BACKGROUND/AIM:The development of colon cancer is influenced by the tumour immune microenvironment, in which specific immune cell subsets may be useful predictors for patient's clinical outcome and devising treatment strategies.MATERIALS AND METHODS:The distribution of tumour-infiltrating immune cell subpopulations of three cohorts of The Cancer Genome Atlas (n=225), GSE39582 (n=493), and GSE17536 (n=137) datasets were analysed on the basis of single cell RNA sequencing data via the Cibersortx software. A prognostic model was constructed via a penalised Cox regression model with least absolute shrinkage and selection operator (LASSO) penalty according to the one standard error rule.RESULTS:Conventional type 2 dendritic cells were correlated with a good prognosis, whereas NLRP3-expressing macrophages, C1QC-expressing tumour-associated macrophages, and GALTB-expressing B cells were correlated with a poor prognosis. We constructed a prognostic model based on prognosis related cell subsets including nine specific immune cell subsets. By using the LASSO method, we found that the model had a superior prediction ability in all three cohorts of patients.CONCLUSION:Multiple immune cell subpopulations in the tumour microenvironment are associated with the prognosis of colon cancer. The established prognostic model has important clinical value in predicting the clinical outcome of patients with colon cancer and in treatment decision.
Background and study aims Endoscopists have been at increased risk because of their direct contact with patients during the COVID-19 pandemic. For patients, being diagnosed with and monitored for gastrointestinal cancer and digestive diseases in timely fashion has been challenging, given pandemic-related adjustments in endoscopy departments. We developed a novel noncontact magnetically controlled capsule endoscopy (ncMCE) system in our medical center. In the current study, we aimed to evaluate the feasibility and safety of ncMCE for gastric examination. Patients and methods Patients were randomly assigned to groups that received ncMCE or MCE in a 1:1 ratio from March 26, 2020 to April 26, 2020. Primary endpoints were feasibility assessed by completion rate (CR) and safety based on the occurrence of adverse events (AEs) including infection. Secondary endpoints included maneuverability of endoscopists, pre-procedure perception and post-procedure satisfaction of patients, gastric examination time (GET), and diagnostic yield (DY). Results Forty patients were enrolled with 100 % CR in both groups without any AEs. Neither the endoscopist nor the patients were infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within 14 days after gastric examination. There were no significant differences in maneuverability (19.3 vs. 20.0, P = 0.179), pre-procedure perception (9 vs. 9, P = 0.626) and post-procedure satisfaction (45 vs. 44, P = 0.999), ord DY (20 % vs. 30 %, P = 0.465). Conclusions ncMCE is a feasible and safe method of gastric examination, which has the potential to protect both medical staff and patients from COVID-19 infection while providing serving as an essential endoscopy service.
Background The lesions of certain diseases are widely distributed in both stomach and small intestine, while the step-by-step strategy of gastroscopy followed by enteroscopy can be burdensome and costly. We aimed to determine if magnetically controlled capsule endoscopy (MCE) could be used in one-time gastro-small intestine (GSI) joint examination. Methods In this study, data of patients in Chinese PLA General Hospital and Changhai Hospital who underwent MCE GSI examination from January 2020 to August 2021 were retrospectively analysed. The primary outcome of this study was the success rate of one-time GSI joint examination, and secondary outcomes included visualization and cleanliness of gastrointestinal tract, gastrointestinal transit times, diagnostic yield and safety of MCE examination. Results A total of 768 patients were included. The success rate of one-time GSI joint examination was 92.58%. There were 94.92% MCEs observed > 90% gastric mucosa in the 6 anatomic landmarks. The rate of complete small bowel examination was 97.40%. The median gastric examination time, gastric transit time and small intestine transit time were 8.18 min, 63.89 min and 4.89 h, respectively. Magnetic steering of MCE significantly decreased gastric transit time (8.92 min vs. 79.68 min, P = 0.001) and increased duodenal lesion detection rate (13.47% vs. 6.26%, P = 0.001) when compared with non-magnetic steering group. Two capsules were retained and were removed by enteroscopy or spontaneously excreted. Conclusions MCE is feasible to complete GSI joint examination and the detection of both gastric and small intestinal diseases can be achieved simultaneously. Trial registration Clinical Trial Registration ClinicalTrials.gov, ID: NCT05069233.
OBJECTIVES: To determine pooled rate of each video capsule endoscopy (VCE) complication, and provide predictors and time-trend analysis of each complication. Systematic search of PubMed and EMBASE for English-language publications reporting VCE complications from January 1, 2000 through March 31, 2019.Information on characteristics of study, patient, procedure, and complications were extracted independently by two investigators. Pooled VCE complications rates were obtained using random-effect meta-analysis. Differences by study-level characteristics were assessed using meta-regression. Primary outcome was pooled rate of each VCE complication. Secondary outcomes were predictors and time-trend analysis of each complication. In total, 402 studies were identified, including 108,079 VCE procedures. Pooled rate of retention, swallow disorder, aspiration, technical failure, and procedural complications were 0.73% (95% confidence interval [CI], 0.59%-0.89%), 0.75% (95% CI, 0.43%-1.13%), 0.00% (95% CI, 0.00%-0.00%), 0.94% (95% CI, 0.65%-1.28%), 0.67% (95% CI, 0.32%-1.10%), respectively; incomplete examination rate of esophagus, stomach, small bowel, and colon were 9.05% (95% CI, 3.14%-17.33%), 7.69% (95% CI, 2.45%-15.21%), 12.08% (95% CI, 10.89%-13.32%), 19.19% (95% CI, 14.06%-24.88%), respectively. Patency capsule reduced retention rate by 4.30% (95% CI, 0.59% to 8.01%; P = .0231), whereas known inflammatory bowel disease increased retention rate by 4.45% (95% CI, 1.64% to 7.26%; P = .0019). Elder was highly associated with small bowel incomplete examination (0.28% [95% CI, 0.07% to 0.49%], P = .0075), while younger age was associated with swallow disorder (0.80% [95% CI, 0.62% to 0.99], P < .0001). Rates of retention and small bowel incomplete examination significantly declined over time (P = .0006 and P < .0001), while other rates remained stable. Rates of VCE complications were low. Rates of retention and small bowel incomplete examination declined over past two decades. Known inflammatory bowel disease is a risk factor, while patency capsule is a protective factor for VCE retention.
Background A full spectrum of video capsule endoscopy (VCE) adverse events over the past two decades has not been evaluated. We aimed to determine pooled rates, predictors and temporal-trend of VCE adverse events over the past two decades. Methods Systematic search of PubMed and EMBASE for English-language publications reporting VCE adverse events (January 1, 2000 to March 31, 2019). Data were extracted independently by two investigators. Pooled VCE adverse event rates were calculated using the random or fixed model as appropriate. Predictors and temporal-trend of each adverse event were performed by meta-regression analyses. Results In total, 402 studies were identified, including 108,079 VCE procedures. Rate of retention, swallow disorder, aspiration, technical failure, and procedural adverse events were 0.73% (95% confidence interval [CI] 0.59-0.89%), 0.75% (95% CI 0.43-1.13%), 0.00% (95% CI 0.00-0.00%), 0.94% (95% CI 0.65-1.28%), 0.67% (95% CI 0.32-1.10%), respectively; incomplete examination rate of esophagus, stomach, small bowel, and colon were 9.05%, 7.69%, 12.08%, 19.19%, respectively. Patency capsule reduced retention rate by 5.04%, whereas known inflammatory bowel disease increased retention rate by 4.29%. Elder was the risk and protective factor for small bowel incomplete examination (0.30%) and swallow disorder (- 0.72%), respectively. Rates of retention and small bowel incomplete examination significantly declined over time (P = .0006 and P < .0001).. Conclusions VCE adverse event rates were generally low, and retention and small bowel incomplete examination rates declined over the past two decades. Patients with known inflammatory bowel disease or elder should be alerted to high risk of retention or small bowel incomplete examination (PROSPERO: CRD42019139595).