Database : MEDLINE
Search on : Adenomatous and Polyps [Words]
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[PMID]: 29524115
[Au] Autor:García-Alonso FJ; Manzano Santamaría I; Guardiola Arévalo A; Pique Becerra R; Leandro Barros A; de Sande Rivera N; Moreno Casas G; Arribas Terradillos S; Llerena Riofrío Á; Escolano Peco CA; Alguacil Rodríguez E; Bermejo F
[Ad] Address:Gastroenterology Department, Hospital Universitario Río Hortega, Calle Dulzaina 2, 47012, Valladolid, Spain. fj.garcia.alonso@gmail.com.
[Ti] Title:Self-Formation Assessed by Cumulative Summation Test Does Not Reach Recommended Thresholds for Optical Diagnosis of Colorectal Polyps ≤ 7 mm.
[So] Source:Dig Dis Sci;, 2018 Mar 09.
[Is] ISSN:1573-2568
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND AND AIMS: Accurate optical diagnosis of diminutive polyps would allow implementing a resect and discard strategy. We evaluated the learning curve of a single training session followed by self-education in subjects with no endoscopic experience. METHODS: Learning curves were evaluated in 38 subjects employing learning curve-cumulative summation (LC-CUSUM) tests, with each participant attending one training session regarding narrow band imaging and optical diagnosis and then individually assessing 100 lesions, receiving feedback after each diagnosis. Diagnostic accuracy was subsequently evaluated in 180 patients with lesions ≤ 7 mm. Evaluators predicted each polyp's histology and recommended a surveillance interval. Determinants of accuracy were explored using regression analysis. RESULTS: According to the LC-CUSUM curve, 20 evaluators (52.6%) reached diagnostic competence after 57 lesions (IQR 55-76.5). During the diagnostic performance assessment, 11,666 diagnoses and 6840 follow-up recommendations were generated. Considering high confidence diagnoses, accuracy was 81.3% (80.5-82.1%), negative predictive value (NPV) for rectosigmoid adenomas 78.6% (76.4-80.6%), and sensitivity for adenomas 86.6% (85.8-87.4%). Two (5.3%) evaluators reached a ≥ 90% accuracy, 3 (7.9%) presented a NPV for rectosigmoid adenomas ≥ 90%, and 18 (47.4%) a sensitivity for adenomas ≥ 90%. Multivariable logistic regression showed high confidence and size ≥ 5 mm as the strongest predictors of accuracy. Fifteen (39.5%) evaluators recommended a correct or reduced follow-up interval in over 90% of subjects. CONCLUSIONS: Self-formation after a single training session did not allow most evaluators to reach the required accuracy. LC-CUSUM tests did not identify competent evaluators. Despite these results, 86.7% of follow-up intervals would have been corrected or reduced.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher
[do] DOI:10.1007/s10620-018-5008-5

  2 / 5925 MEDLINE  
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[PMID]: 29502368
[Au] Autor:Zhang J; Lu XL; Zhao G; Shi HT; Geng Y; Zhong WT; Dong L
[Ad] Address:Department of Digestive Disease, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China.
[Ti] Title:[Relationships between the enrichment of ETBF, Fn, Hp in intestinal and colorectal cancer].
[So] Source:Zhonghua Zhong Liu Za Zhi;40(2):99-104, 2018 Feb 23.
[Is] ISSN:0253-3766
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:To explore relationships between the enrichment of ETBF, Fn, Hp in feces, tissues and colorectal cancer. Feces, lesion tissue and adjacent tissue from 24 patients with colorectal cancer and 31 patients with adenomas were collected, and we collected Feces and tissue of 20 healthy control persons. Then the copy numbers of enterotoxigenic B. fragilis (ETBF), Fusobacterium nucleatum (Fn) and Helicobacter pylori (Hp) were determined by quantitative real-time PCR. Immunohistochemical method was used to examine the expression intensity of EGFR and p53, and the relationships between different expression intensity of EGFR, p53 and the numbers of three bacterias. In the feces, copy numbers of ETBF and Fn were as follous: colorectal cancer group>adenomas group>healthy control group ( <0.05). Copy numbers of Hp were as follous: colorectal cancer group>healthy control group ( <0.01); adenomas group>healthy control group ( <0.01). In the tissue, copy numbers of ETBF, Fn were as follows: colorectal cancer group>adenomas group>healthy control group ( <0.05). Copy numbers of Hp were as follows: colorectal cancer group>healthy control group ( <0.01); adenomas group>healthy control group ( <0.01). Copy numbers of those three bacteria in the lesion tissue and the adjacent tissue had no significant difference. This happened both in colorectal cancer group and adenomas group. The different expression intensity of EGFR, p53 and the number of three bacteria showed no obviously statistical correlation( >0.05). Adenomatous polyp and colorectal cancer patients show high enrichment of ETBF, Fn and Hp in both feces and tissues. ETBF, Fn and Hp probably contribute to the development of adenomatous polyp and colorectal cancer. Trial registration Chinese Clinical Trial Registry, ChiCTR-BOC-17012509.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:In-Process
[do] DOI:10.3760/cma.j.issn.0253-3766.2018.02.004

  3 / 5925 MEDLINE  
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[PMID]: 29496095
[Au] Autor:Sullivan JF; Dumot JA
[Ad] Address:Department of Gastroenterology and Liver Disease, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
[Ti] Title:Maximizing the Effectiveness of Colonoscopy in the Prevention of Colorectal Cancer.
[So] Source:Surg Oncol Clin N Am;27(2):367-376, 2018 Apr.
[Is] ISSN:1558-5042
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Colonoscopy is a proven screening test for colorectal cancer; maximizing its effectiveness is the best way to decrease interval colorectal cancer. The adenoma detection rate can be improved by monitoring physician detection rates. Assistive devices and innovative endoscopic equipment may also decrease adenoma miss rates. Complete polypectomy of adenomatous lesions and recommending the proper date for the next examination are important considerations. Advanced polypectomy techniques including endoscopic mucosal resection and endoscopic mucosal dissection have a clear role in the nonsurgical management of large laterally spreading adenomatous polyps that previously would have required surgical resection.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180302
[Lr] Last revision date:180302
[St] Status:In-Data-Review

  4 / 5925 MEDLINE  
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[PMID]: 29317277
[Au] Autor:Peery AF; Cools KS; Strassle PD; McGill SK; Crockett SD; Barker A; Koruda M; Grimm IS
[Ad] Address:University of North Carolina School of Medicine, Chapel Hill, North Carolina. Electronic address: Anne_Peery@med.unc.edu.
[Ti] Title:Increasing Rates of Surgery for Patients With Nonmalignant Colorectal Polyps in the United States.
[So] Source:Gastroenterology;, 2018 Jan 06.
[Is] ISSN:1528-0012
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND & AIMS: Despite the availability of endoscopic therapy, many patients in the United States undergo surgical resection for nonmalignant colorectal polyps. We aimed to quantify and examine trends in the use of surgery for nonmalignant colorectal polyps in a nationally representative sample. METHODS: We analyzed data from the Healthcare Cost and Utilization Project National Inpatient Sample for 2000 through 2014. We included all adult patients who underwent elective colectomy or proctectomy and had a diagnosis of either nonmalignant colorectal polyp or colorectal cancer. We compared trends in surgery for nonmalignant colorectal polyps with surgery for colorectal cancer and calculated age, sex, race, region, and teaching status/bed-size-specific incidence rates of surgery for nonmalignant colorectal polyps. RESULTS: From 2000 through 2014, there were 1,230,458 surgeries for nonmalignant colorectal polyps and colorectal cancer in the United States. Among those surgeries, 25% were performed for nonmalignant colorectal polyps. The incidence of surgery for nonmalignant colorectal polyps has increased significantly, from 5.9 in 2000 to 9.4 in 2014 per 100,000 adults (incidence rate difference, 3.56; 95% confidence interval 3.40-3.72), while the incidence of surgery for colorectal cancer has significantly decreased, from 31.5 to 24.7 surgeries per 100,000 adults (incidence rate difference, -6.80; 95% confidence interval -7.11 to -6.49). The incidence of surgery for nonmalignant colorectal polyps has been increasing among individuals age 20 to 79, in men and women and including all races and ethnicities. CONCLUSIONS: In an analysis of a large, nationally representative sample, we found that surgery for nonmalignant colorectal polyps is common and has significantly increased over the past 14 years.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[St] Status:Publisher

  5 / 5925 MEDLINE  
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[PMID]: 29367705
[Au] Autor:Ciavarella M; Miccoli S; Prossomariti A; Pippucci T; Bonora E; Buscherini F; Palombo F; Zuntini R; Balbi T; Ceccarelli C; Bazzoli F; Ricciardiello L; Turchetti D; Piazzi G
[Ad] Address:Medical Genetics Unit, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
[Ti] Title:Somatic APC mosaicism and oligogenic inheritance in genetically unsolved colorectal adenomatous polyposis patients.
[So] Source:Eur J Hum Genet;26(3):387-395, 2018 Mar.
[Is] ISSN:1476-5438
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Germline variants in the APC gene cause familial adenomatous polyposis. Inherited variants in MutYH, POLE, POLD1, NTHL1, and MSH3 genes and somatic APC mosaicism have been reported as alternative causes of polyposis. However, ~30-50% of cases of polyposis remain genetically unsolved. Thus, the aim of this study was to investigate the genetic causes of unexplained adenomatous polyposis. Eight sporadic cases with >20 adenomatous polyps by 35 years of age or >50 adenomatous polyps by 55 years of age, and no causative germline variants in APC and/or MutYH, were enrolled from a cohort of 56 subjects with adenomatous colorectal polyposis. APC gene mosaicism was investigated on DNA from colonic adenomas by Sanger sequencing or Whole Exome Sequencing (WES). Mosaicism extension to other tissues (peripheral blood, saliva, hair follicles) was evaluated using Sanger sequencing and/or digital PCR. APC second hit was investigated in adenomas from mosaic patients. WES was performed on DNA from peripheral blood to identify additional polyposis candidate variants. We identified APC mosaicism in 50% of patients. In three cases mosaicism was restricted to the colon, while in one it also extended to the duodenum and saliva. One patient without APC mosaicism, carrying an APC in-frame deletion of uncertain significance, was found to harbor rare germline variants in OGG1, POLQ, and EXO1 genes. In conclusion, our restrictive selection criteria improved the detection of mosaic APC patients. In addition, we showed for the first time that an oligogenic inheritance of rare variants might have a cooperative role in sporadic colorectal polyposis onset.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180227
[Lr] Last revision date:180227
[St] Status:In-Data-Review
[do] DOI:10.1038/s41431-017-0086-y

  6 / 5925 MEDLINE  
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[PMID]: 29323753
[Au] Autor:Thyagarajan B; Guan W; Fedirko V; Barcelo H; Ramasubramaian R; Gross M; Goodman M; Bostick RM
[Ad] Address:Department of Laboratory Medicine and Pathology, Medical School, University of Minnesota, Minneapolis, Minnesota.
[Ti] Title:Associations of mitochondrial polymorphisms with sporadic colorectal adenoma.
[So] Source:Mol Carcinog;, 2018 Jan 11.
[Is] ISSN:1098-2744
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Somatic mutations in mitochondrial DNA have been reported in colorectal adenomatous polyps (adenomas), the precursors to most colorectal cancers. However, there are no reports of associations of germline variation in mitochondrial DNA with adenoma risk. We investigated associations of germline polymorphisms in the displacement loop (D-loop) and non-D-loop region of the mitochondrial genome with incident, sporadic colorectal adenoma in three pooled colonoscopy-based case-control studies (n = 327 adenoma cases, 420 controls) that used identical methods for case and risk factor ascertainment. We sequenced a 1124 bp fragment to identify all genetic variation in the mitochondrial D-loop region, and used the Sequenom platform to genotype 64 tagSNPs in the non-D-loop region. We used multivariable unconditional logistic regression to estimate associations of the polymorphisms with adenoma. The odds ratios (OR) for associations of four polymorphisms in the HV1 region (mt16294, mt16296, mt16278, mt16069) with adenoma were 2.30, 2.63, 3.34, and 0.56, respectively; all 95% confidence intervals (CI) excluded 1.0, however, after correction for multiple comparisons, none of the findings remained statistically significant. Similar results were found for six polymorphisms in the non-D-loop region. In the HV1 region poly C tract, relative to those with 5 repeats, the ORs for those with fewer or more repeats were, respectively, 2.29 (95%CI 1.07-4.89) and 0.63 (95%CI 0.36-1.08), but repeat numbers in the HV2 region were not associated with adenoma. These findings suggest that mitochondrial D-loop HV1 region polymorphisms may be associated with colorectal adenoma risk and support further investigation.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180227
[Lr] Last revision date:180227
[St] Status:Publisher
[do] DOI:10.1002/mc.22783

  7 / 5925 MEDLINE  
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[PMID]: 29475926
[Au] Autor:Michail O; Moris D; Theocharis S; Griniatsos J
[Ad] Address:First Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece.
[Ti] Title:Cullin-1 and -2 Protein Expression in Colorectal Cancer: Correlation with Clinicopathological Variables.
[So] Source:In Vivo;32(2):391-396, 2018 Mar-Apr.
[Is] ISSN:1791-7549
[Cp] Country of publication:Greece
[La] Language:eng
[Ab] Abstract:BACKGROUND/AIM: The cullin (CUL) family of proteins is involved in the ubiquitin/mediated degradation of proteins, regulating cell proliferation, cell-cycle control, migration, invasion and metastasis in the process of tumor progression. The aim of the present study was to examine if there is any correlation between the immunohistochemical (IHC) expression of Cullin-1 and -2 proteins in colorectal cancer tissue specimens with several clinicopathological variables. MATERIALS AND METHODS: Between January 2012 and December 2014, 96 consecutive adenocarcinoma patients were submitted to oncological colectomy, as the first therapeutic option, with a curative intent. CUL-1 and -2 protein expression was examined with IHC on paraffin-embedded tissue sections. CUL-1 and -2 protein positivity, was correlated with patients' age, gender, stage, histological grade, proliferative capacity (Ki-67 labeling index) and mutant p53 protein expression. The positivity for CUL-1, CUL-2, mutant p53 protein and Ki-67 index, was determined by the percentage of their IHC expression in the total number of cancer cells. RESULTS: Choosing as a cut-off point for CUL-1 positivity the 10%, a statistically significant relationship of the expression of the mutant p53 protein (p=0.04) and the co-expression of CUL-2 (p=0.003) were noticed. By setting the cut-off limit for CUL-2 expression to 10%, no statistically significant differences were observed between its expression and the examined clinicopathological variables. However, by increasing the cut-off limit for CUL-2 expression to 30%, a statistically significant correlation of its expression to the mutated p53 protein was noticed (p=0.047). Co-expression of CUL-1 and -2 in more than 10%, significantly correlated to the coexistence of adenomatous polyps along the large bowel (p=0.0329). Multivariate analysis of CUL-1 and -2 co-expression in more than 10% disclosed their expression as an independent factor for adenomatous polyps development in the large bowel (p=0.035, RR=2.1). CONCLUSION: CUL-1 overexpression may happen early in the process of carcinogenesis mainly affecting the vulnerable p53(+) large bowel cells, arresting them in the G1 phase of cell-cycle, while it may also induce the expression of CUL-2. Co-expression of CUL-1 and CUL-2, in the arrested (in G1 phase) large bowel cells, promotes carcinogenesis up to adenomatous polyp formation. Since no relationship between cullins expression and development of cancer on adenoma was found, the results of the present study may be useful explaining the initiation but not the progression of carcinogenesis in colorectal cancer. Further molecular and clinical studies are needed in order to delineate the clinical importance of these proteins in the management of colorectal cancer patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180226
[Lr] Last revision date:180226
[St] Status:In-Process

  8 / 5925 MEDLINE  
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[PMID]: 29475922
[Au] Autor:Takiyama A; Tanaka T; Kazama S; Nagata H; Kawai K; Hata K; Otani K; Nishikawa T; Sasaki K; Kaneko M; Emoto S; Murono K; Takiyama H; Nozawa H
[Ad] Address:Department of Surgical Oncology, The University of Tokyo, Tokyo, Japan takiyamaa-sur@h.u-tokyo.ac.jp.
[Ti] Title:DCLK1 Expression in Colorectal Polyps Increases with the Severity of Dysplasia.
[So] Source:In Vivo;32(2):365-371, 2018 Mar-Apr.
[Is] ISSN:1791-7549
[Cp] Country of publication:Greece
[La] Language:eng
[Ab] Abstract:BACKGROUND: The expression of doublecortin-like kinase 1 (DCLK1) has been investigated in cancer; however not in precancerous adenomatous polyps. MATERIALS AND METHODS: Immunohistological expression of DCLK1 was evaluated in various grades of adenomas, cancerous polyps, and hyperplastic polyps in resected human tissue specimens. RESULTS: Ninety-two specimens were positive for DCLK1 and 134 were negative. Cancerous polyps showed a high DCLK1 positivity rate compared to adenomas (68.4% vs. 36.8%; p<0.01). The rate of DCLK1 positivity was not significantly different among the three grades of adenomas (mild, moderate, and severe). DCLK1 was highly positive in advanced adenomas than low risk adenomas (49.6% vs. 29.3%; p<0.01). CONCLUSION: The expression of DCLK1 was found in low-grade adenomas and increased with worsening severity of dysplasia. DCLK1 expression was highly observed in advanced adenomas, which had a clinically higher malignant potential.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180226
[Lr] Last revision date:180226
[St] Status:In-Process

  9 / 5925 MEDLINE  
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[PMID]: 29429965
[Au] Autor:Saadalla AM; Osman A; Gurish MF; Dennis KL; Blatner NR; Pezeshki A; McNagny KM; Cheroutre H; Gounari F; Khazaie K
[Ad] Address:Department of Immunology, Mayo Clinic, Rochester, MN 55905.
[Ti] Title:Mast cells promote small bowel cancer in a tumor stage-specific and cytokine-dependent manner.
[So] Source:Proc Natl Acad Sci U S A;115(7):1588-1592, 2018 Feb 13.
[Is] ISSN:1091-6490
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Mast cells (MCs) are tissue resident sentinels that mature and orchestrate inflammation in response to infection and allergy. While they are also frequently observed in tumors, the contribution of MCs to carcinogenesis remains unclear. Here, we show that sequential oncogenic events in gut epithelia expand different types of MCs in a temporal-, spatial-, and cytokine-dependent manner. The first wave of MCs expands focally in benign adenomatous polyps, which have elevated levels of IL-10, IL-13, and IL-33, and are rich in type-2 innate lymphoid cells (ILC2s). These vanguard MCs adhere to the transformed epithelial cells and express murine mast cell protease 2 (mMCP2; a typical mucosal MC protease) and, to a lesser extent, the connective tissue mast cell (CTMC) protease mMCP6. Persistence of MCs is strictly dependent on T cell-derived IL-10, and their loss in the absence of IL-10-expressing T cells markedly delays small bowel (SB) polyposis. MCs expand profusely in polyposis-prone mice when T cells overexpress IL-10. The frequency of polyp-associated MCs is unaltered in response to broad-spectrum antibiotics, arguing against a microbial component driving their recruitment. Intriguingly, when polyps become invasive, a second wave of mMCP5 /mMCP6 CTMCs expands in the tumor stroma and at invasive tumor borders. Ablation of mMCP6 expression attenuates polyposis, but invasive properties of the remaining lesions remain intact. Our findings argue for a multistep process in SB carcinogenesis in which distinct MC subsets, and their elaborated proteases, guide disease progression.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180223
[Lr] Last revision date:180223
[St] Status:In-Data-Review
[do] DOI:10.1073/pnas.1716804115

  10 / 5925 MEDLINE  
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[PMID]: 28450390
[Au] Autor:East JE; Atkin WS; Bateman AC; Clark SK; Dolwani S; Ket SN; Leedham SJ; Phull PS; Rutter MD; Shepherd NA; Tomlinson I; Rees CJ
[Ad] Address:Translational Gastroenterology Unit, Nuffield Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK.
[Ti] Title:British Society of Gastroenterology position statement on serrated polyps in the colon and rectum.
[So] Source:Gut;66(7):1181-1196, 2017 07.
[Is] ISSN:1468-3288
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Serrated polyps have been recognised in the last decade as important premalignant lesions accounting for between 15% and 30% of colorectal cancers. There is therefore a clinical need for guidance on how to manage these lesions; however, the evidence base is limited. A working group was commission by the British Society of Gastroenterology (BSG) Endoscopy section to review the available evidence and develop a position statement to provide clinical guidance until the evidence becomes available to support a formal guideline. The scope of the position statement was wide-ranging and included: evidence that serrated lesions have premalignant potential; detection and resection of serrated lesions; surveillance strategies after detection of serrated lesions; special situations-serrated polyposis syndrome (including surgery) and serrated lesions in colitis; education, audit and benchmarks and research questions. Statements on these issues were proposed where the evidence was deemed sufficient, and re-evaluated modified via a Delphi process until >80% agreement was reached. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool was used to assess the strength of evidence and strength of recommendation for finalised statements. : we suggest that until further evidence on the efficacy or otherwise of surveillance are published, patients with sessile serrated lesions (SSLs) that appear associated with a higher risk of future neoplasia or colorectal cancer (SSLs ≥10 mm or serrated lesions harbouring dysplasia including traditional serrated adenomas) should be offered a one-off colonoscopic surveillance examination at 3 years ( ).
[Mh] MeSH terms primary: Colonic Polyps/diagnosis
Colonic Polyps/surgery
Polyps/diagnosis
Polyps/surgery
Rectal Diseases/diagnosis
Rectal Diseases/surgery
[Mh] MeSH terms secundary: Adenoma/diagnosis
Adenoma/genetics
Adenoma/surgery
Adenomatous Polyposis Coli/diagnosis
Benchmarking
Biomarkers/analysis
Cell Transformation, Neoplastic
Colitis/complications
Colonic Polyps/genetics
Colonoscopy
CpG Islands/genetics
DNA/isolation & purification
DNA Methylation
Feces/chemistry
Humans
Parasympatholytics/therapeutic use
Polyps/genetics
Precancerous Conditions/diagnosis
Precancerous Conditions/surgery
Rectal Diseases/genetics
Terminology as Topic
Watchful Waiting
[Pt] Publication type:JOURNAL ARTICLE; PRACTICE GUIDELINE; REVIEW
[Nm] Name of substance:0 (Biomarkers); 0 (Parasympatholytics); 9007-49-2 (DNA)
[Em] Entry month:1708
[Cu] Class update date: 180222
[Lr] Last revision date:180222
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:170429
[St] Status:MEDLINE
[do] DOI:10.1136/gutjnl-2017-314005


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