Background: Circulating tumor cells (CTCs) were a promising liquid biopsy for pancreatic cancer (PC) but circulate in low counts in peripheral blood. We evaluated the diagnostic and prognostic values of portal vein (PoV) CTCs in PC patients. Methods: PoV was aspirated under EUS guidance from 40 patients with suspected pancreaticobiliary cancers. Epithelial-mesenchymal-transition-related subtypes of CTCs were identified via immunofluorescence using EpCAM and Twist antibodies. The diagnostic and prognostic performance of PoV CTCs was investigated by receiver-operating characteristic (AUC) curve and Kaplan-Meier survival analysis. Results: In total, 40 patients including 31 with PC, 4 with non-pancreatic periampullary cancer and 5 with benign pancreatic diseases (BPD) were enrolled. CTCs were detected more in PoV compared with peripheral blood. PoV CTC numbers in BPD patients were lower than in PC patients. The number of PoV CTCs, especially mesenchymal-CTCs (M-CTCs), was positively correlated with the tumor burden, instead of epithelial-CTCs (E-CTCs). The combination of PoV CTC numbers and CA19-9 demonstrated better diagnostic efficiency (AUC value 0.987) than either alone in differentiating PC with BPD. Moreover, the diagnostic efficacy of PoV CTCs and M-CTCs were obviously better than that of E-CTCs and CA19-9 in distinguishing early and late stage PC. Lastly, high PoV CTC and M-CTC numbers were both associated with shorter overall survival. Conclusion: Acquisition of the PoV samples in PC patients via EUS-guided procedures has been proved safe and feasible. PoV CTCs, especially M-CTCs, have great potentials in diagnosing and predicting the prognosis of PC, especially in combination with CA19-9.

No abstract

Background and Aims. Currently sedation is a common practice in colonoscopy to reduce pain of patients and improve the operator satisfaction, whereas its impact on examination quality, especially adenoma detection rate (ADR) is still controversial. Thus, we aimed to investigate the association of sedation with ADR. Methods. Consecutive patients receiving colonoscopy between January 2017 and January 2020 at the Nanjing Drum Tower Hospital, Nanjing, China, were collected. Univariate and multivariate logistic regression models were performed to investigate the association between sedation and ADR. Subgroup analysis and propensity score matching (PSM) analysis, as sensitivity analysis, were performed to validate the independent effect. Results. The ADR was significantly higher in cases with sedation (ADR: 36.9% vs. 29.1%, odds ratio [OR]: 1.42, 95% confidence interval [CI]: 1.31–1.55, P < 0.001 ). Multivariate analysis showed that the sedation was an independent factor associated with ADR (OR: 1.49, 95% CI: 1.35–1.65, P < 0.001 ). The effect was consistent in subgroup analyses ( P > 0.05 ) and PSM analysis (ADR: 37.6% vs. 29.1%, OR: 1.47, 95% CI: 1.33–1.63, P < 0.001 ). Conclusion. Sedation was associated with a higher polyp and ADR s during colonoscopy, which can promote the quality of colonoscopy.

Background and aims: Currently sedation is a common practice in colonoscopy to reduce pain of patients and improve the operator satisfaction, while its impact on examination quality, especially polyp detection rate (PDR) and adenoma detection rate (ADR) is still controversial. Thus, we aimed to investigate the association of sedation with PDR/ADR. Methods: Consecutive patients receiving colonoscopy between January 2017 to January 2020 at the Nanjing Drum Tower Hospital were collected. Univariate and multivariate logistic regression models were performed to investigate the association between sedation and PDR/ADR. Subgroup analysis and propensity score matching analysis (PSM), as sensitivity analysis, were performed to validate the independent effect. Results: The PDR and ADR were significantly higher in cases with sedation (PDR: 55.4% vs 46.6%, OR: 1.42, 95% CI: 1.32~1.53, P < 0.001; ADR: 37.3% vs 30.2%, OR: 1.37, 95% CI: 1.27~1.49, P < 0.001). Multivariate analysis showed that the sedation was an independent factor associated with PDR (OR: 1.54, 95% CI: 1.40~1.69, P < 0.001) and ADR (OR: 1.45, 95% CI: 1.32~1.60, P < 0.001). The effect was consistent in subgroup analyses(P > 0.05) and PSM analysis (PDR: 56.1% vs 46.4%, OR: 1.48, 95% CI: 1.35~1.62, P < 0.001; ADR: 37.4% vs 30.0%, OR: 1.40, 95% CI: 1.27~1.54, P < 0.001). Conclusion: Sedation was associated with a higher polyp and adenoma detection rates during colonoscopy, which can promote the quality of colonoscopy.

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.