ABSTRACT
BACKGROUND: Early diagnosis and treatment are crucial to improve the prognosis of colorectal cancer (CRC). At present, there is a lack of an accurate CRC screening factor. We conducted folate receptor-positive circulating tumor cell analysis (FR + CTC analysis) in distinguishing CRC from benign colorectal diseases to evaluate the diagnostic efficiency. METHODS: Clinical data of patients admitted to The First Affiliated Hospital of Anhui Medical University from January 2021 to July 2022 were retrospectively collected. Levels of FR + CTC and other indicators were analyzed. Receiver operating characteristic (ROC) analysis was performed to assess the diagnostic performance of these molecular biomarkers. RESULTS: Data of 103 patients with CRC and 54 patients with benign colorectal diseases were collected. FR + CTC levels were observed significantly higher in CRC patients than in patients with benign colorectal diseases (P < 0.001). FR + CTC level was correlated with tumor diameter, differentiation, T-stage, pathological stage, clinical stage, and intravascular tumor thrombus in patients with CRC (P < 0.05). The optimal cutoff value of FR + CTC level for diagnosing CRC patients was 7.66 FU/3 ml, with a sensitivity of 85.4%, a specificity of 74.1%, and an Area Under Curve (AUC) of 0.855 (95% CI 0.77-0.923). In < 50-years old patients with CRC, the diagnostic efficiency of FR + CTC was excellent, with an AUC of 0.936 (95% CI 0.877-0.995). CONCLUSION: FR + CTC counting has excellent diagnostic efficiency in screening of CRC. FR + CTC count can also predict the tumor stage of CRC patients before surgery, and guide the choice of treatment.
Subject(s)
Colorectal Neoplasms , Neoplastic Cells, Circulating , Humans , Middle Aged , Retrospective Studies , Neoplastic Cells, Circulating/pathology , Biomarkers, Tumor , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/surgery , Folic AcidABSTRACT
Objective To investigate the risk factors and countermeasures for endoscopic retrograde cholangiopancreatography (ERCP) related duodenal papilla hemorrhage. Methods Retrospective analysis was performed on the clinical data of 890 patients who underwent ERCP. According to whether the patients with ERCP related duodenal papilla hemorrhage, they were divided into the hemorrhage group and the non hemorrhage group. And the risk factors of duodenal papilla hemorrhage and their countermeasures were investigated. Results 51 patients had ERCP related duodenal papilla hemorrhage, and the overall incidence rate was 5.7%. Compared with the non hemorrhage group, the patients proportion of common bile duct stones was lower, but the cholangiocarcinoma and pancreatic head cancer were higher in the hemorrhage group (P < 0.05). The incidence of hypertension and duodenal diverticulum in the hemorrhage group were significantly higher than that in the non hemorrhage group (P < 0.05). Subgroup analysis showed that patients with stone diameter >2 cm, stone incarceration and the duodenal papilla into diverticulum in the hemorrhage group were significantly higher than that in the non hemorrhage group (P < 0.05). Conclusion Common bile duct stone diameter >2 cm, stone incarceration, malignant biliary and pancreatic cancer, hypertension and duodenal papilla into diverticulum were objective risk factors of ERCP related duodenal papilla hemorrhage, focus on prevention of bleeding. Endoscopic hemostasis was safe and effective.
ABSTRACT
Objective To investigate the risk factors and countermeasures for endoscopic retrograde cholangiopancreatography (ERCP) related duodenal papilla hemorrhage. Methods Retrospective analysis was performed on the clinical data of 890 patients who underwent ERCP. According to whether the patients with ERCP related duodenal papilla hemorrhage, they were divided into the hemorrhage group and the non hemorrhage group. And the risk factors of duodenal papilla hemorrhage and their countermeasures were investigated. Results 51 patients had ERCP related duodenal papilla hemorrhage, and the overall incidence rate was 5.7%. Compared with the non hemorrhage group, the patients proportion of common bile duct stones was lower, but the cholangiocarcinoma and pancreatic head cancer were higher in the hemorrhage group (P < 0.05). The incidence of hypertension and duodenal diverticulum in the hemorrhage group were significantly higher than that in the non hemorrhage group (P < 0.05). Subgroup analysis showed that patients with stone diameter >2 cm, stone incarceration and the duodenal papilla into diverticulum in the hemorrhage group were significantly higher than that in the non hemorrhage group (P < 0.05). Conclusion Common bile duct stone diameter >2 cm, stone incarceration, malignant biliary and pancreatic cancer, hypertension and duodenal papilla into diverticulum were objective risk factors of ERCP related duodenal papilla hemorrhage, focus on prevention of bleeding. Endoscopic hemostasis was safe and effective.