WCIM 2014 SEOUL KOREA 541
Poster Session
The Korean Journal of Internal Medicine Vol. 29, No. 5 (Suppl. 1)
PS 0868 Lower GI Tract
Analysis of Mucosal TNFSF15/TL1A Expression in Korean IBD Patients
Youngouk Ro1, Dong Soo Han1, A. Reum Lee1, Chang Soo Eun1, Ju Yeon Pyo2, Young Ha Oh2
Department of Internal Medicine, Hanyang University Guri Hospital, Korea1, Department of Pathology, Hanyang University Guri Hospital, Korea2
Background: It has been well known that genetic mutations and the epidemiology of infl ammatory bowel disease (IBD) differ between Asia and the West. However, TNF superfamily member 15 (TNFSF15) gene has been identifi ed as a common suscepti- bility gene in Asian and Western IBD patients, suggesting that TNFSF15 may play an important role in the pathogenesis of IBD. TNFSF15/TNF-like cytokine 1A (TL1A) is a proinfl ammatory cytokine and a member of the TNFa superfamily, mainly expressed on activated T cells. We investigated mucosal TL1A expression by immunohistochemistry (IHC) in Korean IBD patients.
Methods: TL1A expression was investigated in resected ileal specimens from 8 Crohn’s disease (CD) patients and 8 non-IBD controls by IHC using an affi nity-purifi ed mon- oclonal Antibody against TL1A. TL1A expression was also studied in endoscopically biopsied colonic specimens from 8 ulcerative colitis patients and 8 non-IBD controls.
In addition, the mucosal expressions of CD3, CD4, and CD8, T cell markers, were ex- amined in ileal and colonic specimens of IBD patients and non-IBD controls.
Results: The expression of TL1A at the protein level was absent or minimal in ileal and colonic tissues from controls. On the contrary, intense expression of TL1A was iden- tifi ed in ileal and colonic specimens from IBD patients. Staining for TL1A was signifi - cantly increased in infl ammed area of ileal tissues compared to non-infl ammed area from CD patients. CD3, CD4, and CD8 expressions were also signifi cantly increased in ileal and colonic specimens from IBD patients compared to those from controls.
Conclusions: Mucosal TL1A is upregulated in IBD patients, suggesting an important role of TL1A in the pathogenesis of IBD. Further functional studies of TL1A will provide a better understanding of the pathogenesis of IBD.
PS 0869 Lower GI Tract
Long-Term Outcome of Endoscopic Treatment for Early Colorectal Cancer with Submucosal Invasion Compared to Surgery
Bun Kim1, Soo Jung Park1, Jae Hee Cheon1, Tae Il Kim1, Won Ho Kim1, Sung Pil Hong1 Severance Hospital, Korea1
Background:Endoscopic treatment for early colorectal cancer (ECC) with submucosal invasion has been regarded as one of therapeutic options. However, the long-term effi cacy has not been validated.
Methods: A total of 428 patients with ECC who was treated with endoscopic proce- dures (n=224) or surgery (n=204), as an initial treatment, at Severance Hospital be- tween January 2005 and March 2012 was included. The patients were subdivided into four groups according to the standard indication (SI) of each therapeutic modality.
The SI was defi ned as achieving negative resection margins and satisfying three of the following criteria; (a) within 1,000 μm from muscularis mucosa; (b) no lymphovascular invasion (LVI); (c) well or moderately-differentiated histology. For prognosis evaluation, short-term outcomes (resection margin and complications) and long-term outcomes (recurrence and cancer-specifi c mortality) were evaluated.
Results: The baseline characteristics were not different between initial endoscopic therapy and surgery in ECC patients with SI except tumor size (18.1±9.2 mm vs.
23.7±14.4 mm, p=0.005). In a total of 224 endoscopic therapies, en-bloc resection was achieved in 86.6%. For complications, delayed bleeding was occurred in one (0.4%) and bowel perforation was occurred in two (0.9%). In 204 initial surgery cases, there were seven of anastomosis site leakage (3.4%), two of intestinal obstruction (1.0%), and one case of urinary dysfunction, pneumonia and mortality (0.5%, respectively).
There was no difference in recurrence and cancer-specifi c mortality between endo- scopic therapy and surgical therapy groups with or without SI . In patients with ECC, lymph node metastasis was independently related with positive LVI and poorly-differ- entiated histology in multivariate analysis (p<0.001 and p=0.001, respectively).
Conclusions: Endoscopic treatment with SI is a safe and an effective therapy for ECC as an initial therapeutic option with favorable long-term clinical effi cacy compared to surgery.
PS 0870 Lower GI Tract
The Expression of Chemokine CCL28 is Increased in the Serum and Actively Diseased Tissues of Ulcerative Colitis Patients
Younjeong Choi1, Ji Won Kim1, Seong-Joon Koh1, Sue Shin2, Byeong Gwan Kim1, Kook Lae Lee1, Yoon Jun Kim3
Department of Internal Medicine, SMG-SNU Boramae Medical Center, Korea1, Department of Labo- ratory Medicine, SMG-SNU Boramae Medical Center, Korea2, Department of Internal Medicine, Seoul National University Hospital, Korea3
Background: The rapid recruitment and inappropriate retention of leukocytes is an important mechanism of chronic infl ammation. In leukocyte homing and adhesion, the interaction of infl ammatory cells with endothelial and epithelial cells is needed. Mu- cosa-associated epithelial chemokine CCL28, mainly expressed in colonic vessels and epithelial cells, may play a role in this interaction and cause infl ammation of the guts.
This study compared the levels of CCL28 in the serum of ulcerative colitis (UC) pa- tients and healthy subjects. And the expression levels of CCL28 in the diseased tissues and normal tissues were also detected.
Methods: A total of 50 subjects participated in this study: 25 subjects are ulcerative colitis (UC) patients and 25 subjects are healthy controls. The levels of CCL28 in the serum were analyzed using ELISA. The expression of CCL28 in the tissues was detected using western blot and immunohistochemistry.
Results: Results: The serum CCL28 levels were signifi cantly higher in patients with UC than in healthy control subjects (UC vs. control 235.7±414.7 pg/mL vs. 48.9±44.8 pg/mL, p<0.05). In UC patients, the extent and activity of disease did not influ- ence the CCL28 levels in serum (non-pancolitis vs. pancolitis 338.0±584.1 pg/mL vs. 187.5±317.8 pg/mL, p=0.215, complete remission vs. partial remission vs. active status 181.2±205.5 pg/mL vs. 235.0±504.1 pg/mL vs. 251.1± 386.1 pg/mL, p=0.475).
Although it was not statistically signifi cant, the trend of increasing CCL28 levels ac- cording to the increased activity of disease was noticed. The tissue CCL28 expression was increased in actively diseased tissues.
Conclusions: These results indicate that the chemokine CCL28 can be used as a di- agnostic panel of antibodies to increase the rate of IBD diagnosis. And it could be a potential target for the treatment of IBD and possible marker of disease activity.
PS 0871 Lower GI Tract
Prevalence and Risk Factor of Colorectal Adenoma in Asymptomatic Korean Young Adults Under 40 Years of Age
Ji Yeong Kwak1, Sang Goon Shim1, Kil Jong Yu1, Dae Hyeon Cho1, Ji Eun Oh1, Chang Uk Jeong1, Hyun Chin Cho1, Kwang Min Kim1
Samsung Changwon Hospital, Korea1
Background: The prevalence of colorectal adenoma(CRA) is rapidly increasing in av- erage-risk population over 40 years of age in Korea. But, there was few available data about CRA in young adults under 40 years of age.
Methods: This was a cross-sectional study to evaluate prevalence and risk factor of CRA in Korean young adults 20 to 39 years of age that included asymptomatic young adults who underwent colonoscopy screening at fi rst time as part of employer-pro- vided health wellness program at the Health Promotion Center, Samsung Changwon Hospital from January 2011 to December 2013. Finally, 4286 subjects with no risk of colorectal cancer (personal history of colorectal polyp, infl ammatory bowel disease, or family history of colorectal cancer) were included and we analyzed prevalence and characteristics of CRA by classifying into two groups with CRA group (n=497) and CRA-free group (n=3789). Also, we performed logistic regression model to confi rm risk factor of CRA in young adults.
Results: Among 4286 subjects in young adults under 40 years of age, 497 (11.6%) subjects had one or more colorectal adenomas and advanced adenomas were found in 39 (0.9%) subjects. The prevalence of CRA in the each decade of age group was 5.4%
(33/608) in 20 to 29 years of age and 12.6% (464/3678) in 30 to 39 years of age. In multivariable regression analysis, age over 30 years old (OR, 2.37; 95% CI, 1.64-3.43), current smoker (OR, 1.48; 95% CI, 1.15-1.92) and alcohol consumption (OR, 1.30; 95%
CI, 1.03-1.64) were associated with increased risk of CRA in young adults.
Conclusions: The prevalence of CRA and advanced adenoma in Korean young adults was 11.6% and 0.9%, comparable to those of previous small studies. Age, smoking and alcohol consumption were associated with CRA in young adults.
