Colonic Adenomatous Polyps Research Articles

Astragaloside IV Ameliorates Colonic Adenomatous Polyps Development by Orchestrating Gut Bifidobacterium and Serum Metabolome.

Astragaloside IV (AS-IV), a natural triterpenoid isolated from Astragalus membranaceus, has been used traditionally in Chinese medicine. Previous studies have highlighted its benefits against carcinoma, but its interaction with the gut microbiota and effects on adenomatous polyps are not well understood. This present study investigates the effects of AS-IV on colonic adenomatous polyp (CAP) development in high-fat-diet (HFD) fed [Formula: see text] mice. [Formula: see text] mice were fed an HFD with or without AS-IV or Naringin for 8 weeks. The study assessed CAP proliferation and employed 16S DNA-sequencing and untargeted metabolomics to explore correlations between microbiome and metabolome in CAP development. AS-IV was more effective than Naringin in reducing CAP development, inhibiting colonic proinflammatory cytokines (IL-1β, IL-6, and TNF-α), tumor associated biomarkers (c-Myc, Cyclin D1), and Wnt/β-catenin pathway proteins (Wnt3a, β-catenin). AS-IV also inhibited the proliferative capabilities of human colon cancer cells (HT29, HCT116, and SW620). Multiomics analysis revealed AS-IV increased the abundance of beneficial genera such as Bifidobacterium pseudolongum and significantly modulated serum levels of certain metabolites including linoleate and 2-trans,6-trans-farnesal, which were significantly correlated with the number of CAP. Finally, the anti-adenoma efficacy of AS-IV alone was significantly suppressed post pseudoaseptic intervention in HFD-fed [Formula: see text] mice but could be reinstated following a combined with Bifidobacterium pseudolongum transplant. AS-IV attenuates CAP development in HFD-fed [Formula: see text] mice by regulating gut microbiota and metabolomics, impacting the Wnt3a/β-catenin signaling pathway. This suggests a potential new strategy for the prevention of colorectal cancer, emphasizing the role of gut microbiota in AS-IV's antitumor effects.

Helicobacter pylori infection is associated with the development of sporadic colorectal carcinoma and colorectal adenomatous polyps

Helicobacter pylori (H. pylori) infection is a well-established carcinogen that has been extensively studied in the context of gastric diseases. Recent studies suggested a potential association between H. pylori and the risk of colorectal carcinoma (CRC). However, available data remains insufficient to definitively establish a causal relationship between H. pylori infection and the development of CRC and its precursor lesions. In our study, we reviewed all patients diagnosed with CRC in 2020 at our institution. H. pylori assessment was performed in all 92 CRC specimens by immunohistochemistry. Notably, two of the three patients detected with H. pylori infection are under the age of 50. Subsequently, we reviewed a total of 52 patients under the age of 50 diagnosed with CRC at our institution from 2015 to 2022. Among these patients, H. pylori infection was detected in 7 CRC specimens (13.46 %). All seven patients had adenocarcinoma on the left side of the colon. In exploring the link between H. pylori infection and the risk of developing CRC precursor lesions, we analyzed 242 patients who underwent colonoscopy guided polypectomy and also had stomach biopsies from 2015 to 2022. Of these patients, 21 were proved to be positive for H. pylori infection in the stomach, while the remaining 221 were negative. Among the H. pylori-positive group, 76.19 % (16 patients) exhibited adenomatous polyps, compared to 33.48 % (74 patients) in the H. pylori-negative patients (p=0.0001). However, no H. pylori was detected in any colonic adenomatous polyps. Our findings contribute additional evidence supporting the association between H. pylori infection and the development of sporadic CRC, probably a particular association with early-onset ones. Furthermore, gastric H. pylori infection appears to be linked to the higher prevalence of colonic adenomatous polyps, suggesting that individuals with gastric H. pylori infection may benefit from closer and earlier monitoring through colonoscopy.

Abstract 5276: Immunomodulatory activity of intermittent low-dose erlotinib plus sulindac: Implications for hereditary and sporadic colorectal cancer

Abstract A once-weekly optimized dosing regimen of erlotinib (ERL) in the polyposis in rat colon (Pirc) model [1] was a reliable predictor of antitumor efficacy in familial adenomatous polyposis (FAP) patients [2]. Pirc rats are increasingly used as a translational tool for FAP studies. Based on transcriptomic data from FAP patients receiving ERL plus sulindac (SUL) vs. placebo [3], we determined the timing of changes in interferon-γ signaling in Pirc adenomas, while performing additional dose titration. In rats that were given ERL administered at 5 mg per kilogram of body weight through oral gavage (two times a week) and that received a diet containing 125 parts per million of SUL, a regimen referred to as SUL125+ERL5x2, significant suppression of tumor growth was observed. This combination represented half of the standard of care SUL dose and about one-quarter of the ERL dose in FAP patients. In adenomas collected after one year of treatment from SUL125+ERL5x2 treated rats, the expression of genes related to the major histocompatibility complex (MHC) class I (β2m, Cnx, Psmb8 and Tap1) and MHC class II (RT1-A2, Cd74, RT-1Bb, Cd74, and Ciita) was increased, compared to vehicle controls, excluding a subset of adenomas that remained resistant. Through the use of multiplex mass cytometry (CyTOF), an increase in tumor-infiltrating CD4+ T cells was observed in adenomas from the SUL125+ERL5x2 treatment group. Administration of single or combined agents increased CD68+ cells and reduced the presence of Foxp3+ and Arg1+ cells in Pirc adenomas. The natural history of adenomatous colon polyps indicated an increase in MHC gene expression as tumors increased in size; however, this trend reversed markedly in fully occluding lesions. Additionally, expression of MHC-related factors increased in Pirc colon adenoma and murine colon carcinoma cells treated with ERL±SUL, resulting in enhanced CD8+ T-cell activation and IL-2 secretion. In conclusion, treatment with intermittent low doses of ERL±SUL increased MHC gene expression and induced changes in the immune cell component in the tumor microenvironment of Pirc rat adenomas. A subset of non-responsive adenomas could benefit from additional immunopreventive approaches, with implications for possible clinical applications in both hereditary and sporadic colorectal cancer.

An effective colorectal polyp classification for histopathological images based on supervised contrastive learning

Early detection of colon adenomatous polyps is pivotal in reducing colon cancer risk. In this context, accurately distinguishing between adenomatous polyp subtypes, especially tubular and tubulovillous, from hyperplastic variants is crucial. This study introduces a cutting-edge computer-aided diagnosis system optimized for this task. Our system employs advanced Supervised Contrastive learning to ensure precise classification of colon histopathology images. Significantly, we have integrated the Big Transfer model, which has gained prominence for its exemplary adaptability to visual tasks in medical imaging. Our novel approach discerns between in-class and out-of-class images, thereby elevating its discriminatory power for polyp subtypes. We validated our system using two datasets: a specially curated one and the publicly accessible UniToPatho dataset. The results reveal that our model markedly surpasses traditional deep convolutional neural networks, registering classification accuracies of 87.1% and 70.3% for the custom and UniToPatho datasets, respectively. Such results emphasize the transformative potential of our model in polyp classification endeavors.

Comparative Study on Handheld, Modular, and Laboratory Raman Instruments for the Analysis of Colon Tissues and Colorectal Polyps

Portable Raman spectrometers may offer advantages for clinical medical diagnostics over laboratory instruments by allowing for quick measurements in the field and provision of data suitable for screening analyses. This work evaluates the potential of using available handheld, modular, and laboratory Raman spectrometers for screening normal colon tissues and benign and malignant colon polyps. The Raman spectra of tissue samples and reference biological macromolecules were measured with these instruments and analyzed using curve fitting and multivariate statistics. The spectra of calf thymus DNA measured with portable devices showed suitable signal-to-noise levels and half-widths of the prominent bands. Band positions, resolution, and relative intensities in the Raman spectra of colon tissues and reference compounds varied for the instruments, and the laboratory device demonstrated the best spectral feature. The principal component analysis (PCA) of the spectra obtained with all Raman devices showed well discrimination of normal colon tissue, adenomatous polyp, and adenocarcinoma. Dendrograms of similarity obtained using hierarchy cluster analysis (HCA) for the Raman spectra of all three devices also showed good separation of these samples. The soft independent modeling of class analogy (SIMCA) and support vector machine (SVM) models efficiently classified normal colon tissues and benign/malignant colorectal polyps based on the Raman data from all three devices. Despite its less pronounced spectral characteristics, the handheld Raman spectrometer can be used in early diagnosis of colorectal carcinoma, comparable to the modular and laboratory instruments.

A novel tool for case selection in endoscopic mucosal resection training.

As endoscopic mucosal resection (EMR) of large (≥ 20 mm) adenomatous nonpedunculated colonic polyps (LNPCPs) becomes widely practiced outside expert centers, appropriate training is necessary to avoid failed resection and inappropriate surgical referral. No EMR-specific tool guides case selection for endoscopists learning EMR. This study aimed to develop an EMR case selection score (EMR-CSS) to identify potentially challenging lesions for "EMR-naïve" endoscopists developing competency. Consecutive EMRs were recruited from a single center over 130 months. Lesion characteristics, intraprocedural data, and adverse events were recorded. Challenging lesions with intraprocedural bleeding (IPB), intraprocedural perforation (IPP), or unsuccessful resection were identified and predictive variables identified. Significant variables were used to form a numerical score and receiver operating characteristic curves were used to generate cutoff values. Of 1993 LNPCPs, 286 (14.4 %) were in challenging locations (anorectal junction, ileocecal valve, or appendiceal orifice), 368 (18.5 %) procedures were complicated by IPB and 77 (3.9 %) by IPP; 110 (5.5 %) procedures were unsuccessful. The composite end point of IPB, IPP, or unsuccessful EMR was present in 526 cases (26.4 %). Lesion size, challenging location, and sessile morphology were predictive of the composite outcome. A six-point score was generated with a cutoff value of 2 demonstrating 81 % sensitivity across the training and validation cohorts. The EMR-CSS is a novel case selection tool for conventional EMR training, which identifies a subset of adenomatous LNPCPs that can be successfully and safely attempted in early EMR training.

Evaluation of the Impact of Some Single-Nucleotide Gene Polymorphisms on the Development of Adenomatous Polyps of the Colon in Patients with Irritable Bowel Syndrome.

The number of cases of irritable bowel syndrome is growing worldwide, in which adenomatous polyps can develop as a result of microinflammation of the colonic epithelium. Our study was aimed at the identification of the possible effect of single-nucleotide polymorphisms on the risk of the development of irritable bowel syndrome-related colonic adenomatous polyps. The study involved 187 irritable bowel syndrome patients. The single-nucleotide polymorphisms were investigated by the polymerase chain reaction method and DNA was extracted with the phenol-chloroform: interleukin-1β gene-31C/T (rs1143627), -511C/T (rs16944); interleukin-6 gene-174G/C (rs1800795); interleukin-10 gene-592C/A (rs1800872), -819T/C (rs1800871), -1082A/G (rs1800896); Toll-like receptor-2 gene Arg753Gln (rs5743708); Toll-like receptor-4 gene Thr399ile (rs4986791), Asp299Gly (rs4986790); and metalloproteinase-9 gene-8202A/G (rs11697325). The study of polymorphic loci was checked for compliance with the Hardy- Weinberg equilibrium using Fisher's exact test along with the analyses of the frequency of alleles and the genotypes. The association of diseases with G allele Toll-like receptor-2 gene Arg753Gln (rs5743708) was revealed in irritable bowel syndrome patients with adenomatous polyps of the colon (P < .0006) and AG single-nucleotide polymorphisms s of Toll-like receptor-2 gene (χ2 = 12.78, P < .002); A allele had a protective effect. The AG genotype metalloproteinase-9 gene-8202A/G (rs11697325) polymorphism in irritable bowel syndrome patients with adenomatous polyps of the colon had a protective effect (P < .05). AA genotype interleukin-10 gene-1082A/G (rs1800896) polymorphism in the irritable bowel syndrome patient (χ2 = 33.97, 4.0E-8) can be considered as the risk for adenomatous polyps of the colon in irritable bowel syndrome. G allele Toll-like receptor-2 gene Arg753Gln (rs5743708) and AA genotype interleukin-10 gene-1082A/G (rs1800896) polymorphisms can be the marker of the emergence of adenomatous polyps of the colon concomitant with irritable bowel syndrome.

Офтальмологические проявления семейного аденоматозного полипоза толстой кишки

Purpose. To describe a rare clinical case of bilateral ophthalmic manifestations of familial adenomatous polyposis of the colon. Material and methods. A multimodal imaging complex was carried out, which included the following methods: photo registration on the fundus camera Visucam 500 (Zeiss, Germany) and pediatric retinal camera RetCam 3 (Clarity, USA). Results. Familial adenomatous polyposis (FAP) is a hereditary disease of the colon characterized by adenomatous colon polyps, which in 100% of cases malignize into adenocarcinoma without proper early management. There are some forms of FAP with the eye fundus signs, which can serve as a signal to suspect and diagnose this disease. We report a case of fundus pigment spots in siblings whose mother was diagnosed with genetically confirmed FAP. Conclusions. The presence of randomly scattered pigmented neoplasms in the fundus, shaped like a comet, may be a sign of FAP. All patients at risk with a family history of adenocarcinoma of the large intestine should undergo an ophthalmological examination as a screening diagnostic method. Key words: familial adenomatous polyposis, adenocarcinoma of the colon, fundus pigment spots

Bleeding After Endoscopic Resection of Colonic Adenomatous Polyps Sized 4-10 mm.

Introduction: Colonoscopy with polypectomy is an efficacious procedure in reducing the risk of colorectal cancer development, the precursor are adenomatous polyps. The most common method for resection of polyps measuring 4-10 mm are cold (CSP) and hot snare polypectomy (HSP). CSP has a lower incidence of adverse events, especially delayed post-polypectomy bleeding. Aim: To evaluate the presence of immediate and delayed bleeding in the cold snare polypectomy of sub-centimeter polyps of the colon compared with hot snare polypectomy. Materials and Methods: This prospective clinical study is comprised all patients who were incidentally detected to have adenomatous colonic polyps measuring 4-10 mm during a colonoscopy screening. Polypectomy was done with (hot snare) or without electrocautery (cold snare). After removal of polyps, immediate bleeding, delayed bleeding, and methods for were analyzed. Results: The CSP and HSP groups included 116 patients, 113 (54.4%) polyps in 61 (52.6%) patients with CSP while 95 (45.6%) polyps in 55 (47.4%) patients with HSP. 25 (22.1%) polyps after CSP had immediate bleeding. In 5 patients (20.0%), five hemostatic clips were inserted after CSP for bleeding longer than 150 sek. The average percentage difference between immediate bleeding versus total number of resected polyps using the cold snare method is not statistically significant (p<0.05) (Difference test, p=0.0000). Delayed bleeding was not registered using this method. In the second investigated group (HSP), one patient had delayed bleeding. This was stopped with 2 clips. Immediate bleeding was not registered. Conclusion: CSP is safer than HSP in resecting colon polyps sized 4-10 mm, without risk of delayed bleeding.

Volatile Organic Compounds Determination from Intestinal Polyps and in Exhaled Breath by Gas Chromatography–Mass Spectrometry

In this paper, a new protocol is described, based on solid phase microextraction (SPME) coupled with gas chromatography–mass spectrometry (GC-MS), to monitor ex vivo changes in endogenous volatile organic compounds (VOCs) released by surgically resected colonic tissues (normal colonic mucosa and adenomatous polyps) from seven patients undergoing operative colonoscopy to identify their molecular pattern. The exhalated volatile organic molecules from these patients were sampled by the ReCIVA® breath sampler, shortly before surgery, and analyzed by GC-MS. Comparing VOC patterns identified in the tissues and in the breath of the same patients, a possible correlation can be found between the levels of methylbenzene and benzaldehyde exhaled and the presence of colonic adenomatous polypoid lesions.

From adenoma to CRC stages: the oral-gut microbiome axis as a source of potential microbial and metabolic biomarkers of malignancy

BackgroundApproximately 95% of Colorectal cancers (CRC) consist of adenocarcinomas originating from colonic Adenomatous polyps (AP). Increasing importance in CRC occurrence and progression has been attributed to the gut microbiota; however, a huge proportion of microorganisms inhabit the human digestive system. So, to comprehensively study the microbial spatial variations and their role in CRC progression, from AP to the different CRC phases, a holistic vision is imperative, including the simultaneous evaluation of multiple niches from the gastrointestinal system. Through an integrated approach, we identified potential microbial and metabolic biomarkers, able to discriminate human CRC from AP and/or also the different Tumor node metastasis (TNM) staging. In addition, as the microbiota contributes to the production of essential metabolic products detectable in fecal samples, we analysed and compared metabolites obtained from CRC and AP patients by using a Nuclear magnetic resonance (NMR) approach. MethodsIn this observational study, saliva, tissue and stool samples from 61 patients, have been collected, including 46 CRC and 15 AP patients, age and sex-matched, undergoing surgery in 2018 at the Careggi University Hospital (Florence, Italy). First, the microbiota in the three-district between CRC and AP patients has been characterized, as well as in different CRC TNM stages. Subsequently, proton NMR spectroscopy has been used in combination with multivariate and univariate statistical approaches, to define the fecal metabolic profile of a restricted group of CRC and AP patients. ResultsCRC patients display a different profile of tissue and fecal microbiota with respect to AP patients. Significant differences have been observed in CRC tissue microbial clades, with a rise of the Fusobacterium genus. In addition, significant taxa increase at the genus level has been observed in stool samples of CRC patients. Furthermore, Fusobacterium found in intestinal tissue has been positively correlated with fecal Parvimonas, for the first time. Moreover, as predicted by metagenomics pathway analysis, a significant increase of lactate (p=0.037) has been observed in the CRC fecal metabolic profiles, and positively correlated with Bifidobacterium (p=0.036). Finally, minor bacterial differences in CRC patients at stage T2 (TNM classification) have been detected, with a raise of the Spirochaetota phylum in CRC samples, with a slight increase of the Alphaproteobacteria class in fecal samples. ConclusionOur results suggest the importance of microbiota communities and oncometabolites in CRC development. Further studies on CRC/AP management with a focus on CRC assessment are needed to investigate novel microbial-related diagnostic tools aimed to improve therapeutic interventions.

Proteomic Profiling of Colorectal Adenomas Identifies a Predictive Risk Signature for Development of Metachronous Advanced Colorectal Neoplasia

Colonic adenomatous polyps, or adenomas, are frequent precancerous lesions and the origin of most cases of colorectal adenocarcinoma. However, we know from epidemiologic studies that although most colorectal cancers (CRCs) originate from adenomas, only a small fraction of adenomas (3%-5%) ever progress to cancer. At present, there are no molecular markers to guide follow-up surveillance programs. We profiled, by mass spectrometry-based proteomics combined with machine learning analysis, a selected cohort of formalin-fixed, paraffin-embedded high-grade (HG) adenomas with long clinical follow-up, collected as part of the Danish national screening program. We grouped subjects in the cohort according to their subsequent history of findings: a nonmetachronous advanced neoplasia group (G0), with no new HG adenomas or CRCs up to 10 years after polypectomy, and a metachronous advanced neoplasia group (G1) where individuals developed a new HG adenoma or CRC within 5 years of diagnosis. We generated a proteome dataset from 98 selected HG adenoma samples, including 20 technical replicates, of which 45 samples belonged to the nonmetachronous advanced neoplasia group and 53 to the metachronous advanced neoplasia group. The clear distinction of these 2 groups seen in a uniform manifold approximation and projection plot indicated that the information contained within the abundance of the ∼5000 proteins was sufficient to predict the future occurrence of HG adenomas or development of CRC. We performed an in-depth analysis of quantitative proteomic data from 98 resected adenoma samples using various novel algorithms and statistical packages and found that their proteome can predict development of metachronous advanced lesions and progression several years in advance.

Subcellular Epithelial HMGB1 Expression Is Associated with Colorectal Neoplastic Progression, Male Sex, Mismatch Repair Protein Expression, Lymph Node Positivity, and an 'Immune Cold' Phenotype Associated with Poor Survival.

New treatment targets are needed for colorectal cancer (CRC). We define expression of High Mobility Group Box 1 (HMGB1) protein throughout colorectal neoplastic progression and examine the biological consequences of aberrant expression. HMGB1 is a ubiquitously expressed nuclear protein that shuttles to the cytoplasm under cellular stress. HMGB1 impacts cellular responses, acting as a cytokine when secreted. A total of 846 human tissue samples were retrieved; 6242 immunohistochemically stained sections were reviewed. Subcellular epithelial HMGB1 expression was assessed in a CRC Tissue Microarray (n = 650), normal colonic epithelium (n = 75), adenomatous polyps (n = 52), and CRC polyps (CaP, n = 69). Stromal lymphocyte phenotype was assessed in the CRC microarray and a subgroup of CaP. Normal colonic epithelium has strong nuclear and absent cytoplasmic HMGB1. With progression to CRC, there is an emergence of strong cytoplasmic HMGB1 (p < 0.001), pronounced at the leading cancer edge within CaP (p < 0.001), and reduction in nuclear HMGB1 (p < 0.001). In CRC, absent nuclear HMGB1 is associated with mismatch repair proteins (p = 0.001). Stronger cytoplasmic HMGB1 is associated with lymph node positivity (p < 0.001) and male sex (p = 0.009). Stronger nuclear (p = 0.011) and cytoplasmic (p = 0.002) HMGB1 is associated with greater CD4+ T-cell density, stronger nuclear HMGB1 is associated with greater FOXP3+ (p < 0.001) and ICOS+ (p = 0.018) lymphocyte density, and stronger nuclear HMGB1 is associated with reduced CD8+ T-cell density (p = 0.022). HMGB1 does not directly impact survival but is associated with an 'immune cold' tumour microenvironment which is associated with poor survival (p < 0.001). HMGB1 may represent a new treatment target for CRC.

Improved classification of colorectal polyps on histopathological images with ensemble learning and stain normalization

Background and Objective: Early detection of colon adenomatous polyps is critically important because correct detection of it significantly reduces the potential of developing colon cancers in the future. The key challenge in the detection of adenomatous polyps is differentiating it from its visually similar counterpart, non-adenomatous tissues. Currently, it solely depends on the experience of the pathologist. To assist the pathologists, the objective of this work is to provide a novel non-knowledge-based Clinical Decision Support System (CDSS) for improved detection of adenomatous polyps on colon histopathology images.Methods: The domain shift problem arises when the train and test data are coming from different distributions of diverse settings and unequal color levels. This problem, which can be tackled by stain normalization techniques, restricts the machine learning models to attain higher classification accuracies. In this work, the proposed method integrates stain normalization techniques with ensemble of competitively accurate, scalable and robust variants of CNNs, ConvNexts. The improvement is empirically analyzed for five widely employed stain normalization techniques. The classification performance of the proposed method is evaluated on three datasets comprising more than 10k colon histopathology images.Results: The comprehensive experiments demonstrate that the proposed method outperforms the state-of-the-art deep convolutional neural network based models by attaining 95% classification accuracy on the curated dataset, and 91.1% and 90% on EBHI and UniToPatho public datasets, respectively.Conclusions: These results show that the proposed method can accurately classify colon adenomatous polyps on histopathology images. It retains remarkable performance scores even for different datasets coming from different distributions. This indicates that the model has a notable generalization ability.

Characteristics of adenomatous colorectal polyps among a Saudi population

ObjectivesColorectal cancer is a common cause of cancer-related mortality in KSA with a rising incidence. Although adenomatous polyps are well-recognized as precursors of colorectal cancer, local data are scarce. Therefore, in this study, we aimed to evaluate the characteristics of adenomatous colon polyps in the Saudi population. MethodsWe retrospectively reviewed the electronic databases of all patients who underwent colonoscopy for any indication between January 2015 and December 2019 at a tertiary care hospital. This study included adult patients who were found to have colorectal polyps with identified histopathology reports. We collected clinical and pathological data, including patient age, sex, and histopathological polyp characteristics. A p-value <0.05 was considered significant for descriptive and analytical statistics. ResultsA total of 184 patients with colorectal polyps with identified histopathology reports were included in the analysis. Of these, 130 (70.6%) patients were aged 50 years or older, and 135 (73.3%) were male. Among all polyps, 127 (69%) were adenomatous, 31 (16.8%) were hyperplastic, and 24 (13%) were inflammatory. For adenomatous polyps, 31 (24.4%) were observed in patients younger than 50 years, and high-grade dysplasia was observed in 23 (18%) polyps. Among patients with adenomatous polyps, the anatomical location was as follows: 27 (23%) in the cecum/ascending colon, 12 (9%) in the transverse colon, 45 (35%) in the descending/sigmoid colon, 25 (19%) in the rectum, and 18 (14%) at multiple sites. Age >50 years was significantly associated with adenomatous polyps (P = 0.03). ConclusionApproximately one-third of adenomatous polyps were detected proximal to the splenic flexure. Although adenomatous polyps were significantly associated with increasing age, 24% were observed in patients younger than 50 years of age. This finding supports the current recommendation to start screening at the age of 45.

The relationship between colon polyps and colonic diverticulosis: a retrospective review.

Colonic diverticulosis and colon polyps are common findings on colonoscopy. There is currently no consensus regarding a possible connection between the development of polyps and diverticulosis. Multiple research studies have sought to analyze whether the presence of both conditions is associated with the development of colorectal cancer. Our study aims to add to this body of data and to better assess the relationship between diverticulosis and colon polyps. A retrospective chart review was performed of all patients who underwent screening and diagnostic colonoscopies between January 2011 and December 2020. Data collection included patient demographics; number, pathology, and location of colon polyps; incidence of colon cancer; and presence and location of colonic diverticulosis. Our study demonstrated that the overall presence of diverticulosis in any location increases the likelihood of having nearby colon polyps, regardless of subtype. The presence of left colonic diverticulosis was particularly associated with adjacent adenomatous and non-adenomatous colon polyps. Colonic diverticulosis in any location may lead to an increased incidence of adenomatous colon polyps. It is important to perform careful examination of the mucosa surrounding colon diverticulosis to avoid missing colon polyps.

Diagnostic Value of Inflammation-Related Indicators in Distinguishing Early Colon Cancer and Adenomatous Polyps.

There are few clinical symptoms in early colorectal cancer, so it is necessary to find a simple and economical tumor detection index for auxiliary diagnosis. This study aims to explore the diagnostic value of preoperative inflammation-related indicators, such as neutrophil, lymphocyte, platelet count, platelet to lymphocyte ratio (PLA), neutrophil to lymphocyte ratio (NLR), and systemic immune-inflammation index (SII), for early colorectal cancer, and determine whether inflammation-related indicators can provide more accurate diagnostic judgment for patients. This study was a retrospective study. Patients who were first diagnosed with colorectal cancer or colorectal adenomatous polyp at Beijing Friendship Hospital from October 2016 to October 2017 were retrospectively collected. According to inclusion and exclusion criteria, a total of 342 patients were included, including 216 patients with colorectal cancer and 126 patients with colorectal adenomatous polyp. Fasting venous blood and other clinical features were collected to compare the differences between colorectal cancer and colorectal adenoma. There were statistically significant differences in age, carcinoembryonic antigen, albumin, hemoglobin, mean platelet volume, lymphocyte, monocyte, NLR, PLA, SII, and mean platelet volume to platelet count ratio between colorectal cancer group and colorectal adenoma group (P < .05), and a Nomogram model was established. Using inflammatory markers to differentiate colorectal and colorectal polyps produced greater AUC than using tumor markers alone (.846 vs .695). Inflammation-related indicators, such as lymphocyte, monocyte, and mean platelet volume, may serve as potential indicators to assist in the diagnosis of early colorectal cancer.

Association between diverticular disease and prevalence of colorectal adenomatous polyps or adenocarcinomas

Background/Aim: Although the link between diverticular disease (DD) of the colon and colon polyp is known, the relationship between colon adenocarcinoma is not clear. This study evaluated the association between DD and adenomatous polyp or colon adenocarcinoma. Methods: Patients who underwent colonoscopy for the first time in 2020-2021 were evaluated and included in this retrospective cohort study. Patients with a previous history of cancer diagnosis, colon surgery, DD, and inflammatory bowel disease were excluded from the study. Age, gender, colonoscopy indications, colonoscopy diagnoses, presence of DD, characteristics of polyps (pathology, diameter, number, localization), and presence of adenocarcinoma were recorded. Obtained data were analyzed between DD and non-DD groups. Results: A total of 2633 patients were included in the study. The prevalence of DD was 16.4%. Colon adenocarcinoma was detected in 4.7%. The adenomatous polyp rate was 14.1%. A significantly higher rate of adenomatous polyps was detected in the DD group compared to the non-DD group (19.7% vs. 12.9%; P = 0.001). Higher rates of high-grade dysplasia (3.0 vs. 1.1%; P = 0.002) and colon adenocarcinoma (7.2% vs. 4.2%; P = 0.008) were observed in the DD group also. In logistic regression analyses, it was observed that the presence of concomitant DD increases the risk of adenomatous polyps (OR: 1.469, 95% CI: 1.158–1.865), the risk of adenomatous polyps with positive villous component (OR: 2.378, 95% CI: 1.437–3.934), the risk of adenomatous polyps with high-grade dysplasia (OR: 2.822, 95% CI: 1.426–5.582), and the risk of colon adenocarcinoma (OR: 2.953, 95% CI: 1.445–6.533). Conclusion: DD is associated with precancerous lesions of the colon (adenomatous polyp, villous adenoma, high-grade dysplasia) and colon adenocarcinoma. Further studies are needed to investigate its association with colon carcinogenesis and its role and value in cancer screening.

Comparison of nice classification for optical diagnosis of colorectal polyps and morphology of removed lesions depending on localisation in colon

Abstract The narrow-band imaging (NBI) International Colorectal Endoscopic (NICE) classification is based on narrow-band pictures of colon polyps viewed through a narrow-band spectrum. The categorisation utilises staining, surface structure, and vascular patterns to differentiate between hyperplastic and adenomatous colon polyps. It is known that accuracy of the NICE classification for colorectal polyps varies depending on the localisation in the colon.The aim of this study was to compare the diagnostic accuracy of the NICE classification and the gold standard — morphological analysis for the determination of the type of colorectal lesions depending on localisation in colon. A prospective study was performed in an outpatient clinic. 1214 colonoscopies were performed by two expert endoscopists and 475 polyps were found in 291 patients. The overall diagnostic accuracy of the NICE classification was 80.3%. Optical verification was better in ascending colon — 93.9%, followed by sigmoid colon — 82.1%. Inferior results were found for the descending colon — 64.0%. The results of this study showed that the NICE classification could be a helpful instrument in daily practice for the ascending and sigmoid colon. For better results, proper training should be considered. The NICE system could have a role in the replacement of morphological analysis if appropriate results of verification could be achieved.

S81 Comparison of Clinical Characteristics Between Young IBD and Non-IBD Patients With Adenomatous Colon Polyps

S81 Comparison of Clinical Characteristics Between Young IBD and Non-IBD Patients With Adenomatous Colon Polyps