Intestinal Research

Reviews

Population-based screening colonoscopy in Korea: balancing benefits and limitations: Hyoung Il Choi, Jae Myung Cha; Received August 22, 2025 Accepted September 28, 2025 Published online January 2, 2026; DOI: https://doi.org/10.5217/ir.2025.00188 [Epub ahead of print]

Abstract PDF: Population-based colonoscopy screening is considered one of the most effective strategies for reducing the incidence and mortality of colorectal cancer. Its major strength lies in its dual benefits: early detection of colorectal cancer and prevention via the removal of precancerous lesions. Colonoscopy has a high sensitivity and provides a full colonic evaluation in a single session, thereby reducing the need for frequent testing. However, this approach has notable limitations. Colonoscopy is an invasive procedure associated with rare but serious complications such as perforation and bleeding. Participation rates tend to be lower than those of noninvasive methods like fecal immunochemical tests. Additionally, implementing colonoscopy as a populationbased tool requires significant resources, including trained endoscopists, endoscopy facilities, and financial investments. The quality of colonoscopy may also vary depending on the operator’s skill and adherence to guidelines. Given these trade-offs, population-based colonoscopy screening must be carefully evaluated in terms of cost-effectiveness, feasibility, and public acceptance within each country’s healthcare system. Therefore, population-based colonoscopy screening should be approached with a balanced understanding of its benefits and limitations to ensure cost-effectiveness, feasibility, alignment with each country’s healthcare infrastructure, and integration with existing screening programs.

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Recent updates on the endoscopic treatment of rectal neuroendocrine tumor: Sunghyeok Ryou, Kwangwoo Nam; Received July 18, 2025 Accepted September 8, 2025 Published online November 27, 2025; DOI: https://doi.org/10.5217/ir.2025.00141 [Epub ahead of print]

Abstract PDF PubReader ePub: The incidence of rectal neuroendocrine tumors has been gradually increasing, primarily due to the widespread use of screening colonoscopy and growing awareness of the disease. Most rectal neuroendocrine tumors are small ( < 10 mm), well-differentiated, and low-grade lesions at the time of diagnosis, and they are usually asymptomatic. Given these characteristics, endoscopic resection is considered a feasible treatment option for early-stage lesions. However, due to their inherent malignant potential, a comprehensive initial diagnostic evaluation is essential. Lymph node or distal metastasis can be present at diagnosis or may develop long after apparently successful primary treatment. Therefore, achieving complete resection using the most optimal resection method is crucial. Modified endoscopic mucosal resection and endoscopic submucosal dissection are recommended over conventional forceps or snare polypectomy, which are associated with high incomplete resection rates. In case of incomplete resection, additional endoscopic resection can be a feasible option in selected cases. Furthermore, regular post-resection surveillance is needed, especially in patients with high-risk of recurrence such as poor pathologic result or incomplete resection.

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Original Articles

Alteration of miR-21 and miR-24 expression: biomarker for early detection of synchronous metastases in colorectal cancer: a cross-sectional study in Indonesia: Yudith Annisa Ayu Rezkitha, Amal Arifi Hidayat, Irine Normalina, Ricky Indra Alfaray, Maria Inge Lusida, Takashi Matsumoto, Yoshio Yamaoka, Muhammad Miftahussurur; Received December 2, 2024 Accepted August 26, 2025 Published online November 19, 2025; DOI: https://doi.org/10.5217/ir.2024.00206 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Background/Aims
Timely detection with highly accurate biomarkers would be helpful in effectively managing colorectal cancer (CRC). We aim to investigate the accuracy of 3 emerging biomarkers—miR-21, miR-24, and miR-145—in detecting synchronous metastases in CRC.
Methods
We recruited newly diagnosed CRC patients with extensive investigations to determine cancer staging and metastatic status. The expression levels of miR-21, miR-24, and miR-145 in tumor biopsy were measured using reverse transcription quantitative polymerase chain reaction. Multivariate and receiver operating characteristic analyses were conducted to evaluate the association and performance of these miRNAs in identifying various metastases.
Results
Out of the 63 Indonesian patients involved, 37 (58.7%) were diagnosed with localized CRC, whereas the remaining 26 (41.3%) were identified as having metastases: 31.7% liver, 14.3% lung, 3.2% bone, and 4.8% other metastases. There was a significant downregulation of miR-24 expression in metastatic CRC patients compared to those without metastases (0.024 [4.680] vs. 12.900 [42.376], P< 0.01). Overexpression of miR-21 was identified as an independent risk factor of synchronous metastasis (odds ratio [OR], 1.016; 95% confidence interval [CI], 1.003–1.030; P< 0.05), particularly lung (OR, 1.011; 95% CI, 1.002–1.020; P< 0.05) and bone (OR, 1.022; 95% CI, 1.001–1.043; P< 0.05) metastases. No association was found between miR-145 expression and metastatic status. The miR-21/24 ratio accurately identified synchronous metastases irrespective of organ site, with an area under the curve (95% CI) of 0.833 (0.722–0.944) and positive predictive value of 94.4%.
Conclusions
Alteration of miR-21 and miR-24 expression levels was associated with a high incidence of synchronous metastases in Indonesian CRC. The mir-21/24 ratio demonstrated significant potential as a biomarker for detecting synchronous metastases in CRC.

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Endoscopy

Newly designed flared-end covered versus uncovered self-expandable metallic stents for palliation of malignant colorectal obstruction: a randomized, prospective study: Soo Jung Park, Yehyun Park, Hyun Jung Lee, Jae Jun Park, Jae Hee Cheon, Won Ho Kim, Tae Il Kim; Intest Res 2025;23(2):202-212. Published online February 24, 2025; DOI: https://doi.org/10.5217/ir.2024.00135

Abstract PDF Supplementary Material PubReader ePub: Background/Aims
Self-expandable metallic stents (SEMSs) are widely used as palliative or bridge to surgery treatments in patients with malignant colorectal obstruction (MCO). Stent occlusion is more common with uncovered stents, but stent migration is more common with covered stents. Our purpose was to compare the efficacy and safety of a newly designed covered SEMS with an uncovered proximal flared end (CSEMS-UPF) with that of the conventional uncovered SEMS (UCSEMS) in the treatment of MCO.
Methods
This prospective randomized trial was conducted at a tertiary-care academic hospital. We enrolled 87 patients with stage 4 cancer and MCO: colorectal cancer in 60 patients and extracolonic cancer in 27 patients. Insertion of UCSEMS was randomly assigned to 43 patients, and 44 patients received the CSEMS-UPF. The primary outcome was the duration of stent patency after successful placement. The secondary outcomes were the number of patients with technical and clinical success and early and late complications from the stent insertion.
Results
The median patency of the stent did not differ between the UCSEMS and CSEMS-UPF groups (484 [231–737] days vs. 216 [66–366] days, P= 0.242). The technical and clinical success rates did not differ significantly between the groups, either (100.0% vs. 93.2%, respectively, P= 0.241; 100.0% vs. 92.7%, respectively, P= 0.112), nor did the early (n = 2 [4.7%] vs. n = 4 [9.8%], P> 0.999) or late (n = 12 [27.9%] vs. n = 15 [36.6%], P> 0.999) stent complication rates differ between the groups.
Conclusions
The UCSEMS and newly developed CSEMS-UPF are similarly effective treatments for MCO, with no differences in the stent migration or occlusion rates (Clinical trial registration number: NCT02640781).

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Tumor

The impact of the COVID-19 pandemic on clinical practices related to colorectal cancer and colonoscopy in South Korea: a nationwide population-based study: Jin Young Yoon, Moon Hyung Lee, Min Seob Kwak, Jae Myung Cha; Intest Res 2025;23(1):85-95. Published online November 29, 2024; DOI: https://doi.org/10.5217/ir.2024.00066

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Despite of the coronavirus disease 2019 (COVID-19) pandemic, there is little data regarding its impact on colorectal cancer (CRC)-related clinical practice. This study aimed to assess the changes in its impact during the COVID-19 pandemic.
Methods
This was a retrospective national population-based study using the Health Insurance Review and Assessment database from January 2019 to December 2021. The number of patients in 2020 and 2021 was compared with those in 2019 for the diagnostic and therapeutic colonoscopy, CRC-related operation, and any treatment for CRC.
Results
The annual number of patients undergoing diagnostic colonoscopies decreased by 6.9% in 2020 but increased 8.1% in 2021, compared to those in 2019; number of patients undergoing therapeutic colonoscopies increased by 6.0% and 37.7% in 2020 and 2021, respectively; number of patients operated for CRC decreased by 4.2% in 2020 and increased by 2.3% in 2021. The number of patients treated for CRC decreased by 2.8% in 2020 and increased by 4.4% in 2021. Diagnostic and therapeutic colonoscopies and any CRC-related treatment decreased by 43.8%, 37.5%, and 11.3% in March 2020, during the first surge of COVID-19, but increased by 26.0%, 58.1%, and 9.5% in June 2021, respectively. CRC-related operations decreased by 24.1% in April 2020 and increased by 12.6% in August 2021.
Conclusions
Negative impact of the COVID-19 pandemic on clinical practices related to CRC completely recovered within second year. It could be considered for the development of an optimal strategy on CRC management in response to the pandemic-driven crisis.

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The impact of COVID-19 on clinical practices of colorectal cancer in South Korea
Kwang Woo Kim, Hyoun Woo Kang
Intestinal Research.2025; 23(1): 6. CrossRef

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IBD

Ulcerative colitis-associated neoplasms often harbor poor prognostic histologic components with low detection by biopsy: Ryoya Sakakibara, Shinya Sugimoto, Kaoru Takabayashi, Hiroki Kiyohara, Yusuke Wakisaka, Yuta Kaieda, Miho Kawaida, Yusuke Yoshimatsu, Tomohisa Sujino, Naoki Hosoe, Motohiko Kato, Masayuki Shimoda, Yohei Mikami, Yasushi Iwao, Takanori Kanai; Intest Res 2024;22(4):428-438. Published online May 7, 2024; DOI: https://doi.org/10.5217/ir.2024.00006

Abstract PDF PubReader ePub

Background/Aims
Poorly differentiated adenocarcinoma, signet-ring cell carcinoma, and mucinous adenocarcinoma (por/sig/muc), which are considered to be histologic subtypes with a poor prognosis, occur more frequently with colitis-associated cancer than with sporadic tumors. However, their invasiveness and manifestations are unclear. This study aimed to determine the prevalence of the por/sig/muc component in ulcerative colitis-associated neoplasms (UCANs) and its association with invasiveness and to clarify its clinicohistologic and endoscopic features.
Methods
This retrospective observational study included patients diagnosed with ulcerative colitis-associated high-grade dysplasia or adenocarcinoma from 1997 to 2022 who were divided according to the presence or absence of a por/sig/muc component.
Results
Thirty-five patients had UCAN with a por/sig/muc component and 66 had UCAN without this component. The 5-year survival rate was significantly lower in the por/sig/muc group than in the tub group (67% vs. 96%, P= 0.001), which was attributed to disease above stage III and depth to below the subserosa. Biopsy-based diagnosis before resection detected a por/sig/muc component in only 40% of lesions (14/35). Lesions with a por/sig/muc component were prevalent even in the early stages: stage 0 (4/36, 11%), I (8/20, 40%), II (7/12, 58%), III (10/14, 71%), and IV (6/8, 75%).
Conclusions
This is the first investigation that shows UCANs with a por/sig/muc component tended to be deeply invasive and were often not recognized preoperatively. Endoscopists should be aware that UCAN often has a por/sig/muc component that is not always recognized on biopsy, and the optimal treatment strategy needs to be carefully considered.

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Adjustment of Surveillance Intervals for Ulcerative Colitis‐Associated Neoplasia Based on Disease Duration
Ryoya Sakakibara, Shinya Sugimoto, Yuta Kaieda, Hiroki Kiyohara, Yusuke Yoshimatsu, Kaoru Takabayashi, Soichiro Murakami, Miho Kawaida, Tomohisa Sujino, Naoki Hosoe, Motohiko Kato, Yasushi Iwao, Yohei Mikami, Takanori Kanai
Digestive Endoscopy.2025; 37(10): 1068. CrossRef
Characterization of Computed Tomography Colonography Findings of Ulcerative Colitis-Associated Neoplasia
Yuta Kaieda, Shinya Sugimoto, Tatsuya Suzuki, Shunsuke Matsumoto, Hiroki Kiyohara, Kaoru Takabayashi, Yusuke Yoshimatsu, Koji Okabayashi, Kohei Shigeta, Ryoya Sakakibara, Yusuke Wakisaka, Soichiro Murakami, Masahiro Jinzaki, Yasushi Iwao, Yohei Mikami, Ta
Inflammatory Bowel Diseases.2025;[Epub] CrossRef

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2 Crossref

Colorectal neoplasia

Unraveling molecular similarities between colorectal polyps and colorectal cancer: a systems biology approach: Mehran Radak, Hossein Fallahi; Intest Res 2024;22(2):199-207. Published online February 6, 2024; DOI: https://doi.org/10.5217/ir.2023.00162

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Colorectal cancer (CRC) and colorectal polyps are intimately linked, with polyps acting as precursors to CRC. Understanding the molecular mechanisms governing their development is crucial for advancing diagnosis and treatment. Employing a systems biology approach, we investigated the molecular similarities between polyp and CRC.
Methods
We analyzed gene expression profiles, protein-protein interactions, transcription factors, and gene ontology to identify common differentially expressed genes (DEGs) and unravel shared molecular pathways.
Results
Our analysis revealed 520 commonly dysregulated genes in polyps and CRC, serving as potential biomarkers and pivotal contributors to disease progression. Gene ontology analysis elucidated distinct biological processes associated with upregulated and downregulated DEGs in both conditions, highlighting common pathways, including signal transduction, cell adhesion, and positive regulation of cell proliferation. Moreover, protein-protein interaction networks shed light on subnetworks involved in rRNA processing, positive regulation of cell proliferation, mRNA splicing, and cell division. Transcription factor analysis identified major regulators and differentially expressed transcription factors in polyp and CRC. Notably, we identified common differentially expressed transcription factors, including ZNF217, NR3C1, KLF5, GATA6, and STAT3, with STAT3 and NR3C1 exhibiting increased expression.
Conclusions
This comprehensive analysis enriches our understanding of the molecular mechanisms underlying polyp formation and CRC development, providing potential targets for further investigation and therapeutic intervention. Our findings contribute substantively to crafting personalized strategies for refining the diagnosis and treatment of polyps and CRC.

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Chronic Kidney Disease Increases Risk of Delayed Post‐Polypectomy Bleeding: A Large‐Scale Propensity Score‐Matched Analysis
Hye Kyung Hyun, Nak‐Hoon Son, So Hyeon Gwon, Hyun Chul Lim, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim, Tae‐Hyun Yoo, Shin‐Wook Kang, Hae‐Ryong Yun, Cheal Wung Huh
United European Gastroenterology Journal.2025; 13(5): 759. CrossRef
Genetic Signatures Upon Transition from Colorectal Polyps to colon Cancer
Mehran Radak, Farahnoosh Khodabakhsh Ravand, Nakisa Ghamari, Hossein Fallahi
Current Tissue Microenvironment Reports.2025; 6(2): 21. CrossRef
Epigenetic Silencing of miR-218-5p Modulates BIRC5 and DDX21 Expression to Promote Colorectal Cancer Progression
Hibah Shaath, Radhakrishnan Vishnubalaji, Khalid Ouararhni, Nehad M. Alajez
International Journal of Molecular Sciences.2025; 26(9): 4146. CrossRef
Stool Glycoproteomics Signatures of Pre-Cancerous Lesions and Colorectal Cancer
Janine Soares, Mariana Eiras, Dylan Ferreira, Daniela A. R. Santos, Marta Relvas-Santos, Beatriz Santos, Martina Gonçalves, Eduardo Ferreira, Renata Vieira, Luís Pedro Afonso, Lúcio Lara Santos, Mário Dinis-Ribeiro, Luís Lima, José Alexandre Ferreira
International Journal of Molecular Sciences.2024; 25(7): 3722. CrossRef

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Review

Colorectal neoplasia

Pathogenesis and biomarkers of colorectal cancer by epigenetic alteration: Chang Kyo Oh, Young-Seok Cho; Intest Res 2024;22(2):131-151. Published online February 1, 2024; DOI: https://doi.org/10.5217/ir.2023.00115

Abstract PDF PubReader ePub

Colorectal cancer (CRC) ranks third in cancer incidence and stands as the second leading cause of cancer-related deaths globally. CRC tumorigenesis results from a cumulative set of genetic and epigenetic alterations, disrupting cancer-regulatory processes like cell proliferation, metabolism, angiogenesis, cell death, invasion, and metastasis. Key epigenetic modifications observed in cancers encompass abnormal DNA methylation, atypical histone modifications, and irregularities in noncoding RNAs, such as microRNAs and long noncoding RNAs. The advancement in genomic technologies has positioned these genetic and epigenetic shifts as potential clinical biomarkers for CRC patients. This review concisely covers the fundamental principles of CRC-associated epigenetic changes, and examines in detail their emerging role as biomarkers for early detection, prognosis, and treatment response prediction.

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Influence of Lifestyles on Polyp Burden and Cancer Development in Hereditary Colorectal Cancer Syndromes
Hye Kyung Hyun, Ji Soo Park, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim
Journal of Gastroenterology and Hepatology.2025; 40(2): 433. CrossRef
The role of suppressor of cytokine signaling 3 in inflammatory bowel disease and its associated colorectal cancer
Pengfei Zhang, Bing Pei, Chengxue Yi, Francis Atim Akanyibah, Fei Mao
Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease.2025; 1871(2): 167578. CrossRef
Chronic Kidney Disease Increases Risk of Delayed Post‐Polypectomy Bleeding: A Large‐Scale Propensity Score‐Matched Analysis
Hye Kyung Hyun, Nak‐Hoon Son, So Hyeon Gwon, Hyun Chul Lim, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim, Tae‐Hyun Yoo, Shin‐Wook Kang, Hae‐Ryong Yun, Cheal Wung Huh
United European Gastroenterology Journal.2025; 13(5): 759. CrossRef
An overview of potential of natural compounds to regulate epigenetic modifications in colorectal cancer: a recent update
Susmita Roy, Dikshita Deka, Suresh Babu Kondaveeti, Pavithra Ayyadurai, Sravani Siripragada, Neha Philip, Surajit Pathak, Asim K. Duttaroy, Antara Banerjee
Epigenetics.2025;[Epub] CrossRef
Minimum Platelet Count Threshold for Safe Colonoscopic Polypectomy: A Large-Scale Propensity Scored-Matched Analysis
Hye Kyung Hyun, Nak-Hoon Son, Cheal Wung Huh, Hyun Chul Lim, So Hyeon Gwon, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim
American Journal of Gastroenterology.2025;[Epub] CrossRef
Anthocyanins: From Natural Colorants to Potent Anticancer Agents
Muhammad Maaz, Muhammad Tauseef Sultan, Ahmad Mujtaba Noman, Shehnshah Zafar, Naima Tariq, Muzzamal Hussain, Muhammad Imran, Ahmed Mujtaba, Tadesse Fenta Yehuala, Ehab M. Mostafa, Samy Selim, Soad K. Al Jaouni, Suliman A. Alsagaby, Waleed Al Abdulmonem
Food Science & Nutrition.2025;[Epub] CrossRef
Hsa-miR-21-5p and Hsa-miR-145-5p Expression: From Normal Tissue to Malignant Changes—Context-Dependent Correlation with Estrogen- and Hypoxia–Vascularization-Related Pathways Genes: A Pilot Study
Mateusz Górecki, Aleksandra Żbikowska, Małgorzata Tokłowicz, Stefan Sajdak, Monika Englert-Golon, Mirosław Andrusiewicz
International Journal of Molecular Sciences.2025; 26(9): 4461. CrossRef
Epigenetically Regulating Non-coding RNAs in Colorectal Cancer: Promises and Potentials
Zahra Taheri, Majid Zaki-Dizaji
Middle East Journal of Digestive Diseases.2025; 17(1): 40. CrossRef
Elevated Methylation Contributes to Suppressed Expression of Special AT‐Rich Sequence‐Binding Protein 2 in Colorectal Cancer: A Gene‐Disease Association Study
Weitong Cui, Cong Lu, Huaru Xue, Lei Wei, Shuai Li, Lianzheng Su, Dianfang Wei, Xiaoyu Feng, Kai Wang, Chao Song
Health Science Reports.2025;[Epub] CrossRef
Integrative multi-omics identification and functional validation of potential targets linking metabolism–immune–colorectal cancer causal pathway
Zequn Zheng, Xiaoling Xu
Frontiers in Immunology.2025;[Epub] CrossRef
Identification of isatin-triazole-benzenesulfonamide hybrids as dual hCA IX/XII and c-met inhibitors with hypoxia-mediated chemo-sensitizing activity
Wagdy M. Eldehna, Mohamed R. Elnagar, Simone Giovannuzzi, Amr Tayel, Maha-Hamadien Abdulla, Noura S. Alhassan, Moataz A. Shaldam, Alessio Nocentini, Claudiu T. Supuran, Haytham O. Tawfik
Bioorganic Chemistry.2025; 166: 109071. CrossRef
TET methylcytosine dioxygenases in cancer: Orchestrators of pathogenesis, immunity, immunotherapy, and chemoresistance
Yukai Zhang, Jian Li, Juan Liu
International Immunopharmacology.2025; 167: 115622. CrossRef
miR-3065-5p and miR-26a-5p as Clinical Biomarkers in Colorectal Cancer: A Translational Study
Berenice Carbajal-López, Antonio Daniel Martínez-Gutierrez, Eduardo O. Madrigal-Santillán, Germán Calderillo-Ruiz, José Antonio Morales-González, Jossimar Coronel-Hernández, Joey Lockhart, Oliver Millan-Catalan, Monica G. Mendoza-Rodriguez, Leonardo S. Li
Cancers.2024; 16(21): 3649. CrossRef

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Original Article

Colorectal neoplasia

The elderly population are more vulnerable for the management of colorectal cancer during the COVID-19 pandemic: a nationwide, population-based study: Hong Sun Kang, Seung Hoon Jeon, Su Bee Park, Jin Young Youn, Min Seob Kwak, Jae Myung Cha; Intest Res 2023;21(4):500-509. Published online August 29, 2023; DOI: https://doi.org/10.5217/ir.2023.00004

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
The impact of coronavirus disease 2019 (COVID-19) on the management of colorectal cancer (CRC) may worse in elderly population, as almost all COVID-19 deaths occurred in the elderly patients. This study aimed to evaluate the impact of COVID-19 on CRC management in the elderly population.
Methods
The numbers of patients who underwent colonoscopy, who visited hospitals or operated for CRC in 2020 and 2021 (COVID-19 era) were compared with those in 2019, according to 3 age groups (≥70 years, 50–69 years, and ≤49 years), based on the nationwide, population-based database (2019–2021) in South Korea.
Results
The annual volumes of colonoscopy and hospital visits for CRC in 2020 were more significantly declined in the old age group than in the young age group (both P<0.001). In addition, the annual volume of patients operated for CRC numerically more declined in old age group than in young age group. During the first surge of COVID-19 (March and April 2020), old age patients showed statistically significant declines for the monthly number of colonoscopies (–46.5% vs. –39.3%, P<0.001), hospital visits (–15.4% vs. –7.9%, P<0.001), CRC operations (–33.8% vs. –0.7%, P<0.05), and colonoscopic polypectomies (–41.8% vs. –38.0%, P<0.001) than young age patients, compared with those of same months in 2019.
Conclusions
Elderly population are more vulnerable for the management of CRC during the COVID-19 pandemic. Therefore, the elderly population are more carefully cared for in the management of CRC during the next pandemic.

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The impact of COVID-19 on clinical practices of colorectal cancer in South Korea
Kwang Woo Kim, Hyoun Woo Kang
Intestinal Research.2025; 23(1): 6. CrossRef
To overcome medical gap in screening and surveillance of colorectal cancer during the COVID-19 pandemic
Yoo Min Han
Intestinal Research.2023; 21(4): 418. CrossRef

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205 Download
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2 Crossref

Review

IBD

Does caffeine have a double-edged sword role in inflammation and carcinogenesis in the colon?: Emiko Mizoguchi, Takayuki Sadanaga, Toshiyuki Okada, Takanori Minagawa, Jun Akiba; Intest Res 2023;21(3):306-317. Published online April 20, 2023; DOI: https://doi.org/10.5217/ir.2022.00118

Abstract PDF PubReader ePub

Caffeine (1,3,7-trimethylxanthine, also abbreviated to CAF) is a natural chemical with stimulant effects and is commonly included in many drinks and foods, including coffee, tea, cola, energy drinks, cocoa, chocolates, and so on. Our group previously reported that oral administration of CAF efficiently suppressed the development of intestinal inflammation in a dextran sulfate sodium (DSS)-induced murine acute colitis model by suppressing the expression of chitinase 3-like 1, one of the mammalian chitinases without enzymatic activity. Chitinases are hydrolytic enzymes that break down chitin, a polymer of N-acetylglucosamine, and chitinase-like proteins have no enzymatic activity with preserving chitin-binding ability. CAF binds a cleft of the chitinase active site and plays a role as a pan-chitinase inhibitor. Although CAF showed an anti-inflammatory effect in the above model, oral administration of low-dose CAF with 10% sucrose showed potentially neoplastic effects in colonic epithelial cells in a DSS-induced murine chronic colitis model. In this review, we would like to discuss the pros and cons of coffee/CAF in colonic inflammation and neoplasia with an example of pathological finding.

Citations

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Strategies for enhancing sustainable and economic utilization of almond waste through a comprehensive multi-stage systematic approach to pathogen control
Manjula Nishantha Udagepolage Don, Singarayer Florentine, Chris Turville, Kithsiri Dassanayake
Journal of Natural Pesticide Research.2025; 12: 100126. CrossRef
Caffeine modulates immunoproteasome activity and content in colorectal adenocarcinoma cells
Alexander Burov, Alexander Rezvykh, Valeria Vedernikova, Alexey Belogurov, Vladimir Prassolov, Pavel Spirin, Sergey Funikov, Alexey Morozov, Vadim Karpov
Biochimie.2025;[Epub] CrossRef
Association Between Caffeine Intake and Bowel Habits and Inflammatory Bowel Disease: A Population-Based Study
Xiaoxian Yang, Haiyi Yan, Yan Chen, Rui Guo
Journal of Multidisciplinary Healthcare.2025; Volume 18: 3717. CrossRef
Deciphering the microbiome–metabolome landscape of an inflammatory bowel disease inception cohort
Shiva T. Radhakrishnan, Benjamin H. Mullish, Marton L. Olbei, Nathan P. Danckert, Maria A. Valdivia-Garcia, Jose I. Serrano-Contreras, Despoina Chrysostomou, Sharmili Balarajah, Robert W. Perry, John P. Thomas, Lejla Potari-Gul, Dezso Modos, Lucy C. Hicks
Gut Microbes.2025;[Epub] CrossRef
Evaluation of foliar application of caffeine in almond (Prunus dulcis) cultivation as an alternative to chemical pesticides: Minimizing chemical residue in almond hulls for sustainable use of almond by-products
Manjula Nishantha Udagepolage Don, Singarayer Florentine, Chris Turville, Kithsiri Dassanayake
Journal of Natural Pesticide Research.2025; 14: 100147. CrossRef
Coffee consumption and risk of thyroid cancer: a systematic review and meta-analysis of cohort and case control studies
Mehdi Karimi, Erfan Shahir-Roudi, Fatemeh Shokoohy, Kimia Kazemi, Amir Hossein Aghayan, Mehran Rostami Varnosfaderani, Zahedeh Khoshnazar, Mehdi Chegin, Niyousha Shirsalimi, Omid Asbaghi, Parisa Hosseini Koukamari, Parmis Hassanbeigi
Thyroid Research.2025;[Epub] CrossRef
Evaluation of the effect of roasting and digestion on biological activity of compounds of coffee extracts - in vitro assessment of the bioavailability, cytoprotective properties and modulation of inflammatory response
Joanna Grzelczyk, Grażyna Budryn, Dominik Szwajgier, Ewa Baranowska-Wójcik, Małgorzata Zakłos-Szyda
Food Chemistry.2024; 460: 140648. CrossRef
Recently Updated Role of Chitinase 3-like 1 on Various Cell Types as a Major Influencer of Chronic Inflammation
Emiko Mizoguchi, Takayuki Sadanaga, Linda Nanni, Siyuan Wang, Atsushi Mizoguchi
Cells.2024; 13(8): 678. CrossRef
Comprehensive evaluation of Capsosiphon fulvescens water extract: Assessing its effects on intestinal barrier integrity and inflammation in vitro and in vivo
Yu Rim Kim, Soo-yeon Park, Ji Yeon Kim
Journal of Functional Foods.2024; 123: 106563. CrossRef
Dose–Response Associations Between Diet and Risk of Rheumatoid Arthritis: A Meta-Analysis of Prospective Cohort Studies
Yuanyuan Dong, Darren Greenwood, James Webster, Chinwe Uzokwe, Jinhui Tao, Laura Hardie, Janet Cade
Nutrients.2024; 16(23): 4050. CrossRef

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Original Article

IBD

Risks of colorectal cancer and biliary cancer according to accompanied primary sclerosing cholangitis in Korean patients with ulcerative colitis: a nationwide population-based study: Eun Hye Oh, Ye-Jee Kim, Minju Kim, Seung Ha Park, Tae Oh Kim, Sang Hyoung Park; Intest Res 2023;21(2):252-265. Published online December 2, 2022; DOI: https://doi.org/10.5217/ir.2022.00092

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
We conducted a nationwide population-based study to investigate incidence rates of colorectal and biliary cancers according to accompanying primary sclerosing cholangitis in Korean ulcerative colitis patients.
Methods
We used the Health Insurance Review and Assessment claim database from January 2007 to April 2020. Standardized incidence ratios of colorectal and biliary cancers in ulcerative colitis patients were calculated.
Results
Among 35,189 newly diagnosed ulcerative colitis patients, 1,224 patients were diagnosed with primary sclerosing cholangitis. During the study period, 122 and 52 patients were diagnosed with colorectal and biliary cancers, respectively. Incidences of colorectal cancer were not higher in ulcerative colitis patients than those in the general population (standardized incidence ratios, 0.83; 95% confidence interval, 0.69–0.99), regardless of accompanied primary sclerosing cholangitis (standardized incidence ratio, 0.73; 95% confidence interval, 0.24–1.71). While incidences of biliary cancer were not higher in ulcerative colitis patients than those in the general population (standardized incidence ratio, 1.14; 95% confidence interval, 0.80–1.58), these were much higher with accompanied primary sclerosing cholangitis (standardized incidence ratio, 10.07; 95% confidence interval, 5.75–16.36). Cumulative incidences of colorectal and biliary cancers increased in patients who were diagnosed with ulcerative colitis at an older age.
Conclusions
In Korean ulcerative colitis patients, colorectal cancer incidences were not higher than those in the general population regardless of accompanied primary sclerosing cholangitis. However, biliary cancer incidences were much higher in ulcerative colitis patients with primary sclerosing cholangitis than in those without, or in the general population.

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Treatment of primary sclerosing cholangitis combined with inflammatory bowel disease
You Sun Kim, Edward H. Hurley, Yoojeong Park, Sungjin Ko
Intestinal Research.2023; 21(4): 420. CrossRef
Are the risks of colorectal cancer and biliary cancer really increased if patients with ulcerative colitis have primary sclerosing cholangitis?
Jung Wook Lee, Won Moon
Intestinal Research.2023; 21(2): 171. CrossRef

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Review

Cancer

Endoscopic diagnosis and treatment of early colorectal cancer: Seung Wook Hong, Jeong-Sik Byeon; Intest Res 2022;20(3):281-290. Published online July 26, 2022; DOI: https://doi.org/10.5217/ir.2021.00169

Abstract PDF PubReader ePub

Early colorectal cancer refers to cancer in the colorectum that is confined to the mucosa or submucosa and does not invade the muscularis propria, irrespective of lymph node or distant metastasis. As the number of persons undergoing screening colonoscopy increases, the proportion of patients diagnosed with precancerous colorectal lesions and early colorectal cancer also increases. In the last decade, innovative optical technologies for endoscopic diagnosis have been introduced and endoscopic treatment techniques such as endoscopic submucosal dissection have provided major breakthroughs in the management of early colorectal cancer. With these remarkable developments, endoscopic treatment has established itself as an alternative to surgical resection in the treatment of early colorectal cancer. This review will discuss the endoscopic diagnosis and treatment of early colorectal cancer. Furthermore, the unmet needs in this field and the latest research addressing those issues will be summarized.

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Original Article

IBD

Incidence rates for hospitalized infections, herpes zoster, and malignancies in patients with ulcerative colitis in Japan: an administrative health claims database analysis: Katsuyoshi Matsuoka, Kanae Togo, Noritoshi Yoshii, Masato Hoshi, Shoko Arai; Intest Res 2023;21(1):88-99. Published online March 11, 2022; DOI: https://doi.org/10.5217/ir.2021.00154

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Patients with ulcerative colitis (UC) are at an increased risk of certain infections and malignancies compared with the general population. Incidence rates (IRs) of hospitalized infections, herpes zoster (HZ), and malignancies in patients with UC, stratified by treatment, in Japan were estimated.
Methods
This retrospective study identified patients with UC treated with corticosteroids, immunosuppressants, or tumor necrosis factor inhibitors (TNFi) from 2 administrative databases (Japan Medical Data Center [JMDC] and Medical Data Vision [MDV]). IRs (unique patients with events per 100 patient‐years) were estimated for hospitalized infections, HZ, and malignancies, between June 2010 and May 2018.
Results
Among 6,033 MDV patients with UC receiving corticosteroids, immunosuppressants, or TNFi, IRs (95% confidence intervals) were: hospitalized infections, 1.73 (1.52–1.93); HZ, 1.00 (0.85–1.16), and malignancies, 1.48 (1.29–1.66). Among 958 JMDC patients with UC receiving corticosteroids, immunosuppressants, or TNFi, IRs (95% confidence intervals) were: HZ, 1.82 (1.27–2.37) and malignancies, 1.35 (0.87–1.82). In both cohorts, IRs of malignancies were generally similar among patients receiving immunosuppressants, TNFi, or combination therapy (immunosuppressants and TNFi); this was also true for IRs of hospitalized infections and HZ in the MDV cohort. IRs of hospitalized infections, HZ, and malignancies were higher in patients receiving calcineurin inhibitors compared with immunosuppressants or TNFi, in both cohorts.
Conclusions
IRs of hospitalized infections, HZ, and malignancies among patients with UC were generally similar regardless of UC treatment, except for calcineurin inhibitors.

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Reviews

Microbiota

The role of microbiome in colorectal carcinogenesis and its clinical potential as a target for cancer treatment: Sang Hoon Kim, Yun Jeong Lim; Intest Res 2022;20(1):31-42. Published online May 21, 2021; DOI: https://doi.org/10.5217/ir.2021.00034

Abstract PDF PubReader ePub

The role of gut microbiome-intestinal immune complex in the development of colorectal cancer and its progression is well recognized. Accordingly, certain microbial strains tend to colonize or vanish in patients with colorectal cancer. Probiotics, prebiotics, and synbiotics are expected to exhibit both anti-tumor effects and chemopreventive effects during cancer treatment through mechanisms such as xenometabolism, immune interactions, and altered eco-community. Microbial modulation can also be safely used to prevent complications during peri-operational periods of colorectal surgery. A deeper understanding of the role of intestinal microbiota as a target for colorectal cancer treatment will lead the way to a better prognosis for colorectal cancer patients.

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Microbiota

Gut microbiome and checkpoint inhibitor colitis: Kanika Sehgal, Sahil Khanna; Intest Res 2021;19(4):360-364. Published online December 1, 2020; DOI: https://doi.org/10.5217/ir.2020.00116

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Immune checkpoint inhibitor therapies such as ipilimumab, are increasingly being used as a treatment option for a variety of cancers, including metastatic melanoma and have demonstrated effectively a prolonged survival. These agents have an immunological mode of action that predisposes patients to a number of immune-related adverse events, colitis being one of the most commonly encountered complications. The pathogenesis for the development of colitis is unclear, and there is a growing consensus that the ecosystem of the gastrointestinal microbiota plays a significant role. Based on this suspected connection, studies are being carried out to explore the changes in the microbiota in patients on these medications who develop colitis. Conceivably, the modulation of the gut microbiota could offer a therapeutic benefit. Fecal microbiota transplantation is one therapeutic option that is currently being investigated, though there are still more data needed to evaluate its efficacy. In this review, we recapitulate the mechanisms of action of immune checkpoint inhibitors, their adverse events, with a focus on colitis and the role gut microbiota are suspected to play, and finally discuss the microbiota modulation therapies being investigated.

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MTA1 aggravates experimental colitis in mice by promoting transcription factor HIF1A and up-regulating AQP4 expression
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Exploration of Potential Gut Microbiota-Derived Biomarkers to Predict the Success of Fecal Microbiota Transplantation in Ulcerative Colitis: A Prospective Cohort in Korea
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Physical Activity as the Best Supportive Care in Cancer: The Clinician’s and the Researcher’s Perspectives
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Original Articles

Colorectal neoplasia

Postgastrectomy gastric cancer patients are at high risk for colorectal neoplasia: a case control study: Tae-Geun Gweon, Kyu-Tae Yoon, Chang Hyun Kim, Jin-Jo Kim; Intest Res 2021;19(2):239-246. Published online November 13, 2020; DOI: https://doi.org/10.5217/ir.2020.00009

Abstract PDF PubReader ePub

Background/Aims
Several studies have shown that colorectal neoplasms (CRN) including colorectal cancer (CRC) may be prevalent in patients with gastric cancer. However, in most of these studies, colonoscopy to investigate the prevalence of CRN was performed prior to surgery. We aimed to investigate whether CRN was more prevalent in postgastrectomy gastric cancer patients than in healthy individuals.
Methods
We reviewed the medical records of those patients within a cohort of gastric cancer patients with gastrectomy who underwent colonoscopy between 2016 and 2017. Controls age- and sex-matched with gastric cancer patients at a 2:1 ratio were identified among those who underwent colonoscopy at a health-promotion center. The frequencies of CRN, advanced CRN (ACRN), and CRC among patients with gastrectomy were compared with those in the control subjects. A total of 744 individuals (gastric cancer, 248; control, 496) were included.
Results
The rates of CRN and ACRN in the gastric cancer group were higher than those in the healthy individuals (CRN, 47.6% vs. 34.7%, P< 0.001; ACRN, 16.9% vs. 10.9%, P= 0.020). The rate of CRC was comparable between the 2 groups (2.0% vs. 0.6%, P= 0.125). Multivariate analysis identified previous gastrectomy for gastric cancer and male sex as significant risk factors for (A)CRN.
Conclusions
CRN and ACRN were more prevalent in patients who underwent surgery for gastric cancer than in the control group. Regular surveillance colonoscopy at appropriate intervals is indicated after gastrectomy.

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Safety of cold snare resection techniques for removal of polyps in the small colon in patients taking clopidogrel and aspirin: a Korean Association for the Study of Intestinal Diseases prospective multicenter study
Tae-Geun Gweon, Hyun Gun Kim, Yunho Jung, Seong Ran Jeon, Soo-Young Na, Yoo Jin Lee, Tae Ho Kim
Gastrointestinal Endoscopy.2025; 101(4): 866. CrossRef
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Jun He, Bixian Luo, Hongming Liu, Dong Cao, Weihua Gong
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Effect of bowel preparation completion time on bowel cleansing efficacy: Prospective randomized controlled trial of different bowel preparation completion times precolonoscopy
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Calcium, Vitamin D, and Colorectal Cancer
Young-Jo Wi, Soo-Young Na
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Inflammatory bowel diseases

Advanced neoplasia detection using chromoendoscopy and white light colonoscopy for surveillance in patients with inflammatory bowel disease: Kyeong Ok Kim, Michael V. Chiorean; Intest Res 2020;18(4):438-446. Published online October 26, 2020; DOI: https://doi.org/10.5217/ir.2019.00090

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Background/Aims
Chromoendoscopy (CE) has been shown to be superior to white light endoscopy (WLE) for neoplasia detection in inflammatory bowel disease (IBD). We aimed to compare the yield of CE and WLE for the detection of overall neoplasia and advanced neoplasia in IBD.
Methods
Patients who underwent surveillance colonoscopy from 1999 to 2017 were identified from our IBD database. CE procedures were compared with their respective WLE controls in a paired comparison, and frequency of all neoplasia, advanced neoplasia, and serrated neoplasia was assessed for both targeted and random biopsies.
Results
A total of 290 procedures performed in 98 individuals were identified with a median follow-up 4 years (median 3 colonoscopies/patient). CE and WLE were performed in 159 and 131 episodes, respectively. CE detected neoplasia in 40.9% of colonoscopies versus 23.7% with WLE (P= 0.002). In addition, CE detected more advanced neoplasia (18.2% vs. 6.1%, P= 0.002) and serrated lesions (14.5% vs. 6.1%, P= 0.022). Significantly fewer samples were obtained per procedure with CE (14.9 ± 9.7 vs. 20.9 ± 11.1, P< 0.001). Cancer was diagnosed in 2 cases.
Conclusions
CE has a higher detection rate than WLE for advanced neoplasia and serrated lesions in patients with IBD under surveillance. Further prospective studies evaluating the impact of CE on decreasing the risk of interval cancer and colectomy in IBD patients are warranted.

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Dae Sung Kim, Jeeyoung Hong, Kihyun Ryu, Sang Hyuk Lee, Hwanhyi Cho, Jehyeong Yu, Jieun Lee, Jong-Yeup Kim
Journal of Korean Medical Science.2024;[Epub] CrossRef
Feasibility of moxifloxacin and proflavine dual fluorescence imaging for detecting gastrointestinal neoplastic lesions: A prospective study
Kwangwoo Nam, Noseong Park, Seunghun Lee, Suil Jeon, Jungbin Lee, Seung‐Mo Hong, Sung Wook Hwang, Sang Hyoung Park, Dong‐Hoon Yang, Byong Duk Ye, Jeong‐Sik Byeon, Suk‐Kyun Yang, Jeong Hoon Lee, Do Hoon Kim, Ki Hean Kim, Seung‐Jae Myung
Lasers in Surgery and Medicine.2023; 55(4): 378. CrossRef
Colorectal Cancer Surveillance in Patients with Inflammatory Bowel Diseases: Chromoendoscopy or Non-Chromoendoscopy, That Is the Question
Roberto Gabbiadini, Ferdinando D’Amico, Alessandro De Marco, Maria Terrin, Alessandra Zilli, Federica Furfaro, Mariangela Allocca, Gionata Fiorino, Silvio Danese
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Kyeong Ok Kim, Eun Young Kim, Yoo Jin Lee, Hyun Seok Lee, Eun Soo Kim, Yun Jin Chung, Byung Ik Jang, Sung Kook Kim, Chang Heon Yang
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Olga Maria Nardone, Marietta Iacucci
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Richard Kozarek
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Colorectal neoplasia

Factors associated with the survival of colorectal cancer in Mexico: Carlos Quezada-Gutiérrez, María Teresa Álvarez-Bañuelos, Jaime Morales-Romero, Clara Luz Sampieri, Raúl Enrique Guzmán-García, Evangelina Montes-Villaseñor; Intest Res 2020;18(3):315-324. Published online May 19, 2020; DOI: https://doi.org/10.5217/ir.2019.09179

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Background/Aims
Colorectal cancer (CRC) is a public health problem. In Mexico, there have been no recent studies conducted on survival in terms of this pathology or on the influence of prognostic factors. The study aims to determine the probability of survival in patients with CRC presence of low levels of schooling and a rural population, adjusted for clinical stage and type of treatment.
Methods
A retrospective study was conducted in a cohort of 305 patients with CRC treated at State Cancer Center, located in Veracruz-Mexico; the follow-up period of 60 months (2012–2016). The survival probability was calculated using the Kaplan-Meier estimator and the log-rank test with 95% confidence intervals (CIs). Prognostic factors were determined using hazard ratio (HR) multivariate Cox regression analysis.
Results
Overall survival was 40% at 60 months. Subjects in the age group ≥ 65 years had a low survival rate of 28% (P= 0.026) and an advanced clinical stage of 22% (P< 0.001). Of the patients with bone metastasis, none survived longer than 5 years (P= 0.008). With respect to the unfavorable prognostic factors identified in the multivariate analysis, a decreased level of schooling was associated with an HR of 7.6 (95% CI, 1.1–54.7), advanced clinical stage was associated with an HR of 2.1 (95% CI, 1.2–4.0), and the presence of metastasis had an HR of 1.8 (95% CI, 1.1–2.9).
Conclusions
Poor prognostic factors include an advanced clinical stage, the presence of metastasis and a low level of schooling. These findings confirm the importance of screening for early diagnosis, diminishing the barriers to accessing treatment and prospectively monitoring the population.

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Inflammatory bowel diseases

Safety of tumor necrosis factor inhibitor use in patients with concomitant malignancy: Hiep Phan, Rick A. Weideman, Daisha J. Cipher, Linda A. Feagins; Intest Res 2020;18(3):282-288. Published online April 7, 2020; DOI: https://doi.org/10.5217/ir.2019.09140

Abstract PDF PubReader ePub

Background/Aims
Safety for tumor necrosis factor inhibitors (TNFi) in cancer has been focused on risk of incident malignancies, but studies on prognostic effects have been scarce. We determined survival and recurrence rates at 1, 2, and 5 years after cancer diagnosis in patients with and without concurrent TNFi use.
Methods
Chart reviews were performed between 1996 and 2015 at the VA North Texas Healthcare System. Cases were patients with inflammatory disease, concomitant malignancy, and TNFi use while controls were patients with inflammatory disease, concomitant malignancy but no TNFi use. Cases and controls were matched for type of malignancy. Analysis was performed with log-rank tests on Kaplan-Meier curves.
Results
Thirty-six cases and 72 controls were identified. For cases, survival at 1, 2, and 5 years were 32 (89%), 31 (86%), and 29 (81%) compared to 63 (90%), 61 (87%), and 51 (73%) for the control group (P=0.985). For cases, recurrence rates at 1, 2, and 5 years were 3 (8%), 5 (14%), and 6 (17%) compared to 2 (3%), 5 (7%), and 7 (10%) for the control group (P=0.158).
Conclusions
Our findings suggest TNFi may be safely used in select inflammatory disease patients with concurrent cancer if therapy is needed for proper disease control. However, case-by-case consideration in conjunction with an oncologist is recommended while considering the apparent safety of TNFi for patients suffering from active inflammatory diseases despite having a concomitant malignancy.

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Review

Novel biomarkers for the diagnosis and prognosis of colorectal cancer: Hyung-Hoon Oh, Young-Eun Joo; Intest Res 2020;18(2):168-183. Published online November 30, 2019; DOI: https://doi.org/10.5217/ir.2019.00080

Abstract PDF PubReader ePub

Colorectal cancer (CRC) is among the most common malignancies and remains a major cause of cancer-related death worldwide. Despite recent advances in surgical and multimodal therapies, the overall survival of advanced CRC patients remains very low. Cancer progression, including invasion and metastasis, is a major cause of death among CRC patients. The underlying mechanisms of action resulting in cancer progression are beginning to unravel. The reported molecular and biochemical mechanisms that might contribute to the phenotypic changes in favor of carcinogenesis include apoptosis inhibition, enhanced tumor cell proliferation, increased invasiveness, cell adhesion perturbations, angiogenesis promotion, and immune surveillance inhibition. These events may contribute to the development and progression of cancer. A biomarker is a molecule that can be detected in tissue, blood, or stool samples to allow the identification of pathological conditions such as cancer. Thus, it would be beneficial to identify reliable and practical molecular biomarkers that aid in the diagnostic and therapeutic processes of CRC. Recent research has targeted the development of biomarkers that aid in the early diagnosis and prognostic stratification of CRC. Despite that, the identification of diagnostic, prognostic, and/or predictive biomarkers remains challenging, and previously identified biomarkers might be insufficient to be clinically applicable or offer high patient acceptability. Here, we discuss recent advances in the development of molecular biomarkers for their potential usefulness in early and less-invasive diagnosis, treatment, and follow-up of CRC.

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Original Article

Colorectal neoplasia

Microvascular density under magnifying narrow-band imaging endoscopy in colorectal epithelial neoplasms: Takahiro Gonai, Keisuke Kawasaki, Shotaro Nakamura, Shunichi Yanai, Risaburo Akasaka, Kunihiko Sato, Yousuke Toya, Kensuke Asakura, Jun Urushikubo, Yasuko Fujita, Makoto Eizuka, Noriyuki Uesugi, Tamotsu Sugai, Takayuki Matsumoto; Intest Res 2020;18(1):107-114. Published online November 4, 2019; DOI: https://doi.org/10.5217/ir.2019.00061

Abstract PDF PubReader ePub

Background/Aims
Magnifying endoscopic classification systems, such as the Japan narrow-band imaging (NBI) Expert Team (JNET) classification, have been widely used for predicting the histologic diagnosis and invasion depth of colorectal epithelial tumors. However, disagreement exists among observers regarding magnifying endoscopic diagnosis, because these classification systems are subjective. We herein investigated the utility of endoscopic microvascular density (eMVD) calculated from magnifying NBI endoscopic images in colorectal tumors.
Methods
We reviewed magnifying NBI endoscopic images from 169 colorectal epithelial tumors (97 adenomas, 72 carcinomas/high-grade dysplasias) resected endoscopically or surgically. The eMVD on magnifying NBI endoscopic images was evaluated using image-editing software, and relationships between eMVD and clinical, endoscopic, and pathological findings were retrospectively analyzed.
Results
The eMVD in carcinomas (0.152 ± 0.079) was significantly higher than that in adenomas (0.119 ± 0.059, P< 0.05). The best cutoff value for distinguishing carcinoma from adenoma was 0.133. Sensitivity, specificity, and accuracy were 56.9%, 67.0%, and 62.7%, respectively. In addition, JNET type 2B tumors showed significantly higher eMVD (0.162 ± 0.079) compared to type 2A tumors (0.111 ± 0.050, P< 0.05).
Conclusions
The eMVD as determined by magnifying NBI endoscopy is considered to be a possible objective indicator for differentiating colorectal carcinomas from adenomas.

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9,169 View
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Focused Review

Colorectal neoplasia

Nutritional issues in patients with cancer: Duk Hwan Kim; Intest Res 2019;17(4):455-462. Published online October 14, 2019; DOI: https://doi.org/10.5217/ir.2019.00076

Abstract PDF PubReader ePub

Cancer is a catabolic inflammatory disease that causes patients to often experience weight loss, or even cachexia in severe cases. Undernourishment in patients with cancer impairs the quality of life and therapeutic response, further leading to poor prognosis. Active and frequent nutritional screening and assessment using valid tools are important for fast and appropriate nutritional intervention. Additionally, a suitable individualized nutritional intervention strategy should be established based on the nutritional assessment result. In general, nutritional intervention begins with nutritional counseling of patients diagnosed with cancer, and a well-planned nutritional counseling improves the treatment adherence and nutritional status. When planning nutritional supplementation for cancer patients, specific nutrients, including amino acids and fatty acids, should be considered. However, there has been no consistent result showing that any particular nutrient significantly improves the prognosis of cancer patients. Hence, continuous attention from clinical physicians is needed to plan nutritional improvement in patients with cancer.

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Original Article

Colorectal neoplasia

Parthenolide inhibits transforming growth factor β1-induced epithelial-mesenchymal transition in colorectal cancer cells: Shi Mao Zhu, Yong Ran Park, Seung Yong Seo, In Hee Kim, Soo Teik Lee, Sang Wook Kim; Intest Res 2019;17(4):527-536. Published online August 23, 2019; DOI: https://doi.org/10.5217/ir.2019.00031

Abstract PDF PubReader ePub

Background/Aims
Transforming growth factor-β1 (TGF-β1) induction of epithelial-mesenchymal transition (EMT) is one of the mechanisms by which colorectal cancer (CRC) cells acquire migratory and invasive capacities, and subsequently metastasize. Parthenolide (PT) expresses multiple anti-cancer and anti-inflammatory activities that inhibit nuclear factor κB by targeting the IκB kinase complex. In the present study, we aimed to investigate whether PT can inhibit TGF-β1-induced EMT in CRC cell lines.
Methods
HT-29 and SW480 cell lines were used in the experiment. Cell viability was detected by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and sub-G1 analysis was measured by flow cytometry. The induction of EMT by TGF-β1 and inhibition of the process by PT was analyzed by phase contrast microscopy, wounding healing, cellular migration and invasion assays, and Western blotting.
Results
TGF-β1 inhibits HT-29 cell proliferation, but has no effect on SW480 cell proliferation; different concentrations of TGF-β1 did not induce apoptosis in HT-29 and SW480 cells. PT attenuates TGF-β1-induced elongated, fibroblast-like shape changing in cells. PT inhibits TGF-β1-induced cell migration and cell invasion. In addition, other EMT markers such as β-catenin, Vimentin, Snail, and Slug were suppressed by PT, while E-cadherin was increased by PT.
Conclusions
Our findings show that PT inhibits TGF-β1-induced EMT by suppressing the expression of the mesenchymal protein and increasing expression of the epithelial protein. These findings suggest a novel approach for CRC treatment by suppression of TGF-β1-induced EMT.

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Review

Colorectal neoplasia

Prevalence and risk factors of colorectal cancer in Asia: Martin CS Wong, Hanyue Ding, Jingxuan Wang, Paul SF Chan, Junjie Huang; Intest Res 2019;17(3):317-329. Published online May 20, 2019; DOI: https://doi.org/10.5217/ir.2019.00021

Abstract PDF PubReader ePub

Globally, colorectal cancer (CRC) is a substantial public health burden, and it is increasingly affecting populations in Asian countries. The overall prevalence of CRC is reported to be low in Asia when compared with that in Western nations, yet it had the highest number of prevalent cases. This review described the prevalence of CRC in Asia according to the International Agency for Research on Cancer from World Health Organization (WHO) database and summarized its major risk factors. Non-modifiable factors include genetic factors, ethnicity, age, gender, family history and body height; smoking, alcohol drinking, weight, Westernized diet, physical inactivity, chronic diseases and microbiota were involved in environmental factors. These risk factors were separately discussed in this review according to published literature from Asian countries. CRC screening has been playing an important role in reducing its disease burden. Some recommendations on its screening practices have been formulated in guidelines for Asia Pacific countries.

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Expression of Main Toll-Like Receptors in Patients with Different Types of Colorectal Polyps and Their Relationship with Gut Microbiota
Sama Rezasoltani, Reza Ghanbari, Mehdi Azizmohammad Looha, Ehsan Nazemalhosseini Mojarad, Abbas Yadegar, Delisha Stewart, Hamid Asadzadeh Aghdaei, Mohammad Reza Zali
International Journal of Molecular Sciences.2020; 21(23): 8968. CrossRef
Pathogenic Germline Mutations of DNA Repair Pathway Components in Early-Onset Sporadic Colorectal Polyp and Cancer Patients
Pi-Yueh Chang, Shih-Cheng Chang, Mei-Chia Wang, Jinn-Shiun Chen, Wen-Sy Tsai, Jeng-Fu You, Chia-Chun Chen, Hsiu-Ling Liu, Jy-Ming Chiang
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Obesity Has a Stronger Relationship with Colorectal Cancer in Postmenopausal Women than Premenopausal Women
Ji Won Chang, Dong Wook Shin, Kyung Do Han, Keun Hye Jeon, Jung Eun Yoo, In Young Cho, Yun Jin Choi, Jung Yong Hong
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The significance of colorectal cancer in the morbidity and mortality of the adult population of the South Banat District in the period from 2010 to 2019
Aleksandra Perović, Jasmina Pavlović-Stojanović, Ljiljana Lazić, Dragana Antonijević-Đorđević, Magdalena Bjelica, Ivana Popov, Veronika Popovski
Zdravstvena zastita.2020; 49(4): 1. CrossRef
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Marwan Al-Hajeili, HassanK Abdulwassi, Faisal Alshadadi, Lujain Alqurashi, Mohmmad Idriss, Lamis Halawani
Journal of Family Medicine and Primary Care.2019; 8(10): 3140. CrossRef

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Original Articles

Colorectal neoplasia

Association of visceral adiposity and insulin resistance with colorectal adenoma and colorectal cancer: In Sub Jung, Cheol Min Shin, Sung Jae Park, Young Soo Park, Hyuk Yoon, Hyun Jin Jo, Nayoung Kim, Dong Ho Lee; Intest Res 2019;17(3):404-412. Published online November 12, 2018; DOI: https://doi.org/10.5217/ir.2018.00072

Abstract PDF PubReader ePub

Background/Aims
To examine whether visceral adiposity serves as a risk factor for colorectal cancer (CRC) and colorectal adenomas.
Methods
Two hundred healthy subjects, 200 patients with colorectal adenoma, and 151 patients with CRC (46 with early-stage and 105 with advanced-stage cancers) were enrolled at a tertiary referral hospital. All subjects underwent colonoscopy, and had laboratory data, and computed tomography (CT) scan available for abdominal fat measurement. An abdominal CT scan taken 1 to 4 years (mean interval, 20.6 months) before the diagnosis of CRC was also available in the 42 CRC patients.
Results
The mean areas of visceral adipose tissue (VAT) areas in the control, adenoma, early- and advanced-stage CRC groups were 94.6, 116.8, 110.4, and 99.7 cm2 , respectively (P<0.001). The risk of adenoma positively correlated with VAT area and the visceral-to-total fat ratio (P for trend <0.01), but the risk of CRC did not (P>0.05). The risk of both adenoma and CRC positively correlated with fasting plasma glucose levels (P for trend <0.05). In patients with early-stage cancer (n=17), VAT area decreased when the CT scan at diagnosis was compared with that taken before the diagnosis of CRC, but superficial adipose tissue area did not, so visceral-to-total fat ratio significantly decreased (46.6% vs. 50.7%, respectively, P=0.018)
Conclusions
VAT area is related to the risk of colorectal adenoma. However, VAT decreases from the early stages of CRC. Impaired fasting glucose has a role in colorectal carcinogenesis.

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Iman Elahi Vahed, Mahsa Moshgelgosha, Abdolmajid Kor, Mona Minadi, Faezeh Ebrahimi, Aylar Azhdarian, Mobina Arjmandi, Aida Alamdar, Maede Zare, Niloufar Shabani, Hossein Soltaninejad, Mohammad Rahmanian
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MAFLD with central obesity is associated with increased risk of colorectal adenoma and high-risk adenoma
Jingfang Xiong, Yijun Wu, Dongya Chen, Zhaolin Zhang, Yihui Liu, Jiandong Luo, Hong Xu
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Association between Atherosclerosis and High-Risk Colorectal Adenomas based on Cardio-Ankle Vascular Index and Ankle-Brachial Index
Jung Ho Lee, Hyunseok Cho, Sang Hoon Lee, Sung Joon Lee, Chang Don Kang, Dae Hee Choi, Jin Myung Park, Seung-Joo Nam, Tae Suk Kim, Ji Hyun Kim, Sung Chul Park
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Domenic G. Di Rollo, Josh McGovern, Christopher Morton, Gillian Miller, Ross Dolan, Paul G. Horgan, Donald C. McMillan, David Mansouri
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Chan Hyuk Park, Yoon Suk Jung, Nam Hee Kim, Jung Ho Park, Dong Il Park, Chong Il Sohn
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Obesity, sleep apnea, and cancer
Isaac Almendros, Miguel A. Martinez-Garcia, Ramon Farré, David Gozal
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Opportunistic use of radiological measures of visceral adiposity for assessment of risk of colorectal adenoma
Zi Qin Ng, Ruwan Wijesuriya, Philip Misur, Jih Huei Tan, Kyaw Soe Moe, Mary Theophilus
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Changes in Abdominal Obesity Affect the Risk of Metachronous Advanced Colorectal Neoplasia Development after Polypectomy
Yoon Suk Jung, Nam Hee Kim, Jung Ho Park, Dong Il Park, Chong Il Sohn
Yonsei Medical Journal.2020; 61(7): 579. CrossRef

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Endoscopy

Clinicopathological feature and treatment outcome of patients with colorectal laterally spreading tumors treated by endoscopic submucosal dissection: Young-Hoon Jeong, Jun Lee, Sang-Wook Kim, Geom-Seog Seo, Hyun-Soo Kim, Young-Eun Joo; Intest Res 2019;17(1):127-134. Published online October 10, 2018; DOI: https://doi.org/10.5217/ir.2018.00075

Abstract PDF PubReader ePub

Background/Aims
Endoscopic submucosal dissection (ESD) is an advanced technique that can be used to treat precancerous and early colorectal neoplasms by facilitating en bloc resection regardless of tumor size. In our study, we investigated the clinicopathological feature and the treatment outcome of patients with colorectal laterally spreading tumors (LSTs) that were treated by ESD.
Methods
The study enrolled all of 210 patients with colorectal LSTs who underwent ESD. Clinical outcomes were analyzed by retrospectively reviewing medical records.
Results
A cancerous pit pattern (Vi/Vn) was more common in pseudo-depressed (PD) subtype than in flat elevated (FE) subtype. The incidence of adenocarcinoma in the PD subtype and nodular mixed (NM) subtypes was significantly higher than in the homogenous (HG) subtype and FE subtype. The en bloc and R0 resection rates were 89.0% and 85.7%, respectively. The bleeding and perforation rates were 5.2% and 1.9%, respectively. The mean procedure time was much longer in the PD subtype than in the FE subtype. The en bloc resection rate was significantly higher in the NM subtype than in the HG subtype. However, there were no statistically significant differences in mean procedure time, en bloc resection rate, R0 resection rate, bleeding rate, or perforation rate between LST-granular and LST-nongranular types.
Conclusions
These results indicate that ESD is acceptable for treating colorectal LSTs concerning en bloc resection, curative resection, and risk of complications. Careful consideration is required for complete resection of the PD subtype and NM subtype because of their higher malignant potential.

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Endoscopic resection of colorectal laterally spreading tumors: Clinicopathologic characteristics and risk factors for treatment outcomes
Li-Hua Guo, Ke-Feng Hu, Min Miao, Yong Ding, Xin-Jun Zhang, Guo-Liang Ye
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Risk factors for unsuccessful colorectal endoscopic submucosal dissection: A systematic review and meta-analysis
Feng Gu, Wei Jiang, Jingyi Zhu, Lei Ma, Boyuan He, Huihong Zhai
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Prognosis and risk factors of electrocoagulation syndrome after endoscopic submucosal dissection in the colon and rectum. Large cohort study
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Blue laser imaging combined with JNET (Japan NBI Expert Team) classification for pathological prediction of colorectal laterally spreading tumors
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Comparison of long-term recurrence-free survival between primary surgery and endoscopic resection followed by secondary surgery in T1 colorectal cancer
Eun Hye Oh, Nayoung Kim, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Chang Sik Yu, Jin Cheon Kim, Jeong-Sik Byeon
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Second-look endoscopy findings after endoscopic submucosal dissection for colorectal epithelial neoplasms
Soo-kyung Park, Hyeon Jeong Goong, Bong Min Ko, Haewon Kim, Hyo Sun Seok, Moon Sung Lee
The Korean Journal of Internal Medicine.2021; 36(5): 1063. CrossRef

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Endoscopy

The current capacity and quality of colonoscopy in Korea: Jae Ho Choi, Jae Myung Cha, Jin Young Yoon, Min Seob Kwak, Jung Won Jeon, Hyun Phil Shin; Intest Res 2019;17(1):119-126. Published online October 10, 2018; DOI: https://doi.org/10.5217/ir.2018.00060

Abstract PDF PubReader ePub

Background/Aims
Little is known for the capacity and quality of colonoscopy, and adherence to colonoscopy surveillance guidelines in Korea. This study aimed to investigate the present and potential colonoscopic capacity, colonoscopic quality, and adherence to colonoscopy surveillance guidelines in Korea.
Methods
We surveyed representative endoscopists of 72 endoscopy units from June to August 2015, using a 36-item questionnaire regarding colonoscopic capacity, quality, and adherence to colonoscopy surveillance guidelines of each hospitals.
Results
Among the 62 respondents who answered the questionnaire, 51 respondents were analyzed after exclusion of 11 incomplete answers. Only 1 of 3 of endoscopy units can afford to perform additional colonoscopies in addition to current practice, and the potential maximum number of colonoscopies per week was only 42. The quality of colonoscopy was variable as reporting of quality indicators of colonoscopy were considerably variable (29.4%–94.1%) between endoscopy units. Furthermore, there are substantial gaps in the adherence to colonoscopy surveillance guidelines, as concordance rate for guideline recommendation was less than 50% in most scenarios.
Conclusions
The potential capacity and quality of colonoscopy in Korea was suboptimal. Considering suboptimal reporting of colonoscopic quality indicators and low adherence rate for colonoscopy surveillance guidelines, quality improvement of colonoscopy should be underlined in Korea.

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Ga Hee Kim, Yeong Chan Lee, Tae Jun Kim, Sung Noh Hong, Dong Kyung Chang, Young-Ho Kim, Dong-Hoon Yang, Chang Mo Moon, Kyunga Kim, Hyun Gun Kim, Eun-Ran Kim
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Factors Affecting Adherence to National Colorectal Cancer Screening: A 12-Year Longitudinal Study Using Multi-Institutional Pooled Data in Korea
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Strategies to improve screening colonoscopy quality for the prevention of colorectal cancer
Joo Hye Song, Eun Ran Kim
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Faecal immunochemical tests can improve colonoscopy triage in patients with iron deficiency: A systematic review and meta-analysis
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Jae Woong Lim, Min Jae Kim, Gang Han Lee, Dae Sol Kim, Sang Hyuk Jung, Yu Yeon Kim, Jin Won Kim, Yohan Lee, Hyun Soo Kim, Seon Young Park, Dong Hyun Kim
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Sessile serrated lesions in patients with adenoma on index colonoscopy do not increase metachronous advanced adenoma risk
Seung Wook Hong, Jeongseok Kim, Ji Young Lee, Jong‐Soo Lee, Hye‐Sook Chang, Hye Won Park, Gwang‐Un Kim, Jiyoung Yoon, Byong Duk Ye, Jeong‐Sik Byeon, Seung‐Jae Myung, Suk‐Kyun Yang, Jaewon Choe, Dong‐Hoon Yang
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Sung Noh Hong, Chang Kyun Lee, Jong Pil Im, Chang Hwan Choi, Jeong-Sik Byeon, Young-Seok Cho, Sung-Ae Jung, Tae Il Kim, Yoon Tae Jeen
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Xuan Quy Luu, Kyeongmin Lee, Jae Kwan Jun, Mina Suh, Kyu‐Won Jung, Kui Son Choi
International Journal of Cancer.2022; 150(12): 1958. CrossRef
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Suyeon Park, Seong Ran Jeon, Hyun Gun Kim, Yunho Jung, Min-Seob Kwak, Su Young Kim, Jong Wook Kim, Seung-Joo Nam, Eun Hye Oh, Seon-Young Park, Soo-Kyung Park, Jeong-Sik Byeon, Sun-Jin Boo, Dong Hoon Baek, Soon Man Yoon, Jaeyoung Chun, Jooyoung Lee, Miyoun
American Journal of Gastroenterology.2022; 117(4): 588. CrossRef
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The Korean Journal of Internal Medicine.2021; 36(Suppl 1): S35. CrossRef
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Jae Myung Cha, Min Seob Kwak, Hyun-Soo Kim, Su Young Kim, Sohee Park, Geun U Park, Jung Kuk Lee, Soo Jin Kim, Hun Hee Lee, Joo Sung Kim, Won Ho Kim
Gut and Liver.2020; 14(3): 338. CrossRef

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Colorectal neoplasia

Rates of metachronous adenoma after curative resection for left-sided or right-sided colon cancer: Yuk Fai Lam, Wai Kay Seto, Teresa Tong, Ka Shing Cheung, Oswens Lo, Ivan FN Hung, Wai Lun Law, Wai K Leung; Intest Res 2018;16(4):619-627. Published online October 10, 2018; DOI: https://doi.org/10.5217/ir.2018.00013

Abstract PDF PubReader ePub

Background/Aims
We determined the rates of metachronous colorectal neoplasm in colorectal cancer (CRC) patients after resection for right (R)-sided or left (L)-sided cancer.
Methods
Consecutive CRC patients who had undergone surgical resection for curative intent in our hospital between 2001 and 2004 were identified. R-sided colonic cancers refer to cancer proximal to splenic flexure whereas L-sided cancers include rectal cancers. Patients were included only if they had a clearing colonoscopy performed either before or within 6 months after the operation. Findings of surveillance colonoscopy performed up to 5 years after colonic resection were included in the analysis.
Results
Eight hundred and sixty-three CRC patients underwent curative surgical resection during the study period. Three hundred and twenty-seven patients (107 R-sided and 220 L-sided) fulfilled the inclusion criteria and had at least 1 postoperative surveillance colonoscopy performed. The proportion of patients who had polyp and adenoma on surveillance colonoscopy was significantly higher among patients with L-sided than R-sided cancers (polyps: 30.9% vs. 19.6%, P=0.03; adenomas: 25.5% vs. 13.1%, P=0.01). The mean number of adenoma per patient on surveillance colonoscopy was also higher for patients with L-sided than R-sided tumors (0.52; 95% confidence interval [CI], 0.37–0.68 vs. 0.22; 95% CI, 0.08–0.35; P<0.01). Multivariate analysis showed that L-sided cancers, age, male gender and longer follow-up were independent predictors of adenoma detection on surveillance colonoscopy.
Conclusions
Patients with Lsided cancer had a higher rate of metachronous polyps and adenoma than those with R-sided cancer on surveillance colonoscopy.

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D. Suraci, E. Baria, L. Tirloni, J. L. Lagarto, S. Buccianti, C. Agostini, S. Pillozzi, L. Antonuzzo, A. Taddei, R. Cicchi
Journal of Biophotonics.2025;[Epub] CrossRef
DMMR status and synchronous lesions predicts metachronous lesions after curative resection for rectal cancer
Xijie Chen, Junguo Chen, Liang Xu, Dezheng Lin, Xiaoling Hong, Junsheng Peng, Xiaowen He, Jiancong Hu
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The absolute number of small and diminutive adenomas with high-grade dysplasia is substantially higher compared with large adenomas: a retrospective pooled study
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Intestinal Research.2024; 22(2): 186. CrossRef
IMMUNOREACT 9 metachronous rectal cancers have high HLA-ABC expression on healthy epithelium but a lower infiltration of CD3+ T cells than primary lesions
Beatrice Salmaso, Melania Scarpa, Valerio Pellegrini, Astghik Stepanyan, Roberta Salmaso, Andromachi Kotsafti, Federico Scognamiglio, Dario Gregori, Giorgio Rivella, Ottavia De Simoni, Giulia Becherucci, Silvia Negro, Chiara Vignotto, Gaya Spolverato, Ces
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Risk factors of advanced metachronous neoplasms in surveillance after colon cancer resection
Kwangwoo Nam, Jeong Eun Shin
The Korean Journal of Internal Medicine.2021; 36(2): 305. CrossRef

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Colorectal neoplasia

Clinical significance of carcinoembryonic antigen in peritoneal fluid detected during operation in stage I–III colorectal cancer patients: Jae Hyun Kim, Seunghun Lee, Seung Hyun Lee, Byung Kwon Ahn, Sung Uhn Baek, Won Moon, Seun Ja Park; Intest Res 2018;16(3):467-474. Published online July 27, 2018; DOI: https://doi.org/10.5217/ir.2018.16.3.467

Abstract PDF PubReader ePub

Background/Aims

Early diagnosis of peritoneal metastases in patients with colorectal cancer (CRC) can influence patient prognosis. The aim of this study was to identify the clinical significance of carcinoembryonic antigen (CEA) in peritoneal fluid detected during operation in stage I–III CRC patients.

Methods

Between April 2009 and April 2015, we reviewed medical records from a total of 60 stage I–III CRC patients who had peritoneal fluid collected during operation. Patients who had positive cytology in the assessment of peritoneal fluid were excluded. We evaluated the values of CEA in peritoneal fluid (pCEA) to predict the long-term outcomes of these patients using Kaplan-Meier curves and Cox regression models.

Results

The median follow-up duration was 37 months (interquartile range, 21–50 months). On receiver operating characteristic analysis, pCEA had the largest area under the curve (0.793; 95% confidence interval, 0.635–0.950; P=0.001) with an optimal cutoff value of 26.84 (sensitivity, 80.0%; specificity, 76.6%) for predicting recurrence. The recurrence rate was 8.1% in patients with low pCEA (<26.84 ng/mL, n=37), and 52.2% in patients with high pCEA (≥26.84 ng/mL, n=23). In multivariate Cox regression analysis, high pCEA (≥26.84 ng/mL) was a risk factor for poor cancer-free survival (CFS) in stage I–III patients.

Conclusions

In this study, we determined that high pCEA (≥26.84 ng/mL) detected during operation was helpful for the prediction of poor CFS in patients with stage I–III CRC.

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Nicola Natalizi, Elisabetta Marino, Luigina Graziosi, Annibale Donini
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Prognostic Significance of Preoperative Serum Carcinoembryonic Antigen Varies with Lymph Node Metastasis Status in Colorectal Cancer
Jing Jia, MinZhe Li, Wenhao Teng, Lin Wang, Weidong Zang, Jun Xiao, Ying Chen, Dan Zhao
Journal of Oncology.2021; 2021: 1. CrossRef

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Focused Review: Colorectal Cancers

Colorectal neoplasia

Impact of microbiota in colorectal carcinogenesis: lessons from experimental models: Linda Chia-Hui Yu, Shu-Chen Wei, Yen-Hsuan Ni; Intest Res 2018;16(3):346-357. Published online July 27, 2018; DOI: https://doi.org/10.5217/ir.2018.16.3.346

Abstract PDF PubReader ePub

A role of gut microbiota in colorectal cancer (CRC) growth was first suggested in germ-free rats almost 50 years ago, and the existence of disease-associated bacteria (termed pathobionts) had becoming increasingly evident from experimental data of fecal transplantation, and microbial gavage or monoassociation. Altered bacterial compositions in fecal and mucosal specimens were observed in CRC patients compared to healthy subjects. Microbial fluctuations were found at various cancer stages; an increase of bacterial diversity was noted in the adenoma specimens, while a reduction of bacterial richness was documented in CRC samples. The bacterial species enriched in the human cancerous tissues included Escherichia coli, Fusobacterium nucleatum, and enterotoxigenic Bacteroides fragilis. The causal relationship of gut bacteria in tumorigenesis was established by introducing particular bacterial strains in in situ mouse CRC models. Detailed experimental protocols of bacterial gavage and the advantages and caveats of different experimental models are summarized in this review. The microbial genotoxins, enterotoxins, and virulence factors implicated in the mechanisms of bacteria-driven tumorigenesis are described. In conclusion, intestinal microbiota is involved in colon tumorigenesis. Bacteria-targeting intervention would be the next challenge for CRC.

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Colorectal neoplasia

Intestinal microbiota, chronic inflammation, and colorectal cancer: Chan Hyuk Park, Chang Soo Eun, Dong Soo Han; Intest Res 2018;16(3):338-345. Published online July 27, 2018; DOI: https://doi.org/10.5217/ir.2018.16.3.338

Abstract PDF PubReader ePub

In addition to genetic and epigenetic factors, various environmental factors, including diet, play important roles in the development of colorectal cancer (CRC). Recently, there is increasing interest in the intestinal microbiota as an environmental risk factor for CRC, because diet also influences the composition of the intestinal microbiota. The human intestinal microbiota comprises about 100 trillion microbes. This microbiome thrives on undigested dietary residues in the intestinal lumen and produces various metabolites. It is well known that the dietary risk factors for CRC are mediated by dysbiosis of the intestinal microbiota and their metabolites. In this review, we describe the bacterial taxa associated with CRC, including Fusobacterium nucleatum, enterotoxigenic Bacteroides fragilis, Escherichia coli, and butyrate-producing bacteria. We also discuss the host-diet interaction in colorectal carcinogenesis.

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Colorectal neoplasia

Genetic and epigenetic alterations of colorectal cancer: Sung Noh Hong; Intest Res 2018;16(3):327-337. Published online July 27, 2018; DOI: https://doi.org/10.5217/ir.2018.16.3.327

Abstract PDF PubReader ePub

Colorectal cancer (CRC) arise from multi-step carcinogenesis due to genetic mutations and epigenetic modifications of human genome. Genetic mutations and epigenetic modifications were originally established as 2 independent mechanisms contributing to colorectal carcinogenesis. However, recent evidences demonstrate that there are interactions between these 2 mechanisms. Genetic mutations enable disruption of epigenetic controls while epigenetic modifications can initiate genomic instability and carcinogenesis. This review summarized genetic mutations and epigenetic modifications in colorectal carcinogenesis and molecular classification of CRC subtype based on genetic or epigenetic biomarkers for treatment response and prognosis. Molecular subtypes of CRC will permit the implementation of precision medicine with better outcome of management for CRC.

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Statement

IBD

Predicting outcomes to optimize disease management in inflammatory bowel disease in Japan: their differences and similarities to Western countries: Taku Kobayashi, Tadakazu Hisamatsu, Yasuo Suzuki, Haruhiko Ogata, Akira Andoh, Toshimitsu Araki, Ryota Hokari, Hideki Iijima, Hiroki Ikeuchi, Yoh Ishiguro, Shingo Kato, Reiko Kunisaki, Takayuki Matsumoto, Satoshi Motoya, Masakazu Nagahori, Shiro Nakamura, Hiroshi Nakase, Tomoyuki Tsujikawa, Makoto Sasaki, Kaoru Yokoyama, Naoki Yoshimura, Kenji Watanabe, Miiko Katafuchi, Mamoru Watanabe, Toshifumi Hibi; Intest Res 2018;16(2):168-177. Published online April 30, 2018; DOI: https://doi.org/10.5217/ir.2018.16.2.168

Abstract PDF PubReader ePub

Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), is a chronic inflammatory disease of the gastrointestinal tract, with increasing prevalence worldwide. IBD Ahead is an international educational program that aims to explore questions commonly raised by clinicians about various areas of IBD care and to consolidate available published evidence and expert opinion into a consensus for the optimization of IBD management. Given differences in the epidemiology, clinical and genetic characteristics, management, and prognosis of IBD between patients in Japan and the rest of the world, this statement was formulated as the result of literature reviews and discussions among Japanese experts as part of the IBD Ahead program to consolidate statements of factors for disease prognosis in IBD. Evidence levels were assigned to summary statements in the following categories: disease progression in CD and UC; surgery, hospitalization, intestinal failure, and permanent stoma in CD; acute severe UC; colectomy in UC; and colorectal carcinoma and dysplasia in IBD. The goal is that this statement can aid in the optimization of the treatment strategy for Japanese patients with IBD and help identify high-risk patients that require early intervention, to provide a better long-term prognosis in these patients.

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Review

Endoscopy

Quality is the key for emerging issues of population-based colonoscopy screening: Jin Young Yoon, Jae Myung Cha, Yoon Tae Jeen; Intest Res 2018;16(1):48-54. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.48

Abstract PDF PubReader ePub

Colonoscopy is currently regarded as the gold standard and preferred method of screening for colorectal cancer (CRC). However, the benefit of colonoscopy screening may be blunted by low participation rates in population-based screening programs. Harmful effects of population-based colonoscopy screening may include complications induced by colonoscopy itself and by sedation, psychosocial distress, potential over-diagnosis, and socioeconomic burden. In addition, harmful effects of colonoscopy may increase with age and comorbidities. As the risk of adverse events in population-based colonoscopy screening may offset the benefit, the adverse events should be managed and monitored. To adopt population-based colonoscopy screening, consensus on the risks and benefits should be developed, focusing on potential harm, patient preference, socioeconomic considerations, and quality improvement of colonoscopy, as well as efficacy for CRC prevention. As suboptimal colonoscopy quality is a major pitfall of population-based screening, adequate training and regulation of screening colonoscopists should be the first step in minimizing variations in quality. Gastroenterologists should promote quality improvement, auditing, and training for colonoscopy in a population-based screening program.

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Original Articles

Endoscopy

Clinical outcomes of surveillance colonoscopy for patients with sessile serrated adenoma: Sung Jae Park, Hyuk Yoon, In Sub Jung, Cheol Min Shin, Young Soo Park, Na Young Kim, Dong Ho Lee; Intest Res 2018;16(1):134-141. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.134

Abstract PDF PubReader ePub

Background/Aims

Sessile serrated adenomas (SSAs) are known to be precursors of colorectal cancer (CRC). The proper interval of follow-up colonoscopy for SSAs is still being debated. We sought to determine the proper interval of colonoscopy surveillance in patients diagnosed with SSAs in South Korea.

Methods

We retrospectively reviewed the medical records of patients diagnosed with SSAs who received 1 or more follow-up colonoscopies. The information reviewed included patient baseline characteristics, SSA characteristics, and colonoscopy information.

Results

From January 2007 to December 2011, 152 SSAs and 8 synchronous adenocarcinomas were identified in 138 patients. The mean age of the patients was 62.2 years and 60.1% patients were men. SSAs were located in the right colon (i.e., from the cecum to the hepatic flexure) in 68.4% patients. At the first follow-up, 27 SSAs were identified in 138 patients (right colon, 66.7%). At the second follow-up, 6 SSAs were identified in 65 patients (right colon, 66.7%). At the 3rd and 4th follow-up, 21 and 11 patients underwent colonoscopy, respectively, and no SSAs were detected. The total mean follow-up duration was 33.9 months. The mean size of SSAs was 8.1±5.0 mm. SSAs were most commonly found in the right colon (126/185, 68.1%). During annual follow-up colonoscopy surveillance, no cancer was detected.

Conclusions

Annual colonoscopy surveillance is not necessary for identifying new CRCs in all patients diagnosed with SSAs. In addition, the right colon should be examined more carefully because SSAs occur more frequently in the right colon during initial and follow-up colonoscopies.

Citations

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Prevalence and Characteristics of Colorectal Serrated Polyps
Soo-Young Na
Journal of Digestive Cancer Research.2025; 13(1): 47. CrossRef
Endoscopic Diagnosis, Treatment, and Follow-up of Serrated Polyps
Duk Hwan Kim
Journal of Digestive Cancer Research.2023; 11(1): 30. CrossRef
Features associated with high‐risk sessile serrated polyps at index and follow‐up colonoscopy
Shahzaib Anwar, Charles Cock, Joanne Young, Graeme P Young, Rosie Meng, Kalindra Simpson, Michelle Coats, Junming Huang, Peter Bampton, Robert Fraser, Erin L Symonds
Journal of Gastroenterology and Hepatology.2021; 36(6): 1620. CrossRef
Descriptive epidemiological study of South African colorectal cancer patients at a Johannesburg Hospital Academic institution
Michelle McCabe, Yvonne Perner, Rindidzani Magobo, Sheefa Mirza, Clement Penny
JGH Open.2020; 4(3): 360. CrossRef
Associations between molecular characteristics of colorectal serrated polyps and subsequent advanced colorectal neoplasia
Xinwei Hua, Polly A. Newcomb, Jessica Chubak, Rachel C. Malen, Rebecca Ziebell, Aruna Kamineni, Lee-Ching Zhu, Melissa P. Upton, Michelle A. Wurscher, Sushma S. Thomas, Hana Newman, Sheetal Hardikar, Andrea N. Burnett-Hartman
Cancer Causes & Control.2020; 31(7): 631. CrossRef
The association between colorectal sessile serrated adenomas/polyps and subsequent advanced colorectal neoplasia
Andrea N. Burnett-Hartman, Jessica Chubak, Xinwei Hua, Rebecca Ziebell, Aruna Kamineni, Lee-Ching Zhu, Melissa P. Upton, Rachel C. Malen, Sheetal Hardikar, Polly A. Newcomb
Cancer Causes & Control.2019; 30(9): 979. CrossRef
Surveillance colonoscopy in patients with sessile serrated adenoma
Ji Hyung Nam, Hyoun Woo Kang
Intestinal Research.2018; 16(3): 502. CrossRef

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Predictive factors for malignancy in undiagnosed isolated small bowel strictures: Ujjwal Sonika, Sujeet Saha, Saurabh Kedia, Nihar Ranjan Dash, Sujoy Pal, Prasenjit Das, Vineet Ahuja, Peush Sahni; Intest Res 2017;15(4):518-523. Published online October 23, 2017; DOI: https://doi.org/10.5217/ir.2017.15.4.518

Abstract PDF PubReader ePub

Background/Aims

Patients with small bowel strictures have varied etiologies, including malignancy. Little data are available on the demographic profiles and etiologies of small bowel strictures in patients who undergo surgery because of intestinal obstruction but do not have a definitive pre-operative diagnosis.

Methods

Retrospective data were analyzed for all patients operated between January 2000 and October 2014 for small bowel strictures without mass lesions and a definite diagnosis after imaging and endoscopic examinations. Demographic parameters, imaging, endoscopic, and histological data were extracted from the medical records. Univariate and multivariate analyses were conducted to identify factors that could differentiate between intestinal tuberculosis (ITB) and Crohn's disease (CD) and between malignant and benign strictures.

Results

Of the 7,425 reviewed medical records, 89 met the inclusion criteria. The most common site of strictures was the proximal small intestine (41.5%). The most common histological diagnoses in patients with small bowel strictures were ITB (26.9%), CD (23.5%), non-specific strictures (20.2%), malignancy (15.5%), ischemia (10.1%), and other complications (3.4%). Patients with malignant strictures were older than patients with benign etiologies (47.6±15.9 years vs. 37.4±16.4 years, P=0.03) and age >50 years had a specificity for malignant etiology of 80%. Only 7.1% of the patients with malignant strictures had more than 1 stricture and 64% had proximally located strictures. Diarrhea was the only factor that predicted the diagnosis of CD 6.5 (95% confidence interval, 1.10–38.25; P=0.038) compared with the diagnosis of ITB.

Conclusions

Malignancy was the cause of small bowel strictures in approximately 16% patients, especially among older patients with a single stricture in the proximal location. Empirical therapy should be avoided and the threshold for surgical resection is low in these patients.

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Cryptogenic multifocal ulcerous stenosing enteritis: A ray of light on the umbra of the dark continent
Mithu Bhowmick, Vishal Sharma
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Timothy Peacock, William Harrison, Alexandra Limmer, Suzanne Di Sano, King‐Sang Wong
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Martin Keuchel, Marc Bota, Peter Baltes
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Martin Keuchel, Niehls Kurniawan, Peter Baltes
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Rebleeding rate and risk factors in nonsteroidal anti‐inflammatory drug‐induced enteropathy
Junseok Park, Seong Ran Jeon, Jin‐Oh Kim, Hyun Gun Kim, Tae Hee Lee, Jun‐Hyung Cho, Bong Min Ko, Joon Seong Lee, Moon Sung Lee
Journal of Digestive Diseases.2018; 19(5): 279. CrossRef

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High C-reactive protein level is associated with high-risk adenoma: Hyae Min Lee, Jae Myung Cha, Jung Lok Lee, Jung Won Jeon, Hyun Phil Shin, Kwang Ro Joo, Jin Young Yoon, Joung Il Lee; Intest Res 2017;15(4):511-517. Published online October 23, 2017; DOI: https://doi.org/10.5217/ir.2017.15.4.511

Abstract PDF PubReader ePub

Background/Aims

There is substantial evidence supporting a role of inflammation in the pathogenesis of colorectal cancer; however, little is known about the association between serum C-reactive protein (CRP) and the risk of colorectal adenoma. This study was conducted to investigate the association between serum CRP and colorectal adenoma risk.

Methods

A retrospective cross-sectional study was performed on first-time screening colonoscopies in asymptomatic subjects who also had their serum CRP level measured during a routine health check-up between September 2006 and September 2009 in Korea. Serum CRP level was compared between high-risk and low-risk adenoma groups and independent predictors of high-risk adenoma were analyzed using multivariate regression analysis.

Results

Among the 3,309 eligible patients, the high-risk adenoma group had higher serum CRP levels than the low-risk adenoma group (P=0.000). In addition, patients with a high-risk adenoma were more frequently included in the high CRP group than in the low CRP group (8.6% vs. 4.0%, P<0.001). The prevalence of high-risk adenoma was 3.5 times higher in the highest quartile of CRP level (P=0.000) compared with that in the lowest quartile. In logistic regression analysis, a higher quartile CRP level was found to be an independent risk factor for high-risk adenoma (odds ratio, 1.8; 95% confidence interval, 1.3–2.5; P=0.000).

Conclusions

High CRP level is associated with high-risk adenoma in both men and women. Our data may support the association between chronic inflammation and colorectal neoplasia, which warrants further investigation.

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Self-reported Metabolic Risk Factor Associations with Adenomatous, Sessile Serrated, and Synchronous Adenomatous and Sessile Serrated Polyps
Celina N. Santiago, Samara Rifkin, Julia Drewes, Gerard Mullin, Emma Spence, Linda M. Hylind, Joell J. Gills, David Kafonek, David M. Cromwell, Louis La Luna, Francis Giardello, Cynthia L. Sears
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Increased Th17-Related Cytokine Serum Levels in Patients With Multiple Polyps of Unexplained Origin
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Is methylation analysis of SFRP2, TFPI2, NDRG4, and BMP3 promoters suitable for colorectal cancer screening in the Korean population?: Soo-Kyung Park, Hae Lim Baek, Junghee Yu, Ji Yeon Kim, Hyo-Joon Yang, Yoon Suk Jung, Kyu Yong Choi, Hungdai Kim, Hyung Ook Kim, Kyung Uk Jeong, Ho-Kyung Chun, Kyungeun Kim, Dong Il Park; Intest Res 2017;15(4):495-501. Published online October 23, 2017; DOI: https://doi.org/10.5217/ir.2017.15.4.495

Abstract PDF PubReader ePub

Background/Aims

Colorectal cancer (CRC) screening using stool DNA was recently found to yield good detection rates. A multi-target stool DNA test (Cologuard®, Exact Sciences), including methylated genes has been recently approved by the U.S. Food and Drug Administration. The aim of this study was to validate these aberrantly methylated genes as stool-based DNA markers for detecting CRC and colorectal advanced adenoma (AA) in the Korean population.

Methods

A single-center study was conducted in 36 patients with AA; 35 patients with CRC; and 40 endoscopically diagnosed healthy controls using CRC screening colonoscopy. The methylation status of the SFRP2, TFPI2, NDRG4, and BMP3 promoters was investigated blindly using bisulfate-modified stool DNA obtained from 111 participants. Methylation status was investigated by methylation-specific polymerase chain reaction.

Results

Methylated SFRP2, TFPI2, NDRG4, and BMP3 promoters were detected in 60.0%, 31.4%, 68.8%, and 40.0% of CRC samples and in 27.8%, 27.8%, 27.8%, and 33.3% of AA samples, respectively. The sensitivities obtained using 4 markers to detect CRC and AA were 94.3% and 72.2%, respectively. The specificity was 55.0%.

Conclusions

Our results demonstrate that the SFRP2, TFPI2, NDRG4, and BMP3 promoter methylation analysis of stool sample DNA showed high sensitivity but low specificity for detecting CRC and AA. Because of the low specificity, 4 methylated markers might not be sufficient for CRC screening in the Korean population. Further large-scale studies are required to validate the methylation of these markers in the Asian population and to find new markers for the Asian population.

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Xianhe Kong, Qiuning Wu, Zhi Zhang, Zhiqiang Yu, Feng Niu, Xianshu Wang, Hongzhi Zou
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Georgios Alampritis, Sarah Nohelia Thoukididou, Maria Ramos, Pantelis Georgiou, Melpomeni Kalofonou, Constantinos Simillis
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Li Tang, Xiaoyong Zhao, Guohong Wang, Jiehao Huang, Mu Zhang, Wei Xu
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DNA methylation modulates epigenetic regulation in colorectal cancer diagnosis, prognosis and precision medicine
Jingxin Ye, Jianfeng Zhang, Weifeng Ding
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Chang Kyo Oh, Young-Seok Cho
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Marek Z. Wojtukiewicz, Marta Mysliwiec, Anna Tokajuk, Joanna Kruszewska, Barbara Politynska, Anmbreen Jamroze, Anna M. Wojtukiewicz, Dean G. Tang, Kenneth V. Honn
Cancer and Metastasis Reviews.2024; 43(4): 1185. CrossRef
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Yudith Annisa Ayu Rezkitha, Nur Syahadati Retno Panenggak, Maria Inge Lusida, Raissa Virgy Rianda, Isna Mahmudah, Aditya Doni Pradana, Tomohisa Uchida, Muhammad Miftahussurur
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Aneta L. Zygulska, Piotr Pierzchalski
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Roya Dolatkhah, Saeed Dastgiri, Mohammad Asghari Jafarabadi, Hossein Mashhadi Abdolahi, Mohammad Hossein Somi
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Gastroenterología y Hepatología (English Edition).2022; 45(10): 753. CrossRef
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Ji Hyun Kim, Sung Chul Park
Gut and Liver.2018; 12(5): 479. CrossRef

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Clinical characteristics of patients with serrated polyposis syndrome in Korea: comparison with Western patients: Eun Ran Kim, Jaryong Jeon, Jin Hee Lee, Yoon Jung Lee, Sung Noh Hong, Dong Kyung Chang, Young-Ho Kim; Intest Res 2017;15(3):402-410. Published online June 12, 2017; DOI: https://doi.org/10.5217/ir.2017.15.3.402

Abstract PDF PubReader ePub

Background/Aims

Serrated polyposis syndrome (SPS) has been shown to increase the risk of colorectal cancer (CRC). However, little is known about the characteristics of Asian patients with SPS. This study aimed to identify the clinicopathological features and risk of CRC in Korean patients with SPS as well as the differences between Korean and Western patients based on a literature review.

Methods

This retrospective study included 30 patients with SPS as defined by World Health Organization classification treated at Samsung Medical Center, Korea, between March 1999 and May 2011.

Results

Twenty patients (67%) were male. The median patient age at diagnosis was 56 years (range, 39–76 years). A total of 702 polyps were identified during a median follow-up of 43 months (range, 0–149 months). Serrated polyps were noted more frequently in the distal colon (298/702, 55%). However, large serrated polyps and serrated adenomas were mainly distributed throughout the proximal colon (75% vs. 25% and 81% vs. 19%, respectively); 73.3% had synchronous adenomatous polyps. The incidence of CRC was 10% (3/30 patients), but no interval CRC was detected. A total of 87% of the patients underwent esophagogastroduodenoscopy and 19.2% had significant lesions.

Conclusions

The phenotype of SPS in Korean patients is different from that of Western patients. In Korean patients, SPS is more common in men, there were fewer total numbers of serrated adenoma/polyps, and the incidence of CRC was lower than that in Western patients. Korean patients tend to more frequently have abnormal gastric lesions. However, the prevalence of synchronous adenomatous polyps is high in both Western and Korean patients.

Citations

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Low Yield of Genetic Testing in Serrated Polyposis Syndrome
Ira Upadhye, Husam Al Maliki, Victoria Cuthill, Andrew Latchford, Kevin Monahan
Clinical and Translational Gastroenterology.2025; 16(11): e00923. CrossRef
Risk of Colorectal Cancer in Serrated Polyposis Syndrome: A Systematic Review and Meta-analysis
Charles Muller, Akihiro Yamada, Sachie Ikegami, Haider Haider, Yuga Komaki, Fukiko Komaki, Dejan Micic, Atsushi Sakuraba
Clinical Gastroenterology and Hepatology.2022; 20(3): 622. CrossRef
Synchronized early gastric cancer occurred in a patient with serrated polyposis syndrome: A case report
Ying-Ze Ning, Guan-Yi Liu, Xiao-Long Rao, Yong-Chen Ma, Long Rong
World Journal of Clinical Cases.2022; 10(8): 2644. CrossRef
Usefulness of narrow-band imaging for the detection of remnant sessile-serrated adenoma (SSA) tissue after endoscopic resection: the KASID multicenter study
Yunho Jung, Jung Rock Moon, Seong Ran Jeon, Jae Myung Cha, Hyo-Joon Yang, Suyeon Park, Yumi Ahn, Jeong-Sik Byeon, Hyun Gun Kim
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Serrated Polyposis Syndrome with a Synchronous Colon Adenocarcinoma Treated by an Endoscopic Mucosal Resection
Sang Hoon Lee, Sung Joon Lee, Sung Chul Park, Seung-Joo Nam, Myeong Ho Kang, Tae Suk Kim, Seung Koo Lee
The Korean Journal of Gastroenterology.2020; 76(3): 159. CrossRef

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Current practices in endoscopic submucosal dissection for colorectal neoplasms: a survey of indications among Korean endoscopists: Tae Jun Kim, Eun Ran Kim, Sung Noh Hong, Young-Ho Kim, Dong Kyung Chang; Intest Res 2017;15(2):228-235. Published online April 27, 2017; DOI: https://doi.org/10.5217/ir.2017.15.2.228

Abstract PDF Supplementary Material PubReader ePub

Background/Aims

The indications for colorectal endoscopic submucosal dissection (ESD) vary in clinical practice. To establish colorectal ESD as a standard treatment, standard indications are essential. For establishing standard indications for colorectal ESD, we surveyed the preferences and criteria of endoscopists for colorectal ESD in their practices.

Methods

A multiple-choice questionnaire was sent to 27 members of the Korean Society of Gastrointestinal Endoscopy/ESD group. The indications of endoscopists for selecting ESD as a treatment for colorectal tumors ≥2 cm in diameter were surveyed.

Results

On the basis of the preprocedural assessment of histology, adenoma with high-grade dysplasia, mucosal cancer, and shallow submucosa invasive cancer were included in the indication for ESD. Based on gross morphology, laterally spreading tumor (LST) granular nodular mixed type, LST-nongranular (LST-NG) flat elevated type, and LST-NG pseudodepressed type were included. On the basis of the pit pattern by Kudo classification, types III, IV, and V-I were included. Based on the narrow band imaging pattern by Sano classification, types II and III-a were included. Other lesions, such as sporadic localized tumors in chronic inflammation and local residual early carcinoma after endoscopic resection, were also included in the indication for ESD.

Conclusions

The indications of Korean endoscopists for colorectal ESD are broader than those in recent guidelines, and tend to include more benign-looking tumors. To find the appropriate indications for colorectal ESD, systematic data collection and analysis are required to reach a consensus in a timely manner.

Citations

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Endoscopic treatment vs surgery for T1-stage colorectal cancer: a real-world retrospective cohort study
Wei Su, Han Chen, Die Hu, Xueliang Li, Xinmin Si, Bixing Ye, Guoxin Zhang, Xiaoying Zhou
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Traction methods for endoscopic submucosal dissection
Ji Hyun Kim, Sung Chul Park
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Long-term prognosis of curative endoscopic submucosal dissection for early colorectal cancer according to submucosal invasion: a multicenter cohort study
Jongbeom Shin, Eun Ran Kim, Hyun Joo Jang, Dong Hoon Baek, Dong-Hoon Yang, Bo-In Lee, Kwang Bum Cho, Jin Woong Cho, Sung-Ae Jung, Su Jin Hong, Bong Min Ko, Jung-Won Jeon, Weon Jin Ko, Sun Moon Kim, Young Dae Kim, Kim Chan Gyoo, Gwang Ho Baik, In Kyung Yoo
BMC Gastroenterology.2022;[Epub] CrossRef
Risk of Covert Submucosal Cancer in Patients With Granular Mixed Laterally Spreading Tumors
Ferdinando D’Amico, Arnaldo Amato, Andrea Iannone, Cristina Trovato, Chiara Romana, Stefano Angeletti, Roberta Maselli, Franco Radaelli, Giancarla Fiori, Edi Viale, Emilio Di Giulio, Paola Soriani, Mauro Manno, Emanuele Rondonotti, Piera Alessia Galtieri,
Clinical Gastroenterology and Hepatology.2021; 19(7): 1395. CrossRef
Clinical practice guideline for endoscopic resection of early gastrointestinal cancer
Chan Hyuk Park, Dong-Hoon Yang, Jong Wook Kim, Jie-Hyun Kim, Ji Hyun Kim, Yang Won Min, Si Hyung Lee, Jung Ho Bae, Hyunsoo Chung, Kee Don Choi, Jun Chul Park, Hyuk Lee, Min-Seob Kwak, Bun Kim, Hyun Jung Lee, Hye Seung Lee, Miyoung Choi, Dong-Ah Park, Jong
Intestinal Research.2021; 19(2): 127. CrossRef
Colonoscopic Polypectomy Preferences of Asian Endoscopists: Results of a Survey-Based Study
Dong-Hoon Yang, Bayasgalan Luvsandagva, Quang Trung Tran, Achmad Fauzi, Panida Piyachaturawat, Thida Soe, Zhiqin Wong, Jeong-Sik Byeon
Gut and Liver.2021; 15(3): 391. CrossRef
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Yun Sik Choi, Wan Soo Kim, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jeong-Sik Byeon
Intestinal Research.2020; 18(1): 96. CrossRef
Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer
Chan Hyuk Park, Dong-Hoon Yang, Jong Wook Kim, Jie-Hyun Kim, Ji Hyun Kim, Yang Won Min, Si Hyung Lee, Jung Ho Bae, Hyunsoo Chung, Kee Don Choi, Jun Chul Park, Hyuk Lee, Min-Seob Kwak, Bun Kim, Hyun Jung Lee, Hye Seung Lee, Miyoung Choi, Dong-Ah Park, Jong
Clinical Endoscopy.2020; 53(2): 142. CrossRef
Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer
Chan Hyuk Park, Dong-Hoon Yang, Jong Wook Kim, Jie-Hyun Kim, Ji Hyun Kim, Yang Won Min, Si Hyung Lee, Jung Ho Bae, Hyunsoo Chung, Kee Don Choi, Jun Chul Park, Hyuk Lee, Min-Seob Kwak, Bun Kim, Hyun Jung Lee, Hye Seung Lee, Miyoung Choi, Dong-Ah Park, Jong
The Korean Journal of Gastroenterology.2020; 75(5): 264. CrossRef
Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer
Chan Hyuk Park, Dong-Hoon Yang, Jong Wook Kim, Jie-Hyun Kim, Ji Hyun Kim, Yang Won Min, Si Hyung Lee, Jung Ho Bae, Hyunsoo Chung, Kee Don Choi, Jun Chul Park, Hyuk Lee, Min-Seob Kwak, Bun Kim, Hyun Jung Lee, Hye Seung Lee, Miyoung Choi, Dong-Ah Park, Jong
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2020; 20(2): 117. CrossRef
The risk factors for delayed bleeding after endoscopic resection of colorectal tumors: a meta-analysis
Yanqin Xu, Shishun Zhong, Wei Liang, Xiao Lu Lin
Expert Review of Gastroenterology & Hepatology.2020; 14(11): 1083. CrossRef
Clinical outcomes of endoscopic resection for colorectal laterally spreading tumors with advanced histology
Jin-Sung Jung, Ji-Yun Hong, Hyung-Hoon Oh, Sun-Seog Kweon, Jun Lee, Sang-Wook Kim, Geom-Seog Seo, Hyun-Soo Kim, Young-Eun Joo
Surgical Endoscopy.2019; 33(8): 2562. CrossRef
Clinicopathological feature and treatment outcome of patients with colorectal laterally spreading tumors treated by endoscopic submucosal dissection
Young-Hoon Jeong, Jun Lee, Sang-Wook Kim, Geom-Seog Seo, Hyun-Soo Kim, Young-Eun Joo
Intestinal Research.2019; 17(1): 127. CrossRef
Outcomes of ulcerative colitis‐associated dysplasia patients referred for potential endoscopic submucosal dissection
Dong‐Hoon Yang, Jihun Kim, Eun Mi Song, Kiju Chang, Sun‐Ho Lee, Sung Wook Hwang, Sang Hyoung Park, Byong Duk Ye, Jeong‐Sik Byeon, Seung‐Jae Myung, Suk‐Kyun Yang
Journal of Gastroenterology and Hepatology.2019; 34(9): 1581. CrossRef
Recurrence rate of lateral margin-positive cases after en bloc endoscopic submucosal dissection of colorectal neoplasia
Seohyun Lee, Jihun Kim, Jae Seung Soh, Jungho Bae, Sung Wook Hwang, Sang Hyoung Park, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Dong-Hoon Yang
International Journal of Colorectal Disease.2018; 33(6): 735. CrossRef
Risk factors for procedure-related complications after endoscopic resection of colorectal laterally spreading tumors
Ji-Yun Hong, Sun-Seog Kweon, Jun Lee, Sang-Wook Kim, Geom-Seog Seo, Hyun-Soo Kim, Young-Eun Joo
Medicine.2018; 97(41): e12589. CrossRef

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Diagnostic and prognostic value of preoperative ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography for colorectal cancer: comparison with conventional computed tomography: Joo Young Lee, Soon Man Yoon, Jeong Tae Kim, Ki Bae Kim, Mi Jin Kim, Jae Geun Park, Taek-Gu Lee, Sang-Jeon Lee, Sung Soo Koong, Joung-Ho Han, Hee Bok Chae, Seon Mee Park, Sei Jin Youn; Intest Res 2017;15(2):208-214. Published online April 27, 2017; DOI: https://doi.org/10.5217/ir.2017.15.2.208

Abstract PDF PubReader ePub

Background/Aims

¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) has been used for preoperative staging of colorectal cancer (CRC). However, the diagnostic accuracy of FDG-PET/CT for detection of lymph node or distant metastasis and its prognostic role have not been well established. We therefore evaluated the diagnostic and prognostic value of FDG-PET/CT in comparison with conventional CT for CRC.

Methods

We investigated 220 patients who underwent preoperative FDG-PET/CT and CT, followed by curative surgery for CRC. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of FDG-PET/CT and CT for detection of lymph node metastasis and distant metastasis were evaluated. In addition, we assessed the findings of FDG-PET/CT and CT according to outcomes, including cancer recurrence and cancer-related death, for evaluation of prognostic value.

Results

For detection of lymph node metastasis, FDG-PET/CT had a sensitivity of 44%, a specificity of 84%, and an accuracy of 67%, compared with 59%, 65%, and 62%, respectively, for CT (P=0.029, P=0.000, and P=0.022). For distant metastasis, FDG-PET/CT had a sensitivity of 79%, a specificity of 94%, and an accuracy of 93%, compared with 79%, 87%, and 86%, respectively, for CT (P=1.000, P=0.004, and P=0.037). In addition, positive findings of lymph node metastasis and distant metastasis on FDG-PET/CT were associated significantly with cancer recurrence or cancer-related death (P=0.009, P=0.001, respectively).

Conclusions

Preoperative FDG-PET/CT had a higher specificity and accuracy compared to CT for detection of lymph node metastasis and distant metastasis of CRC. In addition, FDG-PET/CT could be a valuable prognostic tool for CRC.

Citations

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Contrast Media & Molecular Imaging.2018; 2018: 1. CrossRef

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Red flag symptoms: detailed account of clinicopathological features in young-onset colorectal cancer: Ramish Riaz, Nosheen Masood, Arfa Benish; Intest Res 2017;15(2):203-207. Published online April 27, 2017; DOI: https://doi.org/10.5217/ir.2017.15.2.203

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Background/Aims

Colorectal cancer has long been considered disease of the West, typically occurring in old age; however, the incidence is rising in Asia. The pattern of disease is quite different in Asia, occurring at a younger age and at an advanced stage. Recognition of disease at an early stage is still a challenge for physicians. Few data are available regarding young-onset colorectal cancer in Pakistan. We conducted this study to fill this gap and provide deeper insight into clinical symptoms and histopathological features of young-onset colorectal cancer.

Methods

We collected data regarding clinical features by directly interviewing patients and obtaining histopathological data from hospital records. Patients aged less than 50 years were included in the study. Statistical analysis was performed using IBM SPSS version 20.0.

Results

Results in 105 patients showed mean age at diagnosis was 35.90±9.39, with male predominance; the majority of patients had no family history of colorectal cancer. Most patients had left-sided tumors with advance stage and intermediate grade (grade 2). Mucinous histology was common. Rectal bleeding was the first symptom for left-sided tumors, whereas most of the right-sided lesions presented with sudden obstruction.

Conclusions

Painless rectal bleeding in the early thirties should alert physicians to advise appropriate investigation, as the majority of young-onset colorectal cancer patients develop painless bleeding 2 to 3 years before appearance of other symptoms.

Citations

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Patients with computed tomography-proven acute diverticulitis require follow-up to exclude colorectal cancer: Shafquat Zaman, Warren Chapman, Imtiyaz Mohammed, Kathryn Gill, Stephen Thomas Ward; Intest Res 2017;15(2):195-202. Published online April 27, 2017; DOI: https://doi.org/10.5217/ir.2017.15.2.195

Abstract PDF PubReader ePub

Background/Aims

Traditionally, patients with acute diverticulitis undergo follow-up endoscopy to exclude colorectal cancer (CRC). However, its usefulness has been debated in this era of high-resolution computed tomography (CT) diagnosis. We assessed the frequency and outcome of endoscopic follow-up for patients with CT-proven acute diverticulitis, according to the confidence in the CT diagnosis.

Methods

Records of patients with CT-proven acute diverticulitis between October 2007 and March 2014 at Sandwell & West Birmingham Hospitals NHS Trust were retrieved. The National Cancer Registry confirmed the cases of CRC. Endoscopy quality indicators were compared between these patients and other patients undergoing the same endoscopic examination over the same period.

Results

We identified 235 patients with CT-proven acute diverticulitis, of which, 187 were managed conservatively. The CT report was confident of the diagnosis of acute diverticulitis in 75% cases. Five of the 235 patients were subsequently diagnosed with CRC (2.1%). Three cases of CRC were detected in the 187 patients managed conservatively (1.6%). Forty-eight percent of the conservatively managed patients underwent follow-up endoscopy; one case of CRC was identified. Endoscopies were often incomplete and caused more discomfort for patients with diverticulitis compared with controls.

Conclusions

CRC was diagnosed in patients with CT-proven diverticulitis at a higher rate than in screened asymptomatic populations, necessitating follow-up. CT reports contained statements regarding diagnostic uncertainty in 25% cases, associated with an increased risk of CRC. Follow-up endoscopy in patients with CT-proven diverticulitis is associated with increased discomfort and high rates of incompletion. The use of other follow-up modalities should be considered.

Citations

Citations to this article as recorded by

Assessing the Role of Follow-Up Investigations After Acute Diverticulitis in Detecting Colorectal Cancer
Maria Borg, Emma Vella, Svetlana D Brincat, Christian Camenzuli
Cureus.2025;[Epub] CrossRef
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Amy Millicent Yesheng Cao, Vincent Wai Lam, Matthew John Francis Xavier Rickard
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Comparison of colonoscopy after colonic diverticulitis and positive fecal immunochemical tests for the detection of colorectal neoplasia
Dai Nakamatsu, Tsutomu Nishida, Shinji Kuriki, Li-sa Chang, Kazuki Aochi, Emi Meren, Tatsuya Sakamoto, Ryo Tomita, Yu Higaki, Naoto Osugi, Aya Sugimoto, Kei Takahashi, Kaori Mukai, Kengo Matsumoto, Shiro Hayashi, Sachiko Nakajima, Masashi Yamamoto, Koji F
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Kishan Patel, Nanxi Zha, Shana Neumann, Mitiadis Nicholas Tembelis, Mario Juliano, Naziya Samreen, Jawad Hussain, Mariam Moshiri, Michael N. Patlas, Douglas S. Katz
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Jesse Zuckerman, Richard Garfinkle, Carol‐Ann Vasilevksy, Gabriela Ghitulescu, Julio Faria, Nancy Morin, Marylise Boutros
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Diverticulitis: An Update From the Age Old Paradigm
Alexander T. Hawkins, Paul E. Wise, Tiffany Chan, Janet T. Lee, Tamara Glyn, Verity Wood, Timothy Eglinton, Frank Frizelle, Adil Khan, Jason Hall, M.I. Mohammed Ilyas, Maria Michailidou, Valentine N. Nfonsam, Michelle L. Cowan, Jennifer Williams, Scott R.
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Duodenal Diverticulosis as an Unusual Cause of Severe Abdominal Pain
Wajd A Aljabri, Mohammed Hasosah, Abeer AlMehdar, Dohaa Bakhsh, Faris O Alturkistany
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CT colonography: implementation, indications, and technical performance – a follow-up national survey
Fredrik Thorén, Åse A Johnsson, John Brandberg, Mikael Hellström
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Risk of Colorectal Cancer in Patients With Acute Diverticulitis: A Systematic Review and Meta-analysis of Observational Studies
Jeremy Meyer, Lorenzo A. Orci, Christophe Combescure, Alexandre Balaphas, Philippe Morel, Nicolas C. Buchs, Frédéric Ris
Clinical Gastroenterology and Hepatology.2019; 17(8): 1448. CrossRef
Meta-analysis of the role of colonoscopy after an episode of left-sided acute diverticulitis
S J Rottier, S T Dijk, A A W Geloven, W H Schreurs, W A Draaisma, W A Enst, J B C M Puylaert, M G J Boer, B R Klarenbeek, J A Otte, R J F Felt, M A Boermeester
British Journal of Surgery.2019; 106(8): 988. CrossRef

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Parthenolide promotes apoptotic cell death and inhibits the migration and invasion of SW620 cells: Yu Chuan Liu, Se Lim Kim, Young Ran Park, Soo-Teik Lee, Sang Wook Kim; Intest Res 2017;15(2):174-181. Published online April 27, 2017; DOI: https://doi.org/10.5217/ir.2017.15.2.174

Abstract PDF PubReader ePub

Background/Aims

Parthenolide (PT), a principle component derived from feverfew (Tanacetum parthenium), is a promising anticancer agent and has been shown to promote apoptotic cell death in various cancer cells. In this study, we focused on its functional role in apoptosis, migration, and invasion of human colorectal cancer (CRC) cells.

Methods

SW620 cells were employed as representative human CRC cells. We performed the MTT assay and cell cycle analysis to measure apoptotic cell death. The wound healing, Transwell migration, and Matrigel invasion assays were performed to investigate the effect of PT on cell migration/invasion. Western blotting was used to establish the signaling pathway of apoptosis and cell migration/invasion.

Results

PT exerts antiproliferative effect and induces apoptotic cell death of SW620 cells. In addition, PT prevents cell migration and invasion in a dose-dependent manner. Moreover, PT markedly suppressed migration/invasion-related protein expression, including E-cadherin, β-catenin, vimentin, Snail, cyclooxygenase-2, matrix metalloproteinase-2 (MMP-2), and MMP-9 in SW620 cells. PT also inhibited the expression of antiapoptotic proteins (Bcl-2 and Bcl-xL) and activated apoptosis terminal factor (caspase-3) in a dose-dependent manner.

Conclusions

Our results suggest that PT is a potential novel therapeutic agent for aggressive CRC treatment.

Citations

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Artificial Cells, Nanomedicine, and Biotechnology.2018; 46(sup3): 931. CrossRef

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Determining the optimal surveillance interval after a colonoscopic polypectomy for the Korean population?: Jung Lok Lee, Jae Myung Cha, Hye Min Lee, Jung Won Jeon, Min Seob Kwak, Jin Young Yoon, Hyun Phil Shin, Kwang Ro Joo, Joung Il Lee, Dong Il Park; Intest Res 2017;15(1):109-117. Published online January 31, 2017; DOI: https://doi.org/10.5217/ir.2017.15.1.109

Abstract PDF PubReader ePub

Background/Aims

Western surveillance strategies cannot be directly adapted to the Korean population. The aim of this study was to estimate the risk of metachronous neoplasia and the optimal surveillance interval in the Korean population.

Methods

Clinical and pathological data from index colonoscopy performed between June 2006 and July 2008 and who had surveillance colonoscopies up to May 2015 were compared between low- and high-risk adenoma (LRA and HRA) groups. The 3- and 5-year cumulative risk of metachronous colorectal neoplasia in both groups were compared.

Results

Among 895 eligible patients, surveillance colonoscopy was performed in 399 (44.6%). Most (83.3%) patients with LRA had a surveillance colonoscopy within 5 years and 70.2% of patients with HRA had a surveillance colonoscopy within 3 years. The cumulative risk of metachronous advanced adenoma was 3.2% within 5 years in the LRA group and only 1.7% within 3 years in the HRA group. The risk of metachronous neoplasia was similar between the surveillance interval of <5 and ≥5 years in the LRA group; however, it was slightly higher at surveillance interval of ≥3 than <3 years in the HRA group (9.4% vs. 2.4%). In multivariate analysis, age and the ≥3-year surveillance interval were significant independent risk factors for metachronous advanced adenoma (P=0.024 and P=0.030, respectively).

Conclusions

Patients had a surveillance colonoscopy before the recommended guidelines despite a low risk of metachronous neoplasia. However, the risk of metachronous advanced adenoma was increased in elderly patients and those with a ≥3-year surveillance interval.

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Risk of developing metachronous colorectal neoplasia after the resection of proximal versus distal adenomas
Yoon Suk Jung, Nam Hee Kim, Youngwoo Kim, Dong Il Park
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Post-polypectomy surveillance interval and advanced neoplasia detection rates: a multicenter, retrospective cohort study
Amanda J. Cross, Emma C. Robbins, Kevin Pack, Iain Stenson, Matthew D. Rutter, Andrew M. Veitch, Brian P. Saunders, Stephen W. Duffy, Kate Wooldrage
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Comparison of Risk of Metachronous Advanced Colorectal Neoplasia in Patients with Sporadic Adenomas Aged < 50 Versus ≥ 50 years: A Systematic Review and Meta-Analysis
Yoon Suk Jung, Jung Ho Park, Chan Hyuk Park
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British Society of Gastroenterology/Association of Coloproctology of Great Britain and Ireland/Public Health England post-polypectomy and post-colorectal cancer resection surveillance guidelines
Matthew D Rutter, James East, Colin J Rees, Neil Cripps, James Docherty, Sunil Dolwani, Philip V Kaye, Kevin J Monahan, Marco R Novelli, Andrew Plumb, Brian P Saunders, Siwan Thomas-Gibson, Damian J M Tolan, Sophie Whyte, Stewart Bonnington, Alison Scope,
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Eun Ran Kim, Hyuk Nam Kwon, Hoonsik Nam, Jae J. Kim, Sunghyouk Park, Young-Ho Kim
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Seiji Kimura, Masanori Tanaka, Shinsaku Fukuda
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Nam Hee Kim, Yoon Suk Jung, Jung Ho Park, Dong Il Park, Chong Il Sohn
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Nam Hee Kim, Yoon Suk Jung, Jung Ho Park, Dong Il Park, Chong Il Sohn
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The submucosal fibrosis: what does it mean for colorectal endoscopic submucosal dissection?: Eun Kyoung Kim, Dong Soo Han, Youngouk Ro, Chang Soo Eun, Kyo-Sang Yoo, Young-Ha Oh; Intest Res 2016;14(4):358-364. Published online October 17, 2016; DOI: https://doi.org/10.5217/ir.2016.14.4.358

Abstract PDF PubReader

Background/Aims

Endoscopic submucosal dissection (ESD) allows removal of colorectal epithelial neoplasms en bloc regardless of size. Colorectal ESD is a difficult procedure because of technical difficulties and risks of complications. This study aimed to assess the relationship between ESD outcome and degree of submucosal fibrosis.

Methods

Patients with colorectal tumors undergoing ESD and their medical records were reviewed retrospectively. The degree of submucosal fibrosis was classified into three types. The relationship between ESD outcome and degree of submucosal fibrosis was analyzed.

Results

ESD was performed in 158 patients. Thirty-eight cases of F0 (no) fibrosis (24.1%) and 46 cases of F2 (severe) fibrosis (29.1%) were observed. Complete resection was achieved for 138 lesions (87.3%). Multivariate analysis demonstrated that submucosal invasion of tumor and histology of carcinoma were independent risk factors for F2 fibrosis. Severe fibrosis was an independent risk factor for incomplete resection.

Conclusions

Severe fibrosis is an important factor related to incomplete resection during colorectal ESD. In cases of severe fibrosis, the rate of complete resection was low even when ESD was performed by an experienced operator. Evaluation of submucosal fibrosis may be helpful to predict the submucosal invasion of tumors and technical difficulties in ESD.

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Characteristics and outcomes of endoscopically resected colorectal cancers that arose from sessile serrated adenomas and traditional serrated adenomas: Ji Yeon Seo, Seung Ho Choi, Jaeyoung Chun, Changhyun Lee, Ji Min Choi, Eun Hyo Jin, Sung Wook Hwang, Jong Pil Im, Sang Gyun Kim, Joo Sung Kim; Intest Res 2016;14(3):270-279. Published online June 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.3.270

Abstract PDF PubReader ePub

Background/Aims

The efficacy and safety of endoscopic resection of colorectal cancer derived from sessile serrated adenomas or traditional serrated adenomas are still unknown. The aims of this study were to verify the characteristics and outcomes of endoscopically resected early colorectal cancers developed from serrated polyps.

Methods

Among patients who received endoscopic resection of early colorectal cancers from 2008 to 2011, cancers with documented pre-existing lesions were included. They were classified as adenoma, sessile serrated adenoma, or traditional serrated adenoma according to the baseline lesions. Clinical characteristics, pathologic diagnosis, and outcomes were reviewed.

Results

Overall, 208 colorectal cancers detected from 198 patients were included: 198 with adenoma, five with sessile serrated adenoma, and five with traditional serrated adenoma. The sessile serrated adenoma group had a higher prevalence of high-grade dysplasia (40.0% vs. 25.8%, P<0.001) than the adenoma group. During follow-up, local recurrence did not occur after endoscopic resection of early colorectal cancers developed from serrated polyps. In contrast, two cases of metachronous recurrence were detected within a short follow-up period.

Conclusions

Cautious observation and early endoscopic resection are recommended when colorectal cancer from serrated polyp is suspected. Colorectal cancers from serrated polyp can be treated successfully with endoscopy.

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Shaoyu Cheng, Liji Chen, Shujun Liu, Haiyan Zhang, Cailing Zhong, Tianwen Liu
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Small sessile serrated polyps might not be at a higher risk for future advanced neoplasia than low-risk adenomas or polyp-free groups
Eun Hyo Jin, Ji Yeon Seo, Jung Ho Bae, Jooyoung Lee, Ji Min Choi, Yoo Min Han, Joo Hyun Lim
Scandinavian Journal of Gastroenterology.2022; 57(1): 99. CrossRef
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Myung Hee Kim, Hee Seok Moon, In Sun Kwon, Ju Seok Kim, Sun Hyung Kang, Jae Kyu Sung, Eaum Seok Lee, Seok Hyun Kim, Byung Seok Lee, Hyun Yong Jeong
Medicine.2020; 99(29): e20799. CrossRef
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Clinical Gastroenterology and Hepatology.2019; 17(12): 2479. CrossRef
Clinical outcomes of surveillance colonoscopy for patients with sessile serrated adenoma
Sung Jae Park, Hyuk Yoon, In Sub Jung, Cheol Min Shin, Young Soo Park, Na Young Kim, Dong Ho Lee
Intestinal Research.2018; 16(1): 134. CrossRef
Surveillance colonoscopy in patients with sessile serrated adenoma
Ji Hyung Nam, Hyoun Woo Kang
Intestinal Research.2018; 16(3): 502. CrossRef
Identification of risk factors for sessile and traditional serrated adenomas of the colon by using big data analysis
Jeung Hui Pyo, Sang Yun Ha, Sung Noh Hong, Dong Kyung Chang, Hee Jung Son, Kyoung‐Mee Kim, Hyeseung Kim, Kyunga Kim, Jee Eun Kim, Yoon‐Ho Choi, Young‐Ho Kim
Journal of Gastroenterology and Hepatology.2018; 33(5): 1039. CrossRef
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Eun Mi Song, Hyo-Joon Yang, Hyun Jung Lee, Hyun Seok Lee, Jae Myung Cha, Hyun Gun Kim, Yunho Jung, Chang Mo Moon, Byung Chang Kim, Jeong-Sik Byeon
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Yoon Suk Jung
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Hyo‐Joon Yang, Sungkyoung Choi, Soo‐Kyung Park, Yoon Suk Jung, Kyu Yong Choi, Taesung Park, Ji Yeon Kim, Dong Il Park
Journal of Gastroenterology and Hepatology.2017; 32(7): 1328. CrossRef
Risk factors of missed colorectal lesions after colonoscopy
Jeonghun Lee, Sung Won Park, You Sun Kim, Kyung Jin Lee, Hyun Sung, Pil Hun Song, Won Jae Yoon, Jeong Seop Moon
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Systematic Review

Histological inflammation increases the risk of colorectal neoplasia in ulcerative colitis: a systematic review: Ruben J. Colman, David T. Rubin; Intest Res 2016;14(3):202-210. Published online June 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.3.202

Abstract PDF PubReader ePub

Background/Aims

Ulcerative colitis (UC) patients are at greater risk for the development of colorectal neoplasia. Several individual studies have demonstrated associations between severity of histologic inflammation and colorectal neoplasia. However, a comprehensive systematic review has not been completed. We performed a systematic review and meta-analysis to explore the relationship between histologic inflammation and risk for neoplasia among available observational studies.

Methods

Three databases (EMBASE, MEDLINE and the Cochrane Library) were systematically searched. Studies were included if they included UC patients who underwent colonoscopic assessment and when histologic inflammation and colorectal neoplasia were both reported. Colorectal neoplasia rates were compared. Quantitative meta-analysis was attempted.

Results

Four of 1,422 records found were eligible. Results from 2 case-control studies reported a 3.5-fold increased risk for colorectal neoplasia associated with a single point increase in histologic inflammation. This result was further corroborated by one cohort study that demonstrated increased hazard ratios. The second cohort study reported outcomes for patients with normal gross endoscopy, but had increased histological inflammation when neoplasia was assessed. Finally, this study reported increased risk for neoplastic progression by histological inflammation among patients who were normal by gross endoscopic evaluation. Quantitative meta-analysis was unsuccessful due to heterogeneity between study measures.

Conclusions

There is strong evidence that histologic inflammation among patients with UC increases the risk of colorectal neoplasia. The depth and nature of assessment of additional clinical variables was varied and may have resulted in greater outcome discrepancy. Additional study related to mechanisms of inflammation-related neoplasia and therapeutic modification is needed.

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Original Articles

Clinical Features and Prognosis of Resectable Primary Colorectal Signet-Ring Cell Carcinoma: Ho-Su Lee, Jae Seung Soh, Seohyun Lee, Jung Ho Bae, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sun A Kim, Young Soo Park, Seok-Byung Lim, Jin Cheon Kim, Chang Sik Yu, Dong-Hoon Yang; Intest Res 2015;13(4):332-338. Published online October 15, 2015; DOI: https://doi.org/10.5217/ir.2015.13.4.332

Abstract PDF PubReader ePub

Background/Aims

We attempted to investigate the prognosis of signet-ring cell carcinoma (SRC) patients who underwent curative surgery by comparing them with age-, sex-, and stage-matched non-mucinous adenocarcinoma (NMAC) patients.

Methods

Between January 2003 and December 2011, 19 patients with primary SRC of the colorectum underwent curative surgery. Four SRC patients under the age of 40 were excluded, and the clinicopathological data of 15 patients (7 men; median age, 56 years) were reviewed and compared with the data of 75 NMAC patients matched by age, sex, and pathologic stage.

Results

The median follow-up duration was 30.1 months for the SRC group and 43.7 months for the NMAC group (P=0.141). Involvement of the left side of the colon (73.3% vs. 26.7%, P=0.003) and infiltrative lesions such as Borrmann types 3 and 4 (85.7% vs. 24.0%, P=0.001) were more common in the SRC group than in the NMAC group. The five-year overall survival rate was significantly lower for patients with SRC than for those with NMAC (46.0% vs. 88.7%, hazard ratio, 6.99; 95% confidence interval, 2.33-20.95, P=0.001).

Conclusions

Patients with even resectable primary colorectal SRC had a poorer prognosis than age-, sex-, and stage-matched colorectal NMAC patients.

Citations

Citations to this article as recorded by

Comprehensive Characterization of the Immune Microenvironment of Colorectal and Gastric Signet Ring Cell Cancer
Jianqing Zhang, Robin Collingwood, Sameer Al Diffalha, Deborah Della Manna, Ravi Kumar Paluri, Haider A. Mejbel, Olumide Gbolahan
Cells.2025; 15(1): 30. CrossRef
Prognostic implications of T stage in different pathological types of colorectal cancer: an observational study using SEER population-based data
Nan Yao, Wenqiang Li, Jiwei Wang, Hongyuan Chu, Ning Duan, Xinyu Niu, Guoyong Yu, Jun Qu
BMJ Open.2024; 14(2): e076579. CrossRef
Systematic review of risk factors, prognosis, and management of colorectal signet-ring cell carcinoma
Frederiek Nuytens, Vincent Drubay, Clarisse Eveno, Florence Renaud, Guillaume Piessen
World Journal of Gastrointestinal Oncology.2024; 16(5): 2141. CrossRef
Modeling the survival of colorectal cancer patients based on colonoscopic features in a feature ensemble vision transformer
Chung-Ming Lo, Yi-Wen Yang, Jen-Kou Lin, Tzu-Chen Lin, Wei-Shone Chen, Shung-Haur Yang, Shih-Ching Chang, Huann-Sheng Wang, Yuan-Tzu Lan, Hung-Hsin Lin, Sheng-Chieh Huang, Hou-Hsuan Cheng, Jeng-Kai Jiang, Chun-Chi Lin
Computerized Medical Imaging and Graphics.2023; 107: 102242. CrossRef
Metastatic colorectal carcinoma with signet-ring cells: Clinical, histological and molecular description from an Association des Gastro-Entérologues Oncologues (AGEO) French multicenter retrospective cohort
Marion Allart, Florence Leroy, Stephano Kim, David Sefrioui, Mihane Nayeri, Aziz Zaanan, Benoit Rousseau, Meher Ben Abdelghani, Christelle de la Fouchardière, Wulfran Cacheux, Romain Legros, Samy Louafi, David Tougeron, Olivier Bouché, Nadim Fares, Guilla
Digestive and Liver Disease.2022; 54(3): 391. CrossRef
The Molecular Associations of Signet-Ring Cell Carcinoma in Colorectum: Meta-Analysis and System Review
Xueting Liu, Litao Huang, Menghan Liu, Zhu Wang
Medicina.2022; 58(7): 836. CrossRef
Clinicopathological factors and survival outcomes of signet-ring cell and mucinous carcinoma versus adenocarcinoma of the colon and rectum: a systematic review and meta-analysis
Michael G. Fadel, George Malietzis, Vasilis Constantinides, Gianluca Pellino, Paris Tekkis, Christos Kontovounisios
Discover Oncology.2021;[Epub] CrossRef
Clinicopathological Features and Survival of Signet-Ring Cell Carcinoma and Mucinous Adenocarcinoma of Right Colon, Left Colon, and Rectum
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The Characteristics and Prognostic Effect of E-Cadherin Expression in Colorectal Signet Ring Cell Carcinoma
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Younger Age Is Associated with Poorer Survival in Patients with Signet-Ring Cell Carcinoma of the Colon without Distant Metastasis
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Balsalazide Potentiates Parthenolide-Mediated Inhibition of Nuclear Factor-κB Signaling in HCT116 Human Colorectal Cancer Cells: Hyun-Young Kim, Se-Lim Kim, Young-Ran Park, Yu-Chuan Liu, Seung Young Seo, Seong Hun Kim, In Hee Kim, Seung Ok Lee, Soo Teik Lee, Sang Wook Kim; Intest Res 2015;13(3):233-241. Published online June 9, 2015; DOI: https://doi.org/10.5217/ir.2015.13.3.233

Abstract PDF PubReader

Background/Aims

Balsalazide is an anti-inflammatory drug used in the treatment of inflammatory bowel disease. Balsalazide can reduce inflammatory responses via several mechanisms, including inhibition of nuclear factor-κB (NF-κB) activity. Parthenolide (PT) inhibits NF-κB and exerts promising anticancer effects by promoting apoptosis. The present investigated the antitumor effects of balsalazide, combined with PT, on NF-κB in a representative human colorectal carcinoma cell line, HCT116.

Methods

We counted cells and conducted annexin-V assays and cell cycle analysis to measure apoptotic cell death. Western blotting was used investigate the levels of proteins involved in apoptosis.

Results

PT and balsalazide produced synergistic anti-proliferative effects and induced apoptotic cell death. The combination of balsalazide and PT markedly suppressed nuclear translocation of the NF-κB p65 subunit and the phosphorylation of inhibitor of NF-κB. Moreover, PT and balsalazide dramatically enhanced NF-κB p65 phosphorylation. Apoptosis, through the mitochondrial pathway, was confirmed by detecting effects on Bcl-2 family members, cytochrome c release, and activation of caspase-3 and -8.

Conclusions

Combination treatment with PT and balsalazide may offer an effective strategy for the induction of apoptosis in HCT116 cells.

Citations

Citations to this article as recorded by

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Cancer Biology & Therapy.2017; 18(4): 257. CrossRef
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