Chromoendoscopy with a Standard-Resolution Colonoscope for Evaluation of Rectal Aberrant Crypt Foci

Kowalczyk, Marek; Siermontowski, Piotr; Mucha, Dariusz; Ambroży, Tadeusz; Orlowski, M; Zinkiewicz, Krzysztof; Kurpiewski, Waldemar; Paśnik, Krzysztof; Kowalczyk, Iwona; Pedrycz, Agnieszka

doi:10.1371/journal.pone.0148286

Cited by 9 publications

(9 citation statements)

References 24 publications

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“…After 45 years, the number of ACF rapidly increases to reach the plateau phase at ~60 years of age, and slowly decreases thereafter. Other studies have reported similar incidence rates of ACF in these age brackets (15,16). It is essential to identify and remove these early lesions for an adequate CRC prevention strategy (17).…”

Section: Introductionsupporting

confidence: 65%

Deep learning techniques for detecting preneoplastic and neoplastic lesions in human colorectal histological images

et al. 2019

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Trained pathologists base colorectal cancer identification on the visual interpretation of microscope images. However, image labeling is not always straightforward and this repetitive task is prone to mistakes due to human distraction. Significant efforts are underway to develop informative tools to assist pathologists and decrease the burden and frequency of errors. The present study proposes a deep learning approach to recognize four different stages of cancerous tissue development, including normal mucosa, early preneoplastic lesion, adenoma and cancer. A dataset of human colon tissue images collected and labeled over a 10-year period by a team of pathologists was partitioned into three sets. These were used to train, validate and test the neural network, comprising several convolutional and a few linear layers. The approach used in the present study is ‘direct’; it labels raw images and bypasses the segmentation step. An overall accuracy of >95% was achieved, with the majority of mislabeling referring to a near category. Tests on an external dataset with a different resolution yielded accuracies >80%. The present study demonstrated that the neural network, when properly trained, can provide fast, accurate and reproducible labeling for colon cancer images, with the potential to significantly improve the quality and speed of medical diagnoses.

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Section: Introductionsupporting

confidence: 65%

Deep learning techniques for detecting preneoplastic and neoplastic lesions in human colorectal histological images

et al. 2019

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“…Neoplasia progresses over time. ACF are the most common, endoscopy-identifiable colonic epithelial neoplasms [ 20 ]. In our study, ACF occurred sporadically since the age of about 40 years; predominantly single foci were found [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…ACF are the most common, endoscopy-identifiable colonic epithelial neoplasms [ 20 ]. In our study, ACF occurred sporadically since the age of about 40 years; predominantly single foci were found [ 20 ]. Since the age of 45 years, the number of ACF rapidly increased to reach the plateau phase about the age of 60 years and subsequently slowly decreased.…”

Section: Discussionmentioning

confidence: 99%

Occurrence of colorectal aberrant crypt foci depending on age and dietary patterns of patients

Kowalczyk

Orlowski²,

Siermontowski

et al. 2018

BMC Cancer

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BackgroundAberrant crypt foci (ACF) are commonly considered the early pre-cancerous lesions that can progress to colorectal cancer (CRC). The available literature data reveal that age, dietary factors and lifestyle can affect the development of several dozen percentages of malignant tumours, including CRC. In the present study, an attempt was made to assess the incidence and growth dynamics of ACF and to determine whether the type of diet affected the development and number of AFC.MethodsColonoscopy combined with rectal mucosa staining with 0.25% methylene blue was performed in 131 patients. On the day of examination, each patient completed a questionnaire regarding epidemiological data. According to their numbers, colorectal ACF were divided into three groups. The findings were analysed statistically. The Student’s t test and the U test were applied in order to determine the significance of differences of means and frequency of events in both groups. Statistica 7.1 and Excel 2010 were used.ResultsThe single ACF occur in the youngest individuals (ACF < 5). Since the age of 38 years, the number of ACF gradually increases to show a decreasing tendency since the age of 60 years. The number of 5 < ACF < 10 occurs slightly later, since the age of 50 years, and dynamically increases reaching the maximum at the age of 62 years, subsequently the increase is proportional. ACF > 10 occur at a more advanced age (55 years) and their number gradually increases with age. The maximum number is observed at the age of 77 years.In individuals not using high-fibre diets and with high intake of red meat, the probability of higher numbers of ACF increases. The probability of higher numbers of ACF (5 < ACF10) was observed in patients with colon diverticula. In patients with higher BMI, the number of ACF is higher.ConclusionAge significantly affects the number of colorectal ACF. The types of foods consumed can considerably increase the risk of colorectal ACF, which is particularly visible in individuals who do not regularly use high-fibre diets, those obese and with colon diverticula.

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“…Previous studies have reported the diagnostic yield of endoscopy when using histology as gold standard to be between 60% and 68% (11,31). In our cohort, 80% of the lesions identified by endoscopy as potential ACF were corroborated by their histology, thus indicating that high-definition CE was a suitable technique for detecting these subtle lesions (32).…”

Section: Discussionmentioning

confidence: 62%

Rectal Aberrant Crypt Foci in Humans Are Not Surrogate Markers for Colorectal Cancer Risk

Quintanilla

López-Cerón

Cuatrecasas

et al. 2019

Clinical and Translational Gastroenterology

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INTRODUCTION: Over the past 20 years, aberrant crypt foci (ACF) have emerged as potential precursors and biomarkers for colorectal cancer (CRC). However, data regarding their molecular pathogenesis, as well as their endoscopic and histological identification, remain inconsistent. METHODS: A wide cohort of ACF from 100 control subjects and 100 case patients, including patients with adenoma and CRC, were characterized for endoscopic, morphologic, and molecular features. RESULTS: We observed that among all the endoscopic features evaluated, only the number of large ACF correlated with CRC risk ( P = 0.003), whereas the histological classification, as assessed by 2 different pathologists, was inconsistent and did not differ between control and case patients. Moreover, only a few APC and BRAF mutations and no microsatellite instability were detected in our samples. KRAS mutations were detected in 16.3% of ACF samples, which also exhibited increased MGMT hypermethylation. However, none of those events were found to be predictive of CRC risk. DISCUSSION: Although ACF might be preneoplastic lesions of the colon, they are not suitable biomarkers for assessing CRC progression.

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Chromoendoscopy with a Standard-Resolution Colonoscope for Evaluation of Rectal Aberrant Crypt Foci

Cited by 9 publications

References 24 publications

Deep learning techniques for detecting preneoplastic and neoplastic lesions in human colorectal histological images

Deep learning techniques for detecting preneoplastic and neoplastic lesions in human colorectal histological images

Occurrence of colorectal aberrant crypt foci depending on age and dietary patterns of patients

Rectal Aberrant Crypt Foci in Humans Are Not Surrogate Markers for Colorectal Cancer Risk

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