The usage of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for the diagnosis of solid pancreatic cancer is increasing, however mainly retrospective studies are available about the detailed methods of sampling. To compare prospectively the diagnostic yield of EUS-FNA samples obtained with slow-pull (SP) and with standard suction technique (SS). EUS-FNA sampling was diagnostic in 72 of 92 cases (78.3%). Diagnostic yield was 67.4% in the SS and 65.2% in the SP group. The number of smear pairs (1.84 vs. 3.56; p < 0.001) and blood contamination (1.50 vs. 2.19; p < 0.001) were significantly higher in the SS group, which resulted in lower rate of diagnostic samples (41.8% vs. 30.0%; p = 0.003). There was no difference in the cellularity (1.58 vs. 1.37; p = 0.2554), or in the sensitivity and specificity in the identification of malignancy between SP and SS subgroups (69.9, 100% vs. 73.5, 100%). Histological samples were obtained in 60 cases (with SP: 49 cases; with SS: 46 cases). There was no difference in the diagnostic yield of histological samples between the groups (63 and 58.7%). The diagnostic yield, the cellularity of smears and the rate of acquiring sufficient histological material are similar in the SP and SS group, but due to lower bloodiness and decreased number of slides, the pathological diagnosis is faster and more cost-effective.

Colonoscopy plays crucial role in the establishment of the diagnosis, management and follow-up of ulcerative colitis (UC). None of the currently widely used endoscopic scores consider disease extent, and therefore do not correlate with the real severity of UC. Our aim was to assess the accuracy of a new score, the Pancolonic Modified Mayo Score that can reflect not only the severity, but the extent of active UC. One hundred and four UC patients were enrolled in this prospective study. The Endoscopic Mayo Scores of the involved area of the five colorectal segments were added; furthermore, the sum was multiplied by 3 in case of eMayo ≥2 (range 0 [normal] to 45 [most severe]) to obtain the Pancolonic Modified Mayo Score (panMayo) in order to clearly distinguish the active and inactive disease. We analysed the correlation of panMayo Score with eMayo and Ulcerative Colitis Endoscopic Index of Severity (UCEIS) and complicated disease outcome. We compared the endoscopic indices with serum and faecal inflammatory parameters and Riley Score. The panMayo Score correlated with eMayo and UCEIS. Every endoscopic score showed correlation with Riley Score, CRP, haemoglobin, haematocrit, serum iron, faecal MMP-9 and calprotectin and also predicted a complicated disease outcome. Only panMayo score correlated exclusively with the extent of UC. We suggest that this new score gives additional information about disease extent besides disease activity with a strong correlation with laboratory parameters of inflammation and with the other widely used endoscopic indices.

Editorial: Game Changers in Inflammatory Bowel Diseases

INTRODUCTION: In Hungary, population-based colorectal cancer (CRC) screening was introduced shortly before the onset of COVID-19 pandemic. We aimed to assess the combined impact of these 2 factors on the incidence and characteristics of CRC. METHODS: The retrospective cohort study included all patients with newly diagnosed CRC between 2014 and 2023 and divided into prepandemic with screening (2015–2016, 2019), prepandemic without screening (2014, 2017–2018), pandemic (2020–2021), and postpandemic (2022–2023) subgroups. CRC incidence, diagnostic patterns, and tumor stage were compared across subgroups. RESULTS: Crude CRC incidence in institution's care area was lower during pandemic (102.51 per 100,000) compared with the prepandemic with screening (117.92 per 100,000; P = 0.060) and postpandemic (120.60 per 100,000; P = 0.044) subgroups. Age-standardized incidence differed significantly only between the prepandemic with screening and pandemic subgroups (125.30 vs 105.88 per 100,000; P < 0.001). During pandemic, the proportion of early-stage (on the American Joint Committee on Cancer 0–I) cancers was significantly reduced compared with the prepandemic with screening subgroup (18.74% vs 25.08%; P = 0.048) and the proportion of T1 cancers was also lower compared with the postpandemic subgroup (6.90 vs 12.2%; P = 0.026). During pandemic, both the annual number of colonoscopies (2,706.00) and the mean number of colonoscopies required to detect 1 CRC (15.56) were markedly lower compared with the prepandemic with screening (4,590.67 and 13.97), prepandemic without screening (3,824.33 and 10.67), and postpandemic (4,573.50 and 15.50) subgroups. DISCUSSION: The COVID-19 pandemic was associated with unfavorable changes in CRC epidemiology. Organized screening may have mitigated the negative impact during the pandemic and postpandemic periods.