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Abstracts of the 22
nd
National Congress of Digestive Diseases / Digestive and Liver Disease 48S2 (2016) e67–e231
PC.01.6
RISK FACTORS FOR THE OCCURRENCE OF SPORADIC PANCREATIC
NEUROENDOCRINE TUMOURS: A MULTICENTER EUROPEAN
STUDY (EPINET)
Valente R.*
1
, Hayes A.
2
, Haugvik S.P.
3
, Hedenström P.
4
, Siuka D.
6
,
Maisonneuve P.
5
, Delle Fave G.
1
, Lindkvist B.
4
, Capurso G.
1
1
Ospedale Sant’Andrea, Sapienza Università di Roma, Roma, Italy,
2
Department of General Surgery, Royal Infirmary of Edinburgh,
Edinburgh, United Kingdom,
3
Department of Hepato-Pancreato-
Biliary Surgery, Oslo University Hospital, Oslo, Norway,
4
Unit of
Gastroenterology, Department of Medicine, Sahlgrenska University
Hospital, Gothenburg, Sweden,
5
Division of Epidemiology and
Biostatistics, European Institute of Oncology, Milan, Italy,
6
Department
of Gastroenterology, University Medical Centre Ljubljana, Ljubljana,
Slovenia
Background and aim:
Pancreatic neuroendocrine tumors (PNETs)
are rare neoplasms, but their incidence is rising and the prevalence,
due to long survival, is much higher. Few, unicentre, small studies
investigated potential demographic-enviromental risk factors; none
of those the role of obesity (BMI>30). Diabetes, smoking and alcohol
have been suggested as risk factors.
Aim:
To determine risk factors
for the development of sporadic PNETs.
Material and methods:
Prospective case-control study performed
in five European countries. Histologically proved sporadic PNETs and
sex-age matched controls (3:1 ratio, based on a power calculation)
were interviewed about demographics, environmental and familial
risk factors using a pre-definite questionnaire. Cases and controls
were compared by fisher’s test or Chi square tests, risk factors
analyzed by logistic regression analysis.
Results:
196 cases and 570 controls were collected. 1st degree family
history of any cancer (51% vs 46%; p=0.2) nor cancer site specific
family history, smoking (56% vs 50% p=0.18) and alcohol drinking
(76.5% vs 70% p=0.09) were not associated with risk of pNETs.
Obesity (26% vs 19%; p=0.04) and diabetes (18% vs 12%; p=0.05)
were the only factors significantly more frequent in cases than in
controls. In a logistic regression analysis, obesity (OR 1.5; 95% CI
1-2.2) and diabetes (OR 1.5; 95% CI 1-2.4), were both associated with
a significantly increased risk. Previous medical history, the use of
drugs and for women reproductive factors were also not associated
with pNET risk.
Conclusions:
This is the first prospective multicentre study
investigating risk factors for the occurrence of pNETs. Among
previously reported risk factors, only diabetes was confirmed in this
study, while the role of obesity is suggested for the first time.
PC.01.7
EUROPEAN COLONOSCOPY QUALITY INVESTIGATION GROUP:
IMPROVING STANDARDS IN COLONOSCOPY THROUGH A
PRACTICE LEVEL AUDIT TOOL
Spada C.*
1
, Demedts I.
3
, Agrawal A.
4
, Jover R.
5
, Ono A.
6
, Amaro P.
7
,
Ervin T.
8
, Eisendrath P.
9
, Costamagna G.
1
, Riemann J.F.
2
1
Fondazione Policlinico Universitario Gemelli, Rome, Italy,
2
Klinikum
Ludwigshafen, Ludwigshafen, Germany,
3
UZ Leuven, Leuven, Belgium,
4
Doncaster Royal Infirmary, Doncaster, United Kingdom,
5
Hospital
General Universitario de Alicante, Alicante, Spain,
6
Virgen de la
Arrixaca University Hospital, Murcia, Spain,
7
Coimbra University
Hospital, Coimbra, Portugal,
8
Skåne University Hospita, Malmö,
Sweden,
9
Erasme Hospital, Université Libre de Bruxelles, Brussels,
Belgium
Background and aim:
Colorectal cancer is a major cause of
morbidity and mortality. Colonoscopy remains the investigation
of choice for diagnosis and screening. Many countries have
implemented screening programmes to allow for early detection.
The ESGE quality in colonoscopy position statement highlights key
quality indicators in colonoscopy and concluded that the success
of screening programmes is related to the prompt provision of
high quality, patient centred colonoscopy service. The European
Colonoscopy Quality Investigation (ECQI) group of leading European
clinicians developed a practical tool to enable audit of current clinical
practice across Europe to assess whether quality standards are being
achieved and to identify, test, and implement practical ways of
improving quality in colonoscopy. The aim was to understand how
quality is evaluated in current clinical practice via the development
and implementation of an online tool to audit colonoscopy practice.
Material and methods:
At the inaugural meeting in 2013, the
ECQI group recommended a clinical practice level audit tool to be
developed to enable colonoscopists to audit their own practice. The
audit tool was designed to encourage improvement in outcomes
(e.g. adenoma detection rate), and to ensure consistency and high
standards across clinical practice, within countries and across
Europe, and was validated by the group in September 2014. A phase
1 pilot to test this tool was performed in November 2014, with early
outputs discussed by the group in December 2014. The audit tool
was further revised to improve usability via a collaborative iteration
process.
Results:
The online audit tool was piloted at centres across 10
European countries with 313 patient visits recorded on the initial
questionnaire during a 1 week period. Questions included: patient
demographics, the status and experience of the practitioner
performing the endoscopy, details of the bowel preparation
procedure used and the quality of bowel cleansing achieved,
colonoscopic findings, and follow up arrangements. Following the
review of the phase 1 pilot, consensus from the ECQI group resulted
in the refinement of the tool to create an updated version which
included three separate sections: Practitioner, Centre and Patient
level questionnaires to improve efficiency of use. This will form part
of a second phase pilot planned for 2015.
Conclusions:
ECQI Group enabled the development of a validated,
practice level audit tool to enable clinicians to audit their own
practice. This tool will be tested in a second pilot phase, and its
value will be further evaluated by the Group in order to make
recommendations for its use across Europe. The range of experience
and geographical spread of the participants allows for quality
evaluation to be compared across practices and countries. The longer
term aim of this project is to enhance the quality of colonoscopy at
a practice level by enabling clinicians to be involved in improving
their own practice.
PC.01.8
SERUM DETERMINATION OF SQUAMOUS CELLULAR CARCINOMA
ANTIGEN AS A BIOMARKER OF BARRETT’S ESOPHAGUS AND
ESOPHAGEAL CANCER: A PHASE III STUDY
Maddalo G.*, Marafatto F., Fassan M., Cardin R., Piciocchi M.,
Pozzan C., Zaninotto G., Ruol A., Castoro C., Rugge M., Farinati F.
Padua University - School of Medicine-, Padua, Italy
Background and aim:
The cost/effectiveness of surveillance in
patients with Barrett’s esophagus (BE) is still debated and the use
of biomarkers in screening and surveillance not recommended.
Squamous Cell Carcinoma Antigen is expressed in several epithelial
tumors but no information is available regarding SCCA-IgM
determination in BE. The study aimed at evaluating the potential
role of the determination of the immunocomplexed Squamous
Cell Carcinoma Antigen (SCCA-IgM) in screening for BE and in
surveillance for esophageal adenocarcinoma (EAC).
Material and methods:
SCCA-IgM levels were determined (ELISA,
Hepa-Ic, Xeptagen, Marghera, Venezia, Italy) in 213 patients
prospectively recruited in our Department among whom 53 with