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Analysis of differences in the quality of bowel preparation in patients of different age groups undergoing colonoscopy and measures for improvement

Jun GU ; Yan-Yan ZHU ; Jun-Wei ZOU ; Yi-Gui HUANG

Modern Interventional Diagnosis and Treatment in Gastroenterology.2024;29(6):653-659. doi:10.3969/j.issn.1672-2159.2024.06.002

Objective To explore improvements in bowel preparation for patients of different ages by analyzing the factors influencing differences in the quality of bowel preparation for patients undergoing colonoscopy.Methods One hundred and forty-eight patients who underwent colonoscopy in our hospital from January 2022 to June 2023 were selected and divided into adequate(n=106)and inadequate(n=42)groups based on the Ottawa bowel preparation scale scoring criteria,and into young(n=41),middle-aged(n=91),and elderly(n=16)groups based on the age of the patients,with higher than the median age being considered as the high age patients and lower than the median age as the low age patients.Clinical data were collected,logistic regression was used to analyze the factors affecting the quality of bowel preparation,and multivariate regression was used to analyze the risk factors for inadequate bowel preparation in patients of different age strata.Results The overall pass rate of bowel preparation in 148 patients was 71.62％.The middle-aged group was significantly lower than the young group(x2=7.392,P=0.007).The ①-segment colon OBPS scores(sigmoid colon and rectum),②-segment colon OBPS scores(descending colon and transverse colon),and ③-segment colon OBPS scores(cecum and ascending colon)were lower in the senior patients than in the younger patients(all P＜0.05).Age,constipation,bowel cleanser dose＜75％,solid residue in the last bowel movement,and waiting＞6 hours for microscopy were independent risk factors for inadequate bowel preparation.After adjusting for age,having solid residue in the last bowel movement,and waiting＞8 hours for microscopy were risk factors for inadequate bowel preparation in the young group of patients.Constipation,bowel cleanser dose＜75％,solid residue in the last bowel movement and waiting time for microscopy were risk factors for inadequate bowel preparation in patients in the middle-aged group.The risk effect value of waiting＞8 hours for microscopy was higher than waiting 6 to 8 hours for microscopy(OR=3.657 and OR=1.215,all P＜0.05).Conclusion Age is a risk factor for the quality of bowel preparation in patients undergoing colonoscopy,and different bowel preparation strategies should be used for different age groups.

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Safety and efficacy of colon polypectomy in patients taking antithrombotic drugs

Chen MU ; Han ZHANG ; Ying LIU ; Xue LI ; Rui GU ; Chun-Yan CAO ; Xu GUO

Modern Interventional Diagnosis and Treatment in Gastroenterology.2024;29(6):660-663. doi:10.3969/j.issn.1672-2159.2024.06.003

Objective To investigate the safety and effectiveness of colon polypectomy in patients taking antithrombotic drugs.Methods Polyps treated with endoscopic polypectomy at the Department of Gastroenterology,Fu Wai Hospital,Chinese Academy of Medical Sciences,from August 2022 to August 2023 were retrospectively analyzed for the site of polyp,postoperative delayed hemorrhage,perforation,and the completeness of resection,specimen retrieval,and the occurrence of postoperative ischemic events.Results A total of 103 polyps were included in the study,which were divided into two groups according to whether the diameter of the polyp was＞10 mm(87 cases in the small polyp group vs 16 cases in the large polyp group),and there was no statistically significant difference between the two groups in terms of the site of the polyp,its morphology,the type of antithrombotic drug taken,the rate of curative resection,the rate of postoperative hemorrhagic events,and the incidence of postoperative ischemic events;the large polyp group chose more often to undergo EMR treatment(small polyp group vs.large polyp group,4.6％vs.45.5％,P=0.004);postoperative pathology was more adenomatous polyps in the large polyp group(small polyp group vs.large polyp group,77.0％vs.93.8％,P=0.027).Conclusion Endoscopic polypectomy can be used safely and effectively in patients taking antithrombotic drugs.

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Analysis of clinical features and risk factors of acute pancreatitis with metabolic syndrome

Yong-Hong ZHAO ; Ai-Rong CHEN ; Meng-Ru HU ; Yi-Xin WANG ; Gui-Rong YI

Modern Interventional Diagnosis and Treatment in Gastroenterology.2024;29(6):664-669. doi:10.3969/j.issn.1672-2159.2024.06.004

Objective To investigate the clinical features and prognosis of acute pancreatitis(AP)complicated with metabolic syndrome(MS).Methods 139 AP patients were retrospectively selected and divided into MS group(76 cases)and non-MS group(63 cases),general data of the two groups were collected and analyzed;conservative treatment was given to 2 groups of patients,and the general conditions,laboratory indicators,comorbidities,and related indicators of disease severity of the two groups were compared and analyzed,and the influencing factors of poor prognosis in patients(AP combined with MS)were analyzed.Results Compared with non-MS group,HDL,Ca2+in MS group decreased significantly,Body weight、Body Mass Index(BMI)、diabetes mellitus、hypertension(systolic/diastolic blood pressure)、hyperlipidemia、white blood cell count、CRP、PCT、IL-6、FPG、UA、TC、TG、TyG、TYG-BMI and non-traditional lipid parameters TC/HDL-C、TG/HDL-C、LDL-C/HDL-C and non-HDL-C were significantly increased.There were no significant differences in age、sex、length of stay、BUN、CREA、LDL-C、ALT and AST between the two groups(P＞0.05);BMI,white blood cell count,CRP,IL-6,FPG,UA,TC,TG,TyG,TYG-BMI,TC/HDL-C,TG/HDL-C,LDL-C/HDL-C,and non-HDL-C were independent risk factors for poor prognosis in AP patients with MS,and HDL-C was a potential protective factor for prognosis in AP patients with MS,the difference was statistically significant(P＜0.05).Conclusion With the change of modern lifestyle,there are more and more MS patients,and the incidence of MS patients with AP is gradually increasing.TyG,TYG-BMI and non-traditional lipid parameters are novel,convenient and practical markers for clinical evaluation,which have a high diagnostic and predictive value for AP with MS metabolic abnormalities,and provides clinical basis for management and intervention.

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Expression levels of microRNA-452-5p and SRY box related gene 7 in esophageal cancer tissue and their relationship with clinical pathological parameters and prognosis

Jian-Xia ZHAO ; Dong-Hui LI ; Li SHEN

Modern Interventional Diagnosis and Treatment in Gastroenterology.2024;29(6):670-674. doi:10.3969/j.issn.1672-2159.2024.06.005

Objective To investigate the expression levels of microRNA-452-5p(miR-452-5p)and SRY box related gene 7(SOX7)in esophageal cancer tissue and their relationship with clinical pathological parameters and prognosis.Methods 106 esophageal cancer patients admitted to our hospital from June 2017 to May 2019 were selected as the study subjects.The expression of miR-452-5p and SOX7 mRNA are detected in esophageal cancer patients,the relationship between miR-452-5p and SOX7 mRNA expression in cancer tissue and clinical pathological parameters are analyzed.Survival analysis was conducted using the Kaplan Meier method,and COX univariate and multivariate analyses were used to identify risk factors affecting the prognosis of esophageal cancer.Results Compared to adjacent tissues,the expression level of miR-452-5p is higher in cancer tissues(P＜0.05),and the expression level of SOX7 mRNA is lower(P＜0.05).Compared to patients with stage Ⅰ-Ⅱ tumors,no lymph node metastasis,and deep invasion(Tis-T2)esophageal cancer,miR-452-5p has higher expression levels in cancer tissues with lymph node metastasis,stage Ⅲtumors,and deep invasion(T3-T4),and lower expression levels of SOX7 mRNA(P＜0.05).Kaplan Meier survival curve analysis showed that the overall 3-year survival rate of patients in the miR-452-5p high expression group was 30.4％(17/56),while in the miR-452-5p low expression group it was 54.0％(27/50).The difference in cumulative overall survival rate was statistically significant(Log-rank x2=6.082,P=0.014);The 3-year overall survival rates of patients in the SOX7 mRNA high expression group and the SOX7 mRNA low expression group were 53.7％(29/54)and 28.8％(15/52),respectively.The difference in cumulative overall survival rates was statistically significant(Log-rank x2=6.742,P=0.009).The results of COX univariate regression analysis showed that miR-452-5p,SOX7 mRNA,tumor stage,depth of infiltration,lymph node metastasis are related to the prognosis of esophageal cancer.The results of COX multivariate regression analysis showed that independent factors affecting the prognosis of esophageal cancer include lymph node metastasis,low expression of SOX7 mRNA,stage Ⅲ tumor stage,high expression of miR-452-5p,and depth of infiltration(T3～T4).Conclusion MiR-452-5p is highly expressed in esophageal cancer tissue,while SOX7 mRNA is low in esophageal cancer tissue.Its level is related to lymph node metastasis,tumor staging,and depth of infiltration,and is closely related to the prognosis of esophageal cancer patients.

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The correlation between colorectal cancer tissues JAK2 gene mutations and TCF3 protein expression with clinical pathological features and prognosis

Ke-Jin YAN ; Hong-Liang ZHU ; Xian-Qiang XIE ; Dong-Sheng LI ; Zeng-Lu ZHENG ; Ji-Yang LI

Modern Interventional Diagnosis and Treatment in Gastroenterology.2024;29(6):675-680,690. doi:10.3969/j.issn.1672-2159.2024.06.006

Objective To explore the correlation between colorectal cancer tissue Janus kinase 2(JAK2)gene mutations and T cytokine 3(TCF3)protein expression with clinical pathological characteristics and prognosis,and to provide laboratory reference indicators for early evaluation of the illness severity and prognosis of colorectal cancer.Methods A retrospective analysis was conducted on the data of 50 colorectal cancer patients who were admitted from January 2016 to April 2021 and retained colon cancer and adjacent tissue wax blocks.Basic information,clinical and pathological features such as TNM staging,lymph node metastasis,and 3-year survival prognosis of the patients were collected.The wax blocks of colon cancer and adjacent tissues of patients were detected,in which Taqman fluorescence probe method was applied to detect the distribution of JAK2 gene at the rs2230724 locus AA,AG,and GG genotypes in colon cancer tissues,and immunohistochemistry method was applied to detect the positive expression rate of TCF3 protein in colon cancer and adjacent tissues.The basic information,JAK2 rs2230724 gene mutation,and TCF3 protein expression of patients with different clinical and pathological characteristics were compared,and the influencing factors of clinical and pathological characteristics of colon cancer was analyzed by logistic regression model.Kaplan Meier survival curve was applied to compare the survival prognosis of patients with JAK2 gene mutations and TCF3 protein expression in colorectal cancer tissue,and Cox regression model was applied to analyze the risk factors affecting the prognosis of colorectal cancer patients.Results The positive expression rate of TCF3 protein in colon cancer tissues was higher than that in adjacent tissues(P＜0.05).The age,BMI,proportion of GG genotype at rs2230724 locus of JAK2 gene and positive expression rate of TCF3 protein in TNM stage Ⅲ colon cancer patients were higher than those in TNM stage Ⅰ-Ⅱ patients(P＜0.05);The age,BMI,smoking rate,proportion of GG type at the rs2230724 locus of JAK2 gene in colon cancer tissue,and positive expression rate of TCF3 protein in patients with lymph node metastasis were higher than those without lymph node metastasis(P＜0.05);The results of the logistic regression model analysis showed that the influencing factors of clinical pathological features such as TNM staging and lymph node metastasis in colon cancer were age,mutation of JAK2 gene rs2230724 site in colon cancer tissue,and positive expression rate of TCF3 protein(P＜0.05).The Kaplan Meier survival curve analysis showed that patients with JAK2 gene rs2230724 GG genotype and TCF3 protein positivity in colon cancer tissue had higher cumulative all-cause mortality rates(P＜0.05).The results of univariate and multivariate Cox regression model analysis showed that independent risk factors affecting the prognosis of colorectal cancer patients include JAK2 gene rs2230724 site GG type,TCF3 protein positive expression,TNM stage Ⅲ,lymph node metastasis,and age.Conclusion The proportion of JAK2 gene rs2230724 GG type and TCF3 protein expression in colorectal cancer tissues are related to their clinical pathological characteristics and prognosis,and can be used as reference indicators for evaluating clinical pathological characteristics and predicting prognosis of colorectal cancer.

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Role and mechanisms of probiotics in regulating the ROS/JNK signaling pathway in the pathogenesis of Metabolic fatty liver disease

Hui-Yuan XU ; Chang-Ping LI ; Chao LIU ; Tao RE

Modern Interventional Diagnosis and Treatment in Gastroenterology.2024;29(6):681-690. doi:10.3969/j.issn.1672-2159.2024.06.007

Objective This study was aimed to investigate the impact of probiotics on regulating the ROS/JNK signaling pathway their underlying mechanism of action in the treatment of metabolic associated fatty liver disease.Methods Male C57BL/6 mice were randomly divided into three groups:control,probiotics,and model groups.Serum levels of ALT,AST,TC,and TG were detected.Moreover,the pathological changes of the liver and ileum tissues were observed by hematoxylin and eosin(H&E)staining,and the content of reactive oxygen species(ROS)in liver tissues was determined.In addition,the levels of D-lactic acid and serum and small intestine diamine oxidase were measured to evaluate the effects of probiotics on the intestinal tract of MAFLD mice.Results Mice in the probiotic group were treated with probiotic intervention,compared with model group,mice hepatic lobule structure was complete,hepatic steatosis in cells and inflammatory cells infiltration were relieved.After C57BL/6 mice were fed the MCD diet,the body weight of the model group was significantly lower than that of the control group,showing poor mental state.After 4 weeks of probiotics treatment,the body weight of mice in the probiotics group was higher than that in the model group,and their mental state was better than that in the model group.Biochemical analysis showed that the levels of ALT,AST,TC,TG,D-lac,serum and small intestinal DAO and ROS in liver in the model group were considerably higher than those in the control group.After 4 weeks of probiotics intervention,serum ALT,AST,TC,TG,D-lac,DAO and ROS levels decreased compared with the model group(P＜0.05).Western blot analysis showed that the expression levels of p-JNk,Caspase-3,Bax in the model group were up-regulated,and the expression level of intestinal tight junction protein ZO-1 was down-regulated compared with the control group.After 4 weeks of probiotics intervention,the expression levels of p-JNK,caspase-3,Bax in the probiotics group were down-regulated compared with that in the model group,while the expression level of intestinal tight junction protein ZO-1 was up-regulated compared with that in the model group(P＜0.05).PCR analysis showed that the expression levels of Bax and Caspase-3 in the model group were significantly increased,while the expression levels of Bax and Caspase-3 in the probiotic group were significantly decreased compared with those in the model group(P＜0.05).Immunohistochemistry analysis showed that the expression levels of P-JNk,Caspase-3 and Bax in the liver of mice in the probiotic group were lower than those in the model group(P＜0.05).The pathological results in our investigation showed that the ileum mucosa in the control group was intact,and the intestinal villi were complete and neatly arranged,without any infiltration of inflammatory cells.However,in the model group the ileum mucosal structure was seriously damaged,with loose and disorderly villi arrangement.Importantly,the ileum mucosa in the probiotic group had fewer injuries and the villi were arranged more neatly.Besides,the ileum tissue of the control group had the lowest Chiu's score range(0-1),whereas that of the model group was 3-4,and the one of the probiotic group was 1-2.Conclusion The increased expression of P-JNk,ROS,Caspase-3 and Bax in MAFLD indicates that it is associated with the onset of MAFLD.The use of probiotics can improve the histological and serological indicators of MAFLD.Western blot,PCR and immunohistochemical results confirmed that probiotics can regulate the expression of factors related to ROS/JNK signaling pathway,reduce oxidative stress and inhibit cell apoptosis to achieve the goal of treating MAFLD.

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A real-world study evaluating the safety and efficacy of envafolimab-containing regimens in the treatment of digestive adenocarcinoma patients

Jiaxue WU ; Jian ZHAO ; Yusheng WANG

Modern Interventional Diagnosis and Treatment in Gastroenterology.2024;29(7):778-783,788. doi:10.3969/j.issn.1672-2159.2024.07.005

Objective To retrospectively analyze the safety and efficacy data of envafolimab-containing treatment regimens for digestive adenocarcinoma in the real world.Methods Treatment information of 35 patients with digestive adenocarcinoma who received envafolimab-containing regimens at Shanxi Provincial Cancer Hospital from December 2021 to July 2023 was retrospectively collected.Data were analyzed using IBM SPSS Statistics 27.Descriptive statistics were used to present quantitative data as mean±standard deviation or median,and qualitative data as frequency and percentage.Survival status was analyzed using the Kaplan-Meier(KM)method,and graphs were created using GraphPad Prism 9.5.1.Results Among 108 patients,35 met the inclusion criteria.Twenty-four(68.6％)experienced grade 1-3 adverse events(AEs),with no grade 4 or 5 AEs.The incidence rate of immune-related AEs was 31.4％.The median time to overall AE occurrence was 4.8 months.Twenty-three of the 35 patients underwent at least one efficacy evaluation,with 5 achieving partial response(PR)and 15 achieving stable disease(SD).No patients achieved complete response(CR).The objective response rate(ORR)was 21.7％,and the disease control rate(DCR)was 87.0％.Among the six patients with deficient mismatch repair/microsatellite instability-high(dMMR/MSI-H)lesions,the ORR was 50％,and the DCR was 100％.Among the 17 patients with proficient mismatch repair/microsatellite stable(pMMR/MSS)lesions,the ORR was 11.8％,and the DCR was 82.4％.Conclusion Envafolimab-containing regimens demonstrate good safety and favorable efficacy in the real-world treatment of digestive adenocarcinoma.

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The relationship between gastric juice pH,EGF and PGE2 levels with the effectiveness of endoscopic treatment and gastrointestinal function in patients with gastric ulcer bleeding

Juan SHUAI ; Ying WU ; Lina AN

Modern Interventional Diagnosis and Treatment in Gastroenterology.2024;29(7):784-788. doi:10.3969/j.issn.1672-2159.2024.07.006

Objective To explore the relationship between relationship between gastric juice pH,epidermal growth factor(EGF)and prostaglandin E2(PGE2)levels with the effectiveness of endoscopic treatment and gastrointestinal function in patients with gastric ulcer bleeding.Methods 67 patients with gastric ulcer bleeding who underwent digestive endoscopy treatment at Zhongnan Hospital of Wuhan University from January 2022 to May 2024 were selected.The levels of pH,EGF and PGE2 in gastric juice collected during endoscopic treatment of patients were detected.The effectiveness of disease treatment for patients was evaluated.The levels of gastric juice pH,EGF and PGE2 in patients with different therapeutic effects were copared,and the area under the ROC curve was used in the evaluation of gastric juice pH,EGF and PGE2 levels in early evaluation of treatment efficacy of digestive endoscopy treatment.The postoperative gastrointestinal function and recovery indicators such as bowel sound recovery time,anal exhaust time,hemostasis time,hospital stay time,and ulcer healing time for patients were selected,and the relationship between postoperative gastrointestinal function and recovery indicators with the levels of gastric juice pH,EGF and PGE2 were analyzed by Pearson correlation method and.Results The clinical treatment effectiveness rate of 67 patients with gastric ulcer bleeding was 71.64％(48/67).Compared with those of patients with effective treatment result,patients with ineffective treatment result had lower levels of gastric juice pH,EGF and PGE2(P＜0.05).The ROC curve analysis results showed that the levels of gastric juice pH,EGF and PGE2 have certain predictive value for the effectiveness of digestive endoscopy treatment,and the combined detection of the three had the best early evaluation efficacy.The postoperative recovery time of bowel sounds,anal exhaust time,hemostasis time,hospital stay time,and ulcer healing time of patients were(7.16±2.38)minutes,(26.96±6.41)hours,(20.66±4.37)hours,(4.52±1.16)days,and(23.14±4.18)days,respectively.The Pearson correlation analysis results showed that the levels of pH,EGF and PGE2 in gastric juice of patients with gastric ulcer bleeding were negatively correlated with postoperative gastrointestinal function and recovery indicators such as bowel sound recovery time,anal exhaust time,hemostasis time,hospital stay time,and ulcer healing time(P＜0.05).Conclusion The levels of gastric juice pH,EGF and PGE2 in patients with gastric ulcer bleeding are correlated with the effectiveness of endoscopic treatment,postoperative gastrointestinal function,and recovery time.They can be used as early evaluation reference indicators for the efficacy of endoscopic treatment of gastric ulcer bleeding patients.

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The Value of of Pepsinogen and Endothelial Function Changes in Patients with Helicobacter pylori Infection for the Early Evaluation of Atrophic Gastritis and Early Gastric Cancer

Jun GE ; Ling MA ; Xinhua LI

Modern Interventional Diagnosis and Treatment in Gastroenterology.2024;29(7):789-793,798. doi:10.3969/j.issn.1672-2159.2024.07.007

Objective To explore the value of pepsinogen and endothelial function changes in patients with Helicobacter pylori(Hp)infection for the early evaluation of atrophic gastritis and gastric cancer.Methods A retrospective analysis was conducted on the clinical data of 163 patients with chronic gastritis complicated with Hp infection admitted from July 2022 to December 2023.Among them,78 patients with erosive gastritis complicated with Hp infection were in the Hp group,57 patients with chronic atrophic gastritis complicated with Hp infection were in the atrophic group,and 28 patients with gastric cancer complicated with Hp infection were in the gastric cancer group.The serum pepsinogen Ⅰ(PG Ⅰ),pepsinogen Ⅱ(PG Ⅱ)levels,and PG Ⅰ/PG Ⅱ ratio,as well as the levels of plasma nitrogen oxide(NO),endothelin-1(ET-1),intercellular adhesion molecule-1(ICAM-1)and other endothelial function indicators among the three groups of patients were compared,and Spearman correlation method was applied to analyze the relationship between the levels of pepsinogen and endothelial function indicators in patients with chronic gastritis complicated with Hp infection with the severity of their lesions.ROC curve was drawn to analyze the early evaluation value of pepsinogen and endothelial function indicators in patients with chronic gastritis and Hp infection for their progression to chronic atrophic gastritis or gastric cancer.Results Compared with those of the Hp group,the serum PG Ⅰ,PG Ⅰ/PG Ⅱ ratio,and plasma NO levels in the atrophic group and gastric cancer group decreased,while the plasma ET-1 and ICAM-1 levels in the atrophic group and gastric cancer group increased(P＜0.05);Compared with those of the atrophic group,the serum PG Ⅰ,PG Ⅰ/PG Ⅱ ratio,and plasma NO levels in the gastric cancer group decreased,while plasma ET-1 and ICAM-1 levels in the gastric cancer group increased(P＜0.05).There was no statistically significant difference in the levels of serum PG Ⅱ among the three groups(P＞0.05).The Spearman correlation analysis results showed that the serum PGⅠ,PG Ⅰ/PG Ⅱ ratio,and plasma NO level in patients with chronic gastritis complicated with Hp infection were negatively correlated with the severity of the disease(P＜0.05);The levels of plasma ET-1 and ICAM-1 were positively correlated with the severity of the lesion(P＜0.05).The ROC curve analysis results showed that serum PG Ⅰ,PG Ⅰ/PG Ⅱ ratio,and plasma NO,ET-1,and ICAM-1 levels all have certain early evaluation efficacy for the progression of chronic gastritis complicated with Hp infection to chronic atrophic gastritis or gastric cancer.Among them,the combined detection of various indicators had the best early evaluation efficacy.Conclusion Hp infection can lead to a decrease in pepsinogen levels and endothelial dysfunction in patients,and the combined detection of the levels of the two related indicators may serve as reference indicators for early risk assessment of Hp infection progression to chronic atrophic gastritis or gastric cancer.

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Value of cystic fluid carcinoembryonic antigen combined with glucose detection in the diagnosis of mucinous cystadenoma of pancreas

Ying ZHUANG ; Jiayun CHEN ; Yan QIU ; Rong ZUO ; Dandan WANG ; Shihua LIU

Modern Interventional Diagnosis and Treatment in Gastroenterology.2024;29(7):794-798. doi:10.3969/j.issn.1672-2159.2024.07.008

Background and Objective Accurate diagnosis of mucous cystic lesion(PCL)remains a clinical difficult.Both Carcinoembryonic antigen(CEA)and glucose(GLU)are reported to have ability to distinguish mucinous PCL from non-mucinous PCL,but the accuracy was limited.The objective of this study was to evaluate the value of cystic CEA combined with GLU in the diagnosis of mucinous PCL.Methods PCL patients who underwent pancreatic surgery and endoscopic ultrasonography guided fine-needle aspiration(EUS-FNA)were retrospectively collected from the First Affiliated Hospital of Naval Medical University.Clinical data and cystic fluid analysis of included PCLs patients were analyzed using receiver operator(ROC)curves.ROC analysis,sensitivity and specificity analyses were used to evaluate the value of CEA combined with GLU in the diagnosis of mucinous PCL.Results From January 2015 to December 2021,a total of 84 patients underwent cyst fluid CEA and GLU analysis,of whom 44(52.4％)had mucinous PCL and 40(47.6％)had non-mucinous PCL.The AUC for distinguishing mucinous from non-mucinous PCL by CEA was 0.82[(95％confidence interval(CI):0.72-0.92)].When 192 ng/mL was used as the cutoff level,the diagnostic sensitivity and specificity were 50％and 93％,respectively.Using 20 ng/mL as cutoff level,the diagnostic sensitivity increased to 80％and the specificity decreased to 68％.The AUC for the cystic GLU to distinguish mucinous from non-mucinous PCL was 0.73(95％CI:0.99-0.87),and the diagnostic sensitivity and specificity were 100％and 60％,respectively.When the cutoff level of CEA was 192 ng/mL,the AUC of CEA combined with GLU in the diagnosis of mucinous PCLs was 0.94(95％Cl:0.86-0.99),while when the cutoff level of CEA was 20 ng/mL,the AUC of CEA combined with Glu in the diagnosis of mucinous PCLs was 0.94(95％CI:0.85-0.99).The AUCs were significantly higher than the AUC with single diagnostic indicators.Conclusion When using the cutoff level of 192 ng/mL,cyst fluid CEA combined with GLU has high sensitivity and specificity in differentiating mucinous PCL from non-mucinous PCL,so it can be considered for clinical application.Lower CEA cutoff level(20 ng/mL)can improve the sensitivity of diagnosis.

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