Modifiable lifestyle factors have a larger contribution to colorectal neoplasms than family history.

BACKGROUND:  Screening recommendations for colorectal cancer (CRC) are mainly based on family history rather than lifestyle risk factors. We aimed to assess and compare risk factors for colorectal neoplasm (CRN) and evaluate trends in neoplasm detection rates during the three rounds of screening from 2012 to 2020 in Tianjin, China. METHODS: This study was based on 89,535 first-recorded colonoscopies in Tianjin CRC screening program, 2012-2020. Of these, 45,380 individuals with complete family history and lifestyle factors were included for population attributable fraction (PAF) estimation. RESULTS:  The overall detection rate of nonadvanced adenomas, advanced adenomas and CRC was 39.3%, 5.9% and 1.5%, respectively. The PAFs of current smoking, alcohol consumption, physical activity, higher BMI and family history of CRC, respectively, were 8.9%, 2.6%, 1.9%, 5.8%, and 1.1% for males with nonadvanced CRN; 12.3%, 7.3%, 4.9%, 7.2%, and 0.8% for males with advanced CRN; 3.4%, 0.4%, 2.1%, 7.8%, and 0.7% for females with nonadvanced CRN; and 4.3%, 0.2%, 8.2%, 8.5%, and -0.6% for females with advanced CRN. The PAFs of selected lifestyle factors were 19.9% for males with nonadvanced CRN, 29.0% for males with advanced CRN, 9.7% for females with nonadvanced CRN and 13.8% for females with advanced CRN. CONCLUSIONS:  Modifiable lifestyle factors, including smoking, alcohol consumption, physical activity and BMI, have a larger contribution to CRN than family history of CRC. Our findings will provide references for developing guidelines of CRC prevention and control in China.

Circular RNA circWHSC1 facilitates colorectal cancer cell proliferation by targeting miR-130a-5p/zeb1 signaling in vitro and in vivo.

Colorectal cancer is a prevalent cancer globally and has become a threaten of human health. Recently, circular RNAs (circRNAs) have been widely studied in the cancer area, and the function of circular RNA circWHSC1 has been identified in several cancers. However, the role of circWHSC1 in colorectal cancer remains elusive. In this study, we were interested in the effects of circWHSC1 on colorectal cancer progression. We found that level of circWHSC1 was elevated in colorectal cancer cells compared with normal colon epithelial cells. FISH assay further confirmed that circWHSC1 was mainly localized in cytoplasm. CircWHSC1 depletion repressed the viability of colorectal cancer cells. The colony formation number and Edu-positive colorectal cancer cells were inhibited by the depletion of circWHSC1, respectively. The knockdown of circWHSC1 promoted the apoptosis of colorectal cancer cells. The tumor growth of colorectal cancer cells in nude mice was attenuated by circWHSC1 silencing. Meanwhile, the invasion and migration ability of colorectal cancer cells was suppressed by circWHSC1 depletion. Mechanically, circWHSC1 targets miR-130a-5p to promote zeb1 expression in colorectal cancer cell. The depletion of circWHSC1 remarkably reduced the cell viability and Edu-positive colorectal cancer cells, and the miR-130a-5p inhibitor or zeb1 overexpression could restore the phenotypes. Furthermore, the tumor growth of colorectal cancer cells in nude mice was attenuated by circWHSC1 knockdown, while miR-130a-5p depletion or zeb1 overexpression reversed the effect in the model. Therefore, we concluded that Circular RNA circWHSC1 facilitated colorectal cancer cell proliferation by targeting miR-130a-5p/zeb1 signaling in vitro and in vivo.

Young Patients With Colorectal Cancer Have Higher Early Mortality but Better Long-Term Survival.

INTRODUCTION: To define the prognosis of colorectal cancer (CRC) in young patients and to compare their postoperative treatment with that of older patients. METHODS: This multicenter study enrolled 5,457 patients with primary CRC who underwent surgical resection. The overall survival (OS), clinicopathologic characteristics, and postoperative treatment of 253 young patients aged 18-44 years and 5,204 older patients aged 44-80 years were analyzed. RESULTS: The OS rate was 77.1% for young and 74.2% for older patients (P = 0.348). Landmark analysis showed a significant difference in survival between young and older patients, with 63.8% of deaths among young patients being within 25 months of surgery compared with 42.4% among older patients (P = 0.002). Among those who survived more than 25 months, young patients had significantly better survival than older patients (P = 0.009). Multivariable analysis of young patients revealed that the tumor location, perineural invasion, and stage were associated with poor survival within 25 months; after this period, stage was the only prognostic marker. Young patients were more likely to receive chemotherapy, particularly multiagent regimens. For young patients, no significant difference in OS was found based on the chemotherapy regimen, regardless of disease stage (II, III, or IV, all P > 0.05). In addition, unlike in older patients, no difference in OS was found in young patients regardless of the drug regimen administered (all P > 0.05). DISCUSSION: Young-onset CRC may have a unique disease biology that warrants further research and therapy development.

Endoscopic resection of a giant colonic lipoma with endoloop-assisted unroofing technique: A case report.

RATIONALE: Colonic lipomas are uncommon benign submucosal adipose tumorsthat are usually asymptomatic. Large lipomas can cause symptoms require treatment in principle. We report 1 case of giant colonic lipoma removed with endoloop-assisted unroofing technique instead of conventional surgical bowel resection. PATIENT CONCERNS: A 62-year-old female patient presented with intermittent abdominal discomfort for 1 month. DIAGNOSIS: The patient was diagnosed as having a giant colonic lipoma. INTERVENTION: Endoscopic resection with endoloop-assisted unroofing technique was performed. On the 22nd day after resection, intestinal obstruction occurred by shedding mass was found; the symptoms of this patient disappeared soon after removal of the mass by endoscopy. OUTCOMES: A follow-up colonoscopy 6 months later showed a scarred mucosa at the ligation site and no residual lipoma was observed. LESSONS: Endoscopic resection with endoloop-assisted unroofing technique remains a viable option for giant lipomas; however, postoperative intestinal obstruction caused by shedding mass should be noted.

Development and application of a fluorescence protein microarray for detecting serum alpha-fetoprotein in patients with hepatocellular carcinoma.

Objective To develop a simple, effective, time-saving and low-cost fluorescence protein microarray method for detecting serum alpha-fetoprotein (AFP) in patients with hepatocellular carcinoma (HCC). Method Non-contact piezoelectric print techniques were applied to fluorescence protein microarray to reduce the cost of prey antibody. Serum samples from patients with HCC and healthy control subjects were collected and evaluated for the presence of AFP using a novel fluorescence protein microarray. To validate the fluorescence protein microarray, serum samples were tested for AFP using an enzyme-linked immunosorbent assay (ELISA). Results A total of 110 serum samples from patients with HCC ( n = 65) and healthy control subjects ( n = 45) were analysed. When the AFP cut-off value was set at 20 ng/ml, the fluorescence protein microarray had a sensitivity of 91.67% and a specificity of 93.24% for detecting serum AFP. Serum AFP quantified via fluorescence protein microarray had a similar diagnostic performance compared with ELISA in distinguishing patients with HCC from healthy control subjects (area under receiver operating characteristic curve: 0.906 for fluorescence protein microarray; 0.880 for ELISA). Conclusion A fluorescence protein microarray method was developed for detecting serum AFP in patients with HCC.

Protein microarray with horseradish peroxidase chemiluminescence for quantification of serum α-fetoprotein.

OBJECTIVES: To develop and evaluate a protein microarray assay with horseradish peroxidase (HRP) chemiluminescence for quantification of α-fetoprotein (AFP) in serum from patients with hepatocellular carcinoma (HCC). METHODS: A protein microarray assay for AFP was developed. Serum was collected from patients with HCC and healthy control subjects. AFP was quantified using protein microarray and enzyme-linked immunosorbent assay (ELISA). RESULTS: Serum AFP concentrations determined via protein microarray were positively correlated (r = 0.973) with those determined via ELISA in patients with HCC (n = 60) and healthy control subjects (n = 30). Protein microarray showed 80% sensitivity and 100% specificity for HCC diagnosis. ELISA had 83.3% sensitivity and 100% specificity. Protein microarray effectively distinguished between patients with HCC and healthy control subjects (area under ROC curve 0.974; 95% CI 0.000, 1.000). CONCLUSION: Protein microarray is a rapid, simple and low-cost alternative to ELISA for detecting AFP in human serum.