This study aims to help physicians obtain the detection rate and colonoscopic information of colorectal cancer (CRC) among patients in a city in China.A total of 15,189 participants who underwent total colonoscopy between January 2000 and December 2015 were studied. A total of 1022 CRCs were diagnosed. We analyzed the detection rate, anatomic sites, and pathologic types among different sex, age, and decade groups. Moreover, we investigated the corresponding relationships between the anatomic sites and the pathologic types.Colonoscopic examinations revealed that the risk for CRC between men and women showed no significant difference (6.97% vs. 6.42%). The detection rate of CRC significantly increased with age (2.08% vs. 5.95% vs. 15.09%). The proportion of poorly differentiated adenocarcinoma among the youth group was significantly higher than that in the other age groups (25.0% vs. 11.54% vs. 8.33%). However, the numbers of cases with well-differentiated and moderately differentiated adenocarcinoma observed in the old-aged group were higher than other age groups. This finding demonstrated that the differentiation degree of adenocarcinoma increased with the age. Neuroendocrine tumor was mainly located in the rectum (95.0%), and appeared more frequently among the youth group (7.5% vs. 1.48% vs. 1.06%).We found the detection rate of CRC varied in terms of sex and decade. The CRC cases in the youth group exhibited a high malignant degree. The most common anatomic site was rectum, so we should focus more on digital rectal examination.
BACKGROUND:The effects of Helicobacter pylori (H. pylori) infection on gastroesophageal reflux disease (GERD) remain unclear. The aim of this study was to compare the results of clinical esophageal function tests and the effect of H. pylori infection on GERD. MATERIAL AND METHODS:A prospective clinical study included 124 patients diagnosed with GERD (four grades). H. pylori infection was determined by gastroscopy and a rapid urease test (RUT) to divide patients into an HP-positive and an HP-negative group. Esophageal function tests included high-resolution manometry (HRM), peristalsis break (PB), and 24-hour pH monitoring (composite pH DeMeester score). Different grades of GERD, with and without H. pylori infection, esophageal function test results were analyzed. RESULTS:The HP-positive group, compared with the HP-negative group with GERD, showed a significantly reduced median PB value (3.41±3.65 vs. 6.18±5.27), reduced PBs >5 cm per ten swallows (2.23±3.05 vs. 4.04±3.70) indicating that that H. pylori infection improved esophageal peristalsis. During 24-hour esophageal pH monitoring, the HP-positive group showed a significantly reduced percentage of time for esophageal pH <4.0, number of reflux events >5 min, and number of reflux episodes in 24 hours, compared with the HP-negative group. The DeMeester score was significantly increased in the HP-negative group, indicating a higher esophageal acid exposure (9.11±8.15 vs. 24.30±30.27). CONCLUSIONS:H. pylori infection improved esophageal peristalsis, enhanced lower esophageal sphincter (LES) pressure, and reduced esophageal acid exposure, which might be protective factors for GERD.
This study aims to investigate the effect of miR-21-5p on process of colon adenocarcinoma (COAD) cells and its connection with neural cell adhesion molecule L1 (CHL1).Different expressions of mRNAs and miRNAs were calculated with microarray analysis. QRT-PCR and western blot were performed to quantify miR-21-5p and CHL1 expression. Flow Cytometry, MTT assay, colony formation assay, transwell assay and ELISA were performed to evaluate propagation and invasiveness of COAD cells. Dual luciferase reporter assay was employed to scrutinize the relationship between miR-21-5P and CHL1. We performed in vivo experiment to detect the impact of miR-21-5p and CHL1 on COAD tumor growth.Expression level of miR-21-5p increased in both COAD tissues and cells. MTT and Cell cycle assay showed that overexpression of miR-21-5p accelerated proliferation of COAD cells. Transwell assay indicated that miR-21-5p promoted cell invasion. The result of dual luciferase reporter assay indicated that miR-21-5p targeted CHL1 directly and inhibited its expression. The result of in vivo experiments showed that down-regulation of miR-21-5p decreased the volume and weight of tumor, while knockdown of CHLI stimulated tumor growth.The overexpression of miR-21-5p can promote propagation and invasiveness of COAD cells through inhibiting the expression of CHL1.
Synchronous neoplastic lesions are usually present in patients with colorectal cancer (CRC) at diagnosis or postoperative follow-up endoscopy. However, few studies have been published about the clinicopathological features of synchronous lesions, especially those of synchronous advanced neoplasia. This study aimed to describe synchronous lesions in patients with CRC because this knowledge may be useful for preventing the development of metachronous cancer.We retrospectively reviewed 261 primary CRC cases with synchronous lesions referred to our hospital during a 4-year period. Personal history, habits, family history, characteristics of index cancer, and synchronous lesions were assessed.In total, the 261 patients with CRC had 812 synchronous adenomas and 146 advanced neoplasia. Diminutive, small, and large polyps made up 66.7%, 20.2%, and 13.1% of all lesions, respectively; 9.3% of diminutive and small adenomas were advanced neoplasia, and 45.2% of synchronous advanced lesions were subcentimeter polyps. Both synchronous non-advanced lesions and advanced lesions developed most frequently in the distal colon, followed by the proximal colon, and were least frequently found in the rectum (P < 0.001). Older age (P = 0.04) and male gender (P = 0.001) were associated with the presence of advanced neoplasia in CRC cases with synchronous neoplastic lesions. Meanwhile, the use of aspirin may be associated with a lower incidence of advanced neoplasia (P = 0.04).Patients diagnosed with CRC require detailed clearing of the remainder of the colon at baseline coloscopy or postoperative follow-up examination, and we should take a more cautious approach to synchronous subcentimeter polyps in this group of patients.
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