Colitis and colorectal tumors should be further explored and differentiated

TO THE EDlTOR

We read with great interest the study by Kida Y

[1] which was published in the world journal of gastroenterology.The study focused on whether the Japan Narrow-Band Imaging Expert Team (JNET)classification and pit pattern classification are applicable for diagnosing neoplastic lesions in patients with ulcerative colitis (UC).This study found that The JNET and pit pattern classifications did not show high accuracy in diagnosing the pathology and invasion depth of neoplastic lesions in UC patients.Endoscopic diagnosis of neoplastic lesions in UC patients is still difficult and treatment strategies need to be carefully determined.Although the authors' findings provide new methods and ideas for existing diagnosis and treatment problems,our team agrees that there are still some issues that need further discussion in this paper.

In the case of genetic factors,environmental factors,living habits,and other adverse factors,everyone is theoretically at risk of developing colorectal tumors.The study by Simon[2] showed that genetic disorders such as Lynch syndrome,a personal history of inflammatory bowel disease,and type 2 diabetes are all predisposing factors for developing colorectal tumors.In genetic factors,deletion or mutation of some genes,such as the p53 gene,can also lead to colorectal tumors[3,4].There are significant gender differences in the development of colorectal tumors,and the colorectum is a common tumor-producing organ in both men and women[5].The study by Kim

[6] showed that women over 65 had higher colorectal cancer mortality compared with men of the same age group.Colorectal cancer detection time and mortality are related to the site of colorectal cancer.Compared with right-sided colon cancer,left-sided colon cancer was detected later and more differentiated.In clinical work,it was found that the proportion of right-sided colorectal cancer in women is much higher than in men.All of the above evidence suggests that the mortality rate of female patients with colorectal cancer may be higher than that of male patients.

Some non-genetic factors,such as smoking,are also associated with the development of colorectal tumors.Among the etiologies of non-hereditary colorectal tumors,smoking has local and systemic effects on the colorectal mucosa through the production of carcinogens[7].The nicotine in tobacco is potentially addictive and increases the patient’s dependence on tobacco,thereby increasing the risk of colorectal cancer.In addition,the mutation rate of tumor suppressor genes in smokers was significantly higher than in non-smokers.Among the many mutant genes,the p53 gene mutation is the most important.These phenomena are related to the occurrence and development of colorectal tumors.The study by Siegel

[8] shows that women under 49 are about 3% more likely to die than men.

In summary,colorectal tumors are not only caused by ulcerative colitis.Research by Curtin K shows that smoking (＞ 20 pack-years

non-smokers) was associated with TP53 mutations (OR = 1.4,95%CI 1.02-2.0),BRAF mutations (OR = 4.2,95%CI 1.3-14.2),and MSI mutations (OR = 1.4,95%CI 1.02-2.0) in rectal tumors and was associated with an increased risk of rectal cancer.Long-term exposure to ＞ 10 h/wk of environmental tobacco smoke was associated with an increased risk of KRAS2 mutations (OR =1.5,95%CI 1.04-2.2)[9].Colorectal cancer is also related to genetic factors,living habits,eating habits,

It may not be clear that patients with chronic ulcerative colitis developed colorectal tumors due to chronic inflammation in this study.To further explore whether chronic ulcerative colitis is a risk factor for colorectal tumors,genetic factors,dietary habits,lifestyle habits and other factors need to be further discussed.

As it turned out, the flight was full, and they couldn t sit together. The boy was terrified to be separated from his mother. Those were the days when the first-class cabins were not always full and Nancy, the special service representative working with me that afternoon, seated mother and son up in first class.

This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers.It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BYNC 4.0) license,which permits others to distribute,remix,adapt,build upon this work non-commercially,and license their derivative works on different terms,provided the original work is properly cited and the use is noncommercial.See: https://creativecommons.org/Licenses/by-nc/4.0/

Years passed. I was twenty-six, and my friends were getting nervous about my prospects4. They kept lining5 up blind dates for me. Many of these dates were fiascoes, and they were interfering6 with my social life. So I made up a few rules about blind dates:

Now that doesn t sound like a very tough assignment, until you stop to realize that most of the men were over 35 and were raised in the generation of men that were taught that expressing emotions is not macho. Showing feelings or crying (heaven forbid!) was just not done. So this was a very threatening assignment for some.

All authors declare no potential conflicts of interest with respect to the research,authorship,and/or publication of this article.All other authors have read the manuscript and have agreed to submit it in its current form for consideration for publication in the world Journal of Gastrointestinal Oncology.

China

Wang XJ and He LP conceived of the presented idea and provided critical feedback to the final manuscript,revised the manuscript and approved the main conceptual ideas and outline; Xu DH,Zhou B,and Li ZP wrote the manuscript; all authors provided final edits and approved the manuscript.

Type 2 diabetes has been shown to be a risk factor for colorectal tumors.Among genetic factors,deletion or mutation of some genes,such as the p53 gene,can lead to colorectal tumors.There are significant gender differences in the occurrence and development of colorectal tumors.Some nongenetic factors,such as smoking,are also associated with the development of colorectal tumors.These all suggest that colorectal tumors are not only caused by ulcerative colitis.Therefore,we suggest further exploration and differentiation between colitis and colorectal tumors.

the General Research Project of Education Department of Zhejiang Province,No.Y202146955; and the Second Batch of Research Projects on Teaching Reform in the 13th Five-year Plan of Zhejiang Province,No.Jg20190460.

The second came soon afterwards, thinking only of how she might get a feather for herself, but she had scarcely touched her sister than she was held fast.

Dong-Hui Xu 0000-0002-4365-9257; Bo Zhou 0000-0002-2141-4523; Zhi-Peng Li 0000-0002-0355-7889;Lian-Ping He 0000-0002-9627-5599; Xin-Juan Wang 0000-0002-3888-2016.

Wang LL

Filipodia

Wang LL

1 Kida Y,Yamamura T,Maeda K,Sawada T,Ishikawa E,Mizutani Y,Kakushima N,Furukawa K,Ishikawa T,Ohno E,Kawashima H,Nakamura M,Ishigami M,Fujishiro M.Diagnostic performance of endoscopic classifications for neoplastic lesions in patients with ulcerative colitis: A retrospective case-control study.

2022; 28: 1055-1066[PMID: 35431498 DOI: 10.3748/wjg.v28.i10.1055]

2 Simon K.Colorectal cancer development and advances in screening.

2016; 11: 967-976 [PMID: 27486317 DOI: 10.2147/CIA.S109285]

3 Kadosh E,Snir-Alkalay I,Venkatachalam A,May S,Lasry A,Elyada E,Zinger A,Shaham M,Vaalani G,Mernberger M,Stiewe T,Pikarsky E,Oren M,Ben-Neriah Y.The gut microbiome switches mutant p53 from tumour-suppressive to oncogenic.

2020; 586: 133-138 [PMID: 32728212 DOI: 10.1038/s41586-020-2541-0]

4 Cho YH,Ro EJ,Yoon JS,Mizutani T,Kang DW,Park JC,Il Kim T,Clevers H,Choi KY.5-FU promotes stemness of colorectal cancer

p53-mediated WNT/β-catenin pathway activation.

2020; 11: 5321 [PMID: 33087710 DOI: 10.1038/s41467-020-19173-2]

5 Hendifar A,Yang D,Lenz F,Lurje G,Pohl A,Lenz C,Ning Y,Zhang W,Lenz HJ.Gender disparities in metastatic colorectal cancer survival.

2009; 15: 6391-6397 [PMID: 19789331 DOI:10.1158/1078-0432.CCR-09-0877]

6 Kim SE,Paik HY,Yoon H,Lee JE,Kim N,Sung MK.Sex- and gender-specific disparities in colorectal cancer risk.

2015; 21: 5167-5175 [PMID: 25954090 DOI: 10.3748/wjg.v21.i17.5167]

7 Cappellani A,Zanghì A,Di Vita M,Cavallaro A,Piccolo G,Veroux P,Lo Menzo E,Cavallaro V,de Paoli P,Veroux M,Berretta M.Strong correlation between diet and development of colorectal cancer.

2013; 18:190-198 [PMID: 23276917 DOI: 10.2741/4095]

8 Siegel RL,Miller KD,Fedewa SA,Ahnen DJ,Meester RGS,Barzi A,Jemal A.Colorectal cancer statistics,2017.

2017; 67: 177-193 [PMID: 28248415 DOI: 10.3322/caac.21395]

9 Curtin K,Samowitz WS,Wolff RK,Herrick J,Caan BJ,Slattery ML.Somatic alterations,metabolizing genes and smoking in rectal cancer.

2009; 125: 158-164 [PMID: 19358278 DOI: 10.1002/ijc.24338]