, Nannan Dai, Xingxing Yu, Jianping Wang","doi":"10.1159/000544914","DOIUrl":"10.1159/000544914","url":null,"abstract":"<p><strong>Introduction: </strong>Colon cancer (CC) is a malignant tumor commonly found in the intestines with high incidence and mortality rates. Oxaliplatin (OXA) is a platinum-based chemotherapy drug widely used to treat CC. However, frequent drug resistance in patients results in suboptimal treatment outcomes. Though kinesin family member 4A (KIF4A) has been reported to be upregulated in various cancers and linked with poor prognosis in patients, its regulatory mechanism in cellular metabolism remains unclear.</p><p><strong>Methods: </strong>The human CC/OXA-resistant cell line (HCT116-R) was constructed. CCK-8 assay was employed to calculate the half-maximal inhibitory concentration (IC₅₀) of CC cells. The level of cell stemness was assessed by cell sphere formation assay. The enrichment of KIF4A in signaling pathways of CC was analyzed through Gene Set Enrichment Analysis (GSEA). The bioinformatics analysis was applied to reveal the differential expression of KIF4A in CC and its correlation with genes related to stemness or glycolysis. The assessment of lactate in the supernatant was finished by utilizing the lactate detection kit. The oxidative phosphorylation and glycolysis levels in cells were measured by a Seahorse analyzer. The mRNA expression level of KIF4A was detected by quantitative real-time PCR. Furthermore, the Western blot (WB) was employed to determine the protein expression of glycolysis-related enzymes in cells. A mouse OXA-resistant CC xenograft tumor model was established, with changes in tumor volume and final weight recorded. TUNEL was utilized to detect the apoptosis level in tissues and immunohistochemistry to examine the distribution of KIF4A and ki-67 in tissues. The levels of stemness-related proteins in tissues were detected through WB.</p><p><strong>Results: </strong>KIF4A was upregulated in CC, exhibiting a positive association with OXA resistance. High expression of KIF4A promoted cancer cell survival and cancer stemness. In GSEA prediction, KIF4A in CC may be linked with the glycolysis pathway. Correspondingly, the expression of KIF4A in CC was positively correlated with the expression of glycolysis-related proteins. Tests for lactate content and glycolysis/oxidative phosphorylation levels revealed that knocking down KIF4A repressed glycolytic function in the drug-resistant strain but reinforced mitochondrial oxidative phosphorylation. Furthermore, KIF4A overexpression effectively boosted the OXA resistance and stemness of cells, which was reversed by glycolysis inhibitor. The mouse model validated the above results.</p><p><strong>Conclusion: </strong>KIF4A is significantly upregulated in CC to reinforce the glycolysis of cancer cells, thus facilitating cell stemness and resistance to OXA-based therapy.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"416-428"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729315","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":"Is the <italic>Helicobacter pylori</italic> Stool Antigen Test with the Bioluminescent Enzyme Immunoassay Affected by Proton Pump Inhibitors?","authors":"Chika Kusano, Chika Kusano, Koshiro Tsutsumi, Toshiki Horii, Sho Suzuki, Hirofumi Kiyokawa, Tadateru Maehata, Itsuko Hirayama, Shinya Minami, Tetsuya Sumiyoshi, Ryuji Nagahama","doi":"10.1159/000545347","DOIUrl":"10.1159/000545347","url":null,"abstract":"<p><p><p>Introduction: Proton pump inhibitors (PPIs) can lead to false-negative results in Helicobacter pylori stool antigen (HpSA) testing. A new bioluminescent enzyme immunoassay (BLEIA)-based HpSA test was introduced. This study aimed to evaluate the sensitivity of this test in patients on PPIs and compare its sensitivity with that of the enzyme immunoassay (EIA).</p><p><strong>Methods: </strong>We included patients without a history of H. pylori eradication who were diagnosed as H. pylori-positive via culture, microscopy, rapid urease tests, urea breath tests, serum H. pylori antibody tests, or HpSA tests. The sensitivity of HpSA detection was compared among patients based on their PPI intake using both BLEIA and conventional EIA.</p><p><strong>Results: </strong>Enrollment occurred from December 2020 to July 2022 across 10 facilities, with 109 patients enrolled in both the PPI and non-PPI groups. The sensitivity of BLEIA was 65.9% in the PPI group and 87.1% in the non-PPI group, showing a difference of -22.0% (95% CI: -11.0% to -32.9%) (p = 0.0003). For EIA, the sensitivity was 54.1% in the PPI group and 72.4% in the non-PPI group, with a difference of -18.3% (95% CI: -5.5% to -30.4%) (p = 0.0076). Significant differences in sensitivity were observed for both BLEIA and EIA between the PPI and non-PPI groups (p = 0.005 and p < 0.0001, respectively), with BLEIA demonstrating higher sensitivity.</p><p><strong>Conclusion: </strong>This study indicated that the sensitivity of HpSA detection using BLEIA decreased under PPI administration. Additionally, BLEIA may have higher sensitivity than EIA. </p>.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"429-436"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DYRK2 regulates epithelial-mesenchymal transition restriction in pancreatic cancer liver metastasis by inhibiting Twist.","authors":"Hang Pan, Yin Liu, Kejiu Bao, Yulin Wang, Yuping Zhang, Lina Zhou","doi":"10.1159/000541039","DOIUrl":"https://doi.org/10.1159/000541039","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the underlying variables and molecular pathways leading to pancreatic cancer liver metastasis.</p><p><strong>Methods: </strong>Hs766T and Hs766T-L3 cells were used to create in vitro and in vivo pancreatic cancer liver metastasis models. DYRK2 involvement in pancreatic cancer metastasis was investigated using cell adhesion assays, wound healing assays, and migration and invasion assays. To examine the link between DYRK2 expression and epithelial-mesenchymal transition, Western blot, quantitative real-time PCR, immunofluorescence assays, and immunoprecipitation (IP) were utilized. We found that mice with DYRK2 overexpression had a lower incidence of liver metastasis compared to controls.</p><p><strong>Results: </strong>DYRK2 expression decreased pancreatic cancer tumorigenic activities, including proliferation, migration, and invasion. By analyzing the expression levels of epithelial-mesenchymal transition markers and IP results after overexpressing DYRK2, we found that DYRK2 decreased Twist levels by increasing Twist ubiquitination, thereby inhibiting epithelial-mesenchymal transition.</p><p><strong>Conclusions: </strong>Our findings provide theoretical and experimental support for the ongoing development of DYRK2-based targeted therapies for pancreatic cancer liver metastases.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-18"},"PeriodicalIF":3.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675321","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":"Characteristics and Prognosis of Sporadic Neoplasias Detected in Patients with Ulcerative Colitis.","authors":"Noriko Yamamoto, Ken Yamashita, Yudai Takehara, Shin Morimoto, Fumiaki Tanino, Yuki Kamigaichi, Hidenori Tanaka, Koji Arihiro, Fumio Shimamoto, Shiro Oka","doi":"10.1159/000537756","DOIUrl":"10.1159/000537756","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with ulcerative colitis (UC) develop not only UC-associated neoplasias but also sporadic neoplasias (SNs). However, few studies have described the characteristics of SNs in patients with UC. Therefore, this study aimed to evaluate the clinical features and prognosis of SNs in patients with UC.</p><p><strong>Methods: </strong>A total of 141 SNs in 59 patients with UC, detected by surveillance colonoscopy at Hiroshima University Hospital between January 1999 and December 2021, were included. SNs were diagnosed based on their location, endoscopic features, and histopathologic findings along with immunohistochemical staining for Ki67 and p53.</p><p><strong>Results: </strong>Of the SNs, 91.5% were diagnosed as adenoma and 8.5% were diagnosed as carcinoma (Tis carcinoma, 3.5%; T1 carcinoma, 5.0%). 61.0% of the SNs were located in the right colon, 31.2% were located in the left colon, and 7.8% were located in the rectum. When classified based on the site of the lesion, 70.9% of SNs occurred outside and 29.1% within the affected area. Of all SNs included, 95.7% were endoscopically resected and 4.3% were surgically resected. Among the 59 patients included, synchronous SNs occurred in 23.7% and metachronous multiple SNs occurred in 40.7% during surveillance. The 5-year cumulative incidence of metachronous multiple SNs was higher in patients with synchronous multiple SNs (54.2%) than in those without synchronous multiple SNs (46.4%).</p><p><strong>Conclusion: </strong>Patients with UC with synchronous multiple SNs are at a higher risk of developing metachronous multiple SNs and may require a closer follow-up by total colonoscopy than patients without synchronous SNs.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"213-223"},"PeriodicalIF":3.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139989597","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":"Closing the Gap: A Critical Examination of Adherence, Inconsistency, and Improvements in Colonoscopy Reporting Practices.","authors":"Thomas J Lux, Katja Herold, Ioannis Kafetzis, Phillip Sodmann, Zita Sassmanshausen, Alexander Meining, Alexander Hann","doi":"10.1159/000538113","DOIUrl":"10.1159/000538113","url":null,"abstract":"<p><strong>Introduction: </strong>Comprehensive and standardized colonoscopy reports are crucial in colorectal cancer prevention, monitoring, and research. This study investigates adherence to national and international guidelines by analyzing reporting practices among 21 endoscopists in 7 German centers, with a focus on polyp reporting.</p><p><strong>Methods: </strong>We identified and assessed German, European, American, and World Health Organization-provided statements to identify key elements in colonoscopy reporting. Board-certified gastroenterologists rated the relevance of each element and estimated their reporting frequency. Adherence to the identified report elements was evaluated for 874 polyps from 351 colonoscopy reports ranging from March 2021 to March 2022.</p><p><strong>Results: </strong>We identified numerous recommendations for colonoscopy reporting. We categorized the reasoning behind those recommendations into clinical relevance, justification, and quality control and research. Although all elements were considered relevant by the surveyed gastroenterologists, discrepancies were observed in the evaluated reports. Particularly diminutive polyps or attributes which are rarely abnormal (e.g., surface integrity) respectively rarely performed (e.g., injection) were sparsely documented. Furthermore, the white light morphology of polyps was inconsistently documented using either the Paris classification or free text. In summary, the analysis of 874 reported polyps revealed heterogeneous adherence to the recommendations, with reporting frequencies ranging from 3% to 89%.</p><p><strong>Conclusion: </strong>The inhomogeneous report practices may result from implicit reporting practices and recommendations with varying clinical relevance. Future recommendations should clearly differentiate between clinical relevance and research and quality control or explanatory purposes. Additionally, the role of computer-assisted documentation should be further evaluated to increase report frequencies of non-pathological findings and diminutive polyps.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"224-231"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11151964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140119120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}