The Colorectal Pit Pattern Clinical Significance And Its Relationship With The APC Gene Protein Truncated

Background Colorectal cancer is one of the most common of the digestive malignancies, its occult onset, early, often without apparent specificity performance deadline in tumor Bureau, only about40%of patients were detected to be symptoms mostly inlate. Therefore, early detection and timely diagnosis and treatment junction cancer and precancerous lesions can greatly reduce the morbidity and mortality of colorectal cancer. In recent years, the staining zoom endoscopy and narrow-band imaging magnifying endoscopy applications pit subtle changes can be clearly observed, studies have shown that stained magnifying endoscopy with NBI magnifying endoscopy knot rectal mucosa of non-neoplastic and neoplasticlesionsthe accuracy of the diagnostic value of87-94%, has a high compliance rate with histopathologic diagnosis. APC gene is a susceptibility gene for familial adenomatous polyposis (familial adenomatous polyposis, FAP) and sporadic colorectal tumors change studies havereported that the APC gene is approximately95%of the mutations result of the APCprotein was truncated changethe truncation of the gene product is a very extremechanges, it willcause changes in the normal function of the intracellular protein, and thus induce the disease. This research project intends to explore endoscopic colorectal mucosa duct openingparting with histopathological consistency relations, as well as pit typing of non-neoplastic colorectal lesions or neoplastic lesions of diagnostic value, and compareendoscopictwo assistivetechnology application value in the diagnosis of colorectallesions; combined with molecularbiology techniques, by comparing the different ductopenings colorectal lesions truncated AP C protein expression, explore the APC proteintruncated points in different pathologicaltype and pit typing and expressed.Objective1. Amplifier technology through the use of stained amplification technology and NBIobservation knot rectal mucosa pit type, explore endoscopic colorectal mucosa pitgenotyping of colorectal non-neoplastic lesions or neoplastic lesions of diagnostic value, aswell as a comparative studystained magnification endoscopy and narrow band imaging (NBI) magnifying endoscopy in the diagnosis of colorectal lesions.2. by comparing the different duct openings the colorectal mucosa lesions of the APCgene protein expression truncated explore the correlation between different pit typecolorectal lesions APC gene protein truncated.Method1. June2011to December2011,64patients in our hospital colonoscopy, a total of73polypoid lesions, polypoid lesions, including endoscopic mucosal staining amplification technology observation pitlesions in tumor and non-tumor properties of pit Kudo typingjudgment(Ⅰ-Ⅱ type of non-neoplastic lesions, Ⅲ-Ⅴ type of tumor lesions), Control and pathological diagnosis, the consistency of the two diagnostic methods.2. Stained magnifying endoscopy observed73cases of polypoid lesions, kudo standardgenotyping, and truncated protein truncation test detected lesions APC gene proteinexpression levels, and Ⅰ-Ⅱ merged groupⅢ–Ⅳ combined group, V-type grouppairwise comparison, the pathological diagnosis results are divided into non-neoplasticpolyps (inflammatory polyps, hyperplastic polyps, juvenile polyps merged group), adenoma (tubular adenomas, tubulovillousadenoma, villous adenoma consolidatedgroup) and adenocarcinoma pairwise comparison, compare protein expression oftruncated APC gene colorectal mucosa pit.Result1. Magnifying endoscopy found by staining colorectal polypoid lesions73, with endoscopic pit pattern diagnosis: typeⅠpit11, typeⅡpit9, Ⅲs-pit1, ⅢL-The pit19, typeⅣ pit11, typeⅤ pit12mixed pit10. Histopathological diagnosis: inflammatory polyps in13(17.8%),8(10.9%) ofhyperplastic polyps, juvenile polyps, one (1.4%), tubular adenom as,22(30.1%), tubular-villous glandulartumor in10(13.7%), villous adenoma,7(9.6%), adenocarcinoma in12(16.4%). The diagnosis of non-neoplastic (Ⅰ-Ⅱ type) and tumor (Ⅲ-Ⅴ)polypoid lesions of94.5%(69/73);diagnosis of non-neoplastic polyps diagnosed sensitivity86.4%, specificity of Dada95.0%; diagnosis of neoplastic polyps sensitivity of98.0%, a specificity of94.3%.2. Conventional endoscopy detected in87(94.6%) lesions, NBI magnifying endoscopydetected in90(97.8%), all stained magnifying endoscopy detected (100.0%). Thelesion contour Microvessels image display NBI magnifying endoscopy significantlybetter than the stained magnifying endoscopy (P=0.000), endoscopy staining zoom andNBI zoom the pit morphology image display on endoscopy difference was not statistically significance (P=0.394). NBI magnifying endoscopy in the diagnosis of colorectal neoplastic lesions coincidence rate, sensitivity, specificity91.3%(84/92),83.9%(26/31),95.1%(58/61), dyeing magnifying endoscopy corresponding, respectively,89.1%(82/92),80.6%(25/31),93.4%(57/61), the difference was not statistically significant (P>0.05).3. protein truncation test technology test results show, APC truncated proteins, respectively, in the pathological type inflammatory polyps, hyperplastic polyps, juvenile polyps, tubular adenoma, tubular-villous adenoma, villous adenoma,adenocarcinoma0%(0/13),0%(0/8),0%(0/1),36.4%(8/22),30%(3/10),28.6%(2/7),33.3%(4/12). Non-neoplastic consolidated group with the adenomatous combinedgroup and adenocarcinoma difference was statistically significant (p<0.0125), adenomamerged group with adenocarcinoma difference was not statistically significant (P>0.0125); APC truncated protein The expression rate of colorectal pit pattern typeⅠ, Ⅱtype, ⅢS-type, ⅢL-type, Ⅳtype, Ⅴtype in, respectively, to0%(0/11),0%(0/9),0%(0/1),31.8%(7/22),33.3%(6/18),33.3%(4/12); Ⅰ-Ⅱcombined groupⅢ-Ⅳ combinedgroup and typeⅤ group difference was statistically significant (p<0.0125), Ⅲ-Ⅳcombinedgroup Ⅴ-type group, the difference was not statistically significant (P>0.0125).Conclusion1.staining magnifying endoscopy with NBI magnifying endoscopy throughobservation pitand microvascular morphology in the diagnosis of colorectal neoplastic and non-neoplastic lesions with high specificity, sensitivity and compliance rate can be increased and early colorectal cancer its rate of precancerous lesions, the combinedapplication of both their great help.2.APC truncated protein expression in colorectal tumors occur in theearly stages of the process.3.APC binding protein truncation test were observed within the pit pattern and subtlechanges in blood vessels in the prevention, early diagnosis and early treatment ofcolorectal cancer has important clinical significance.