3328Relationship between streptococcal infective endocarditis and pre-neoplastic colorectal lesions

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
P Vilardell ◽  
S Moral ◽  
D Bosch ◽  
M Morales ◽  
J M Frigola ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Infective Endocarditis ◽  
Precancerous Lesions ◽  
Statistical Significance ◽  
World Health ◽  
Low Grade ◽  
Muscularis Mucosa ◽  
Streptococcus Gallolyticus ◽  
Neoplastic Lesions ◽  
Cancerous Lesions

Abstract Background Colorectal cancer is associated with infective endocarditis (IE), due to specific gut pathogens like streptococcus Gallolyticus that use the tumor presence as a point of blood entry. However, the association between streptococcal IE and pre-cancerous lesions such as dysplastic adenomas is unknown. Objectives To determine the association with pre-neoplastic colorectal lesions and streptococcal IE. Methods Two hundred eighty consecutive patients with IE were included retrospectively in a protocol of clinical, microbiological and imaging follow-up, between January 2008 and December 2018. Pre-cancerous lesions were divided as high and low-grade dysplasia based on World Health Organization criteria. Colorectal cancer was defined as the presence of malignant cell beyond the muscularis mucosa. Results Fifty patients (18%) presented neoplastic or pre-neoplastic lesions, and 26 of them (52%) were colorectal: 10 (38%) colorectal cancer and 16 (62%) precancerous lesions (12% high degree (n=2); 88% low degree (n=14)). Both, colorectal cancer (20% vs 5%; p=0.03) and pre-neoplastic lesions (44% vs 3%; p<0.05) were associated with higher incidence of streptococcus Gallolyticus IE (Figure 1). Additionally, 42% (n=11) of colorectal lesions were diagnosed in the IE event. No significant differences were found about cardiac surgery and in-hospital mortality in these patients. Figure 1. Relationship between S. Gallolyticus IE and colorectal lesions. (a) Statistical significance between colorectal cancer and S. Gallolyticus IE. (b) Statistical significance between pre-neoplastic colorectal lesions and S. Gallolyticus IE. Conclusions Pre-cancerous colorectal lesions are also associated with streptococcus Gallolyticus IE, even low-grade lesions. Hence, it is necessary to rule out occult neoplastic and also pre-neoplastic colorectal lesions with colonoscopy in these patients.

scholarly journals P661 Relationship between streptococcal infective endocarditis and preneoplastic colorectal lesions

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
P Vilardell ◽  
S Moral ◽  
D Bosch ◽  
J M Frigola ◽  
M Morales ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Infective Endocarditis ◽  
Precancerous Lesions ◽  
Statistical Significance ◽  
World Health ◽  
Low Grade ◽  
Muscularis Mucosa ◽  
Preneoplastic Lesions ◽  
Streptococcus Gallolyticus ◽  
Low Degree

Abstract Background Colorectal cancer is associated with infective endocarditis (IE), due to specific gut pathogens like streptococcus Gallolyticus that use the tumor presence as a point of blood entry. However, the association between streptococcal IE and pre-cancerous lesions such as dysplastic adenomas is unknown. Objectives To determine the association with pre-neoplastic colorectal lesions and streptococcal IE. Methods Two hundred eighty consecutive patients with IE were included in a protocol of clinical, microbiological and imaging follow-up, between January 2008 and December 2018. Precancerous lesions were divided as high and low-grade dysplasia based on World Health Organization criteria. Colorectal cancer was defined as the presence of malignant cell beyond the muscularis mucosa. Results A colonoscopy was performed in 81 patients (29%) and 26 of them (32%) presented colorectal lesions: 10 (38%) colorectal cancer and 16 (62%) precancerous lesions (12% high degree (n = 2); 88% low degree (n = 14)). Both, colorectal cancer (20% vs 11%; p = 0.02) and preneoplastic lesions (44% vs 8%; p &lt; 0.001) were associated with higher incidence of streptococcus Gallolyticus IE (Figure 1). Additionally, the subgroup of precancerous lesions with low degree also showed this association (43% vs 9%; p = 0.001). Conclusions Precancerous colorectal lesions are also associated with streptococcus Gallolyticus IE, even low-grade lesions. Hence, it is necessary to rule out occult neoplastic and preneoplastic colorectal lesions with colonoscopy in these patients. Figure 1: Relationship between S. Gallolyticus IE and colorectal lesions. a Statistical significance between colorectal cancer and S. Gallolyticus IE. b Statistical significance between preneoplastic colorectal lesions and S. Gallolyticus IE. Abstract P661 Figure.

scholarly journals Clinicopathological features of Egyptian colorectal cancer patients regarding somatic genetic mutations especially in KRAS gene and microsatellite instability status: a pilot study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Neemat M. Kassem ◽  
Gamal Emera ◽  
Hebatallah A. Kassem ◽  
Nashwa Medhat ◽  
Basant Nagdy ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Microsatellite Instability ◽  
Cpg Island ◽  
Human Cancer ◽  
Statistical Significance ◽  
Public Health Problem ◽  
World Health ◽  
Cpg Island Methylator Phenotype ◽  
Number Of Patients ◽  
The Impact

Abstract Background Colorectal cancer (CRC) is the third most common cause of cancer-related deaths which contributes to a significant public health problem worldwide with 1.8 million new cases and almost 861,000 deaths in 2018 according to the World Health Organization. It exhibits 7.4% of all diagnosed cancer cases in the region of the Middle East and North Africa. Molecular changes that happen in CRCs are chromosomal instability, microsatellite instability (MSI), and CpG island methylator phenotype. The human RAS family (KRAS, NRAS, and HRAS) is the most frequently mutated oncogenes in human cancer appearing in 45% of colon cancers. Determining MSI status across CRCs offers the opportunity to identify patients who are likely to respond to targeted therapies such as anti-PD-1. Therefore, a method to efficiently determine MSI status for every cancer patient is needed. Results KRAS mutations were detected in 31.6% of CRC patients, namely in older patients (p = 0.003). Codons 12 and 13 constituted 5/6 (83.3%) and 1/6 (16.7%) of all KRAS mutations, respectively. We found three mutations G12D, G12C, and G13D which occur as a result of substitution at c.35G>A, c.34G>T, and c.38G>A and have been detected in 4/6 (66.6%), 1/6 (16.7%), and 1/6 (16.7%) patients, respectively. Eleven (57.9%) patients had microsatellite instability-high (MSI-H) CRC. A higher percentage of MSI-H CRC was detected in female patients (p = 0.048). Eight patients had both MSI-H CRC and wild KRAS mutation with no statistical significance was found between MSI status and KRAS mutation in these studied patients. Conclusion In conclusion, considering that KRAS mutations confer resistance to EGFR inhibitors, patients who have CRC with KRAS mutation could receive more tailored management by defining MSI status. MSI-high patients have enhanced responsiveness to anti-PD-1 therapies. Thus, the question arises as to whether it is worth investigating this association in the routine clinical setting or not. Further studies with a larger number of patients are needed to assess the impact of MSI status on Egyptian CRC care.

scholarly journals Cervical Visual Inspection with Acetic Acid (VIA) and Oncogenic Human Papillomavirus Screening in Rural Indigenous Guatemalan Women: Time to Rethink VIA

2021 ◽  
Vol 18 (23) ◽  
pp. 12406
Author(s):  
Anne Jeffries ◽  
Consuelo M. Beck-Sagué ◽  
Ariel Bernardo Marroquin-Garcia ◽  
Michael Dean ◽  
Virginia McCoy ◽  
...  
Keyword(s):  
Acetic Acid ◽  
Human Papillomavirus ◽  
Visual Inspection ◽  
Clinical Laboratory ◽  
Precancerous Lesions ◽  
World Health ◽  
Low Grade ◽  
Hpv Testing ◽  
Abnormal Cytology ◽  
Hpv Test

Single-visit “screen-and-treat” strategies using visual inspection with acetic acid (VIA) and cryotherapy (liquid nitrous oxide ablation) in low-resource settings are commonly used to detect and treat precancerous lesions for cervical cancer prevention. This study compared VIA sensitivity and specificity in rural indigenous Guatemalan communities, to that of oncogenic human papillomavirus (HPV) testing for detection of precancerous changes, using cytology as the reference standard. Between 3–8 September 2017, trained nurses examined 222 women aged 23–58 years with VIA. Specimens for liquid-based cytology and HPV testing were obtained prior to VIA with a cytobrush and transported in PreservCyt to a US clinical laboratory. VIA and HPV test sensitivities were assessed as proportions of women with abnormal cytology that had abnormal VIA or HPV results, respectively, and specificities, as proportions with normal cytology with normal VIA or negative HPV tests. Of 222 women, 18 (8.1%) had abnormal cytology (1 carcinoma in a participant who received VIA-based cryotherapy in 2015, 4 high- and 5 low-grade squamous intraepithelial lesions, and 8 atypical squamous cells of undetermined significance (ASCUS)). Excluding ASCUS, sensitivities of VIA and HPV were 20.0% and 100%, respectively. VIA-based screening may not be acceptable for detecting precancerous lesions, and field cryotherapy for preventing malignancy. The World Health Organization recommended in 2021 “…using HPV DNA detection as the primary screening test rather than VIA or cytology.”

scholarly journals P299 A prospective randomised trial comparing dye-based chromoendoscopy with electronic virtual chromoendoscopy for detection of colonic neoplastic lesions during IBD surveillance colonoscopy

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S302-S303
Author(s):  
O González-Bernardo ◽  
S Vivas ◽  
R de Francisco ◽  
I Pérez-Martínez ◽  
A Castaño-García ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Digital Image ◽  
Detection Rate ◽  
Low Grade ◽  
Surveillance Colonoscopy ◽  
Detection Rates ◽  
Neoplastic Lesion ◽  
Neoplastic Lesions ◽  
History Of ◽  
Virtual Chromoendoscopy

Abstract Background Patients with inflammatory bowel disease (IBD) have an increased risk of colorectal cancer. Dye-based chromoendoscopy (CE) is the currently recommended method for the detection of dysplasia in IBD surveillance colonoscopy; the role of virtual chromoendoscopy (VCE) is not yet well defined. To compare CE with VCE using iSCAN1 digital image enhanced colonoscopy in the detection of colonic neoplastic lesions in IBD patients. Methods Randomised, single-centre trial to assess the detection rate of colonic neoplastic lesions in patients with long-standing IBD. Patients were randomised in two arms: dye-spraying CE using indigo carmine and electronic VCE using iSCAN1 digital image. Detection rates of dysplasia or any neoplastic lesion were compared by the two endoscopic techniques. Results A total of 129 patients were studied (67 by CE and 62 by VCE). Demographic and clinical characteristics were homogeneous in the two groups; 26 Crohn′s disease and 103 ulcerative colitis, 52% women, mean age 50 years, median duration of IBD 204 months, family history of colorectal cancer in 10 (8%), associated primary sclerosing cholangitis in 8 (6%), personal history of colorectal dysplastic lesions in 12 (9%), and more than 50% colonic involvement in 72 (56%). In total, 27 lesions (9 hyperplastic, 8 adenomatous and 10 low-grade dysplasia) were detected in 23 patients, without differences between CE and VCE arms (15 [22%] and 12 [19%] lesions, respectively; p = 0.98); on the other hand, neoplastic lesion (dysplasia or adenoma) detection rates was similar (12 [18%] in CE and 6 [10%] in VCE arms, p = 0.2). The duration of the withdrawal time of colonoscopy in minutes for patients in the CE group was median 14 min and in the VCE group was median 10 min (p &lt; 0.001). Conclusion There is no statistical difference between CE and VCE using iSCAN1 in the detection rate of colonic neoplastic lesions in IBD patients. Surveillance colonoscopy with VCE (iSCAN1) spends less time than conventional CE.

scholarly journals A retrospective analysis of cervical smears for detection of precancerous lesions

2015 ◽  
Vol 5 (10) ◽  
pp. 847-849
Author(s):  
A Jha ◽  
AK Chaurasia
Keyword(s):  
Squamous Cell Carcinoma ◽  
Epithelial Cell ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Precancerous Lesions ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Smears ◽  
Neoplastic Lesions ◽  
Intraepithelial Lesion

Background:  Diseases of the cervix are common in women. Detection of neoplastic lesions is of prime importance in the evaluation of cervical smears although their frequency is less than the non-neoplastic conditions. Reactive and inflammatory conditions, however, may mimic or obscure the dysplastic changes. The aim of this study was to evaluate the frequencies of various inflammatory, reactive and neoplastic   lesions in the cervical smears.Materials and Methods: This was a retrospective study of 150 cases of cervical smears collected from medical record section of the hospital and Department of Pathology at National Medical College from April 2013 to April 2015.Results: Of 150 patients who underwent cervical cytology, only 15 cases (10%) had epithelial cell abnormalities. This was followed by reactive cellular changes associated with inflammation (16.7%), infections (5.3%) and atrophy (1.3%). Low grade squamous intraepithelial lesion (6%) was the most common epithelial cell abnormality followed by high grade squamous intraepithelial lesion (2%), atypical glandular cells (1.3%) and squamous cell carcinoma (0.7%).Conclusion: Reactive changes including atrophy were the commonest finding. Squamous intraepithelial lesion was commonest finding among epithelial abnormalities. Glandular intraepithelial lesions and squamous cell carcinoma were also identified. Among infections Trichomoniasis  and candidiasis  were seen.

scholarly journals Identification ofStreptococcus gallolyticussubsp.gallolyticus(Biotype I) Competence-Stimulating Peptide Pheromone

2018 ◽  
Vol 200 (14) ◽  
Author(s):  
Anthony Harrington ◽  
Yftah Tal-Gan
Keyword(s):  
Colorectal Cancer ◽  
Infective Endocarditis ◽  
Quorum Sensing ◽  
Opportunistic Pathogen ◽  
Regulatory Role ◽  
Human Pathogen ◽  
Content Type ◽  
Regulatory Pathways ◽  
Streptococcus Gallolyticus ◽  
Peptide Pheromone

ABSTRACTStreptococcus gallolyticussubsp.gallolyticus, a member of the group D streptococci, is normally found in the bovine rumen and human gut. It is an opportunistic pathogen that was recently determined to be a bacterial driver of colorectal cancer, in addition to causing other diseases, such as infective endocarditis, bacteremia, neonatal meningitis, and septicemia. As an emerging pathogen, not much is known about this bacterium, its virulence mechanisms, or its virulence regulatory pathways. Previous studies suggest thatS. gallolyticussubsp.gallolyticususes a ComRS pathway, one of manyStreptococcusquorum-sensing circuitries, for competence. However, thus far, the ubiquitous ComABCDE pathway has not been studied, nor has its regulatory role inS. gallolyticussubsp.gallolyticus. We therefore sought to study theS. gallolyticussubsp.gallolyticusComABCDE quorum-sensing pathway and have identified its peptide pheromone, which is termed the competence-stimulating peptide (CSP). We further determined that this peptide regulates the production of bacteriocin-like inhibitory substances (BLISs), a phenotype that has been linked with the ComABCDE pathway in bothStreptococcus pneumoniaeandStreptococcus mutans. Our data show thatS. gallolyticussubsp.gallolyticusTX20005 produces a 21-mer CSP signal, which differs from CSP signals of otherStreptococcusspecies in that its active form begins three residues after the double-glycine leader signal of the ComC precursor peptide. Additionally, our data suggest that this peptide might not be related to competence induction, as opposed to CSP signaling peptides in otherStreptococcusspecies. This study provides the first evidence thatS. gallolyticussubsp.gallolyticusutilizes quorum sensing to eliminate competitors, presenting a potential pathway to target this emerging human pathogen.IMPORTANCEStreptococcus gallolyticussubsp.gallolyticusis an emerging human pathogen known as a causative agent of infective endocarditis, and recently, of colorectal cancer. In this work, we revealed a functional quorum-sensing circuitry inS. gallolyticussubsp.gallolyticus, including the identification of the central signaling peptide pheromone, competence-stimulating peptide (CSP), and the regulatory role of this circuitry in the production of bacteriocin-like inhibitory substances (BLISs). This work uncovered a mechanism by which this bacterium outcompetes other bacterial species and thus provides a potential tool to study this opportunistic pathogen.

scholarly journals Clinical application of the 2011 IFCPC colposcope terminology in the era of HPV vaccines

2020 ◽  
Author(s):  
Bei Zhang ◽  
Shuhui Hong ◽  
Guihui Zhang ◽  
Fengnian Rong
Keyword(s):  
Diagnostic Accuracy ◽  
Precancerous Lesions ◽  
High Specificity ◽  
Diagnostic Value ◽  
World Health ◽  
Low Grade ◽  
Hpv Vaccines ◽  
Squamous Intraepithelial Lesion ◽  
Diagnostic Significance ◽  
Intraepithelial Lesion

Abstract Background Colposcopy is the conjunction with screening and diagnosis of cervical precancerous lesions. However the diagnostic accuracy of colposcopy is unsatisfied. This study was to evaluate colposcopic accuracy according to the 2011 International Federation of Cervical Pathology and Colposcopy (IFCPC) terminology.Methods A retrospective cohort study was performed in 1,838 patients who underwent colposcopy in Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University from October 2013 to April 2018. Using conization or cervical biopsy pathology as the gold standard, the agreement between colposcopic diagnosis and pathologic diagnosis was calculated, and correlations between variables were analyzed. Results As an authoritative and widely used terminology for colposcopy diagnosis, the 2011 IFCPC terminology has certain clinical practicality and diagnostic accuracy. However, some signs such as mosaic, punctuation, sharp border, inner border sign and ridge sign had high specificity but unsatisfactory sensitivity, which limited the diagnostic value. Therefore, we discussed the Lugol’s staining, a very common sign in colposcopy, and analyzed the diagnostic significance of bright yellow staining in low-grade squamous intraepithelial lesion (LSIL) and mustard yellow staining in high-grade squamous intraepithelial lesion (HSIL). The results showed that mustard yellow may be a valuable indicator in the diagnosis of HSIL. Conclusion With the wide acceptance of human papilloma virus (HPV) vaccines and HPV-based screening, there will be new challenges to accurately identify the signs of non-HPV16 and non-HPV18 infections and of minor lesions using colposcopy. In this study, we provide some recommendations in dealing with these challenges. More clinical research will be needed to further refine colposcopy terminology, improve diagnostic accuracy, and ensure that the World Health Organization’s goal of eliminating cervical cancer worldwide by 2030 is achieved.

COMPARATIVE EVALUATION OF MULTIPARAMETRIC ENDORECTAL ULTRASOUND AND ENHANCED IMAGING COLONOSCOPY IN THE DIAGNOSIS OF EARLY COLORECTAL CANCER

2020 ◽  
Vol 19 (3) ◽  
pp. 49-64
Author(s):  
E. M. Bogdanova ◽  
Yu. L. Trubacheva ◽  
O. M. Yugai ◽  
S. V. Chernyshov ◽  
E. G. Rybakov ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Statistical Significance ◽  
Muscle Layer ◽  
Endorectal Ultrasound ◽  
Diagnostic Methods ◽  
Early Colorectal Cancer ◽  
Morphological Examination ◽  
Optical Magnification ◽  
The Difference ◽  
Enhanced Imaging

AIM: to compare multiparametric endorectal ultrasound (ERUS) and enhanced imaging colonoscopy in the diagnosis of early colorectal cancer.PATIENTS AND METHODS: the study included 78 patients with epithelial rectal tumor. All the patients underwent multiparametric ERUS and colonoscopy with examination by narrow beam imaging (NBI) at optical magnification. All the patients were operated.RESULTS: a morphological examination removed specimens revealed adenomas in 48 cases, in 19 specimens – adenocarcinomas in situ and T1, and in 11 specimens – adenocarcinomas with invasion of the muscle layer or deeper. When calculating the accuracy indicators of diagnostic methods for groups of patients with adenoma, Tis-T1 adenocarcinoma, and T2-T3 adenocarcinoma, the difference in the sensitivity and specificity of the methods in none of the presented groups did not reach the level of statistical significance (p>0.05).ROC analysis showed that ultrasound has a prognostic value comparable to colonoscopy. The area difference was 0.013 (p=0.85).CONCLUSION: endoscopy and ultrasound have similar value in the diagnosis of malignant transformation of rectal adenomas.

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