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Objective To investigate the epidemiological characteristics and identify the risk factors of Giardia lamblia infections among patients with colorectal cancer in Henan Province. Methods A cross-sectional study was performed for questionnaire surveys among colorectal cancer patients in Henan Cancer Hospital during the period from March to July, 2021. Patients’ stool samples were collected, and the triosephosphate isomerase (tpi) gene of G. lamblia was amplified in stool samples using nested PCR assay to characterize the parasite genotype. Univariate analysis and multivariate logistic regression analyses were employed to identify the risk factors of G. lamblia infections among colorectal cancer patients. Results A total of 307 colorectal cancer patients were investigated, including 176 males (57.3%) and 131 females (42.7%). PCR assay detected 8.1% [95% confidential interval (CI): (0.056, 0.117)] prevalence of G. lamblia infections among the study subjects, and there was no significant difference in the prevalence between men [9.1%, 95% CI: (0.057, 0.143)] and women [6.9%, 95% CI: (0.037, 0.125)] (χ2 = 0.495, P = 0.482). In addition, there was no age-specific prevalence of G. lamblia infections among the participants (χ2 = 1.534, P = 0.675). Multivariate logistic regression analysis identified use of septic tanks [odds ratio (OR) = 3.336, 95% CI: (1.201, 9.267)], daily use of well water [OR = 3.042, 95% CI: (1.093, 8.465)] and raising livestock [OR = 3.740, 95% CI: (1.154, 12.121)] as risk factors of G. lamblia infections among colorectal cancer patients, and the prevalence of abdominal pain was significantly greater in colorectal cancer patients with G. lamblia infections than in those without infections (P = 0.017). Among the 25 patients with G. lamblia infections, assemblage A was characterized in 24 (96.0%) cases and assemblage B in one case (4.0%). Conclusions The prevalence of G. lamblia is high among colorectal cancer patients in Henan Province, and assemblage A is the dominant genotype of G. lamblia. Use of septic tanks, daily use of well water and raising livestock are risk factors of G. lamblia infections among patients with colorectal cancer.
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PURPOSE: To evaluate retrospectively the incidence, predictive factors, and management of acute pancreatitis which develops following placement of duodenal stents in patients with malignant gastroduodenal obstruction. MATERIALS AND METHODS: Among 242 patients with symptomatic malignant gastroduodenal obstruction successfully treated with duodenal stent placement, acute pancreatitis occurred in 10 patients (4.1%) at 1-7 days after stent placement. Univariate and multivariate analyses were performed to evaluate factors predictive of acute pancreatitis. Management of acute pancreatitis was also evaluated. RESULTS: Ten patients with acute pancreatitis presented with abdominal pain and distention with vomiting at 1-7 days after stent placement, and seven patients developed acute jaundice. Pancreatitis resolved in four patients with a regime of fasting and intravenous nutrition. The remaining six cases were managed with percutaneous transhepatic cholangiography and drain (PTCD) placement. Univariate analysis showed that acute pancreatitis was associated with stent location in the descending duodenum (P = 0.001) and with stents bridging the duodenal papilla (P < 0.001). Multivariate analysis demonstrated that the presence of a stent bridging the duodenal papilla (odds ratio, 18.48; 95% confidence interval, 2.298- 148.48; P = 0.006) was an independent predictor of acute pancreatitis. CONCLUSION: Acute pancreatitis is an uncommon early complication of duodenal stent placement in patients with malignant gastroduodenal obstruction. In this group of patients, acute pancreatitis was associated with stent location in the descending duodenum and occurred in patients with stents bridging the duodenal papilla; the latter may be the most important predictor of acute pancreatitis. Jaundice can be managed conservatively or with PTCD.