Browsing by Subject "adenoma"

Now showing 1 - 3 of 3
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    Endoscopist Adenoma Per Colonoscopy Detection Rates and Risk for Post Colonoscopy Colorectal Cancer: Data From New Hampshire Colonoscopy Registry
    (Elsevier, 2023-11-21) Anderson, Joseph C.; Rex, Douglas K.; Mackenzie, Todd A.; Hisey, William; Robinson, Christina M.; Butterly, Lynn F.; Medicine, School of Medicine
    Background and Aims Adenomas per colonoscopy (APC) may be a better measure of colonoscopy quality than adenoma detection rate (ADR) since it credits endoscopists for each detected adenoma. There are few data examining the association between APC and post colonoscopy colorectal cancer (PCCRC) incidence. We used data from the New Hampshire Colonoscopy Registry (NHCR) to examine APC and PCCRC risk. Methods We included NHCR patients with an index exam and at least one follow up event, either a colonoscopy or a CRC diagnosis. Our outcome was PCCRC defined as any CRC diagnosed > 6 months after an index exam. The exposure variable was endoscopist specific APC quintiles of 0.25, 0.40, 50 and 0.70. Cox regression was used to model the hazard of PCCRC on APC, controlling for age, sex, year of index exam, index findings, bowel preparation and having more than 1 surveillance exam. Results In 32,535 patients, a lower hazard for PCCRC (n=178) was observed for higher APCs as compared to APCs <0.25 (Reference) (0.25-<0.40:HR=0.35, 95% CI: 0.22-0.56;0.40-<0.50: HR=0.31, 95% CI: 0.20-0.49; 0.50-<0.70: HR=0.20, 95% CI: 0.11-0.36; and ≥0.70: HR=0.19, 95% CI: 0.09-0.37). When examining endoscopists with an ADR of at least 25%, an APC < 0.50 was associated with a significantly higher hazard than an APC > 0.50 (HR=1.65; 95% CI: 1.06-2.56). A large proportion of endoscopists, 1/5th (32/152; 21.1%), had an ADR >25 but an APC <0.50. Discussion Our novel data demonstrating lower PCCRC risk in exams performed by endoscopists with higher APCs suggest that APC could be a useful quality measure. Quality improvement programs may identify important deficiencies in endoscopist detection performance by measuring APC for endoscopists with ADR > 25%.
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    Identification of Novel Biomarker and Therapeutic Target Candidates for Diagnosis and Treatment of Follicular Adenoma
    (International Institute of Anticancer Research, 2015-11) Lai, Xianyin; Chen, Shaoxiong; Department of Biochemistry and Molecular Biology, IU School of Medicine
    ollicular adenoma is a type of benign and encapsulated nodule in the thyroid gland, but some adenomas have the potential to progress to follicular carcinoma. Therefore, it is important to monitor the state and progress of follicular adenoma in the clinic and discover drug development targets for the treatment of follicular adenoma to prevent its worsening to follicular carcinoma. Currently, the study of biomarkers and therapeutic targets lacks applications of up-to-date technologies, including proteomics and bioinformatics. To discover novel protein biomarker and therapeutic target candidates, a liquid chromatography-tandem mass spectrometry approach was applied to directly compare follicular adenoma with normal thyroid tissue samples. The proteomics analysis revealed 114 protein biomarker candidates out of 1,780 identified and quantified proteins. A comprehensive approach to prioritize the biomarker candidates by category and rank revealed CD63, DDB1, TYMP, VDAC2, and DCXR as the top five biomarker candidates. Upstream regulator analysis using the Ingenuity Pathway Analysis (IPA) software discovered four therapeutic target candidates for follicular adenoma, including TGFB1, MYC, ANGPT2, and NFE2L2. This study provided biomarker and therapeutic target candidates for a follow-up study, which will facilitate monitoring and treatment of follicular adenoma.
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    Use of Endoscopic Impression, Artificial Intelligence, and Pathologist Interpretation to Resolve Discrepancies Between Endoscopy and Pathology Analyses of Diminutive Colorectal Polyps
    (Elsevier, 2020-02) Shahidi, Neal; Rex, Douglas K.; Kaltenbach, Tonya; Rastogi, Amit; Ghalehjegh, Sina Hamidi; Byrne, Michael F.; Medicine, School of Medicine