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| 1 | Sessile serrated adenoma/polyps: Where are we at in 2016?显示文摘It is currently known that colorectal cancers(CRC) arise from 3 different pathways: the adenoma to carcinoma chromosomal instability pathway(50%-70%); the mutator 'Lynch syndrome' route(3%-5%); and the serrated pathway(30%-35%). The World Health Organization has classified serrated polyps into three types of lesions: hyperplastic polyps(HP),sessile serrated adenomas/polyps(SSA/P) and traditional serrated adenomas(TSA),the latter two strongly associated with development of CRCs. HPs do not cause cancer and TSAs are rare. SSA/P appear to be the responsible precursor lesion for the development of cancers through the serrated pathway. Both HPs and SSA/Ps appear morphologically similar. SSA/P are difficult to detect. The margins are normally inconspicuous. En bloc resection of these polyps can hence be troublesome. A careful examination of borders,submucosal injection of a dye solution(for larger lesions) and resection of a rim of normal tissue around the lesion may ensure total eradication of these lesions. | Rajvinder Singh Leonardo Zorrón Cheng Tao Pu Doreen Koay Alastair Burt | 2016 | World Journal of Gastroenterology2016，22，34： | 13 |
| 2 | Randomised controlled trial comparing modified Sano's and narrow band imaging international colorectal endoscopic classifications for colorectal lesions显示文摘AIM To assess the utility of modified Sano′s(MS) vs thenarrow band imaging international colorectal endoscopic(NICE) classification in differentiating colorectal polyps.METHODS Patients undergoing colonoscopy between 2013 and 2015 were enrolled in this trial.Based on the MS or the NICE classifications,patients were randomised for real-time endoscopic diagnosis.This was followed by biopsies,endoscopic or surgical resection.The endoscopic diagnosis was then compared to the final(blinded) histopathology.The primary endpoint was the sensitivity(Sn),specificity(Sp),positive predictive value(PPV) and negative predictive value(NPV) of differentiating neoplastic and non-neoplastic polyps(MSⅡ/Ⅱo/Ⅲa/Ⅲb vs I or NICE 1 vs 2/3).The secondary endpoints were 'endoscopic resectability'(MSⅡ/Ⅱo/Ⅲa vs Ⅰ/Ⅲb or NICE 2 vs 1/3),NPV for diminutive distal adenomas and prediction of post-polypectomy surveillance intervals.RESULTS A total of 348 patients were evaluated.The Sn,Sp,PPV and NPV in differentiating neoplastic polyps from non-neoplastic polyps were,98.9%,85.7%,98.2% and 90.9% for MS;and 99.1%,57.7%,95.4% and 88.2% for NICE,respectively.The area under the receiver operating characteristic curve(AUC) for MS was 0.92(95%CI:0.86-0.98);and AUC for NICE was 0.78(95%CI:0.69,0.88).The Sn,Sp,PPV and NPV in predicting 'endoscopic resectability' were 98.9%,86.1%,97.8% and 92.5% for MS;and 98.6%,66.7%,94.7% and 88.9% for NICE,respectively.The AUC for MS was 0.92(95%CI:0.87-0.98);and the AUC for NICE was 0.83(95%CI:0.75-0.90).The AUC values were statistically different for both comparisons(P = 0.0165 and P = 0.0420,respectively).The accuracy for diagnosis of sessile serrated adenoma/polyp(SSA/P) with high confidence utilizing MS classification was 93.2%.The differentiation of SSA/P from other lesions achieved Sp,Sn,PPV and NPV of 87.2%,91.5%,89.6% and 98.6%,respectively.The NPV for predicting adenomas in diminutive rectosigmoid polyps(n = 150) was 96.6% and 95% with MS and NICE respectively.The calculated accuracy of post-polypectomy surveillance for MS group was 98.2%(167 out of 170) and for NICE group was 92.1%(139 out of 151).CONCLUSION The MS classification outperformed the NICE classification in differentiating neoplastic polyps and predicting endoscopic resectability.Both classifications met ASGE PIVI thresholds. | Leonardo Zorrón Cheng Tao Pu Kuan Loong Cheong Doreen Siew Ching Koay Sze Pheh Yeap Amanda Ovenden Mahima Raju Andrew Ruszkiewicz Philip W Chiu James Y Lau Rajvinder Singh | 2018 | World Journal of Gastrointestinal Endoscopy2018，10，9： | 4 |
| 3 | Recent advances in the diagnostic evaluation of pancreatic cystic lesions显示文摘Pancreatic cystic lesions(PCLs)are becoming more prevalent due to more frequent abdominal imaging and the increasing age of the general population.It has become crucial to identify these PCLs and subsequently risk stratify them to guide management.Given the high morbidity associated with pancreatic surgery,only those PCLs at high risk for malignancy should undergo such treatment.However,current diagnostic testing is suboptimal at accurately diagnosing and risk stratifying PCLs.Therefore,research has focused on developing new techniques for differentiating mucinous from non-mucinous PCLs and identifying high risk lesions for malignancy.Cross sectional imaging radiomics can potentially improve the predictive accuracy of primary risk stratification of PCLs at the time of detection to guide invasive testing.While cyst fluid glucose has reemerged as a potential biomarker,cyst fluid molecular markers have improved accuracy for identifying specific types of PCLs.Endoscopic ultrasound guided approaches such as confocal laser endomicroscopy and through the needle microforceps biopsy have shown a good correlation with histopathological findings and are evolving techniques for identifying and risk stratifying PCLs.While most of these recent diagnostics are only practiced at selective tertiary care centers,they hold a promise that management of PCLs will only get better in the future. | Devarshi R Ardeshna Troy Cao Brandon Rodgers Chidiebere Onongaya Dan Jones Wei Chen Eugene J Koay Somashekar G Krishna | 2022 | World Journal of Gastroenterology2022，28，6： | 3 |
| 4 | Multicenter randomised controlled trial comparing the high definition white light endoscopy and the bright narrow band imaging for colon polyps显示文摘AIM To compare high definition white light endoscopy and bright narrow band imaging for colon polyps' detection rates. METHODS Patients were randomised to high definition white light endoscopy(HD-WLE) or the bright narrow band imaging(b NBI) during withdrawal of the colonoscope. Polyps identified in either mode were characterised using b NBI with dual focus(b NBI-DF) according to the Sano's classification. The primary outcome was to compare adenoma detection rates(ADRs) between the two arms. The secondary outcome was to assess the negative predictive value(NPV) in differentiating adenomas from hyperplastic polyps for diminutive rectosigmoid lesions.RESULTS A total of 1006 patients were randomised to HD-WLE(n = 511) or b NBI(n = 495). The mean of adenoma per patient was 1.62 and 1.84, respectively. The ADRs in b NBI and HD-WLE group were 37.4% and 39.3%, respectively. When adjusted for withdrawal time(OR = 1.19, 95%CI: 1.15-1.24, P < 0.001), the use of b NBI was associated with a reduced ADR(OR = 0.69, 95%CI: 0.52-0.92). Nine hundred and thirty three polyps(86%) in both arms were predicted with high confidence. The sensitivity(Sn), specificity(Sp), positive predictive value and NPV in differentiating adenomatous from non-adenomatous polyps of all sizes were 95.9%, 87.2%, 94.0% and 91.1% respectively. The NPV in differentiating an adenoma from hyperplastic polyp using b NBI-DF for diminutive rectal polyps was 91.0%.CONCLUSION ADRs did not differ between b NBI and HD-WLE, however HD-WLE had higher ADR after adjustment of withdrawal time. b NBI surpassed the PIVI threshold for diminutive polyps. | Rajvinder Singh Kuan Loong Cheong Leonardo Zorron Cheng Tao Pu Dileep Mangira Doreen Siew Ching Koay Carmen Kee Siew Chien Ng Rungsun Rerknimitr Satimai Aniwan Tiing-Leong Ang Khean-Lee Goh Shiaw Hooi Ho James Yun-Wong Lau | 2017 | World Journal of Gastrointestinal Endoscopy2017，9，6： | 2 |
| 5 | Quality indicators in pediatric colonoscopy in a low-volume center:Implications for training显示文摘AIM To study implications of measuring quality indicators on training and trainees' performance in pediatric colonoscopy in a low-volume training center.METHODS We reviewed retrospectively the performance of pediatric colonoscopies in a training center in Malaysia over 5 years(January 2010-December 2015), benchmarked against five quality indicators: appropriateness of indications, bowel preparations, cecum and ileal examination rates, and complications. The European Society of Gastrointestinal Endoscopy guideline for pediatric endoscopy and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition training guidelines were used as benchmarks.RESULTS Median(± SD) age of 121 children [males = 74(61.2%)] who had 177 colonoscopies was 7.0(± 4.6) years. On average, 30 colonoscopies were performed each year(range: 19-58). Except for investigations of abdominal pain(21/177, 17%), indications for colonoscopies were appropriate in the remaining 83%. Bowel preparation was good in 87%. One patient(0.6%) with severe Crohn's disease had bowel perforation. Cecum examination and ileal intubation rate was 95% and 68.1%. Ileal intubation rate was significantly higher in diagnosing or assessing inflammatory bowel disease(IBD) than non-IBD(72.9% vs 50.0%; P = 0.016). Performance of four trainees was consistent throughout the study period. Average cecum and ileal examination rate among trainees were 97% and 77%.CONCLUSION Benchmarking against established guidelines helps units with a low-volume of colonoscopies to identify area for further improvement. | Way-Seah Lee Chun-Wei Tee Zhong-Lin Koay Tat-Seng Wong Fatimah Zahraq Hee-Wei Foo Sik-Yong Ong Shin-Yee Wong Ruey-Terng Ng | 2018 | World Journal of Gastroenterology2018，24，9： | 2 |
| 6 | Perihepatic nodes detected by point-of-care ultrasound in acute hepatitis and acute-on-chronic liver disease显示文摘AIM: To study the manifestations of perihepatic lymph nodes during the episode of acute hepatitis flare by point-of-care ultrasonography.METHODS: One hundred and seventy-six patients with an episode of acute hepatitis flare(ALT value > 5 × upper normal limit) were enrolled retrospectively. Diagnosis of etiology of the acute hepatitis flare was based on chart records and serological and virological assays. The patients were categorized into two groups(viral origin and non-viral origin) and further defined into ten subgroups according to the etiologies. An ultrasonograpy was performed within 2 h to 72 h(median, 8 h). The maximum size of each noticeable lymph node was measured. Correlation between clinical parameters and nodal manifestations was analyzed RESULTS: Enlarged lymph nodes(width ≥ 5mm)were noticeable in 110(62.5%) patients, mostly in acute on chronic hepatitis B(54.5%). The viral group had a higher prevalence rate(89/110 = 80.9%) and larger nodal size(median, 7 mm) than those of the non-viral group(21/66 = 31.8%; median, 0 mm)(P < 0.001 for both). Meanwhile, there were significant differences in the nodal size between acute and chronic viral groups(P < 0.01), and between acute hepatitis A and non-hepatitis A viral groups(P < 0.001). In logistical regression analysis, the nodal width still showed strong significance in multivariate analysis(P < 0.0001) to stratify the two groups. The area under the curve of ROC was 0.805, with a sensitivity of 80.9%, a specificity of 68.2%, positive predictive value of 80.92%, negative predictive value of 68.18%, and an accuracy of 76.14%. CONCLUSION: Point-of-care ultrasonography to detect perihepatic nodal change is valuable for clarifying the etiologies in an episode of acute hepatitis flare. | I Che Feng Szu Jen Wang Ming Jen Sheu Lok-Beng Koay Ching Yih Lin Chung Han Ho Chi Shu Sun Hsing Tao Kuo | 2015 | World Journal of Gastroenterology2015，21，44： | 2 |
| 7 | Equilibrium and kinetics studies of adsorption of copper(Ⅱ)on chitosan and chitosan and chitosan/PVA beads显示文摘 | Wan W S Kamari N A Koay Y J | 2004 | International Journal of Biological Marcromolecules2004，34，1： | 1 |
| 8 | Lactate procalcitonin and am ino-teminalpro B-type natriuretic peptide versus cytokinemeasurements and clinical severity scores for prognostication inseptic shock显示文摘 | Phua J Koay ES Lee KH | 2008 | Shock2008，29，3： | 1 |
| 9 | Lactate,procalcitonin,and amino-ter-minal pro-B-type nalriuretic peptide Velrsus cytokine meas-urements and clinial severity scores for prognostication in septic shock显示文摘 | Phua J Koay ES Lee KH | 2008 | Shock2008，29，3： | 1 |
| 10 | Equilibrium and ki- netics studies of adsorption of copper(Ⅱ) on chitosan and chitosan/PVA beads 显示文摘 | Wan Ngah W S Kamari A Koay Y J | 2004 | International Journal of Biologi- cal Macromolecules2004，34，3： | 1 |
| 11 | Butein downregulates chemokine receptor CXCR4 expression and function through suppression of NF-κB activation in breast and pancreatic tumor cells显示文摘 | Angeline Wei Ling Chua Hui Sin Hay Peramaiyan Rajendran Muthu K. Shanmugam Feng Li Pradeep Bist Evelyn S.C. Koay Lina H.K. Lim Alan Prem Kumar Gautam Sethi | 2010 | Biochemical Pharmacology2010，，10： | 1 |
| 12 | Lactate , procalcitonin and a- mino-terminal pro-B-type natriuretic peptide versus cyto- kine measurements and clinical severity scores for prognos- tication in septic shock 显示文摘 | Phua J Koay ES Lee KH | 2008 | Shock2008，29，3： | 1 |
| 13 | Solar-powered/Fuel-assisted rankine- cycle power and cooling system:simulation method and seasonal performance显示文摘 | Lior' N Koai K | 1984 | Journal of solar energy engineering-transactions of the ASME1984，106，2： | 1 |
| 14 | Post-transcriptional regulation of O (6)-methylguanine- DNA methyhransferase MGMT in glioblastomas 显示文摘 | RAMAKRISHNAN V KUSHWAHA D KOAY D C | 2011 | Cancer Biomark2011，10，34： | 1 |
| 15 | Lactate,procalcitonin,and amino-terminal pro-B-type natriuretic peptide versus cytokine measurements and clinical severity scores for prognostication in septic shock显示文摘 | Phua J Koay ES Lee KH | | 0，，： | 1 |
| 16 | Solar-powered/Fuel-assisted rankine- cycle power and cooling system: sensitivity analysis显示文摘 | Lior N Koai K | 1984 | Journal of solar energy engineering- transactions of the ASME1984，106，4： | 1 |
| 17 | Equilibrium and kinetics studies of adsorption of copper( II ) on chitosan and chitosan/ PVA beads显示文摘 | Wan Ngah W S Kamari A Koay Y J | 2004 | Int J Biologieal Maeromoleeules2004，34，3： | 1 |
| 18 | Soluble triggering receptor expressed on myeloid cells-1 in acute respiratory infections显示文摘 | PHUA J KOAY E S ZHANG D | 2006 | Eur Respir J2006，28，4： | 1 |
| 19 | Efficacy and late recurrences with wide electrical pulmonary vein isolation for persistent and permanent atrial fibrillation显示文摘 | Seow SC Lim TW Koay CH | 2007 | Europace2007，9，12： | 1 |
| 20 | Influence of LRP5 polymorphisms on normal variation in BMD显示文摘 | Koay M A Woon P Y Zhang Y | 2004 | J Bone Miner Res2004，19，10： | 1 |
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