Benign Colorectal Tumors Research Articles

Clinical significance of peripheral blood UL16 and DR-70 for the early diagnosis and prognostic evaluation of colorectal cancer.

Early diagnosis of colorectal cancer (CRC) is of great significance to improve the survival rate and quality of life of patients, but early diagnosis of CRC requires more sensitive techniques. Peripheral blood UL16-binding protein 2 (ULBP2) and human fibrinogen degradation products (DR-70) are the main indicators for the diagnosis of malignant tumors. To assess ULBP2 and DR-70 potential for the early diagnosis and prognostic evaluation of CRC to provide a reference. This study involved 60 patients with early-stage CRC (CRC group), 50 patients with benign colorectal tumors (benign group), and 50 healthy patients (control group) enrolled at the Affiliated Hospital of Jiangnan University and Jiangsu Province Official Hospital between January, 2020 and January, 2022. ULBP2 and DR-70 levels in the blood were determined and differences among the three groups and early diagnostic values for CRC were determined. Patients with CRC were divided into the good prognosis and poor prognosis groups, and ULBP2 and DR-70 levels in the blood and diagnostic values were compared. ULBP2 and DR-70 serum levels were significantly higher in the CRC group than in the control and benign groups (P < 0.05); however, no significant differences were observed between the benign and control groups (P > 0.05). Among the 60 patients with CRC followed up for two years, two died (3.33%) and 15 exhibited tumor metastasis, progression, or recurrence (25.00%). ULBP2 and DR-70 serum levels were significantly higher in the poor prognosis group than in the good prognosis group (P < 0.05). A receiver operating characteristic curve was plotted. Area under the curve, sensitivity, and specificity of serum ULBP2 with DR-70 for the early diagnosis of CRC were higher than those of the single serum indices (P < 0.05) in both the good and poor prognosis groups. ULBP2 and DR-70 serum levels were significantly high in patients with early-stage CRC. They improved the diagnostic rate of early-stage CRC and predicted patient prognosis, thereby showing clinical application potential.

Understanding colorectal polyps to prevent colorectal cancer

Background: Colorectal cancer (CRC) is one of the leading causes of cancer-related mortality worldwide. Most CRCs arise through carcinogenesis pathways from precancerous lesions, such as adenoma and sessile serrated lesions (SSLs). Understanding the characteristics of such precancerous colorectal polyps and the carcinogenesis pathways helps to develop CRC preventive strategies via screening, colonoscopic polypectomy, and surveillance.Current Concepts: Benign colorectal tumors can be classified as conventional adenomatous and serrated polyps. Conventional adenoma is one of the most prevalent precancerous polyps detected on screening colonoscopy, but most are small. Small colorectal adenomas are less likely to contain advanced histology, such as villous features, high-grade dysplasia, or invasive cancer. A small adenoma may progress slowly over 10 years to become an invasive cancer via the chromosomal instability pathway. SSL is a recently established precancerous lesion and is estimated to account for approximately 15% of sporadic CRC. Most SSLs are not dysplastic and progress very slowly through the serrated carcinogenesis pathway. Conversely, SSL with dysplasia (SSLD) may progress more rapidly, as a mismatch repair gene product is defective. According to colonoscopy studies, SSLD comprises only 4% to 8% of SSLs, with a prevalence of 0.1% to 0.9%. Most precancerous lesions detected on colonoscopy progress slowly to CRC and are appropriate targets for colonoscopic polypectomy for the prevention of CRC.Discussion and Conclusion: Colorectal adenoma and SSL are representative precancerous lesions of CRC and most are slow progressing enough to be detected and removed via colonoscopy before CRC development.

Benign neoplasms of the colon: problems and solutions

Benign neoplasms of the colon, rectum, anus and anal canal are true neoplasia of the colon mucosa and are associated with a high risk of colorectal cancer (CC). The literature review analyzes epidemiology, risk factors, and modern methods of diagnosis and treatment, and describes priority minimally invasive interventions for benign colorectal tumors.

The ability of HALP score to distinguish between malignant and benign colorectal neoplasms and its prognostic importance in colorectal cancers

Systemic inflammation and nutritional status play important roles in the development and progression of various cancers, including colorectal cancer. The prognosis for malignancies can be predicted using the inflammatory marker known as HALP (calculated by hemoglobin, albumin, lymphocytes, and platelets). Furthermore, recent studies have claimed the HALP score to help distinguish between benign and malignant lesions. We aimed to research the diagnostic importance of the HALP score in the differentiation of malignant (colorectal cancer) and benign colorectal neoplasms (colorectal adenomas and hyperplastic polyps) and its prognostic significance in colorectal cancer patients. Patients diagnosed with colorectal cancer, colorectal adenoma, and hyperplastic polyps were evaluated retrospectively between January 2017 and January 2022. The median HALP score in the colorectal cancer group was significantly lower than the other groups (colorectal adenoma and hyperplastic polyps) (p&lt;0.001). There was no statistical difference between the median HALP scores of the colorectal adenoma and hyperplastic groups (p=0.525). ROC analysis found the cut-off value of the HALP score as 41.01 to differentiate colorectal cancer from benign colorectal lesions (sensitivity= 0.73, specitivity=0.62, 95% CI=0.67-0.76, p&lt;0.001). The HALP level below 28.1 was associated with worse overall survival (p=0.046) and was shown to be an independent prognostic factor in the colorectal cancer group. The HALP score can be used to differentiate colorectal cancer from benign colorectal neoplasms and as a prognostic factor in colorectal cancer.

The Impact of CD37 Ectoenzyme Expression in Benign and Malignant Colorectal Tumors.

The depth of invasion of colorectal cancer through the bowel wall provided the basis for pathological staging. The establishment of prognostic markers for CRC is important in the search for potential targets for therapeutic intervention. The cell surface nucleotidase (CD73) is an enzyme involved in tumor progression and metastasis. Its main function is to convert adenosine monophosphate (AMP) to adenosine. Preclinical studies suggest that CD73 can be targeted for cancer treatment. This study was designed to investigate the prognostic value of CD73 in malignant and benign colorectal tumors among Iraqi patients and its correlation with clinicopathological features using the immunohistochemistry (IHC) technique. In the current study, 60 cases of formalin-fixed paraffin-embedded (FFPE) tissues of colorectal tumors were collected from the Teaching Laboratories of Baghdad Medical City Teaching Hospital, Baghdad - Iraq & private labs in Baghdad. Of them, 52 were malignant, and 8 of benign cases. In addition, 10 cases of the non-pathological significance of colorectal tissues were used as a control group. This study's results revealed significant differences (P=0.001) in the expression of CD73 between malignant tumors and benign and non-significant pathology groups. The highest expression of CD73 was detected in 76.9% of malignant cases, while in the benign group, only 12.5% of cases showed weak positive expression for this marker. Furthermore, significant differences had been reported in CD73 expression with patients' age groups for malignant (P=0.0335), tumor side (P=0.0409), and tumor grade & stage (P=≤0.01). No significant differences had been seen between CD73 expression with tumor diameter and patients' gender.

Molecular Interplay of John Cunningham Virus with Interleukin 1 Beta in Colorectal Carcinomatous Tissues from a Group of Iraqi Patients.

Colorectal cancer is ranked to have high mortality among most malignancies worldwide. In the adult population, the seroprevalence rates of the John Cunningham virus (JCV) range from 70% to 90%. Recently the association for JCV in many malignant tumours have been reported worldwide, including colonic and rectum cancers. Interleukin-1β (IL-1β) can promote tumour growth where it is abundant in the tumour microenvironment, and its up-regulation is considered a poor prognostic feature in different types of solid tumours, including colon malignancies. One hundred tissue biopsies belonged to 50 patients with colorectal cancers and 30 benign colonic tumour patients, and 20 colorectal control tissues were enrolled in this study. JCV was detected via chromogenic in situ hybridization (CISH), while IL-1 beta was detected by immunohistochemistry (IHC). The recorded data showed that 21 out of 50 (42%) tissue samples with colorectal carcinoma showed positive CISH reactions for JCV DNA in this study. The benign colorectal tumours group revealed positive signals in 2 out of 30 tissues representing 6.7% of this group. Lastly, no control tissues showed positive signals for the JCV -CISH test. The positive signals of IL-1 Beta-IHC detection were found in 26 out of 50 (52 %) colorectal carcinoma tissues, while in the benign colorectal tumour was 43.3% (13 out of 30) and in AHC was 20% (4 out of 20 tissues). The high rates of JCV infection in this group of Iraqi patients with colonic adenocarcinoma in concordance with IL-1 Beta expression could play an essential role in the development and progression of these malignant tumours along with benign colonic tumours. To analyze the concordant expression of IL-1 beta gene and JCV in issues from a group of Iraqi patients with colonic adenocarcinomas.

The Number of Intraoperative Intestinal Venous Circulating Tumor Cells Is a Prognostic Factor for Colorectal Cancer Patients.

Purpose To assess the association between intestinal venous blood (IVB) circulating tumor cells (CTCs) and clinicopathological parameters in stage I-III colorectal cancer (CRC) patients. Methods Participants were retrospectively retrieved, who were admitted to our hospital or took annual physical exams between December 1, 2015 and December 31, 2018. A negative enrichment-immunofluorescence in situ hybridization (NE-imFISH) technique was used to isolate and identify CTCs. Receiver operating characteristic (ROC) curves and Youden index values were used to determine the critical CTC cutoff value for the diagnosis of CRC. Kaplan-Meier and log-rank methods were used to conduct survival analyses, and multivariate Cox regression analyses were employed for multivariate corrections to comprehensively evaluate the value of CTCs in the diagnosis of CRC. Relationships between IVB CTCs, clinicopathological parameters, and prognosis were then analyzed based upon patient postoperative follow-up data. Results In total, we retrieved 282 patients including 48 healthy controls, 72 patients with benign colorectal tumors, and 162 CRC patients. CRC patients exhibited significantly higher numbers of CTCs relative to control patients or those with benign disease. CTC numbers in CRC patient peripheral blood (PB) and IVB were closely associated with tumor node metastasis (TNM) staging (P < 0.01), carbohydrate antigen-125 (CA-125) levels (P < 0.001), and KRAS (Kirsten rat sarcoma virus oncogene) mutation status (P < 0.001). The disease-free survival (DFS) of patients in the CTC-negative group was significantly longer than that of patients in the CTC-positive group (24.60 ± 13.31 months vs. 18.70 ± 10.19 months, P < 0.05), with the same being true with respect to their overall survival (OS) (30.60 ± 12.44 months vs. 35.25 ± 11.57 months, P < 0.05). A multivariate analysis revealed that the detection ≥2 CTCs/3.2 ml was independently associated with poorer DFS and OS. CTC counts were independently predictive of CRC patients TNM staging, CA-125, and KRAS mutation status in both univariate and multivariate Cox proportional hazards regression analyses. Conclusion CTCs are valuable biomarkers that can be monitored to predict CRC patient disease progression.

Phenome-wide association study (PheWAS) of colorectal cancer risk SNP effects on health outcomes in UK Biobank

BackgroundAssociations between colorectal cancer (CRC) and other health outcomes have been reported, but these may be subject to biases, or due to limitations of observational studies.MethodsWe set out to determine whether genetic predisposition to CRC is also associated with the risk of other phenotypes. Under the phenome-wide association study (PheWAS) and tree-structured phenotypic model (TreeWAS), we studied 334,385 unrelated White British individuals (excluding CRC patients) from the UK Biobank cohort. We generated a polygenic risk score (PRS) from CRC genome-wide association studies as a measure of CRC risk. We performed sensitivity analyses to test the robustness of the results and searched the Danish Disease Trajectory Browser (DTB) to replicate the observed associations.ResultsEight PheWAS phenotypes and 21 TreeWAS nodes were associated with CRC genetic predisposition by PheWAS and TreeWAS, respectively. The PheWAS detected associations were from neoplasms and digestive system disease group (e.g. benign neoplasm of colon, anal and rectal polyp and diverticular disease). The results from the TreeWAS corroborated the results from the PheWAS. These results were replicated in the observational data within the DTB.ConclusionsWe show that benign colorectal neoplasms share genetic aetiology with CRC using PheWAS and TreeWAS methods. Additionally, CRC genetic predisposition is associated with diverticular disease.

Is periodontitis a risk factor of benign or malignant colorectal tumor? A population-based cohort study.

To examine the risk of developing benign or malignant colorectal tumors in patients with periodontitis within 15years using Taiwan's National Health Insurance Database. Studies have shown that colorectal carcinoma often develops under inflammatory conditions and changes of microbiota in the gut. Recently, a link between Fusobacterium nucleatum, a periodontal pathogen, and colorectal carcinoma has been proposed. However, whether periodontitis is a risk of developing colorectal tumor remains uncertain. In total, 35124 participants were enrolled from 2000 to 2015 to examine the development risk of benign colorectal tumors, including 11708 patients with periodontitis who received therapy (group 1), 11708 patients with periodontitis not receiving periodontal treatment (group 2), and 11708 non-periodontitis controls after matching for gender, age, and index year. To examine the risk of developing colorectal malignancy, 11720 participants were assigned to each of the three groups. Cox proportional hazards model and Kaplan-Meier methods were used to compare the risks. Sensitivity analysis was performed, excluding the diagnoses during the first 1 or 5years. After the follow-up, 177, 154, and 63 participants in group 1, group 2, and control group had benign colorectal tumors. Patients with periodontitis tended to be associated with a greater rate of having a benign colorectal tumor. The adjusted hazard ratios (aHRs) were 3.77 (95% confidence interval [CI] 2.01-4.82, p<.001) and 2.85 (95% CI 1.62-3.74, p<.001) for groups 1 and 2, respectively. Regarding the risk of malignant colorectal tumor, 20, 18, and 14 participants who developed malignant tumors were included in group 1, group 2, and control group; however, no significant increase in malignancy was observed in periodontitis groups (aHR1.92, 95% CI 0.74-2.36, p=.482; aHR 1.50, 95% CI 0.68-1.97, p=.529, for the two periodontitis groups, respectively). The results of this study suggest that patients with periodontitis may have an increased risk of developing benign, but not malignant, colorectal tumors.

A Surveillance Endoscopy Strategy Based on Local Recurrence Rates after Colorectal Endoscopic Submucosal Dissection.

Backgrounds: It is not clear when and how frequently surveillance endoscopy should be performed after colorectal endoscopic submucosal dissection (ESD). We aimed to suggest a surveillance endoscopy strategy by investigating the cumulative local recurrence rates and identifying risk factors for local recurrence after colorectal ESD. Methods: We reviewed the medical records of 770 patients who underwent colorectal ESD for 778 lesions at our institution from 2005 to 2016. We investigated the cumulative local recurrence rates and risk factors for local recurrence. Results: Local recurrence developed in 12 (1.5%) of 778 lesions during the follow-up period of 37.4 ± 31.7 months. The one-, three-, and five-year cumulative local recurrence rates were 0.4%, 1.7%, and 2.2%, respectively. The risk factors for local recurrence were piecemeal resection (odds ratio (OR) 3.948, 95% confidence interval (CI) 1.164–13.385; p = 0.028) and histological incomplete resection (OR 8.713, 95% CI 2.588–29.334; p < 0.001). Local recurrence tended to develop frequently after ESD of early cancers. Conclusions: Short-term surveillance endoscopy should be recommended after piecemeal ESD, histological incomplete resection, and ESD of early colorectal cancers. Surveillance endoscopy with longer intervals can be suggested after en bloc ESD with the histological complete resection of benign colorectal tumors.

Pks+ Escherichia coli more prevalent in benign than malignant colorectal tumors.

Some E. coli strains that synthesize the toxin colibactin within the 54-kb pks island are being implicated in colorectal cancer (CRC) development. Here, the prevalence of pks+ E. coli in malignant and benign colorectal tumors obtained from selected Filipino patients was compared to determine the association of pks+ E. coli with CRC in this population. A realtime qPCR protocol was developed to quantify uidA, clbB, clbN, and clbA genes in formalin fixed paraffin embedded colorectal tissues. The number of malignant tumors (44/62; 71%) positive for the uidA gene was not significantly different (p = 0.3428) from benign (38/62; 61%) tumors. Significantly higher number of benign samples (p < 0.05) were positive for all three colibactin genes (clbB, clbN, and clbA) compared with malignant samples. There was also higher prevalence of pks+ E. coli among older females and in tissue samples taken from the rectum. Hence, pks+ E. coli may not be associated with CRC development among Filipinos.

Effect of antifoaming agent on benign colorectal tumors in colonoscopy: A meta-analysis.

BACKGROUNDAlthough several trials have shown that the addition of antifoaming agents to polyethylene glycol (PEG) can improve bowel preparation, whether PEG plus antifoaming agents have a beneficial role in the detection of benign tumors during colonoscopy has yet to be confirmed. Our aim was to clarify whether adding simethicone to PEG solution could improve the detection of benign colorectal tumors.AIMTo clarify whether adding simethicone to PEG solution could improve the detection of benign colorectal tumors.METHODSThe PubMed, EMBASE, and Cochrane Library databases were searched for articles published prior to September 2019. The outcomes included the detection rates of colorectal adenomas and polyps.RESULTTwenty studies were eligible. Although there was no difference in the colorectal adenoma detection rate (ADR), a significant effect of simethicone for diminutive adenomas (< 10 mm) was revealed in the group taking simethicone. We also found that simethicone could significantly improve the ADR in the proximal colon but did not affect the colorectal polyp detection rate. Furthermore, the subgroup analyses revealed a beneficial effect of simethicone on the ADR among Asians (P = 0.005) and those with an ADR < 25% (P = 0.003). Moreover, it was a significant finding that the low dose simethicone was as effective as the high dose one with respect to the detection of benign colorectal tumors.CONCLUSIONIn summary, the addition of simethicone to PEG might improve the detection of diminutive adenomas in the right colon by colonoscopy in Asia. Low-dose simethicone was recommended for the detection of benign colorectal tumors. However, large clinical trials are necessary to validate our results and determine the ideal dose of simethicone.

Возможности повышения эффективности диагностики и лечения новообразований ободочной и прямой кишки (на примере работы Хабаровского краевого колопроктологического центра)

The paper analyses activities of the Khabarovsk Regional Coloproctological Center (KhRCC) that includes coloproctological, surgical and endoscopic units of the Khabarovsk City Hospital № 10 and provides diagnostics and treatment of colorectal neoplasms. It was found out that for the last 3 years KhRCC has significantly increased the number of colonoscopies (from 436 to 1 388), the number of detected early rectal cancer cases (from 8 to 39), the amount of benign colorectal neoplasms (from 605 to 2 308) and total number of patients treated for benign (from 147 to 427) and malignant (from 50 to 81) colorectal neoplasms. The conclusion can be made that the organization of regional centers for coloproctology and the implementation of activities, including changing the regulatory framework and making a clear road map for patients with benign and malignant colorectal neoplasms, positively influences the quality and availability of medical care for this pathology.

Expression and clinical significance of miR-4516 and miR-21-5p in serum of patients with colorectal cancer

BackgroundThis study sought to detect the expression and clinical significance of miR-4516 and miR-21-5p in serum of patients with colorectal cancer.MethodsBioinformatics methods were used to analyze the expression patterns of miR-4516 and miR-21-5p in colorectal cancer. A total of 80 patients with colorectal cancer, 65 patients with benign colorectal tumors and 50 healthy persons were selected. qRT-PCR was performed to detect the expression levels of serum miR-4516 and miR-21-5p before and after operation or postoperative recurrence. The correlation of miR-4516 and miR-21-5p expression levels with the clinical characteristics and prognosis of colorectal cancer was analyzed, and that with the patient’s survival was further examined by Kaplan-Meier analysis.ResultsMiR-4516 was poorly expressed in colorectal cancer in the preoperative group, and miR-21-5p was highly expressed. While in the postoperative group, miR-4516 was up-regulated, and miR-21-5p was down-regulated. The low expression of miR-4516 was shown to be related to TNM staging, invasion degree, lymph node metastasis and distant metastasis of the patients. Whereas the high expression of miR-21-5p was proved to be correlated with TNM staging and lymph node metastasis. Kaplan-Meier survival analysis showed that high expression of miR-4516 or low expression of miR-21-5p could contribute to better overall survival.ConclusionLow miR-4516 or high miR-21-5p could be used as an independent risk factor for prognosis of colorectal cancer.

The location of premalignant colorectal polyps under age 50: a further rationale for screening sigmoidoscopy.

The incidence of colorectal cancer (CRC) among young adults has been dramatically rising, with guidelines for screening recently adjusted to start at age 45. However, knowledge of the precursor lesions is limited. We recently reported that 83% of CRC diagnosed under age 50 are left sided. Our aim was to analyze the location and histology of benign colorectal lesions found in a cohort of patients younger than 50, documenting the presence of advanced histology. We used the database in the Department of Pathology to retrospectively review the location and histology of all benign colorectal neoplasms in patients under age 50 submitted to pathology examination during 2006-2016. A total of 8364 lesions were examined from 4773 patients, and 3534 (65.5%) of the patients had only one polyp and the rest had multiple. Mean age was 41.9years (range 16-49) while 3843 (72.8%) of the patients were between the ages of 40 and 49. In total, 4570/8364 lesions (54.6%) were distal to the splenic flexure. The most common pathology was tubular adenoma (63.7%), then hyperplastic polyps (16.6%), sessile serrated lesions (SSLs) (13.1%), and tubulovillous adenomas (6.3%). Tubulovillous adenomas, villous lesions, advanced adenomas, and adenomas with high-grade dysplasia were all predominantly left sided (left colon and rectum = 77.6%, 85%, 78.3%, and 87.6% respectively). Of the SSLs, 71.5% were in the right colon while 16.6% of hyperplastic lesions were right sided. High-risk advanced adenomas are predominantly left sided. This focuses attention on the rectum and left colon where carcinogenesis is strong in the young.

Serum piRNA-54265 is a New Biomarker for early detection and clinical surveillance of Human Colorectal Cancer.

Background: Our previous study has demonstrated an oncogenic role of PIWI-interacting RNA-54265 (piR-54265) in colorectal cancer (CRC). Here, we investigate whether it can be a blood biomarker for population screening and clinical applications.Methods: Serum piR-54265 levels were determined by a digital PCR method in 209 cancer-free healthy controls, 725 patients with CRC, 1303 patients with other types of digestive cancer and 192 patients with benign colorectal tumors. A prospective case-control analysis was conducted to assess the predictive value of serum piR-54265 for future CRC diagnosis. Receiver operating characteristic (ROC) curve was constructed to quantify the diagnostic performance of serum piR-54265 levels by assessing its sensitivity, specificity and respective areas under curve (AUC). The odds ratios (ORs) were computed using multivariate logistic regression models.Results: Serum piR-54265 levels were significantly elevated only in patients with CRC compared with controls and patients with other cancer types. The AUC for recognizing CRC was 0.896 (95% CI, 0.874-0.914), with a sensitivity and specificity being 85.7% and 65.1% at 1500 copies/µL as a cut-off value. The serum piR-54265 levels in patients declined substantially after surgery but increased significantly again when tumor relapses. The prediagnostic serum piR-54265 levels were significantly associated with future CRC diagnosis, with the ORs of 7.23, 2.80, 2.45, and 1.24 for those whose CRC was diagnosed within 1, 2, 3 and >3 years. Serum piR-54265 test is more sensitive than other blood CRC markers.Conclusion: Serum piR-54265 may serve as a valuable biomarker for CRC screening, early detection and clinical surveillance.

Principles of the modern approach to the treatment of benign colorectal tumors

Principles of the modern approach to the treatment of benign colorectal tumors

Use of Phosphodiesterase 5 Inhibitors Is Associated With Lower Risk of Colorectal Cancer in Men With Benign Colorectal Neoplasms

Phosphodiesterase 5 (PDE5) inhibitors have been proposed to have chemopreventative effects on colorectal cancer (CRC), although data are needed from population-based studies. We performed a nationwide cohort study to investigate the association between the use of PDE5 inhibitors and the risk of CRC in men with benign colorectal neoplasms. We identified men who received a diagnosis of benign colorectal neoplasm from July 2005 through March 2015 who were listed in the Swedish Hospital Discharge Register. We linked data with those from other national Swedish registers to obtain information about the prescription of PDE5 inhibitors and CRC diagnoses. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). A total of 4823 patients were prescribed PDE5 inhibitors during the study period; the incidence rate of CRC was 2.64 per 1000 person-years for men prescribed PDE5 inhibitors compared with 4.46 per 1000 person-years for men without a prescription. We found a significant negative association between PDE5 inhibitor use and risk of CRC (adjusted HR, 0.65; 95% CI, 0.49-0.85); the decreased risk of CRC was associated with an increased cumulative dose of PDE5 inhibitors (P= .003). PDE5 prescription was associated with greater reduction in risk of advanced-stage CRC (adjusted HR, 0.61; 95% CI, 0.37-1.00) than early-stage CRC (adjusted HR, 0.70; 95% CI, 0.50-0.98), but the difference was not significant. In a nationwide population-based study of men with a diagnosis of benign colorectal neoplasm in Sweden, we found evidence that use of PDE5 inhibitors is associated with a reduced risk of CRC. Further studies are needed to confirm the observed association.

Differentiation between malignant and benign rectal tumors by dual-energy computed tomography - a feasibility study

Introduction: To assess the performance of Dual Energy Computed Tomography (DECT) in the differentiation between benign and malignant tumors in the rectum.Material and methods: We enrolled 8 subjects with rectal tumors suspected to be an early rectal cancer during colonoscopy. All subjects underwent Computed Tomography (CT), Magnetic Resonance Imaging (MRI) and Endorectal Ultrasound (ERUS) for staging. Furthermore, all subjects underwent fast switching of tube voltage between 80 and 140 kVp DECT of the pelvis. The 8 subjects had histopathological verified benign adenomas after transanal endoscopic microsurgery resection (TEM). The 8 subjects were matched with 8 consecutively selected subjects with histopathologically verified malignant rectal tumors. The DECT images were analyzed to assess the difference between malignant and benign rectal tumors. All DECT images were reviewed by experienced radiologists. In each DECT scanning, we applied three regions of interest (ROIs) for the acquisition of the DECT unique quantitative parameters. The mean atomic mass (effective Z value), iodine concentration, dual energy ratio (DER) and dual-energy index (DEI) was determined in both groups.Results: The comparison of the 2 groups showed a significant difference in effective Z and a nonsignificant difference regarding iodine concentration, DER, and DEI in the two groups.Conclusion: Dual-energy CT demonstrated a difference in the mean atomic mass in benign colorectal tumors in comparison to malignant colorectal tumors.

Competing endogenous RNA network crosstalk reveals novel molecular markers in colorectal cancer.

The competing endogenous RNA networks play a pivotal role in cancer diagnosis and progression. Novel properstrategies for early detection of colorectal cancer (CRC) are strongly needed. We investigated a novel CRC-specific RNA-based integrated competing endogenous network composed of lethal3 malignant brain tumor like1 (L3MBTL1) gene, long non-coding intergenic RNA- (lncRNA RP11-909B2.1) and homo sapiens microRNA-595 (hsa-miRNA-595) using in silico data analysis. RT-qPCR-based validation of the network was achieved in serum of 70 patients with CRC, 40 patients with benign colorectal neoplasm, and 20 healthy controls. Moreover, in cancer tissues of 20 of the 70 CRC cases were involved in the study. The expression of RNA-based biomarker network in both CRC and adjacent non-tumor tissues and their correlation with the serum levels of this network members was investigated. Lastly, the expression levels of the chosen ceRNA was verified in CRC cell line. Our results revealed that the three RNAs-based biomarker network (long non-coding intergenic RNA-[lncRNA RP11-909B2.1], Homo sapiens microRNA-595 [hsa-miRNA-595], and L3MBTL1 mRNA), had high sensitivity and specificity for discriminating CRC from healthy controls and also from benign colorectal neoplasm. The data suggest that among these three RNAs, serum lncRNA RP11-909B2.1 could be a promising independent prognostic factors in CRC. The circulatory RNA based biomarker panel can act as potential biomarker for CRC diagnosis and prognosis.