| Background Adequate bowel preparation is essential for a high quality colonoscopy.At present,in clinical practice,patients mainly evaluate the effects of bowel preparation before examination by themselves,which could lead to the problem that the judgment is not timely or the judgment result is not accurate.Therefore,an objective evaluation procedure is needed to assist in assessing the adequacy of intestinal preparation.In this study,a new type of artificial intelligence was developed,by using the smartphone camera application to analyze the bowel preparation quality.By comparing the quality of bowel preparation between the AI group and the non-AI control group,this study evaluated whether AI could objectively judge the state of bowel preparation of patients and enable patients to undergo colonoscopy after adequate bowel preparation,thus increasing the colonoscopy efficiency,the detection rate of adenoma and the early screening effectiveness of CRC.Methods In the first part,outpatients and inpatients who underwent colonoscopy in Gaoxin Campus of the First Affiliated Hospital of Anhui Medical University from September 2020 to January 2021 were randomly divided into AI group(n = 197)and non-AI control group(n = 171).Colonoscopy was performed for the AI group after the last defecation was judged as "sufficient" by AI,and colonoscopy was performed for the control group after self-rated bowel preparation was "sufficient".The OBPS and BBPS were used to compare the quality of bowel preparation of the two groups,and the polyp detection rate of the two groups were also observed.In the second part,outpatients and inpatients who underwent colonoscopy in Gaoxin Campus of the First Affiliated Hospital of Anhui Medical University from December 2020 to January 2021 were collected and randomly divided into AI intervention bowel preparation group(n =39)and non-AI control group(n =57).The AI intervention group continued to clean the intestines of those whose photos showed "inadequate” by AI,and colonoscopy was performed until bowel preparation was evaluated as "sufficient",and the control group was the same as before.The OBPS and BBPS were used to compare the quality of bowel preparation of the two groups,and the polyp detection rate of the two groups were also observed.Results 1.There were no statistically significant differences in gender and age between the AI group and the control group(P > 0.05).The polyp detection rate in the AI group was about 30.9%,while that in the non-AI control group was 21.6%,slightly lower than that in the AI group,but there was no statistically significant difference between the two groups(P=0.549).The OBPS of AI group was lower than that of control group(P < 0.01),and the BBPS of AI group was higher than that of control group(P < 0.01),the difference was statistically significant,which indicated that bowel preparation in the AI group was slightly better than that in the control group.In addition,the consistency test of OBPS and BBPS showed that the Kappa value was 0.455(P < 0.01),between 0.4 and 0.7,suggesting that the evaluation results of the two scoring systems were consistent,but the consistency was moderate.2.In the second part,there were no statistical differences in gender and age between the AI intervention group and the control group(P > 0.05),and the polyp detection rate in the AI intervention group was slightly higher than that in the control group.The OBPS of AI group was lower than that of control group(P < 0.01),and the BBPS of AI group was higher than that of control group(P < 0.01),the difference was statistically significant,which indicated that bowel preparation in the AI group was slightly better than that in the control group.Conclusion By objectively judging the quality of bowel preparation of the patients,AI enables patients to undergo colonoscopy after adequate bowel preparation,thus increasing the colonoscopy efficiency,the detection rate of adenoma and the early screening effectiveness of CRC.In addition,AI-assisted intervention can help patients to further improve the cleaning rate of bowel preparation and affect the effectiveness of the quality of colonoscopy examination due to inadequate bowel preparation.Background The tumor origin of CRC is caused by the accumulation of genetic and epigenetic abnormalities in the genome.Abnormal methylation of specific Cp G sites in the genome can be used as biomarkers for early detection of CRC.SDC2 affects the proliferation and oncogenic activity of colon cancer cells,and its abnormal methylation occurs frequently in all stages of CRC.Therefore,it is urgent to develop a new non-invasive examination method with better diagnostic efficiency for the early screening of colorectal cancer in the primary screening population and those who are unwilling to participate in colonoscopy,so as to facilitate the extensive development of early screening of colorectal cancer.In this study,the methylation status of the fecal gene SDC2 was detected to evaluate its application value in the early screening of colorectal cancer to evaluate its application value for early screening of colorectal cancer.Methods Fecal specimens were collected from 43 patients who visited the gastroenterology endoscopy center of the First Affiliated Hospital of Anhui Medical University between November 26,2019 and August 25,2020,including 10 patients in the colorectal cancer group,18 patients in the advanced adenoma group,and 13 patients in the control group.Fecal DNA extraction,sulfite treatment and PCR detection were performed respectively to evaluate the sensitivity and specificity of SDC2 gene methylation in fecal DNA detection of CRC,as well as the consistency with colonoscopy and pathological "gold standard" diagnosis.Results 1.The positive rate of methylation of SDC2 gene in the colorectal cancer group was 90%,which was significantly higher than that in the advanced adenoma group(50%)(χ2 =4.48,P=0.034),and much higher than that in the control group(7.7%)(χ2 =15.581,P=0.000).2.The positive rate of methylation of SDC2 gene in stool of the advanced adenoma group was 50%,which was also much higher than that of the control group(7.7%),the difference was statistically significant(χ2 =6.183,P=0.013).The specificity of methylation of SDC2 gene was 92.3%.The Kappa value of methylation of SDC2 gene test in feces and the diagnostic consistency test of gold standard pathology was 0.477,P<0.001,suggesting that the diagnostic results of the two methods were consistent,but the Kappa was in the range of 0.4~0.75,showing a general consistency.Conclusion Results of this study validated the capability of fecal DNA based-SDC2 methylation test for early detection of CRC patient with high specificity,and this test is one of the ideal options for non-invasive detection of colorectal cancer.Background Colorectal cancer(CRC)is one of the most common gastrointestinal malignancies in China,and distant metastasis is still an important cause of death in patients with colorectal cancer.The intrinsic molecular mechanisms of metastasis,recurrence and drug resistance of colorectal cancer that affect the therapeutic effect of patients are still not clear,so further basic research is necessary.In recent years,more and more studies have found that Long non-coding RNA(lnc RNA),as a class of linear RNA without the translation ability of coding proteins,plays an important role in the regulation of biological functions in a variety of biological processes,and its role in mediating the proliferation,metastasis and invasion of tumor cells in a variety of cancers has attracted increasing attention.Previous studies have found that OTUD6B-AS1,as an lnc RNA,has tumor suppressive effects in a variety of cancers,but its role in the occurrence and development of colorectal cancer remains unclear.Previous studies have found that OTUD6B-AS1,as an lnc RNA,has tumor suppressive effects in many kinds of cancers,but its role in the occurrence and development of colorectal cancer remains unclear.This study aims to explore the regulatory effect of LNC RNA OTUD6B-AS1 on the malignant biological behavior of colorectal cancer,and further explore its specific internal molecular mechanism,which might provide a theoretical basis for finding new and effective biomarkers for diagnosis and treatment of colorectal cancer.Methods The expression level of OTUD6B-AS1 in colorectal cancer tissues and non-cancer tissues was compared by immunohistochemistry(IHC)staining,and the expression difference of OTUD6B-AS1 in normal colorectal epithelial cell lines and colorectal cancer cell lines was verified.After OTUD6B-AS1 was overexpressed,the effects of OTUD6B-AS1 on the proliferation,migration and invasion ability of colorectal cancer cells were observed by CCK-8 cell proliferation assay,cell plate clone formation assay and Transwell assay,and the effect of OTUD6B-AS1 on the epithelial-mesenchymal transition(EMT)was investigated by Western Blot.Bioinformatics techniques were used to predict the micro RNAs(miRNAs)that might share binding sites with OTUD6B-AS1.The correlation between OTUD6B-AS1 and miRNAs was verified by RNA binding protein immunoprecipitation(RIP)technique and luciferase reporting assay.The downstream target genes of miRNAs regulated by OTUD6B-AS1 were further explored by bioinformatics techniques,and the expression levels of target m RNAs in colorectal cancer tissues and cells were explored by quantitative reverse transcription PCR(RT-q PCR).Finally,by up-regulated or down-regulated the expression levels of various molecules in OTUD6B-AS1/miRNAs/m RNAs,the regulation of OTUD6B-AS1 on downstream miRNAs and m RNAs and the effect of OTUD6B-AS1 on malignant phenotypes of colorectal cancer were further verified.Results The expression level of OTUD6B-AS1 in colorectal cancer tissues was significantly decreased compared with that in non-cancer tissues,and the expression level of OTUD6B-AS1 in colorectal cancer cell lines was also significantly decreased compared with that in normal colon epithelial FHC cells.In cell experiments,CCK-8,colony formation,flow cytometry,Transwell test,Western Blot and other experiments showed that overexpression of OTUD6B-AS1 could inhibit the proliferation ability of colorectal cancer cells,increase the apoptosis rate of colorectal cancer cells,weaken the invasion and metastasis ability,and inhibit the effect of EMT.Among miRNAs that may interact with OTUD6B-AS1,the expression of miR-21-5p in colorectal cancer tissues was negatively correlated with the expression of OTUD6B-AS1 through bioinformatics analysis,and RIP experiment confirmed that OTUD6B-AS1 could bind to miR-21-5p.In further analysis of m RNAs,the downstream action targets of miR-21-5p,revealed that the expression of PNRC2 was closely related to miR-21-5p,and the expression level of PNRC2 was significantly decreased in colorectal cancer tissues.RIP also confirmed that OTUD6B-AS1,miR-21-5p and PNRC2 were enriched in RNA-induced silencing complex(RISC).Upregulation of miR-21-5p or knockdown of PNRC2 can reverse the inhibition of OTUD6B-AS1 on colorectal cancer cells,restore the effect of overexpression of OTUD6B-AS1 on promoting apoptosis of colorectal cancer cells,and make the original inhibition of EMT effect significant again.Conclusion OTUD6B-AS1 can competitively bind with miR-21-5p and reduce the m RNA expression level of its downstream target gene p NRC2,thus inhibiting the proliferation,invasion and metastasis of colorectal cancer.In other words,OTUD6B-AS1 can play a regulatory role on the malignant phenotype of colorectal cancer by affecting the expression level of p NRC2 by adsorbing miR-21-5p. |
