Screening and verification of potential gene targets in esophageal carcinoma by bioinformatics analysis and immunohistochemistry.

Background: To evaluate the potential of candidate proteins as diagnostic markers or drug targets in esophageal carcinoma (ESCA). Methods: GSE20347, GSE17351, and GSE45670 were downloaded from Gene Expression Omnibus (GEO). Differently expressed genes (DEGs) between ESCA and normal esophageal tissues from patients were obtained. Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed. The genes commonly featured in ESCA were screened by least absolute shrinkage and selection operator (LASSO) logistic regression and Boruta feature selection algorithm. The transcriptome data and corresponding clinical data of ESCA were downloaded from The Cancer Genome Atlas (TCGA) public database. Kaplan-Meier survival analysis was used to explore the core genes related to the prognosis of patients. A protein-protein interaction (PPI) network was generated by GeneMANIA to visualize the functional network between genes. Expressions of CRIP2, FOS, and HOXA10 genes in ESCA cells were verified by immunohistochemistry (IHC). Results: Out of 11,207 genes, 430 DEGs were identified, including 210 up-regulated genes and 220 down-regulated genes. After taking the intersection of LASSO regression and Boruta algorithm, 15 core genes were identified. Survival analyses demonstrated that low expression of CRIP2 (P=2.643e-02), as well as high expression of FOS (P=4.837e-02) and HOXA10 (P=4.97e-02), was significantly associated with the worse prognosis of ESCA patients. The 3 genes were strongly correlated with the content of immune cells and the stage of tumors. The expression of CRIP2 was correlated with the sensitivity of patients to dasatinib; FOS expression was correlated with the sensitivity of patients to erlotinib, and HOXA10 expression affected the sensitivity of patients to cisplatin, dasatinib, erlotinib, and gefitinib. The cBioportal database showed that 56 patients (31%) had the above core gene mutations: CRIP2 (8%), FOS (10%), and HOXA10 (17%). The IHC showed that there were differences in the expressions of these core genes between ESCA patients and the normal population (P<0.05), with ESCA patients showing higher expression. Conclusions: The low CRIP2 expression and high expressions of FOS and HOXA10 are associated with more advanced tumor stage, which may have the potential to be novel biomarkers for treatment selection in ESCA.

Risk factors for rebleeding in patients with obscure gastrointestinal bleeding from southern China.

BACKGROUND: To identify the risk factors associated with rebleeding in obscure gastrointestinal bleeding (OGIB) patients from southern China. METHODS: This retrospective study involved 229 patients who underwent small bowel endoscopy in our hospital between 1 January 2018 and 1 December 2020. The clinical characteristics and risk factors related to rebleeding were retrospectively evaluated. RESULTS: Rebleeding patients were significantly older than non-rebleeding patients (53.0 ± 15.9 vs. 46.2 ± 17.8 years), had lower hemoglobin concentrations (89.2 ± 28.1 vs. 126.2 ± 25.1 g/L), and higher blood urea nitrogen concentrations (5.4 ± 2.6 vs. 4.5 ± 2.2 µmol/L), respectively. A higher percentage of rebleeding patients had diabetes mellitus (13.9% vs. 2.9%) and overt bleeding (70.4% vs. 38.6%), and required blood transfusions (43.1% vs. 8.0%), compared with non-rebleeding patients, respectively. Multivariate logistic analysis indicated that drinking alcohol (odds ratio (OR): 9.27; 95% confidence interval (CI) = 1.35-63.78), anemia (OR: 17.38; 95% CI = 5.48-55.10), and blood transfusion (OR: 3.76; 95% CI = 1.04-13.56) increased the risk of rebleeding in OGIB patients. CONCLUSION: Our data suggested that OGIB patients who drink alcohol, have anemia, and require blood transfusion have an increased risk of rebleeding.

Elevated serum triglyceride predicts recurrence of colorectal polyps in patients with advanced adenomas.

BACKGROUND: Recurrence of colorectal polyps is common and impacted by various factors. This study was performed to explore the association between lipid profiles and recurrence of colorectal polyps. METHODS: This study retrospectively analyzed the lipid profiles of 435 patients who underwent colonoscopy with removal of colorectal polyps and assessed recurrence of polyps by follow-up colonoscopy. Multivariate regression logistic analysis was used to evaluate the association between lipid profiles and polyp recurrence. RESULTS: During the 1.5-year follow-up, recurrence of colorectal polyps was observed in 135 of 435 patients (30.34%). Patients with recurrent polyps showed a higher level of triglycerides (P = 0.006) and lower levels of high-density lipoprotein cholesterol (P = 0.008) and apolipoprotein A1 (P = 0.033). The multivariate regression logistic model suggested that an elevated triglyceride level was an independent risk factor for polyp recurrence (odds ratio, 1.55; 95% confidence interval, 1.02-2.35; P = 0.039) in patients with advanced adenoma. CONCLUSIONS: Lipid profiles are associated with recurrence of colorectal polyps. An elevated triglyceride level is an independent risk predictor of polyp recurrence in patients with advanced adenoma.

Elevated serum triglyceride and low-density lipoprotein cholesterol promotes the formation of colorectal polyps.

BACKGROUND: Hyperlipidaemia may be a potential risk factor for the occurrence of intestinal polyps. This study aimed to evaluate correlation between lipidaemia and the formation of colorectal polyps. METHODS: One hundred and fourteen patients with colorectal polyps and forty-eight healthy controls were included in this study. Colonoscopies were performed for all patients and controls within 1 week before blood samples were taken. The concentrations of serum lipids and lipoproteins were measured simultaneously using an automatic biochemical analyser. The colorectal lesions were classified based on pathological characteristics, and four types were identified in the study: hyperplastic polyp (HP), tubular adenoma (TA), tubulovillous adenoma (TVA) and adenoma with high-grade dysplasia (A-HGD). Advanced adenoma was classified according to the number, size and histological type of polyps. RESULTS: The value of low-density lipoprotein cholesterol (LDL-C) was significantly higher in the group with advanced adenoma than in the controls (p < 0.05). Moreover, the LDL-C values in the HP and TA groups were higher when compared to that of controls (p < 0.05). Obesity, age, and increased TG and LDL-C were independent risk factors for the formation of colorectal polyps. The cut-off values of triglyceride (TG) and LDL-C to distinguish polyp patients from healthy controls were 0.96 mmol/L (AUC = 0.604, p = 0.036) and 3.05 mmol/L (AUC = 0.654, p = 0.002). The combined use of increased LDL-C and TG levels to distinguish polyp patients was effective, with a sensitivity of 50.0% and a specificity of 89.6% (AUC = 0.733, p < 0.01). CONCLUSIONS: Colorectal polyps are more often found in obese and older patients. Increased LDL-C and TG were correlated with the occurrence of polyps. Combination of the two serum indicators was useful to assess risk of colorectal lesions, maybe more effective in screening hyperplastic polyp, tubular adenoma and advanced adenoma.