• MeSH
• časná detekce nádoru MeSH
• kolonoskopie MeSH
• kolorektální nádory * diagnóza   MeSH
• lidé MeSH
• polypy tlustého střeva * diagnóza   MeSH
• rizikové faktory MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Inflammatory cloacogenic polyp is a rare lesion arising in the anal transitional zone. It is usually benign, but rare cases of malignant transformation are known. It is most commonly seen in the adult population from the fourth to the sixth decade of life, but it can be found among children and adolescents as well. The most common clinical symptoms include rectal bleeding and altered bowel habits, although some patients may be asymptomatic. Treatment involves transanal endoscopic microsurgery followed by a bowel regimen with stool softeners. We present the case report of a 14-year-old boy presenting with intermittent rectal bleeding in whom a polypoid lesion was found during digital rectal examination. The patient underwent proctosigmoidoscopy during which the suspicious lesion was removed by transanal endoscopic microsurgery and the histological diagnosis of inflammatory cloacogenic polyp was established. In the postoperative period, the patient was without any further problems. In this case report, we want to raise awareness of this rare diagnosis and emphasize its place in the differential diagnosis of rectal bleeding across all age groups.

• Klíčová slova
• body mass index, children, inflammatory cloacogenic polyp, mucosal prolapse, rectal bleeding, transanal endoscopic microsurgery,
• MeSH
• dítě MeSH
• dospělí MeSH
• gastrointestinální krvácení etiologie   MeSH
• lidé MeSH
• mladiství MeSH
• nádory anu * komplikace   patologie   chirurgie   MeSH
• polypy střeva diagnóza   chirurgie   patologie   MeSH
• rektum MeSH
• transanální mikroskopická chirurgie * škodlivé účinky   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• přehledy MeSH

1: ESGE recommends that all duodenal adenomas should be considered for endoscopic resection as progression to invasive carcinoma is highly likely.Strong recommendation, low quality evidence. 2: ESGE recommends performance of a colonoscopy, if that has not yet been done, in cases of duodenal adenoma.Strong recommendation, low quality evidence. 3: ESGE recommends the use of the cap-assisted method when the location of the minor and/or major papilla and their relationship to a duodenal adenoma is not clearly established during forward-viewing endoscopy.Strong recommendation, moderate quality evidence. 4: ESGE recommends the routine use of a side-viewing endoscope when a laterally spreading adenoma with extension to the minor and/or major papilla is suspected.Strong recommendation, low quality evidence. 5: ESGE suggests cold snare polypectomy for small (< 6 mm in size) nonmalignant duodenal adenomas.Weak recommendation, low quality evidence. 6: ESGE recommends endoscopic mucosal resection (EMR) as the first-line endoscopic resection technique for nonmalignant large nonampullary duodenal adenomas.Strong recommendation, moderate quality evidence. 7: ESGE recommends that endoscopic submucosal dissection (ESD) for duodenal adenomas is an effective resection technique only in expert hands.Strong recommendation, low quality evidence. 8: ESGE recommends using techniques that minimize adverse events such as immediate or delayed bleeding or perforation. These may include piecemeal resection, defect closure techniques, noncontact hemostasis, and other emerging techniques, and these should be considered on a case-by-case basis.Strong recommendation, low quality evidence. 9: ESGE recommends endoscopic surveillance 3 months after the index treatment. In cases of no recurrence, a further follow-up endoscopy should be done 1 year later. Thereafter, surveillance intervals should be adapted to the lesion site, en bloc resection status, and initial histological result. Strong recommendation, low quality evidence.

• MeSH
• gastrointestinální endoskopie MeSH
• kolonoskopie MeSH
• lidé MeSH
• lokální recidiva nádoru MeSH
• nádory duodena * chirurgie   MeSH
• polypy tlustého střeva * MeSH
• směrnice jako téma MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

PURPOSE OF REVIEW: Peutz-Jeghers syndrome is a rare, autosomal dominant, hereditary polyposis syndrome defined by gastrointestinal hamartomas and mucocutaneous pigmentations, caused by a germline mutation in the serine/ threonine kinase 11 or liver kinase B1 (STK11/LKB1) genes. Hamartomatous polyps located throughout the gastrointestinal tract can be complicated by bleeding and small bowel intussusception, potentially leading to the need for emergency surgery. Individuals suffering from Peutz-Jeghers syndrome have an increased lifetime risk of various forms of cancer (gastrointestinal, pancreatic, lung, breast, uterine, ovarian and testicular). Surveillance should lead to the prevention of complications and thus a reduction in mortality and morbidity of patients. RECENT FINDINGS: A combined approach based on wireless capsule endoscopy, magnetic resonance enterography and device-assisted enteroscopy is effective in reduction of the polyp burden and thus decreasing the risk of bleeding and intussusception. Current guidelines for screening and surveillance are mostly based on expert opinion rather than evidence. SUMMARY: Peutz-Jeghers syndrome is an emerging disease that significantly affects the quality of life enjoyed by patients. Despite of all the progress in improved early diagnostics, options for advanced endoscopic therapy and elaborate surveillance, acute and chronic complications decrease the life expectancy of patients suffering from Peutz-Jeghers syndrome.

• MeSH
• kapslová endoskopie * MeSH
• kvalita života MeSH
• lidé MeSH
• Peutzův-Jeghersův syndrom * komplikace   diagnóza   MeSH
• polypy střeva patologie   MeSH
• tenké střevo patologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

Background and aims: The majority of colorectal cancers arise from detectable adenomatous or serrated lesions. Here we demonstrate how deregulated alternative splicing of CD44 gene in diseased colon mucosa results in downregulation of standard isoform of CD44 gene (CD44s) and upregulation of variant isoform CD44v8-10. Our aim is to show that upregulation of CD44v8-10 isoform is a possible marker of precancerous lesion in human colon. Methods: We analysed pairs of fresh biopsy specimen of large intestine in a cohort of 50 patients. We studied and compared alternative splicing profile of CD44 gene in colon polyps and adjoined healthy colon mucosa. We performed end-point and qRT PCR, western blotting, IHC staining and flow cytometry analyses. Results: We detected more than five-fold overexpression of CD44v8-10 isoform and almost twenty-fold downregulation of standard isoform CD44s in colon polyps compared to adjoined healthy tissue with p = 0.018 and p < 0.001 in a cohort of 50 patients. Our results also show that aberrant splicing of CD44 occurs in both biologically distinct subtypes of colorectal adenoma possibly in ESRP-1 specific manner. Conclusion: 92% of the colon polyp positive patients overexpressed CD44v8-10 isoform in their colon polyps while only 36% of them had positive fecal occult blood test which is currently a standard non-invasive screening technique. Impact: We believe that our results are important for further steps leading to application of CD44v8-10 isoform as a biomarker of colorectal precancerosis in non-invasive detection. Early detection of colon precancerosis means successful prevention of colorectal carcinoma.

• Klíčová slova
• CD44 isoforms, RNA splicing, cancer markers, colon polyps, colorectal precancerosis,
• MeSH
• antigeny CD44 genetika   metabolismus   MeSH
• kolon metabolismus   patologie   MeSH
• kolorektální nádory diagnóza   genetika   metabolismus   MeSH
• lidé MeSH
• nádorové biomarkery genetika   metabolismus   MeSH
• polypy tlustého střeva metabolismus   patologie   MeSH
• prognóza MeSH
• protein - isoformy MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antigeny CD44 MeSH
• CD44 protein, human MeSH Prohlížeč
• nádorové biomarkery MeSH
• protein - isoformy MeSH

The adenoma detection rate (ADR) is the primary quality indicator for colonoscopies. The polyp detection rate (PDR) is available from administrative data and does not depend on histology verification. The correlation between PDR and ADR and the ADR/PDR conversion factor in preventive colonoscopies were evaluated. In the prospective study, asymptomatic individuals aged 45-75 years with preventive colonoscopy in 2012-2016 were included. Spearman's correlation coefficient was used to assess PDR/ADR for each endoscopist. Conversion factor predicting ADR from PDR was obtained by linear regression and subsequently compared with adenoma to polyp detection rate quotient. One thousand six hundred fourteen preventive colonoscopies performed by 16 endoscopists in 8 screening colonoscopy centres in the Czech Republic were analysed. Correlation between PDR and ADR in all preventive colonoscopies was high and statistically significant (Rs 0.82; P < 0.001). There was a strong correlation between PDR and ADR in men (Rs 0.74; P = 0.002) and in screening colonoscopies (Rs 0.85; P < 0.001). The conversion factor to convert ADR from PDR was 0.72 in all preventive colonoscopies, 0.76 in FOBT+ colonoscopies and 0.67 in screening colonoscopies. ADR may be replaced by PDR in the assessment of colonoscopy quality. The value of the conversion factor varies according to colonoscopy indication and gender of examined individuals; in this Czech study, it was 0.72 in all preventive colonoscopies. The minimum requested ADR of 25 % corresponds to a PDR of 35 %, when converted with the appropriate conversion factor.

• MeSH
• adenom diagnóza   epidemiologie   patologie   prevence a kontrola   MeSH
• administrativní požadavky na zdravotní péči statistika a číselné údaje   MeSH
• časná detekce nádoru metody   statistika a číselné údaje   MeSH
• hodnocení rizik metody   statistika a číselné údaje   MeSH
• kolon diagnostické zobrazování   MeSH
• kolonoskopie statistika a číselné údaje   MeSH
• kolorektální nádory diagnóza   epidemiologie   patologie   prevence a kontrola   MeSH
• lidé středního věku MeSH
• lidé MeSH
• plošný screening metody   statistika a číselné údaje   MeSH
• polypy tlustého střeva diagnóza   epidemiologie   patologie   MeSH
• prospektivní studie MeSH
• retrospektivní studie MeSH
• senioři MeSH
• sexuální faktory MeSH
• střevní sliznice diagnostické zobrazování   patologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

Chronically inflamed mucosa in inflammatory bowel disease (IBD) is associated with an increased risk of cancer. Besides IBD-associated dysplasia, there are non-conventional mucosal changes that may act as potential precursors. The aim of the study was to retrospectively review samples from IBD patients focusing on detection of such lesions with evaluation of their immunohistochemical and molecular properties. Surgical specimens and/or endoscopical biopsy samples of IBD patients examined during a 10-year period were reviewed. Detected mucosal lesions were divided into three groups-group 1 (non-conventional or putative precursor lesions - PPLs) with serrated or villous hypermucinous morphology, group 2 (true serrated polyps fulfilling valid criteria), and group 3 (IBD-associated neoplasia). Lesions from all groups were analyzed with antibodies against MLH1, p53, and MGMT and by molecular testing of KRAS, NRAS, and BRAF mutation. Samples from 309 IBD patients were reviewed. A total of 88 mucosal lesions were found in 51 patients. Most common were lesions from group 1 with superficial serrated epithelial change seen in 41 samples (46.6%) and villous hypermucinous change in 6 (6.8%). Group 2 consisted of 15 true serrated polyps. Six conventional IBD-dysplasia cases and 11 carcinomas were seen in group 3. Six lesions from group 1 were associated with invasive carcinoma whereas two shared the same mutation in KRAS or BRAF. Lesions from group 1 were characterized by loss of MGMT expression in 44.6%, aberrant p53 expression, and by mutations in KRAS gene in 42.9% of cases. This study proves the existence of mucosal changes other than conventional IBD-dysplasia and extends the knowledge about their immunohistochemical and molecular properties and relation to carcinoma further supporting their potential role in IBD-related carcinogenesis.

• Klíčová slova
• Colitis, ulcerative, Colorectal carcinoma, Crohn disease, Dysplasia, Inflammatory bowel diseases, Serrated epithelial change, Villous hypermucinous change,
• MeSH
• adenokarcinom patologie   MeSH
• adenom diagnóza   patologie   MeSH
• dítě MeSH
• dospělí MeSH
• idiopatické střevní záněty diagnóza   patologie   MeSH
• kolorektální nádory diagnóza   patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mutace genetika   MeSH
• nádorové biomarkery analýza   MeSH
• polypy tlustého střeva diagnóza   patologie   MeSH
• protoonkogenní proteiny B-Raf genetika   MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• nádorové biomarkery MeSH
• protoonkogenní proteiny B-Raf MeSH

CT colonography is a CT examination focused on the detection of colonic polyps and masses. Its most common indications include incomplete optical colonoscopy and generally personal preference in symptomatic or frail patients. CT colonography has a diagnostic yield similar to optical colonoscopy. It is less demanding for the patient, has shorter examination times, lower rates of adverse effects (including bowel perforation) and allows limited evaluation of extracolonic structures. In 10-15 % of asymptomatic patients, optical colonoscopy is needed if either a colonic polyp or mass is detected. CT colonography requires bowel prior preparation, including laxatives and stool tagging with contrast material. Stool tagging can be completed for same-day CT colonography after an incomplete colonoscopy. Evaluation of extracolonic structures in CT colonography is limited, but CT colonography can be combined with other CT examinations (eg. CT of abdomen). C-RADS classification has been established for a more straightforward interpretation of findings on CT colonography. CT colonography and optical colonoscopy complement each other but do not compete.Key words: colonoscopy - colorectal carcinoma - CT colonography - polyp - screening - virtual colonoscopy.

• MeSH
• časná detekce nádoru MeSH
• feces MeSH
• karcinom diagnóza   diagnostické zobrazování   MeSH
• kolonografie počítačovou tomografií * MeSH
• kolonoskopie MeSH
• kolorektální nádory diagnóza   diagnostické zobrazování   MeSH
• kontrastní látky MeSH
• lidé MeSH
• polypy tlustého střeva diagnóza   diagnostické zobrazování   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• kontrastní látky MeSH

The European Society of Gastrointestinal Endoscopy and United European Gastroenterology present a short list of key performance measures for lower gastrointestinal endoscopy. We recommend that endoscopy services across Europe adopt the following seven key performance measures for lower gastrointestinal endoscopy for measurement and evaluation in daily practice at a center and endoscopist level: 1 Rate of adequate bowel preparation (minimum standard 90 %); 2 Cecal intubation rate (minimum standard 90 %); 3 Adenoma detection rate (minimum standard 25 %); 4 Appropriate polypectomy technique (minimum standard 80 %); 5 Complication rate (minimum standard not set); 6 Patient experience (minimum standard not set); 7 Appropriate post-polypectomy surveillance recommendations (minimum standard not set). Other identified performance measures have been listed as less relevant based on an assessment of their importance, scientific acceptability, feasibility, usability, and comparison to competing measures.

• MeSH
• adenom diagnostické zobrazování   MeSH
• časové faktory MeSH
• cékum MeSH
• intubace normy   MeSH
• kolonoskopie škodlivé účinky   normy   MeSH
• kolorektální nádory diagnostické zobrazování   MeSH
• lidé MeSH
• polypy tlustého střeva chirurgie   MeSH
• pooperační komplikace etiologie   MeSH
• purgativa terapeutické užití   MeSH
• schůzky a rozvrhy MeSH
• spokojenost pacientů MeSH
• surveillance populace * MeSH
• výběr pacientů MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• směrnice pro lékařskou praxi MeSH
• Názvy látek
• purgativa MeSH

Approximately 5 - 35 % of colorectal carcinomas arise through serrated carcinogenesis. The precursor of such carcinomas are serrated adenomas, which differ from conventional adenomas morphologically as well as genetically. Herein, we provide a basic overview of serrated lesions of the large intestine with the focus on histological diagnosis and molecular biology.

• Klíčová slova
• hyperplastic polyp - sessile serrated adenoma - traditional serrated adenoma - serrated carcinoma - serrated carcinogenesis.,
• MeSH
• adenom patologie   MeSH
• karcinogeneze MeSH
• karcinom patologie   MeSH
• lidé MeSH
• nádory tračníku patologie   MeSH
• polypy tlustého střeva patologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH