BACKGROUND: Fecal occult blood tests have been widely used to screen for colorectal cancer. SENTiFIT 270 (Sentinel diagnostics, Italy) is a fecal occult blood test with an immunochemical method that utilizes FOB Gold reagents. We evaluated the performance of SENTiFIT 270 using the FOB Gold reagent. In addition, FOB Gold was evaluated with the HITACHI 7180 (Hitachi Ltd., Japan). METHODS: The precision and linearity of the SENTiFIT 270 was evaluated in accordance with applicable Clinical and Laboratory Standard Institute guidelines. The comparison study between SENTiFIT 270-FOB Gold and the OC-Sensor (Eiken chemical Co., Japan) was performed using stool specimens. RESULTS: In the precision evaluation, the total precision of SENTiFIT 270-FOB Gold was 4.94% and 2.54% at high and low concentrations, respectively. The HITACHI 7180-FOB Gold had excellent precision of 4.60% and 2.09% at high and low concentrations, respectively. Linearity was also excellent for the SENTiFIT 270-FOB Gold and HITACHI 7180-FOB Gold at 0.9987 and 0.9986, respectively. The SENTITIF 270-FOB Gold showed excellent agreement with a kappa value of 0.830 and a concordance rate of 93.6%. The HITACHI 7180-FOB Gold showed high agreement with a kappa value of 0.832 and a concordance rate of 93.9%. CONCLUSION: The SENTiFIT 270-FOB Gold showed excellent performance in accuracy, linearity, and comparative inspection ability.
Colonic Neoplasms ; Colorectal Neoplasms ; Indicators and Reagents ; Methods ; Occult Blood

BACKGROUND: Fecal occult blood test is a useful method for mass screening of colorectal cancer. HM-JACK is automatic analyzer for detecting fecal occult blood with latex agglutination methods. We evaluated its apparatus for compatibility for clinical testing. METHODS: The linearity, precision and effect of temperature and container in stool storage were evaluated. The comparison study with OC-Hemodia and prozone phenomenon were evaluated. RESULTS: The linearity was good(R(2)=0.997) and coeffiecinet variation(CV) of within-day precision were 4.6% and 2.6% in low concentration and high concentration. The CV of between-day precision were 4.8% and 3.5%. The hemoglobin concentration of 0.1 g/dL(1x10(6) ng/mL) was measured to 651 ng/mL for Antigen excess zone. The hemoglobin were more decreased in room temperature storage and usual container storage than in low temperature storage and HM-JACK container storage. The concordance rate between HM-JACK and OC-Hemodia was 90%. CONCLUSION: HM-JACK showed good performance for linearity, precision and comparison study. Therefore, it can be used effectively in clinical laboratory due to convenience, and possibility of quantitation and fast reporting.
Agglutination ; Colorectal Neoplasms ; Latex ; Mass Screening ; Occult Blood*

BACKGROUND: Fecal occult blood tests have been widely used as a means of gastrointestinal bleeding and colorectal cancer screening. HM-JACKarc (Kyowa Medex Co. Ltd, Japan) is a recently introduced automated fecal occult blood test analyser, which uses latex agglutination method. We evaluated the analytical performance of HM-JACKarc. METHODS: The linearity and precision for HM-JACKarc were evaluated according to the corresponding Clinical and Laboratory Standard Institute guidelines. The comparison study between HM-JACKarc and OC-SENSOR DIANA (Eiken Chemical Co. Ltd., Japan) was done with stool specimens. RESULTS: The linearity was good (R²=0.999) and the coefficients of variation of within-day precision and between-day precision were 5.2% and 4.9%, respectively, in low concentration and 2.7% each in high concentration. The concordance rate between HM-JACKarc and OCSENSOR DIANA was 99.0% (198 out of 200). CONCLUSIONS: HM-JACKarc showed excellent performance in linearity, precision, and comparison studies. Therefore, it appears to be a useful automated fecal occult blood test analyser.
Agglutination ; Colorectal Neoplasms ; Hemorrhage ; Latex ; Mass Screening ; Methods ; Occult Blood*

The fecal immunochemical test (FIT) is the initial non-invasive investigation of choice for population-based colorectal cancer (CRC) screening. We evaluated the positivity rate in repeated tests using the same fecal specimen that showed borderline results in the FIT. A total of 6,465 patients were tested with the FIT in a tertiary-care hospital from July to December 2016. FIT was done using OC-Sensor PLEDIA (Eiken Chemical Co., Tokyo, Japan). Among 6,465 patients, 364 (5.6%) patients showed a positive FIT result of over 20 µg Hb/g feces. A total of 112 (1.7%) patients showed borderline scores of 10.2–20 µg Hb/g feces, and 5,989 (92.6%) patients showed negative results of less than 10 µg Hb/g feces. Among the 101 repeat-tested patients, 19 (18.8%) of the patients' scores converted to levels above the positive cut-off threshold. Repeated results of 19 patients showed score elevations from 20.2 to 68 µg Hb/g feces. These results suggest that it is most important to analyze properly prepared samples, even if only once. Therefore, the laboratory staff should ensure the proper preparation of stool specimens for FIT. Laboratory directors should choose the best cut-off value for detecting CRC at their respective institutions.
Colorectal Neoplasms ; Feces ; Humans ; Mass Screening ; Occult Blood

Isolated splenic metastasis arising from colorectal carcinoma is very rare and there has been only 6 cases reported in the English literature. A new case is esented, and its possible pathogenesis was considered with previously reported ses. A 65-year-old male patient had received a right hemicolectomy for cending colon cancer 36 months earlier. He was followed up regularly with rial measurement of serum carcinoembryonic antigen (CEA). Rising serum CEA was scovered from 33 months postoperatively and CT revealed an isolated splenic tastasis. He therefore underwent splenectomy, which was proven to be a tastatic adenocarcinoma with similar histological feature to the original mor. As all reported cases showed elevated serum CEA at the time of tastasis, isolated splenic metastasis might be associated with CEA in regard its biological functions of immunosuppression and adhesion.
Adenocarcinoma/surgery ; Adenocarcinoma/secondary* ; Adenocarcinoma/pathology ; Adenocarcinoma/blood ; Aged ; Carcinoembryonic Antigen/blood ; Case Report ; Colorectal Neoplasms/surgery ; Colorectal Neoplasms/pathology* ; Colorectal Neoplasms/blood ; Human ; Male ; Splenic Neoplasms/surgery ; Splenic Neoplasms/secondary* ; Splenic Neoplasms/blood ; Tomography Scanners, X-Ray Computed

Colorectal cancer (CRC) is the most common cancer in digestive system, with the highest mortality rate. Its pathogenesis, diagnosis and treatment have been studied extensively. With the deepening of the investigations, more and more studies show that miRNA is closely related with the carcinogenesis, diagnosis and treatment of CRC. The abnormal expression of blood miRNA is expected to become the biomarkers for early diagnosis of CRC and prognostic evaluation, and it may provide a new strategy for clinical treatment.
Biomarkers, Tumor ; blood ; Carcinogenesis ; Colorectal Neoplasms ; blood ; Early Detection of Cancer ; Humans ; MicroRNAs ; blood ; Prognosis

BACKGROUND/AIMS: Although it has been known that folate will participate in colorectal carcinogenesis, the relationship between blood folate level and colorectal cancer is less consistent. The blood folate level does not reflect the systemic folate status. By contrast, serum homocysteine has become a sensitive marker for the folate deficiency. We attempted to explain the correlation between folate and colorectal cancer according to the serum homocysteine level. METHODS: We reviewed the clinical records, including alcohol history of 184 patients taking the colonoscopy and measurement of the serum homocysteine level at Health Promotion Center from 2001 to 2002. One hundred fifty-one of 184 were included, excluding 33 patients with previous history of colonic polyp, cerebrovascular, cardiovascular attack and thromboembolism. They were divided into the normal control (n=111) and the adenomatous polyp group (n=40). We had selected the colorectal cancer group (n=50) from the collection list of the tissue and blood bank less than 3 months storage interval. RESULTS: There was no significant difference in the mean serum homocysteine level among three groups. However, in the subjects with high alcohol consumption, there was a significant difference in the mean serum homocysteine between the normal control (n=7) and the adenomatous polyp group (n=9) (10.2 vs 15.1 micromol/L, p<0.05). CONCLUSIONS: There was no correlation of serum homocysteine and colorectal tumor. However, in the subjects with high alcohol consumption, high serum homocysteine might be related to the development of adenomatous polyp.
Adenomatous Polyps/*blood/pathology ; Alcohol Drinking/blood ; Colonoscopy ; Colorectal Neoplasms/*blood/pathology ; Female ; Homocysteine/*blood ; Humans ; Male ; Middle Aged

PURPOSE: Colorectal cancer is regarded as preventable with routine checkups. The purpose of this study was to evaluate the usefulness of each test performed during routine checkups and to assess the clinicopathological characteristics of colorectal cancer detected at the Health Promotion Center (HPC). RESULTS: We recruited 120 colorectal cancer patients identified on routine checkup at the HPC. The control group was composed of 3,829 colorectal cancer patients who underwent surgery during the same period. Clinicopathological variables were compared using the chi-square test. RESULTS: The male-to-female ratio was 79:41; the mean age was 57.9 (30~78) years. The incidence of right colon cancer was 16.7%, and that of left colon cancer was 83.7%. Sigmoidoscopy (55.5%), colonoscopy (28.3%), and fecal occult blood tests (FOBT, 10.8%) were used for detecting colorectal cancer. The overall positive rates of FOBT and serum carcinoembryonic antigen (CEA) were 28.3% and 20.8%, respectively, but were higher in advanced colon cancer (49.0% and 31.4%) and right colon cancer (60% and 25%). Early colorectal cancer was more frequent in the study group (54.9%) than in the control group (16.9%, P<0.001). Right colon cancer was significantly associated with advanced colon cancer (80%), and left colon cancer was associated with early colon cancer (62.3%, P=0.001). CONCLUSIONS: Endoscopy, including sigmoidoscopy and colonoscopy, played a crucial role in detecting early colorectal cancer at the HPC. Including endoscopy in basic routine checkup programs should help to increase early detection of colorectal cancer.
Carcinoembryonic Antigen ; Colonic Neoplasms ; Colonoscopy ; Colorectal Neoplasms* ; Endoscopy ; Health Promotion* ; Humans ; Incidence ; Occult Blood ; Sigmoidoscopy

OBJECTIVETo explore the risk factors for pulmonary metastasis after curative resection of colorectal cancer in order to improve the effectiveness of follow-up and the rate of early diagnosis for the high-risk patients.

METHODSThe clinicopathological and follow-up data of 268 patients with colorectal cancer undergoing radical resection from January 2004 to December 2006 in the Beijing Cancer Hospital were analyzed retrospectively. Patients were divided into study group including 16(6.0%) patients who developed lung metastasis and control group without lung metastasis. The high-risk variables associated with lung metastasis were reviewed by univariate analysis and multivariate analysis.

RESULTSLung metastasis developed in 16 patients, including 10 cases with unilateral lung metastasis and 6 with bilateral. The median duration from colorectal surgery to identification of lung metastasis was 13.9 months. The diagnosis rate of pulmonary metastasis by enhanced chest CT was 81.3%(13/16). Univariate analysis identified the following associated with significant factors associated with pulmonary metastasis: primary tumor location(P=0.003), adjuvant chemotherapy(P=0.034), TNM stage(P=0.005) and preoperative serum carcinoembryonic antigen(CEA) level (P=0.001). Multivariate analysis revealed that primary tumor location(rectum) and preoperative serum CEA level(≥5 μg/L) were independent risk factors for pulmonary metastasis(both P<0.05).

CONCLUSIONSPrimary tumor location and elevated preoperative CEA level are independent risk factors for pulmonary metastasis. Strict postoperative follow-up and routine chest enhanced CT examination is necessary for this particular patient population.

PURPOSE: Emergency colorectal surgery has high rates of complications and mortality because of incomplete bowel preparation and bacterial contamination. The authors aimed to evaluate the surgical outcomes and the risk factors for the mortality and the complication rates of patients who underwent emergency surgery to treat colorectal diseases. METHODS: This is a prospective study from January 2014 to April 2016, and the results are based on a retrospective analysis of the clinical results for patients who underwent emergency colorectal surgery at Chosun University Hospital. RESULTS: A total of 99 patients underwent emergency colorectal surgery during the study period. The most frequent indication of surgery was perforation (75.8%). The causes of disease were colorectal cancer (19.2%), complicated diverticulitis (21.2%), and ischemia (27.2%). There were 27 mortalities (27.3%). The major morbidity was 39.5%. Preoperative hypotension and perioperative blood transfusion were independent risk factors for both morbidity and mortality. CONCLUSION: These results revealed that emergency colorectal surgeries are associated with significant morbidity and mortality. Furthermore, the independent risk factors for both morbidity and mortality in such patiients were preoperative hypotension and perioperative transfusion.
Blood Transfusion ; Colorectal Neoplasms ; Colorectal Surgery* ; Diverticulitis ; Emergencies* ; Humans ; Hypotension ; Ischemia ; Mortality ; Prospective Studies ; Retrospective Studies ; Risk Factors*