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Objective To study the value of the use of balloon-assisted enteroscopy (BAE) in the diagnosis and treatment of small bowel tumor. Methods From May 2007 to September 2014, a total of 126 patients with suspected small bowel tumor were enrolled. BAE was performed in all the patients. Of them, abdominal CT scan were performed in 80 patients, gastrointestinal barium radiography in 22, and capsule endoscopy in 24. The positive detection rate, sensitivity, specificity, and the rates of missed diagnosis and misdiagnosis of different examinations were compared. Balloon-assisted endoscopic treatment was conducted in some patients, and its safety and feasibility were assessed. Results The positive rate, sensitivity, and specificity of BAE for suspected small bowel tumor were significantly higher than that of abdominal CT scan, gastrointestinal barium radiography and CE (The positive rates of balloon-assisted enteroscopy, abdominal CT, gastrointestinal barium, capsule endoscopy were 92.9%, 47.5%, 68.2%, 91.7% respectively; their sensitivity 100%,71.1%, 66.7%, 100%, and specificity 100%, 82.9%, 28.6%, 22.2%), respectively (P<0.01), while the rates of diagnostic failure and misdiagnosis were remarkably lowered (The rates of diagnostic failure of balloon assisted enteroscopy, abdominal CT, gastrointestinal barium, capsule endoscopy were 0%, 28.9%, 33.3%, 0%, and the rates of misdiagnosis from these 0%, 17.1%, 71.4%, 77.8% respectively) (P<0.0l). In a certain number patients with intestinal neoplasm, removal of the tumor could be performed with the aid of BAE. Conclusion With the aid of BAE, the rate of positive diagnostic rate of small bowel tumor is significantly elevated, and it is safe and reliable for endoscopic removal for some small bowel tumors, thus it is valuable in clinical application.
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<p><b>OBJECTIVE</b>To understand the association between multiple genetic loci identified by genome-wide association studies (GWASs) and colorectal cancer (CRC) risk, and whether these genetic factors, along with traditional risk factors, could contribute to the colorectal cancer risk prediction in a Chinese Han population.</p><p><b>METHODS</b>A case-control study (1 066 CRC cases and 3 880 controls) was initially conducted to assess the association between 21 recently discovered single-nucleotide polymorphisms (SNPs) and CRC risk. Genetic risk score (GRS) and weighted genetic risk score (wGRS) were calculated to evaluate the joint effects of selected loci. Multiple models combining genetic and non-genetic factors were established and receiver operating characteristic curve analysis was used to compare the discriminatory power of different predictive models.</p><p><b>RESULTS</b>There were 7 SNPs significantly associated with CRC susceptibility. As the GRS or wGRS increased, the risk of CRC also increased (trend P=0.002 6 for GRS, trend P<0.000 1 for wGRS). The ORs for highest versus lowest quartile of GRS and wGRS were 1.33 (95% CI: 1.12-1.58, P=0.001 0) and 1.76 (95% CI: 1.45-2.14, P<0.000 1) , respectively. The model incorporating wGRS and traditional risk factors, including sex, age, smoking and drinking, was the best one to predict CRC risk in this population, with an area under curve of 0.593 (95% CI: 0.573-0.613).</p><p><b>CONCLUSION</b>Multiple genetic loci identified by GWASs jointly influenced the CRC risk. The combination of genetic factors and conventional non-genetic factors improved the performance of risk predictive model for colorectal cancer.</p>