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Pardamean CI, Sudigyo D, Budiarto A, Mahesworo B, Hidayat AA, Baurley JW, Pardamean B. Changing Colorectal Cancer Trends in Asians: Epidemiology and Risk Factors. Oncol Rev 2023; 17:10576. [PMID: 37284188 PMCID: PMC10241074 DOI: 10.3389/or.2023.10576] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/11/2023] [Indexed: 06/08/2023] Open
Abstract
Once an infrequent disease in parts of Asia, the rate of colorectal cancer in recent decades appears to be steadily increasing. Colorectal cancer represents one of the most important causes of cancer mortality worldwide, including in many regions in Asia. Rapid changes in socioeconomic and lifestyle habits have been attributed to the notable increase in the incidence of colorectal cancers in many Asian countries. Through published data from the International Agency for Cancer Research (IARC), we utilized available continuous data to determine which Asian nations had a rise in colorectal cancer rates. We found that East and South East Asian countries had a significant rise in colorectal cancer rates. Subsequently, we summarized here the known genetics and environmental risk factors for colorectal cancer among populations in this region as well as approaches to screening and early detection that have been considered across various countries in the region.
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Mata R, Nakkala JR, Sadras SR. Therapeutic role of biogenic silver and gold nanoparticles against a DMH-induced colon cancer model. BIOMATERIALS ADVANCES 2023; 146:213279. [PMID: 36708685 DOI: 10.1016/j.bioadv.2023.213279] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 12/12/2022] [Accepted: 01/02/2023] [Indexed: 06/18/2023]
Abstract
Colorectal cancer (CRC) ranks third among fatal diseases afflicting mankind globally due to the shortage of primary detection methods and appropriate choice of drugs. Moreover, current treatments such as chemo drugs and radiotherapies create adverse effects and lead to drug resistance. In this context, recent advances in nanomedicine offer novel clinical solutions for colon cancer therapy. The current study denotes the therapeutic roles of biogenic Abutilon indicum silver and gold nanoparticles (AIAgNPs and AIAuNPs) against a 1, 2-dimethyl hydrazine (DMH)-induced CRC in Wistar rats. Following treatment of nanoparticles (NPs), the CRC rats showed great localization of AIAgNPs and AIAuNPs in colon tumors shown by ICP-OES, indicating their bioavailability. The AIAgNPs and AIAuNPs significantly enhanced cellular antioxidant enzyme levels including catalase, SOD, GSH, GPx and reduced lipid peroxidation (LPO) compared to the standard drug paclitaxel. AIAgNPs and AIAuNPs revealed significant protection against metastasis compared to paclitaxel shown in the histopathological study. The important CRC signaling molecules of the Wnt pathway, the β-catenin and Tcf-4 levels were significantly downregulated in AIAgNPs and AIAuNPs treated CRC rats compared to paclitaxel. Furthermore, the expression levels of cleaved apoptotic caspase-9, -8, and - 3 and lamins were significantly upregulated in AIAgNPs and AIAuNPs treated CRC rats compared to paclitaxel. This preclinical study provides substantial insights into the anti-colon cancer roles of biogenic NPs and gives an idea for targeting different cancers.
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Affiliation(s)
- Rani Mata
- Department of Biochemistry and Molecular Biology, School of Life Sciences, Pondicherry University, Puducherry 605014, India.
| | - Jayachandra Reddy Nakkala
- Department of Biochemistry and Molecular Biology, School of Life Sciences, Pondicherry University, Puducherry 605014, India; College of Pharmacy, The University of Rhode Island, Kingston, RI 02881, United States of America.
| | - Sudha Rani Sadras
- Department of Biochemistry and Molecular Biology, School of Life Sciences, Pondicherry University, Puducherry 605014, India.
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Wong SW, Ling DY, Yeow RQ, Chong RW, Aziz MRA, Aziz NA, Poh KS, Roslani AC. Clinicopathological patterns and survival outcomes of colorectal cancer among young adults in Malaysia: an institutional cohort study. Singapore Med J 2021; 62:636-641. [PMID: 34005846 DOI: 10.11622/smedj.2021051] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION This study aimed to investigate the clinicopathological patterns and survival outcomes of young-onset colorectal cancer (CRC) in Malaysia. METHODS The study consisted of 206 patients with young-onset CRC (age < 50 years at diagnosis) and 1,921 patients with late-onset CRC (age ≥ 50 years at diagnosis) diagnosed during 2002-2016. The clinicopathological characteristics of patients with young-onset CRC were compared with those of patients with late-onset CRC during 2009-2013. Kaplan-Meier survival analysis was performed to determine the overall survival (OS) and disease-specific survival (DSS) in these patients. RESULTS The overall proportion of young-onset CRC was 10.7%. Mean age for young-onset CRC was 39.5 ± 7.4 years, with male-to-female ratio of 1.2:1.0. There were more Malay patients with young-onset CRC than late-onset CRC (44.0% vs. 19.9%, p = 0.004). Most CRC were diagnosed at advanced stage in both groups. However, young-onset CRC showed more aggressive tumour characteristics, such as poorer differentiation and mucinous subtype. Despite such differences, OS and DSS in both groups were similar (five-year OS for young-onset CRC vs. late-onset CRC: 44.2% vs. 49.0%, p = 0.40; five-year DSS for young-onset CRC vs. late-onset CRC: 48.8% vs. 57.6%, p = 0.53; mean survival of young-onset CRC vs. late-onset CRC: 4.9 years vs. 5.4 years, p = 0.15). Advanced stage at diagnosis and treatment modality were independent prognostic factors. CONCLUSION The unique ethnic and histological differences between patients with young- and late-onset CRC suggest that young-onset CRC may represent a distinct entity. However, despite such differences, prognosis between both groups were equivalent.
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Affiliation(s)
- Sui-Weng Wong
- Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Dao-Yao Ling
- Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Ri-Qi Yeow
- Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Ro-Wan Chong
- Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | | | - Nora Abdul Aziz
- Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Keat-Seong Poh
- Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia
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Valan A, Najid F, Chandran P, Abd Rahim AB, Chuah JA, Roslani AC. Distinctive Clinico-Pathological Characteristics of Colorectal Cancer in Sabahan Indigenous Populations. Asian Pac J Cancer Prev 2021; 22:749-755. [PMID: 33773538 PMCID: PMC8286687 DOI: 10.31557/apjcp.2021.22.3.749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Indexed: 12/30/2022] Open
Abstract
Background: Malaysia is an ethnically diverse nation, comprising Malay, Chinese, Indian and indigenous groups. However, epidemiological studies on colorectal cancer have mainly focused on the three main ethnic groups. There is evidence that the clinico-pathological characteristics of some cancers may differ in indigenous populations, namely that they occur earlier and behave more aggressively. We aimed to determine if there were similar differences in colorectal cancer, focusing on the indigenous populations of Sabah. Methods: Histopathological reports of all patients diagnosed with colorectal carcinoma from January 2012 to December 2016 from public hospitals in Sabah were retrieved from the central computerized database of the Pathology Department of Queen Elizabeth Hospital in Kota Kinabalu, Sabah. Supplementary data was obtained from patients’ case files from each hospital. Clinico-pathological data were analysed using the IBM SPSS Statistical Software Version 23 for Windows for descriptive statistics (mean, median, ASR, AR, relative risk) and inferential statistics (Chi square test). Results: A total of 696 patients met the inclusion criteria. The median age for colorectal cancer in Sabah was 62 years (95% CI 60.3 to 62.3), with an age specific incidence rate of 21.4 per 100 000 population. The age specific incidence rate in the indigenous populations was 26.6 per 100 000, much lower than the Chinese, at 65.0 per 100 000. The risk of colorectal cancer occurring before the age of 50 was three times higher in the indigenous population compared to the Chinese. The tumours were mainly left-sided (56.5%), adenocarcinoma in histology (98.4%) and moderately differentiated (88.7%). Approximately 79.2% of patients received curative treatment. Conclusion: Indigenous populations in Sabah develop colorectal cancer at an earlier age, and present at more advanced stages. This has implications for screening and therapeutic strategic planning.
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Affiliation(s)
- Anuradha Valan
- Department of General Surgery, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia.,Department of Surgery, Faculty of Medicine, University of Malaya, Malaysia
| | - Fatimah Najid
- Department of General Surgery, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia
| | - Pradeep Chandran
- Department of Surgery, Duchess of Kent Hospital, Sandakan, Sabah, Malaysia
| | | | - Jitt Aun Chuah
- Department of General Surgery, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia
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Vasudevan S, Mehta A. Clinical characteristics and survival profile of young versus old colorectal cancer patients at a tertiary cancer center in North India over a period of 5 years. Indian J Cancer 2021; 58:355-364. [PMID: 33402579 DOI: 10.4103/ijc.ijc_246_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Colorectal cancer (CRC) is mostly considered a disease of the elderly. But the rate is increasing among young adults and is associated with different clinical patterns. The objective was to study the frequency of CRC in young patients and compare the clinicopathological profile and survival with the older cohort. Methods Five-year (2012-2016) data of the 912 consecutive CRC cases treated at the center were analyzed. Clinical and histopathological characteristics were compared in young (≤40) and older (>40) patients. Descriptive statistics were used for data presentation. Categorical data were compared by the Chi-square test; survival analyses were performed by Kaplan-Meier method. Results In total, 231 (25.3%) and 681 (74.7%) cases were in the young and older age groups, respectively. Male predominance was noted. Young patients presented predominantly in stage III (46%). Majority of the young patients harbored left-sided tumors (75.8% vs 63.7% in old patients, P = 0.001) and rectum was the favored site in young patients (53.7% vs 37%; P < 0.001). Poorly differentiated adenocarcinoma was more common in the young age group (46.88% vs 24.16% in old patients, P < 0.001), also signet-ring cell morphology occurred more often in young patients (11.7% vs 4%, P < 0.001). Survival was inferior in the patients presenting at an advanced stage or with adverse histology or poor tumor grade. However, stage-specific survival showed no significant difference between both groups. Conclusion This study shows that though young CRC patients present with higher stage, aggressive morphology, and predominantly rectal localization, the overall survival and stage-specific survival did not differ significantly from the older patients.
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Affiliation(s)
- Smreti Vasudevan
- Department of Research, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, Delhi, India
| | - Anurag Mehta
- Department of Laboratory and Transfusion Services, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, Delhi, India
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Lim KG, Lee CS, Chin DHJ, Ooi YS, Veettil SK, Ching SM, Burud IAS, Zakaria J. Clinical characteristics and predictors of 5-year survival among colorectal cancer patients in a tertiary hospital in Malaysia. J Gastrointest Oncol 2020; 11:250-259. [PMID: 32399266 DOI: 10.21037/jgo.2020.02.04] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background Colorectal cancer is the second most common cancer in Malaysia. Its disease burden is likely to increase over time owing to its current trends in this region. This study was undertaken to determine the 5-year survival rate and prognostic factors for survival in colorectal cancer patients treated in a tertiary hospital, in Malaysia. Methods We reviewed the records of colorectal cancer patients treated in Hospital Tuanku Ja'afar Seremban, Malaysia from 2008 to 2012. Survival analysis at five years was performed using the Kaplan-Meier method. Cox proportional hazard regression analysis was carried out to determine the predictors of 5-year colorectal cancer survival. Results Of the 275 patients, 43.3% were colon cancers, 51.8% were rectal cancers. Only 2.2% were diagnosed in Stage I. 28.7%, 33.1%, and 16.7% were in Stage II, III and IV respectively; 62/79 (78%) of Stage II patients were in Stage IIb; 15.7% of patients were below the age of 50 and fewer of them presented early (P=0.002). The overall 5-year survival was 46.5%. It was 67.9%, 50.5% and 12.8% for Stage I&II, III and IV patients respectively. Early stage of cancer (P<0.001) and age below the mean (P=0.01) were the most significant factor in predicting better survival. Gender and ethnic group were not associated with late presentation nor survival. Neither was there a difference between colon and rectum cancers nor patients who received elective surgical treatment compared to patients receiving other treatment first (P=0.085). Conclusions Late presentation is the most important predictor for poor outcome for colorectal cancer in Seremban. Patients under the age of 50 years present late more often, but do not have poorer survival.
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Affiliation(s)
- Kean Ghee Lim
- Clinical School, Department of Surgery, International Medical University, Jalan Rasah, Seremban, Negeri Sembilan, Malaysia
| | - Chit Seng Lee
- Clinical School, Department of Surgery, International Medical University, Jalan Rasah, Seremban, Negeri Sembilan, Malaysia
| | - Daniel Hong Jeng Chin
- Clinical School, Department of Surgery, International Medical University, Jalan Rasah, Seremban, Negeri Sembilan, Malaysia
| | - Yong Song Ooi
- Clinical School, Department of Surgery, International Medical University, Jalan Rasah, Seremban, Negeri Sembilan, Malaysia
| | - Sajesh K Veettil
- School of Pharmacy/School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia
| | - Siew Mooi Ching
- Department of Family Medicine, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, Malaysia
| | - Ismail Abdul Sattar Burud
- Clinical School, Department of Surgery, International Medical University, Jalan Rasah, Seremban, Negeri Sembilan, Malaysia
| | - Jasiah Zakaria
- Department of Surgery, Hospital Tuanku Ja'afar Seremban, Negeri Sembilan, Malaysia
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Wu JY, Chen DF, Liu TY, Dong WX, Liu X, Wang SN, Xie RX, Liu WT, Wang BM, Cao HL. Reevaluation of a rightward shift in colorectal cancer: A single-center retrospective study in Tianjin. J Dig Dis 2019; 20:532-538. [PMID: 31390161 DOI: 10.1111/1751-2980.12812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 07/25/2019] [Accepted: 08/04/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Some Western reports have shown a proximal shift in colorectal cancer (CRC), but there are few studies in China. This study aimed to provide more information for the management and screening of CRC by investigating trends in the anatomic distribution of CRC among the Chinese population in recent years. METHODS A retrospective study was conducted on patients with CRC admitted to the Digestive Endoscopy Center of Tianjin Medical University General Hospital between January 2000 and December 2017. Patients were divided into a left-sided colorectal cancer (LSCRC) group and a right-sided colon cancer (RSCC) group. The detection rates of LSCRC and RSCC based on patients' age and sex, and on the time periods were analyzed. RESULTS A total of 2319 cases were diagnosed with CRC among 75 183 consecutive patients. The prevalence of CRC showed a significant reduction from 2000-2008 to 2009-2017 (3.8% vs 2.7%, P < .001). The proportion of RSCC presented a downtrend from 2000-2008 to 2009-2017 (40.6% vs 37.7%, P > .05). There were slightly more RSCCs in female patients than in male patients, with no significant difference (40.9% vs 36.5%, P > .05). The proportion of RSCC in patients aged ≥50 years was similar to that in younger patients. The alarming symptoms between LSCRC and RSCC showed a significant difference (P < .05). CONCLUSIONS In the present study, the prevalence of CRC declined significantly with time. However, there did not appear to be a rightward shift in CRC among the patients in Tianjin over the past 18 years.
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Affiliation(s)
- Jing Yi Wu
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin Institute of Digestive Disease, Tianjin, China
| | - Dan Feng Chen
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin Institute of Digestive Disease, Tianjin, China
| | - Tian Yu Liu
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin Institute of Digestive Disease, Tianjin, China
| | - Wen Xiao Dong
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin Institute of Digestive Disease, Tianjin, China
| | - Xiang Liu
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin Institute of Digestive Disease, Tianjin, China
| | - Si Nan Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin Institute of Digestive Disease, Tianjin, China
| | - Run Xiang Xie
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin Institute of Digestive Disease, Tianjin, China
| | - Wen Tian Liu
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin Institute of Digestive Disease, Tianjin, China
| | - Bang Mao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin Institute of Digestive Disease, Tianjin, China
| | - Hai Long Cao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin Institute of Digestive Disease, Tianjin, China
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Onyoh EF, Hsu WF, Chang LC, Lee YC, Wu MS, Chiu HM. The Rise of Colorectal Cancer in Asia: Epidemiology, Screening, and Management. Curr Gastroenterol Rep 2019; 21:36. [PMID: 31289917 DOI: 10.1007/s11894-019-0703-8] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
PURPOSE OF REVIEW Colorectal cancer (CRC) remains the third most commonly diagnosed cancer globally, and its incidence and mortality rates have been on the rise in Asia. In this paper, we summarize the recent trends and screening challenges of CRC in this region. RECENT FINDINGS In 2018, Asia had the highest proportions of both incident (51.8%) and mortality (52.4%) CRC cases (all genders and ages) per 100,000 population in the world. In addition, there has been a rising trend of this disease across Asia with some regional geographic variations. This rise in CRC can be attributed to westernized dietary lifestyle, increasing population aging, smoking, physical inactivity, and other risk factors. In curbing the rising trend, Japan, South Korea, Singapore, and Taiwan have launched nationwide population-based screening programs. CRC screening across this region has been found to be effective and cost-effective compared with no screening at all. The emergence of new therapies has caused a reduction in case fatality; however, these new options have had a limited impact on cure rates and long-term survival due to the great disparity in treatment capacity/resources and screening infrastructures among Asian countries with different degrees of economic development. CRC is still rising in Asia, and implementation of screening is necessary for moderate- to high-incidence countries and construction of treatment capacity is the priority task in low-incidence and low-income countries. Unless countries in Asia implement CRC screening, the incidence and mortality rates of this disease will continue to rise especially with the rapidly rising population growth, economic development, westernized lifestyle, and increasing aging.
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Affiliation(s)
- Elias F Onyoh
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
- AIDS Care and Prevention Program, Cameroon Baptist Convention Health Services, Bamenda, Cameroon
- Taiwanese Colorectal Cancer Screening Program, Taipei, Taiwan
| | - Wen-Feng Hsu
- Taiwanese Colorectal Cancer Screening Program, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei, Taiwan
| | - Li-Chun Chang
- Department of Internal Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei, Taiwan
| | - Yi-Chia Lee
- Taiwanese Colorectal Cancer Screening Program, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei, Taiwan
| | - Ming-Shiang Wu
- Department of Internal Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei, Taiwan
| | - Han-Mo Chiu
- Taiwanese Colorectal Cancer Screening Program, Taipei, Taiwan.
- Department of Internal Medicine, College of Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei, Taiwan.
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Chuah KH, Mahadeva S. Cultural Factors Influencing Functional Gastrointestinal Disorders in the East. J Neurogastroenterol Motil 2018; 24:536-543. [PMID: 30153722 PMCID: PMC6175561 DOI: 10.5056/jnm18064] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 07/16/2018] [Accepted: 07/21/2018] [Indexed: 01/06/2023] Open
Abstract
Culture forms an integral aspect of environmental factors which influences disease presentation and clinical outcomes in functionalgastrointestinal disorders (FGIDs). In this review, the role of culture in FGIDs in the East is briefly explored with regards to symptompresentation and diagnostic issues, lifestyle and cultural habits, epidemiology, and healthcare seeking behavior. In both functionaldyspepsia and irritable bowel syndrome, symptom presentation and disease sub-typing in Asians are known to differ from their Western counterparts, possibly relating to cultural dietary practices and from cultural perception of symptoms. Dietary patterns, together with defecating practices are explored as factors contributing to a lower prevalence of constipation in the East. An urban-rural difference in the prevalence of FGIDs in Asia is attributed to a change in dietary patterns in rapidly developing urban communities, together with an increased level of psychological morbidity. Lastly, cultural attitudes towards traditional/local remedies, variation in healthcare systems, anxiety regarding organic disease, and religious practices have been shown to influence healthcare seeking behavior among FGID patients in the East.
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Affiliation(s)
- Kee-Huat Chuah
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur,
Malaysia
| | - Sanjiv Mahadeva
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur,
Malaysia
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Ca 2+/nuclear factor of activated T cells signaling is enriched in early-onset rectal tumors devoid of canonical Wnt activation. J Mol Med (Berl) 2017; 96:135-146. [PMID: 29124284 DOI: 10.1007/s00109-017-1607-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 09/20/2017] [Accepted: 10/27/2017] [Indexed: 12/31/2022]
Abstract
Our previous extensive analysis revealed a significant proportion of early-onset colorectal tumors from India to be localized to the rectum in younger individuals and devoid of deregulated Wnt/β-catenin signaling. In the current study, we performed a comprehensive genome-wide analysis of clinically well-annotated microsatellite stable early-onset sporadic rectal cancer (EOSRC) samples. Results revealed extensive DNA copy number alterations in rectal tumors in the absence of deregulated Wnt/β-catenin signaling. More importantly, transcriptome profiling revealed a (non-Wnt/β-catenin, non-MSI) genetic signature that could efficiently and specifically identify Wnt- rectal cancer. The genetic signature included a significant representation of genes belonging to Ca2+/NFAT signaling pathways that were validated in additional samples. The validated NFAT target genes exhibited significantly higher expression levels than canonical Wnt/β-catenin targets in Wnt- samples, an observation confirmed in other CRC expression data sets as well. We confirmed the validated genes to be transcriptionally regulated by NFATc1 by (a) evaluating their respective transcript levels and (b) performing promoter-luciferase and chromatin immunoprecipitation assays following ectopic expression as well as knockdown of NFATc1 in CRC cells. NFATc1 and its targets RUNX2 and GSN could drive increased migration in CRC cells. Finally, the validated genes were associated with poor survival in the cancer genome atlas CRC expression data set. This study is the first comprehensive molecular characterization of EOSRC that appears to be driven by noncanonical tumorigenesis pathways. KEY MESSAGES Early-onset sporadic rectal cancer exhibits DNA gain and loss without Wnt activation. Ca2+/NFAT signaling appears to be activated in the absence of Wnt activation. An eight-gene genetic signature distinguishes Wnt+ and Wnt- rectal tumors. NFAT and its target genes regulate tumorigenic properties in CRC cells.
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Chandrasinghe PC, Ediriweera DS, Hewavisenthi J, Kumarage SK, Fernando FR, Deen KI. Colorectal cancer burden and trends in a South Asian cohort: experience from a regional tertiary care center in Sri Lanka. BMC Res Notes 2017; 10:535. [PMID: 29084610 PMCID: PMC5663050 DOI: 10.1186/s13104-017-2869-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 10/24/2017] [Indexed: 11/18/2022] Open
Abstract
Objective Colorectal cancer (CRC) burden is increasing in the south Asian region due to the changing socio-economic landscape and population demographics. There is a lack of robust high quality data from this region in order to evaluate the disease pattern and comparison. Using generalized linear models assuming Poisson distribution and model fitting, authors describe the variation in the landscape of CRC burden along time since 1997 at a regional tertiary care center in Sri Lanka. Results Analyzing 679 patients, it is observed that both colon and rectal cancers have significantly increased over time (pre 2000—61, 2000 to 2004—178, 2005 to 2009—190, 2010 to 2014–250; P < 0.05). Majority of the cancers were left sided (82%) while 77% were rectosigmoid. Over 25% of all CRC were diagnosed in patients less than 50 years and the median age at diagnosis is < 62 years. Increasing trend is seen in the stage at presentation while 33% of the rectal cancers received neoadjuvant chemoradiation. Left sided preponderance, younger age at presentation and advanced stage at presentation was observed. CRC disease pattern in the South Asian population may vary from that observed in the western population which has implications on disease surveillance and treatment.
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Affiliation(s)
- P C Chandrasinghe
- Department of Surgery, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka.
| | - D S Ediriweera
- Centre for Health Informatics, Biostatistics and Epidemiology, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
| | - J Hewavisenthi
- Department of Pathology, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
| | - S K Kumarage
- Department of Surgery, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
| | - F R Fernando
- Department of Surgery, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
| | - K I Deen
- Department of Surgery, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
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Detection Rate, Anatomic Sites, and Pathologic Types of Colorectal Cancer During Colonoscopy Procedures. Surg Laparosc Endosc Percutan Tech 2017; 27:394-399. [DOI: 10.1097/sle.0000000000000456] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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van Rooijen SJ, Jongen ACHM, Wu ZQ, Ji JF, Slooter GD, Roumen RMH, Bouvy ND. Definition of colorectal anastomotic leakage: A consensus survey among Dutch and Chinese colorectal surgeons. World J Gastroenterol 2017; 23:6172-6180. [PMID: 28970733 PMCID: PMC5597509 DOI: 10.3748/wjg.v23.i33.6172] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 03/28/2017] [Accepted: 07/24/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To determine the level of consensus on the definition of colorectal anastomotic leakage (CAL) among Dutch and Chinese colorectal surgeons.
METHODS Dutch and Chinese colorectal surgeons were asked to partake in an online questionnaire. Consensus in the online questionnaire was defined as > 80% agreement between respondents on various statements regarding a general definition of CAL, and regarding clinical and radiological diagnosis of the complication.
RESULTS Fifty-nine Dutch and 202 Chinese dedicated colorectal surgeons participated in the online survey. Consensus was found on only one of the proposed elements of a general definition of CAL in both countries: ‘extravasation of contrast medium after rectal enema on a CT scan’. Another two were found relevant according to Dutch surgeons: ‘necrosis of the anastomosis found during reoperation’, and ‘a radiological collection treated with percutaneous drainage’. No consensus was found for all other proposed elements that may be included in a general definition.
CONCLUSION There is no universally accepted definition of CAL in the Netherlands and China. Diagnosis of CAL based on clinical manifestations remains a point of discussion in both countries. Dutch surgeons are more likely to report ‘subclinical’ leaks as CAL, which partly explains the higher reported Dutch CAL rates.
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Affiliation(s)
- Stefanus J van Rooijen
- Department of Surgery, Máxima Medical Center, 5500 MB Veldhoven, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, 6200 MD Maastricht, The Netherlands
| | - Audrey CHM Jongen
- Department of Surgery, Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, 6200 MD Maastricht, The Netherlands
| | - Zhou-Qiao Wu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Ward I of Gastrointestinal Cancer Center, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Jia-Fu Ji
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Ward I of Gastrointestinal Cancer Center, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Gerrit D Slooter
- Department of Surgery, Máxima Medical Center, 5500 MB Veldhoven, The Netherlands
| | - Rudi MH Roumen
- Department of Surgery, Máxima Medical Center, 5500 MB Veldhoven, The Netherlands
| | - Nicole D Bouvy
- Department of Surgery, Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, 6200 MD Maastricht, The Netherlands
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14
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Kumarasamy V, Kuppusamy UR, Jayalakshmi P, Samudi C, Ragavan ND, Kumar S. Exacerbation of colon carcinogenesis by Blastocystis sp. PLoS One 2017; 12:e0183097. [PMID: 28859095 PMCID: PMC5578604 DOI: 10.1371/journal.pone.0183097] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 07/28/2017] [Indexed: 01/14/2023] Open
Abstract
Colorectal cancer (CRC) is one the most commonly diagnosed cancers worldwide and the number is increasing every year. Despite advances in screening programs, CRC remains as the second leading cause of cancer deaths in the United States. Oxidative stress plays an important role in the molecular mechanisms of colorectal cancer (CRC) and has been shown to be associated with Blastocystis sp., a common intestinal microorganism. In the present study, we aimed to identify a role for Blastocystis sp. in exacerbating carcinogenesis using in vivo rat model. Methylene blue staining was used to identify colonic aberrant crypt foci (ACF) and adenomas formation in infected rats whilst elevation of oxidative stress biomarker levels in the urine and serum samples were evaluated using biochemical assays. Histological changes of the intestinal mucosa were observed and a significant number of ACF was found in Blastocystis sp. infected AOM-rats compared to the AOM-controls. High levels of urinary oxidative indices including advanced oxidative protein products (AOPP) and hydrogen peroxide were observed in Blastocystis sp. infected AOM-rats compared to the uninfected AOM-rats. Our study provides evidence that Blastocystis sp. has a significant role in enhancing AOM-induced carcinogenesis by resulting damage to the intestinal epithelium and promoting oxidative damage in Blastocystis sp. infected rats.
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Affiliation(s)
- Vinoth Kumarasamy
- Department of Microbiology, Faculty of Medicine, MAHSA University, Bandar Saujana Putra, Shah Alam, Malaysia
| | - Umah Rani Kuppusamy
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Pailoor Jayalakshmi
- Department of Pathology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chandramathi Samudi
- Department of Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nanthiney Devi Ragavan
- Department of Biomedical Science, Faculty of Medicine, Mahsa University, Bandar Saujana Putra, Shah Alam, Malaysia
| | - Suresh Kumar
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- * E-mail:
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15
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Magaji BA, Moy FM, Roslani AC, Law CW. Descriptive epidemiology of colorectal cancer in University Malaya Medical Centre, 2001 to 2010. Asian Pac J Cancer Prev 2017; 15:6059-64. [PMID: 25124558 DOI: 10.7314/apjcp.2014.15.15.6059] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Colorectal cancer is the second most frequent cancer in Malaysia. Nevertheless, there is little information on treatment and outcomes nationally. We aimed to determine the demographic, clinical and treatment characteristics of colorectal cancer patients treated at the University Malaya Medical Centre (UMMC) as part of a larger project on survival and quality of life outcomes. MATERIALS AND METHODS Medical records of 1,212 patients undergoing treatment in UMMC between January 2001 and December 2010 were reviewed. A retrospective-prospective cohort study design was used. Research tools included the National Cancer Patient Registration form. Statistical analysis included means, standard deviations (SD), proportions, chi square, t-test/ ANOVA. P-value significance was set at 0.05. RESULTS The male: female ratio was 1.2:1. The mean age was 62.1 (SD12.4) years. Patients were predominantly Chinese (67%), then Malays (18%), Indians (13%) and others (2%). Malays were younger than Chinese and Indians (mean age 57 versus 62 versus 62 years, p<0.001). More females (56%) had colon cancers compared to males (44%) (p=0.022). Malays (57%) had more rectal cancer compared to Chinese (45%) and Indians (49%) (p=0.004). Dukes' stage data weres available in 67%, with Dukes' C and D accounting for 64%. Stage was not affected by age, gender, ethnicity or tumor site. Treatment modalities included surgery alone (40%), surgery and chemo/radiotherapy 32%, chemo and radiotherapy (8%) and others (20%). CONCLUSIONS Significant ethnic differences in age and site distribution, if verified in population-based settings, would support implementation of preventive measures targeting those with the greatest need, at the right age.
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Affiliation(s)
- Bello Arkilla Magaji
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia E-mail : ,
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16
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Periasamy S, Liu CT, Wu WH, Chien SP, Liu MY. Dietary Ziziphus jujuba Fruit Influence on Aberrant Crypt Formation and Blood Cells in Colitis-Associated Colorectal Cancer in Mice. Asian Pac J Cancer Prev 2016; 16:7561-6. [PMID: 26625762 DOI: 10.7314/apjcp.2015.16.17.7561] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Ziziphus jujuba (ZJ) fruit is rich in bioactive functional components such as polysaccharides, triterpenoid acid, flavonoids and oleamide. It has been commonly used in the treatment of various diseases including diabetes, digestive disorders, diarrhea, skin infections, liver and urinary complaints. However, dietary effects with regard to chemoprevention of colon cancer have not been studied. The present study was performed to evaluate the protective effects of dietary ZJ against colitis-associated colon carcinogenesis in azoxymethane (AOM)-dextran sodium sulphate (DSS)-treated mice. AOM was injected (10 mg/kg b.wt., i.p.) and three cycles of 2% DSS in drinking water for 7 days with 14 days of normal drinking water in-between were administered to induce colitis-associated colon cancer. ZJ fruit was supplemented into feed at levels of 5 and 10%. Dietary ZJ significantly attenuated aberrant crypt foci (ACF) formation and also decreased the progression of hyperplasia to dysplasia. In addition, it significantly reduced circulating white blood cells, lymphocytes, neutrophils, monocytes, eosinophils, basophils and platelets compared to colon cancer mice. We conclude that ZJ supplementation may delay the progression of colon cancer from hyperplasia to dysplasia and ultimately adenocarcinoma and cancer. In addition, it decreased circulating tumor-related leukocytes, main regulators of cancer inflammation. Dietary consumption of ZJ fruit attenuated the formation of ACF and delayed the progression of colon cancer.
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Affiliation(s)
- Srinivasan Periasamy
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan E-mail :
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17
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Colorectal cancer in Malaysia: Its burden and implications for a multiethnic country. Asian J Surg 2016; 40:481-489. [PMID: 27492344 DOI: 10.1016/j.asjsur.2016.07.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 03/18/2016] [Accepted: 03/21/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND This study aims to provide an analytical overview of the changing burden of colorectal cancer and highlight the implementable control measures that can help reduce the future burden of colorectal cancer in Malaysia. METHODS We performed a MEDLINE search via OVID with the Medical Subject Headings (MeSH) terms "Colorectal Neoplasms"[Mesh] and "Malaysia"[Mesh], and PubMed with the key words "colorectal cancer" and "Malaysia" from 1990 to 2015 for studies reporting any clinical, societal, and economical findings associated with colorectal cancer in Malaysia. Incidence and mortality data were retrieved from population-based cancer registries/databases. RESULTS In Malaysia, colorectal cancer is the second most common cancer in males and the third most common cancer in females. The economic burden of colorectal cancer is substantial and is likely to increase over time in Malaysia owing to the current trend in colorectal cancer incidence. In Malaysia, most patients with colorectal cancer have been diagnosed at a late stage, with the 5-year relative survival by stage being lower than that in developed Asian countries. Public awareness of the rising incidence of colorectal cancer and the participation rates for colorectal cancer screening are low. CONCLUSION The efficiency of different screening approaches must be assessed, and an organized national screening program should be developed in a phased manner. It is essential to maintain a balanced investment in awareness programs targeting general population and primary care providers, focused on increasing the knowledge on symptoms and risk factors of colorectal cancer, awareness on benefits of screening, and promotion of healthy life styles to prevent this important disease.
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18
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Saha M, Shil BC, Saha SK, Banik RK, Perveen I, Chowdhury MS, Islam AN, Saifullah A. Study of Clinicopathological Profile of Sporadic Cases of Colorectal Cancer. Euroasian J Hepatogastroenterol 2016; 6:134-136. [PMID: 29201745 PMCID: PMC5578581 DOI: 10.5005/jp-journals-10018-1185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Accepted: 05/19/2016] [Indexed: 01/19/2023] Open
Abstract
Objectives Colorectal cancer (CRC) is the third leading cause of cancer-related deaths in the world. This study was carried out to see the epidemiological and clinicopathological profile of sporadic cases of CRC in Bangladesh. Materials and methods The patients diagnosed to have colorectal carcinoma in two private medical centers of Bangladesh from January 2012 to December 2014 were enrolled in this study. Demographic data, clinical presentations, site of lesions, and histological types were analyzed. Results Total 158 patients were included in this study. The mean age was 50.77 years and male to female ratio was 1.55:1. Rectal bleeding was the commonest symptom irrespective of age and sex followed by abdominal pain (33, 20.9%), weight loss (29, 18.3%), abdominal mass (26, 16.4%), and altered bowel habit (22, 13.9%). Common histological type was adenocarcinoma (156, 98.7%). Conclusion Colorectal cancer commonly affects males >40 years of age. Most common site of involvement is rectum, which is followed by left colon. How to cite this article Saha M, Shil BC, Saha SK, Banik RK, Perveen I, Chowdhury MKS, Nazmul Islam ASM, Saifullah ANM. Study of Clinicopathological Profile of Sporadic Cases of Colorectal Cancer. Euroasian J Hepato-Gastroenterol 2016;6(2):134-136.
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Affiliation(s)
- Madhusudan Saha
- Department of Gastroenterology, North East Medical College, Sylhet, Bangladesh
| | - Bimal C Shil
- Department of Gastroenterology, Sir Salimullah Medical College, Dhaka, Bangladesh
| | - Shasanka K Saha
- Department of Gastroenterology, Sir Salimullah Medical College, Dhaka, Bangladesh
| | - Ranjit K Banik
- Department of Gastroenterology, Sir Salimullah Medical College, Dhaka, Bangladesh
| | - Irin Perveen
- Department of Gastroenterology, Enam Medical College and Hospital, Savar, Dhaka, Bangladesh
| | - Mk Sur Chowdhury
- Department of Gastroenterology, MAG Osmani Medical College, Sylhet, Bangladesh
| | - Asm Nazmul Islam
- Department of Gastroenterology, Sir Salimullah Medical College, Dhaka, Bangladesh
| | - Anm Saifullah
- Department of Gastroenterology, Sir Salimullah Medical College, Dhaka, Bangladesh
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19
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Kashfi SMH, Nazemalhosseini Mojarad E, Pourhoseingholi MA, Asadzadeh Aghdaei H, Anaraki F, Zali MR. Evaluation of the left-to-right shift of colon tumors in Iran: Is the trend changing? JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2016; 20:978-86. [PMID: 26929764 PMCID: PMC4746873 DOI: 10.4103/1735-1995.172789] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: Colorectal cancer (CRC) is the second cause of cancer-related deaths worldwide. There have been several studies reporting the proximal tumor shift, especially in Western countries. In the present study, we investigated the clinicopathologic and anatomical distributions of colorectal tumors in Iranian CRC patients. Materials and Methods: In this retrospective cohort study, 258 patients with CRC from 2008 to 2013 were evaluated. Comparison of variables was performed using Pearson's chi-square test and Fisher's exact test depending on the nature of the data. Results: A total of 258 patients including 124 (48.1%) females and 134 (51.9%) males enrolled in this study. The majority of cancers were detected in the rectosigmoid, i.e., 98 (38%) followed by the left colon, i.e., 84 (32.6%) and the right colon, i.e., 76 (29.5%). In the present study, we observed the significant association between metastases, adjuvant therapy, family history, and history of inflammatory bowel disease (IBD) with tumor, node, and metastasis (TNM) staging (P < 0.001). In univariate analysis, there was a strong association between overall survival (OS) and stage II CRC (P = 0.03). However, the predictive value was lost in multivariate analysis (P = 0.145). Conclusion: Unlike the majority of previous studies on Iranian CRC patients, we observed a considerably higher occurrence of right-sided colon cancers (84 versus 76). Although this phenomenon did not reach the statistical significance rate, based on recent studies on Iranian population including the present one, the pattern of anatomical distribution of colorectal tumors has been changed toward the proximal colon. This requires an urgent need to provide other strategies and complementary detecting approaches in order to identify proximal tumors in Iranian CRC patients.
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Affiliation(s)
- Seyed Mohammad Hossein Kashfi
- Gastroenterology and Liver Diseases Research center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ehsan Nazemalhosseini Mojarad
- Gastroenterology and Liver Diseases Research center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohamad Amin Pourhoseingholi
- Gastroenterology and Liver Diseases Research center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Asadzadeh Aghdaei
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fakhrialsadat Anaraki
- Colorectal Division of General Surgery Department, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Zali
- Gastroenterology and Liver Diseases Research center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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20
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Zahary MN, Ahmad Aizat AA, Kaur G, Yeong Yeh L, Mazuwin M, Ankathil R. Polymorphisms of cell cycle regulator genes CCND1 G870A and TP53 C215G: Association with colorectal cancer susceptibility risk in a Malaysian population. Oncol Lett 2015; 10:3216-3222. [PMID: 26722315 DOI: 10.3892/ol.2015.3728] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 07/07/2015] [Indexed: 12/13/2022] Open
Abstract
Colorectal cancer (CRC) occurs as a more common sporadic form and a less common familial form. Our earlier analysis of germline mutations of mismatch repair genes confirmed only 32% of familial CRC cases as Lynch syndrome cases. It was hypothesized that the remaining familial aggregation may be 'polygenic' due to single nucleotide polymorphisms (SNPs) of low penetrance genes involved in cancer predisposition pathways, such as cell cycle regulation and apoptosis pathways. The current case-control study involving 104 CRC patients (52 sporadic and 52 familial) and 104 normal healthy controls investigated the contribution of the SNPs cyclin D1 (CCND1) G870A and tumor protein p53 (TP53) C215G in modulating familial and sporadic CRC susceptibility risk. DNA was extracted from peripheral blood and the polymorphisms were genotyped by employing a polymerase chain reaction-restriction fragment length polymorphism method. The association between these polymorphisms and CRC susceptibility risk was calculated using a binary logistic regression analysis and deriving odds ratios (ORs). The A/A variant genotype of CCND1 and G/G variant genotype of TP53 exhibited a significantly greater association with the risk of sporadic CRC [CCND1: OR, 3.471; 95% confidence interval (CI), 1.443-8.350; P=0.005. TP53: OR, 2.829; CI, 1.119-7.152; P=0.026] as well as familial CRC susceptibility (CCND1: OR, 3.086; CI, 1.270-7.497; P=0.019. TP53: OR, 3.048; CI, 1.147-8.097; P=0.030). The results suggest a potential role of the SNPs CCND1 G870A and TP53 C215G in the modulation of sporadic and familial CRC susceptibility risk.
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Affiliation(s)
- Mohd Nizam Zahary
- Human Genome Centre, School of Medical Sciences, University of Science Malaysia Health Campus, Kubang Kerian, Kelantan 16150, Malaysia ; School of Diagnostic and Biomedicine, Faculty of Health Sciences, Sultan Zainal Abidin University, Kuala Terengganu, Terengganu 21300, Malaysia
| | - Abdul Aziz Ahmad Aizat
- Human Genome Centre, School of Medical Sciences, University of Science Malaysia Health Campus, Kubang Kerian, Kelantan 16150, Malaysia
| | - Gurjeet Kaur
- Institute for Research in Molecular Medicine, University of Science Malaysia, Minden, Penang 11800, Malaysia
| | - Lee Yeong Yeh
- Department of Medicine, School of Medical Sciences, University of Science Malaysia Health Campus, Kubang Kerian, Kelantan 16150, Malaysia
| | - Maya Mazuwin
- Department of Surgery, School of Medical Sciences, University of Science Malaysia Health Campus, Kubang Kerian, Kelantan 16150, Malaysia
| | - Ravindran Ankathil
- Human Genome Centre, School of Medical Sciences, University of Science Malaysia Health Campus, Kubang Kerian, Kelantan 16150, Malaysia
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21
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Wan Juhari WK, Wan Abdul Rahman WF, Mohd Sidek AS, Abu Hassan MR, Ahmad Amin Noordin KB, Zakaria AD, Macrae F, Zilfalil BA. Analysis of Hereditary Nonpolyposis Colorectal Cancer in Malay Cohorts using Immunohistochemical Screening. Asian Pac J Cancer Prev 2015; 16:3767-71. [PMID: 25987035 DOI: 10.7314/apjcp.2015.16.9.3767] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lynch syndrome (LS) is an inherited predisposition to colorectal, endometrial (uterine) and other cancers. Although most cancers are not inherited, about 5 percent (%) of people who have colorectal or endometrial cancer have the Lynch syndrome. It involves the alteration of mismatch repair (MMR) genes; MLH1, MSH2, MSH6 or PMS2. In this study, we analyzed the expression of MMR proteins in colorectal cancer in a Malay cohort by immunohistochemistry. MATERIALS AND METHODS A total of 17 patients were selected fulfilling one of the Bethesda criteria: colorectal cancer diagnosed in a patient aged less than 50 years old, having synchronous and metachronous colorectal cancer or with a strong family history. Immunohistochemical staining was performed on paraffin embedded tumour tissue samples using four antibodies: MLH1, MSH2, MSH6 and PMS2. RESULTS Twelve out of 17 patients (70.6%) were noted to have a family history. A total of 41% (n=7) of the patients had abnormal immunohistochemical staining with one or more of the four antibodies. Loss of expression were noted in 13 tumour tissues with a negative staining score <4. Of 13 tumour tissues, four showed loss expression of MLH1. For PMS2, loss of expression were noted in five cases. Both MSH2 and MSH6 showed loss of expression in two tumour tissues respectively. CONCLUSIONS Revised Bethesda criteria and immunohistochemical analysis constituted a convenient approach and is recommended to be a first-line screening for Lynch syndrome in Malay cohorts.
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Affiliation(s)
- Wan Khairunnisa Wan Juhari
- Department of Paediatric, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia E-mail :
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22
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Norwati D, Harmy MY, Norhayati MN, Amry AR. Colorectal cancer screening practices of primary care providers: results of a national survey in Malaysia. Asian Pac J Cancer Prev 2015; 15:2901-4. [PMID: 24761922 DOI: 10.7314/apjcp.2014.15.6.2901] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The incidence of colorectal cancer has been increasing in many Asian countries including Malaysia during the past few decades. A physician recommendation has been shown to be a major factor that motivates patients to undergo screening. The present study objectives were to describe the practice of colorectal cancer screening by primary care providers in Malaysia and to determine the barriers for not following recommendations. In this cross sectional study involving 132 primary care providers from 44 Primary Care clinics in West Malaysia, self-administered questionnaires which consisted of demographic data, qualification, background on the primary care clinic, practices on colorectal cancer screening and barriers to colorectal cancer screening were distributed. A total of 116 primary care providers responded making a response rate of 87.9%. About 21% recommended faecal occult blood test (FOBT) in more than 50% of their patients who were eligible. The most common barrier was "unavailability of the test". The two most common patient factors are "patient in a hurry" and "poor patient awareness". This study indicates that colorectal cancer preventive activities among primary care providers are still poor in Malaysia. This may be related to the low availability of the test in the primary care setting and poor awareness and understanding of the importance of colorectal cancer screening among patients. More awareness programmes are required for the public. In addition, primary care providers should be kept abreast with the latest recommendations and policy makers need to improve colorectal cancer screening services in health clinics.
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Affiliation(s)
- Daud Norwati
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia E-mail :
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23
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Sung JJY, Ng SC, Chan FKL, Chiu HM, Kim HS, Matsuda T, Ng SSM, Lau JYW, Zheng S, Adler S, Reddy N, Yeoh KG, Tsoi KKF, Ching JYL, Kuipers EJ, Rabeneck L, Young GP, Steele RJ, Lieberman D, Goh KL. An updated Asia Pacific Consensus Recommendations on colorectal cancer screening. Gut 2015; 64:121-32. [PMID: 24647008 DOI: 10.1136/gutjnl-2013-306503] [Citation(s) in RCA: 307] [Impact Index Per Article: 34.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Since the publication of the first Asia Pacific Consensus on Colorectal Cancer (CRC) in 2008, there are substantial advancements in the science and experience of implementing CRC screening. The Asia Pacific Working Group aimed to provide an updated set of consensus recommendations. DESIGN Members from 14 Asian regions gathered to seek consensus using other national and international guidelines, and recent relevant literature published from 2008 to 2013. A modified Delphi process was adopted to develop the statements. RESULTS Age range for CRC screening is defined as 50-75 years. Advancing age, male, family history of CRC, smoking and obesity are confirmed risk factors for CRC and advanced neoplasia. A risk-stratified scoring system is recommended for selecting high-risk patients for colonoscopy. Quantitative faecal immunochemical test (FIT) instead of guaiac-based faecal occult blood test (gFOBT) is preferred for average-risk subjects. Ancillary methods in colonoscopy, with the exception of chromoendoscopy, have not proven to be superior to high-definition white light endoscopy in identifying adenoma. Quality of colonoscopy should be upheld and quality assurance programme should be in place to audit every aspects of CRC screening. Serrated adenoma is recognised as a risk for interval cancer. There is no consensus on the recruitment of trained endoscopy nurses for CRC screening. CONCLUSIONS Based on recent data on CRC screening, an updated list of recommendations on CRC screening is prepared. These consensus statements will further enhance the implementation of CRC screening in the Asia Pacific region.
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Affiliation(s)
- J J Y Sung
- Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, NT, Hong Kong
| | - S C Ng
- Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, NT, Hong Kong Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - F K L Chan
- Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, NT, Hong Kong Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - H M Chiu
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - H S Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - T Matsuda
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - S S M Ng
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - J Y W Lau
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - S Zheng
- Cancer Institute, Zhejiang University, Hanggzhou, Zhejiang, China
| | - S Adler
- Division of Gastroenterology, Bikur Holim Hospital, Jerusalem, Israel
| | - N Reddy
- Asian Healthcare Foundation, Asian Institute of Gastroenterology, Hyderabad, Andhra Pradesh, India
| | - K G Yeoh
- Department of Medicine, Asian Healthcare Foundation, National University of Singapore and Senior Consultant Gastroenterologist, Singapore
| | - K K F Tsoi
- School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - J Y L Ching
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - E J Kuipers
- Department of Medicine & Therapeutics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - L Rabeneck
- Institute of Clinical Evaluative Sciences, University of Toronto, Ontario, Canada
| | - G P Young
- Department of Gastroenterology, Flinders Medical Centre, Adelaide, South Australia, Australia
| | - R J Steele
- Department of Surgery and Molecular Oncology, University of Dundee, Dundee, UK
| | - D Lieberman
- Portland VA Medical Centre, Portland, Oregon, USA
| | - K L Goh
- Department of Gastroenterology and Hepatology, University of Malaya, Kuala Lumpur, Malaysia
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Law CW, Rampal S, Roslani AC, Mahadeva S. Development of a risk score to stratify symptomatic adults referred for colonoscopy. J Gastroenterol Hepatol 2014; 29:1890-6. [PMID: 24909623 DOI: 10.1111/jgh.12638] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/29/2014] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIM With an increasing burden on overstretched colonoscopy services, a simple risk score for significant pathology in symptomatic patients may aid in the prioritization of patients. METHODS A derivative study of a risk score model for colonic neoplasia (colorectal carcinoma [CRC] and advanced adenoma) and CRC alone was conducted in symptomatic adults referred for an index colonoscopy. The accuracy of the final model was assessed by the area under the curve (AUC) of the receiver operating characteristic curve and the Hosmer-Lemeshow goodness-of-fit statistic. RESULTS A total of 1013 subjects (mean age 59.9 ± 13.7 years, 52.3% females) from a multi-ethnic Asian background (Chinese 56%, Malay 20.4%, Indian 21.5%) were recruited. Colonic neoplasia and CRC were identified in 175 (17.3%) and 114 (11.3%) cases, respectively. Risk scores were assigned to individual factors identified in a logistic regression model of both demographic (age, gender, ethnicity, education level, smoking history, Aspirin use) and clinical symptoms (change in bowel habit, bloody stool, weight loss, appetite loss, lethargy). The risk score for each patient was the sum of their individual risk factors. The AUC of the risk score for colonic neoplasia and CRC was 0.76 (Hosmer-Lemeshow goodness-of-fit statistic of P = 0.745) and 0.83 (Hosmer-Lemeshow goodness-of-fit statistic of P = 0.982), respectively. CONCLUSION A simple risk score for colonic neoplasia and CRC may be able to prioritize colonoscopy referrals in symptomatic subjects from a multi-ethnic background. A further study to validate this scoring system is required.
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Affiliation(s)
- Chee-Wei Law
- Division of Colorectal Surgery, Department of Surgery, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
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Goh LY, Leow AHR, Goh KL. Observations on the epidemiology of gastrointestinal and liver cancers in the Asia-Pacific region. J Dig Dis 2014; 15:463-8. [PMID: 24894597 DOI: 10.1111/1751-2980.12164] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Gastric cancer (GC) has long been thought to be an Asian type of cancer that is broadly associated with poverty, whereas colorectal cancer (CRC) has been thought to be a Western type of cancer associated with affluence. The incidence of GC has declined dramatically in the West but has a very high incidence in East Asia. The age-standardized incidence rates (ASR) have also declined. The decrease in the incidence of GC is associated with the decrease in the prevalence of Helicobacter pylori (H. pylori) infection worldwide. The discrepancy between a high H. pylori infection rate and a low GC incidence is seen chiefly among southern Asians of Indian origin and has been aptly termed the "Indian enigma". CRC is a new emerging cancer in this region. Some of the highest CRC ASR have been reported from Asian countries, in many of which it has now surpassed that of GC. Liver cancer is also an important cancer in the Asia-Pacific region. The highest ASR worldwide is reported from the Asian countries of Mongolia, Korea and Japan. The predominant underlying etiology across the region has been hepatitis B virus infection, except in Japan, where hepatitis C is an important cause of hepatocellular carcinoma (HCC). With mass vaccination of hepatitis B at birth and improved public health measures in many countries, hepatitis B and C are set to decline with time. However, the exponential increase in obesity and consequent non-alcoholic fatty liver disease portends a future epidemic of fatty liver-related HCC.
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Affiliation(s)
- Li-Yen Goh
- Faculty of Medicine, University of Nottingham, Nottingham, United Kingdom
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Zhiqin W, Palaniappan S, Raja Ali RA. Inflammatory Bowel Disease-related Colorectal Cancer in the Asia-Pacific Region: Past, Present, and Future. Intest Res 2014; 12:194-204. [PMID: 25349593 PMCID: PMC4204722 DOI: 10.5217/ir.2014.12.3.194] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 07/01/2014] [Accepted: 07/01/2014] [Indexed: 12/17/2022] Open
Abstract
Patients with inflammatory bowel disease (IBD) are at an increased risk of developing colorectal cancer (CRC), and key contributing factors include chronic colonic inflammation and the extent and duration of disease. This increase in risk is more likely to result from chronic inflammation of the colonic mucosa than from any clearly defined genetic predisposition. However, globally, the true magnitude of this risk is debatable, since results from different studies are heterogeneous in terms of geographical and methodological variables. The prevalence of IBD-related CRC in the Asia-Pacific region ranges from 0.3% to 1.8% and a recent study found that the cumulative incidence of IBD-related CRC is comparable to that in Western countries. However, the CRC mortality rate in the Asia-Pacific region is on the rise compared with that in Western countries, and a few Asian countries show particularly rapid upward trends in CRC incidence. Although our understanding of the molecular and clinical basis for IBD-related CRC has improved substantially, our means of prevention, endoscopic surveillance, chemoprevention, and prophylactic surgery remain modest at best. Furthermore, published data on IBD-related CRC in the Asia-Pacific region is lacking, and this review addresses many aspects including epidemiology, natural history, etiopathogenesis, morphology, and biological behaviors of IBD-related CRC and sporadic CRC in the Asia-Pacific region. In this review, we will also discuss the risk factors for CRC in IBD patients, endoscopic technology screening, and surveillance programs and management strategies for IBD-related CRC.
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Affiliation(s)
- Wong Zhiqin
- Department of Gastroenterology and Hepatology, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Shanthi Palaniappan
- Department of Gastroenterology and Hepatology, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Raja Affendi Raja Ali
- Department of Gastroenterology and Hepatology, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia. ; Medical Molecular Biology Institute, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
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Nizam ZM, Abdul Aziz AA, Kaur G, Abu Hassan MR, Mohd Sidek AS, Yeh LY, Mazuwin M, Ankathil R. Contribution of the MLH1 -93G>a promoter polymorphism in modulating susceptibility risk in Malaysian colorectal cancer patients. Asian Pac J Cancer Prev 2014; 14:619-24. [PMID: 23621208 DOI: 10.7314/apjcp.2013.14.2.619] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) exists in a more common sporadic form and less common hereditary forms, associated with the Lynch syndrome, familial adenomatous polyposis (FAP) and other rare syndromes. Sporadic CRC is believed to arise as a result of close interaction between environmental factors, including dietary and lifestyle habits, and genetic predisposition factors. In contrast, hereditary forms such as those related to the Lynch syndrome result from inheritance of germline mutations of mismatch repair (MMR) genes. However, in certain cases, the influence of low penetrance alleles in familial colorectal cancer susceptibility is also undeniable. AIM To investigate the genotype frequencies of MLH1 promoter polymorphism -93G>A and to determine whether it could play any role in modulating familial and sporadic CRC susceptibility risk. METHODS A case-control study comprising of 104 histopathologically confirmed CRC patients as cases (52 sporadic CRC and 52 Lynch syndrome patients) and 104 normal healthy individuals as controls was undertaken. DNA was extracted from peripheral blood and the polymorphism was genotyped employing PCR-RFLP methods. The genotypes were categorized into homozygous wild type, heterozygous and homozygous variants. The risk association between these polymorphisms and CRC susceptibility risk was calculated using binary logistic regression analysis and deriving odds ratios (ORs). RESULTS When risk association was investigated for all CRC patients as a single group, the heterozygous (G/A) genotype showed a significantly higher risk for CRC susceptibility with an OR of 2.273, (95%CI: 1.133-4.558 and p-value=0.021). When analyzed specifically for the 2 types of CRC, the heterozygous (G/A) genotype showed significantly higher risk for sporadic CRC susceptibility with and OR of 3.714, (95%CI: 1.416-9.740 and p-value=0.008). Despite high OR value was observed for Lynch syndrome (OR: 1.600, 95%CI: 0.715-3.581), the risk was not statistically significant (P=0.253). CONCLUSION Our results suggest an influence of MLH1 promoter polymorphism -93G>A in modulating susceptibility risk in Malaysian CRC patients, especially those with sporadic disease.
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Albasri A, Yosef H, Hussainy A, Bukhari S, Alhujaily A. Profile of colorectal polyps: a retrospective study from King Fahad Hospital, Madinah, Saudi Arabia. Asian Pac J Cancer Prev 2014; 15:2669-73. [PMID: 24761882 DOI: 10.7314/apjcp.2014.15.6.2669] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
AIM To evaluate the predominant colorectal polyps in the Almadinah region of Saudi Arabia. MATERIALS AND METHODS In this iretrospective study, we analyzed pathology reports of colonoscopies performed in King Fahad Hospital, Madinah, Saudi Arabia during the period 2006 to 2013. Data based on patient age, gender, size, site and type of polyps and the degree of dysplasia were analyzed by software SPSS 17 and compared with other published studies from different geographic regions of the world. RESULTS During these years, 224 patients had colonic polyps, of whom 149 (66.5%) were men and 75 (33.5%) were women. The most common types of polyps were adenomatous (166), followed by hyperplastic polyps (24), juvenile (18), inflammatory (13), lipomatous (2) and one patient with Peutz-Jegher polyps. Tubulovillous adenoma was the commonest adenomatous polyp (102), followed by tubular (41) and villous (23) types. The sigmoid colon was the most commonly involved region (36.6%). Dysplasia was significantly associated with female patients who had large size tubulovillous polyps located in the left colon. CONCLUSIONS The type and distribution of colorectal polyps in Saudi Arabia is very similar to Western countries. Patient gender, and size, histological type and location of polyps are closely related to dysplastic change in colonic polyps.
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Affiliation(s)
- Abdulkader Albasri
- Department of Pathology, Taibah University, Madinah, Saudi Arabia E-mail :
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Clinical features and outcome of sporadic colorectal carcinoma in young patients: a cross-sectional analysis from a developing country. ISRN ONCOLOGY 2014; 2014:461570. [PMID: 25006505 PMCID: PMC4004039 DOI: 10.1155/2014/461570] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Accepted: 03/12/2014] [Indexed: 01/03/2023]
Abstract
Background. Early onset colorectal carcinoma (CRC) is rare and has been hypothesized to be a biologically and clinically distinct entity personifying aggressive disease and worse survival. Methods. Data for 131 patients was collected by retrospective chart review. Cox proportional hazard model was used to compute prevalence ratios and 95% confidence intervals. Results. Early onset sporadic CRC accounted for 32% of all CRC treated in the specified time period. The mean age was 33.3 ± 7.9 years and the male to female ratio was 2 : 1. Colon and rectal cancers accounted for 55% and 45% of patients, respectively. 96% of rectal carcinoma patients received appropriate therapy as opposed to 65% of colon cancers. On multivariable analysis, appropriate reception of therapy (PR 4.99; 95% CI, 1.21–20.6) and signet ring morphology (PR 2.40; 95% CI, 1.33–4.32) were significantly associated with rectal cancers as opposed to colon cancer. Kaplan-Meier analysis revealed a trend towards inferior survival for rectal carcinoma 2 years after diagnosis. Conclusion.A high prevalence of early onset CRC was noted in the study. A trend towards inferior survival was seen in patients with rectal cancer. This finding raises the possibility of rectal carcinoma being an aggressive subset of young CRC.
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Albasri A, Yosef H, Hussainy AS, Sultan SA, Alhujaily A. Histopathological Features of Colorectal Cancer in Al-Madinah Region of Saudi Arabia: 8 Years Experience. Asian Pac J Cancer Prev 2014; 15:3133-7. [DOI: 10.7314/apjcp.2014.15.7.3133] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
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Shah SA, Neoh HM, Syed Abdul Rahim SS, Azhar ZI, Hassan MR, Safian N, Jamal R. Spatial Analysis of Colorectal Cancer Cases in Kuala Lumpur. Asian Pac J Cancer Prev 2014; 15:1149-54. [DOI: 10.7314/apjcp.2014.15.3.1149] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Ansil PN, Prabha SP, Nitha A, Latha MS. Chemopreventive Effect of Amorphophallus campanulatus (Roxb.) blume tuber against aberrant crypt foci and cell proliferation in 1, 2-dimethylhydrazine induced colon carcinogenesis. Asian Pac J Cancer Prev 2013; 14:5331-9. [DOI: 10.7314/apjcp.2013.14.9.5331] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Venkatachalam K, Gunasekaran S, Jesudoss VAS, Namasivayam N. The effect of rosmarinic acid on 1,2-dimethylhydrazine induced colon carcinogenesis. EXPERIMENTAL AND TOXICOLOGIC PATHOLOGY : OFFICIAL JOURNAL OF THE GESELLSCHAFT FUR TOXIKOLOGISCHE PATHOLOGIE 2013; 65:409-18. [PMID: 22236574 DOI: 10.1016/j.etp.2011.12.005] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Revised: 12/06/2011] [Accepted: 12/18/2011] [Indexed: 12/30/2022]
Abstract
This study was carried out to investigate the chemopreventive potential of rosmarinic acid (RA) against 1,2-dimethylhydrazine (DMH) induced rat colon carcinogenesis by evaluating the effect of RA on tumour formation, antioxidant enzymes, cytochrome P450 content, p-nitrophenol hydroxylase and GST activities. Rats were divided into six groups and fed modified pellet diet for the entire experimental period. Group 1 served as control, group 2 received RA (10 mg/kgb.w.). Groups 3-6 were induced colon cancer by injecting DMH (20 mg/kgb.w.) subcutaneously once a week for the first four weeks (groups 3-6). In addition, RA was administered at the doses of 2.5, 5 and 10 mg/kgb.w. to groups 4-6 respectively. DMH treated rats showed large number of colonic tumours; decreased lipid peroxidation; decreased antioxidant status; elevated CYP450 content and PNPH activities; and decreased GST activity in the liver and colon. Supplementation with RA (5 mgkg/b.w.) to DMH treated rats significantly decreased the number of polyps (50%); reversed the markers of oxidative stress (21.0%); antioxidant status (38.55%); CYP450 content (29.41%); and PNPH activities (21.9%). RA at the dose of 5 mg/kgb.w. showed a most pronounced effect and could be used as a possible chemopreventive agent against colon cancer.
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Affiliation(s)
- Karthikkumar Venkatachalam
- Department of Biochemistry and Biotechnology, Faculty of Science, Annamalai University, Annamalainagar 608002, Tamilnadu, India
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Yusoff HM, Daud N, Noor NM, Rahim AA. Participation and barriers to colorectal cancer screening in Malaysia. Asian Pac J Cancer Prev 2013; 13:3983-7. [PMID: 23098504 DOI: 10.7314/apjcp.2012.13.8.3983] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
In Malaysia, colorectal cancer is the most common cancer in males and the third most common in females. Mortality due to colorectal cancer can be effectively reduced with early diagnosis. This study was designed to look into colorectal cancer screening participation and its barriers among average risk individuals in Malaysia. A cross sectional study was conducted from August 2009 till April 2010 involving average risk individuals from 44 primary care clinics in West Malaysia. Each individual was asked whether they have performed any of the colorectal cancer screening methods in the past five years. The barrier questions had three domains: patient factors, test factors and health care provider factors. Descriptive analysis was achieved using Statistical Program for Social Sciences (SPSS) version 12.0. A total of 1,905 average risk individuals responded making a response rate of 93.8%. Only 13 (0.7%) respondents had undergone any of the colorectal cancer screening methods in the past five years. The main patient and test factors for not participating were embarrassment (35.2%) and feeling uncomfortable (30.0%), respectively. There were 11.2% of respondents who never received any advice to do screening. The main reason for them to undergo screening was being advised by health care providers (84.6%). The study showed that participation in colorectal cancer screening in Malaysia is extremely low and multiple factors contribute to this situation. Given the importance of the disease, efforts should be made to increase colorectal cancer screening activities in Malaysia.
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Affiliation(s)
- Harmy Mohamed Yusoff
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
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Knowledge of, attitudes toward, and barriers to participation of colorectal cancer screening tests in the Asia-Pacific region: a multicenter study. Gastrointest Endosc 2012; 76:126-35. [PMID: 22726471 DOI: 10.1016/j.gie.2012.03.168] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2011] [Accepted: 03/08/2012] [Indexed: 01/22/2023]
Abstract
BACKGROUND The rapid increase in the incidence of colorectal cancer (CRC) in the Asia-Pacific region in the past decade has resulted in recommendations to implement mass CRC screening programs. However, the knowledge of screening and population screening behaviors between countries is largely lacking. OBJECTIVE This multicenter, international study investigated the association of screening test participation with knowledge of, attitudes toward, and barriers to CRC and screening tests in different cultural and sociopolitical contexts. METHODS Person-to-person interviews by using a standardized survey instrument were conducted with subjects from 14 Asia-Pacific countries/regions to assess the prevailing screening participation rates, knowledge of and attitudes toward and barriers to CRC and screening tests, intent to participate, and cues to action. Independent predictors of the primary endpoint, screening participation was determined from subanalyses performed for high-, medium-, and low-participation countries. RESULTS A total of 7915 subjects (49% male, 37.8% aged 50 years and older) were recruited. Of the respondents aged 50 years and older, 809 (27%) had undergone previous CRC testing; the Philippines (69%), Australia (48%), and Japan (38%) had the highest participation rates, whereas India (1.5%), Malaysia (3%), Indonesia (3%), Pakistan (7.5%), and Brunei (13.7%) had the lowest rates. Physician recommendation and knowledge of screening tests were significant predictors of CRC test uptake. In countries with low-test participation, lower perceived access barriers and higher perceived severity were independent predictors of participation. Respondents from low-participation countries had the least knowledge of symptoms, risk factors, and tests and reported the lowest physician recommendation rates. "Intent to undergo screening" and "perceived need for screening" was positively correlated in most countries; however, this was offset by financial and access barriers. LIMITATIONS Ethnic heterogeneity may exist in each country that was not addressed. In addition, the participation tests and physician recommendation recalls were self-reported. CONCLUSIONS In the Asia-Pacific region, considerable differences were evident in the participation of CRC tests, physician recommendations, and knowledge of, attitudes toward, and barriers to CRC screening. Physician recommendation was the uniform predictor of screening behavior in all countries. Before implementing mass screening programs, improving awareness of CRC and promoting the physicians' role are necessary to increase the screening participation rates.
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Zahary MN, Kaur G, Abu Hassan MR, Singh H, Naik VR, Ankathil R. Germline mutation analysis of MLH1 and MSH2 in Malaysian Lynch syndrome patients. World J Gastroenterol 2012; 18:814-20. [PMID: 22371642 PMCID: PMC3286145 DOI: 10.3748/wjg.v18.i8.814] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 04/26/2011] [Accepted: 05/03/2011] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the protein expression profile of mismatch repair (MMR) genes in suspected cases of Lynch syndrome and to characterize the associated germline mutations.
METHODS: Immunohistochemical analysis of tumor samples was performed to determine the protein expression profile of MMR protein. Germline mutation screening was carried out on peripheral blood samples. The entire exon regions of MLH1 and MSH2 genes were amplified by polymerase chain reaction, screened by denaturing high performance liquid chromatography (dHPLC) and analyzed by DNA sequencing to characterize the germline mutations.
RESULTS: Three out of 34 tissue samples (8.8%) and four out of 34 tissue samples (11.8%) showed loss of nuclear staining by immunohistochemistry, indicating the absence of MLH1 and MSH2 protein expression in carcinoma cells, respectively. dHPLC analysis followed by DNA sequencing showed these samples to have germline mutations of MSH2 gene. However, no deleterious mutations were identified in any of the 19 exons or coding regions of MLH1 gene, but we were able to identify MLH1 promoter polymorphism, -93G > A (rs1800734), in 21 out of 34 patients (61.8%). We identified one novel mutation, transversion mutation c.2005G > C, which resulted in a missense mutation (Gly669Arg), a transversion mutation in exon 1, c.142G > T, which resulted in a nonsense mutation (Glu48Stop) and splice-site mutation, c.2006-6T > C, which was adjacent to exon 13 of MSH2 gene.
CONCLUSION: Germline mutations were identified in four Malaysian Lynch syndrome patients. Immunohistochemical analysis of tumor tissue proved to be a good pre-screening test before proceeding to germline mutation analysis of DNA MMR genes.
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Chung WC, Lee BI, Roh SY, Kwak JW, Hwang SM, Ko YH, Oh JH, Cho H, Chae HS, Cho YS. Increased prevalence of colorectal neoplasia in korean patients with sporadic duodenal adenomas: a case-control study. Gut Liver 2011; 5:432-6. [PMID: 22195240 PMCID: PMC3240785 DOI: 10.5009/gnl.2011.5.4.432] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Revised: 03/05/2011] [Accepted: 03/29/2011] [Indexed: 12/21/2022] Open
Abstract
Background/Aims Recent data from Western populations have suggested that patients with sporadic duodenal adenomas are at a higher risk for the development of colorectal neoplasia. In this study, we compared the frequency of colorectal neoplasia in patients with sporadic duodenal adenomas to healthy control subjects. Methods This retrospective case-control study used the databases of 3 teaching hospitals in Gyeonggi-do Province, South Korea. The colonoscopy findings of patients with sporadic duodenal adenomas were compared with those of age- and gender-matched healthy individuals who had undergone gastroduodenoscopies and colonoscopies during general screening examinations. Results Between 2001 and 2008, 45 patients were diagnosed endoscopically with sporadic duodenal adenomas; 26 (58%) of these patients received colonoscopies. Colorectal neoplasia (42% vs 21%; odds ratio [OR], 2.8; 95% confidence interval [CI], 1.1 to 7.4) and advanced colorectal adenoma (19% vs 3%; OR, 9.0; 95% CI, 1.6 to 50.0) were significantly more common in patients with sporadic duodenal adenomas than in healthy control subjects. Conclusions Compared with healthy individuals, patients with sporadic duodenal adenomas were at a significantly higher risk for developing colorectal neoplasia. Such at-risk patients should undergo routine screening colonoscopies.
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Affiliation(s)
- Woo Chul Chung
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
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Analysis of differentially expressed proteins in colorectal cancer using hydroxyapatite column and SDS-PAGE. Appl Biochem Biotechnol 2011; 165:1211-24. [PMID: 21863284 DOI: 10.1007/s12010-011-9339-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Accepted: 08/10/2011] [Indexed: 12/18/2022]
Abstract
Limitation on two dimensional (2D) gel electrophoresis technique causes some proteins to be under presented, especially the extreme acidic, basic, or membrane proteins. To overcome the limitation of 2D electrophoresis, an analysis method was developed for identification of differentially expressed proteins in normal and cancerous colonic tissues using self-pack hydroxyapatite (HA) column. Normal and cancerous colon tissues were homogenized and proteins were extracted using sodium phosphate buffer at pH 6.8. Protein concentration was determined and the proteins were loaded unto the HA column. HA column reduced the complexity of proteins mixture by fractionating the proteins according to their ionic strength. Further protein separation was accomplished by a simple and cost effective sodium dodecyl sulfate-polyacrylamide gel electrophoresis method. The protein bands were subjected to in-gel digestion and protein analysis was performed using electrospray ionization (ESI) ion trap mass spectrometer. There were 17 upregulated proteins and seven downregulated proteins detected with significant differential expression. Some of these proteins were low abundant proteins or proteins with extreme pH that were usually under presented in 2D gel analysis. We have identified brain mitochondrial carrier protein 1, T-cell surface glycoprotein CD1a, SOSS complex subunit B2, and Protein Jade 1 which were previously not detected in 2D gel analysis method.
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Song HR, Kweon SS, Kim HN, Piao JM, Yun WJ, Choi JS, Hwang JE, Yoon JY, Kim HR, Park YK, Kim SH, Choi YD, Shin MH. p53 codon 72 polymorphism in patients with gastric and colorectal cancer in a Korean population. Gastric Cancer 2011; 14:242-8. [PMID: 21461655 DOI: 10.1007/s10120-011-0034-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Accepted: 02/13/2011] [Indexed: 02/07/2023]
Abstract
BACKGROUND The common p53 codon 72 polymorphism has been investigated as a risk factor for cancer in different populations; however, the results have been inconsistent. This study investigated the risk of developing gastric or colorectal cancer associated with the p53 codon 72 polymorphism in a Korean population. METHODS We conducted a large-scale case-control study that included 2,213 gastric cancer patients; 1,829 colorectal cancer patients; and 1,700 healthy controls. Genotyping was performed with real-time polymerase chain reaction (PCR), using a TaqMan single-nucleotide polymorphism (SNP) genotyping assay. RESULTS The frequencies of Arg/Arg, Arg/Pro, and Pro/Pro genotypes of the p53 codon 72 polymorphism were 43.3, 42.0, and 13.0% in the gastric cancer patients; 40.5, 45.0, and 14.0% in the colorectal cancer patients; and 43.2, 45.6, and 11.2% in the controls, respectively. The Pro/Pro genotype was associated with an increased risk of gastric [age- and sex-adjusted odds ratio (OR) = 1.25, 95% confidence interval (CI) = 1.01-1.56, P = 0.04] and colorectal cancer (OR = 1.36, 95% CI = 1.07-1.72, P = 0.01). There were no significant interactions between the p53 codon 72 polymorphism and smoking or drinking. CONCLUSIONS Our results suggest that the Pro/Pro genotype is associated with modest increases in the risks of gastric cancer and colorectal cancer in a Korean population.
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Affiliation(s)
- Hye-Rim Song
- Department of Preventive Medicine, Chonnam National University Medical School, 5, Hak 1-dong, Dong-gu, Gwangju, 501-746, South Korea
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Hu HY, Yao YM, Wang JP, Lin WL, Huang ZH. Epidemiological and clinical characteristics of colorectal cancer in Huidong District, Guangdong Province, over the past 10 years. Shijie Huaren Xiaohua Zazhi 2011; 19:1195-1198. [DOI: 10.11569/wcjd.v19.i11.1195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To analyze the epidemiological and clinical characteristics of colorectal cancer in Huidong District, Guangdong Province, over the past 10 years.
METHODS: Data were collected from all consecutive patients receiving colonoscopy at our hospital during the past 10 years. The epidemiological data, clinical presentations, endoscopic findings, and pathohistological characteristics of patients with colorectal cancer were reviewed and analyzed retrospectively.
RESULTS: A total of 10 532 patients received colonoscopy from 2001 to 2010, and of them 853 cases of colorectal cancer were identified by histological assessment. The detection rate of colorectal cancer rose from 8.0% in the first 5-year period to 8.2% in the second five-year period. The median age of patients with colorectal cancer in the second five-year period was older than that in the first five-year period (65 years vs 59 years). The rectum is the most frequent site for colorectal cancer (55.0%), while hematochezia is the most common symptom (56.0%). The detection rate of right-sided colonic cancer in the second five-year period was significantly higher than that in the first five-year period (19.2% vs 15.1%, P < 0.05). Histologically, adenocarcinoma was the most frequent histological subtype (65.5%).
CONCLUSION: The onset age of patients with colorectal cancer is becoming older in Huidong District, Guangdong Province. The rectum remains the most frequent site for colorectal cancer. The shift in site of colonic cancer toward the right has occurred.
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Lee WS, Jeong Heum Baek, Jung Nam Lee, Woon Kee Lee. Mutations in K-ras and Epidermal Growth Factor Receptor Expression in Korean Patients With Stages III and IV Colorectal Cancer. Int J Surg Pathol 2011; 19:145-51. [DOI: 10.1177/1066896911400411] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
K-Ras somatic mutations in advanced colorectal cancer (CRC) can predict resistance to mAbs that target the epidermal growth factor receptor (EGFR). The relationships between K-ras mutations and the EGFR status have not yet been examined, especially in Korean patients. A total of 82 colorectal tumors (stage III-IV) were analyzed. K-Ras mutations at codons 12 and 13 were detected by polymerase chain reaction—single strand conformational polymorphism. The EGFR expressions were examined by immunohistochemistry, and these were graded according to a modified EGFR expression scoring system. The relationships between the patients’ characteristics and the survival time and the gene mutation status were analyzed. The EGFR expression was positive in 69 patients (84.1%) and negative in 13 patients (15.9%). The K-ras mutation rate was 35.4%. In all, 20 (68.9%) cases were mutated at codon 12 and 9 (31.1%) cases were mutated at codon 13. No relationship was observed between the EGFR status and K-ras mutation. The median overall survival (OS) was 68.1 months. There was no difference between the K-ras mutant group and the wild type group for overall survival (30.3% vs 21.0%, respectively, at 36 months, P = .777). K-ras mutation and the EGFR status were not independent prognostic factors for OS ( P = .105 and P = .499, respectively). For the Korean patients with CRC, the rate of an EGFR protein expression was greater than that for the patients in Western countries, and the rate of K-ras mutations was lower than that for patients in Western countries. This study found no correlation between the EGFR status and K-ras mutations in colorectal tumors.
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Affiliation(s)
- Won-Suk Lee
- Gachon University of Medicine and Science, Incheon, Korea,
| | | | - Jung Nam Lee
- Gachon University of Medicine and Science, Incheon, Korea
| | - Woon Kee Lee
- Gachon University of Medicine and Science, Incheon, Korea
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Bai Y, Gao J, Zou DW, Li ZS. Distribution trends of colorectal adenoma and cancer: a colonoscopy database analysis of 11,025 Chinese patients. J Gastroenterol Hepatol 2010; 25:1668-73. [PMID: 20880177 DOI: 10.1111/j.1440-1746.2010.06414.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND AIM A left-to-right shift of colorectal cancer (CRC) has been reported in Western studies. However, few Asian studies have investigated the anatomic distribution of colorectal adenoma and CRC. We aimed to describe the time trends in the distribution of colorectal adenoma and CRC in a Chinese population. METHODS A colonoscopy database was reviewed, and all consecutive patients with lower gastrointestinal symptoms who underwent colonoscopy from 1998 to 2009 were identified. Data, including patients' sex, age, symptoms, and the number and anatomic locations of colorectal adenoma and CRC, were documented. RESULTS A total of 11,025 patients were included in the final analysis; 1012 and 363 patients were diagnosed with colorectal adenoma and CRC, respectively. Overall, there were more distal than proximal adenomas (54.4% vs 37.9%), and the proportion of proximal adenomas remained stable from 1998-2006 to 2007-2009 (38.2% vs 37.6%). Similarly, there were more distal than proximal CRC (56.5% vs 42.4%), and the proportion of proximal CRC declined from 45.8% in 1998-2006 to 38.4% in 2007-2009. Colorectal adenoma and CRC were equally distributed among both sexes. For elderly patients (> 50 years), there was a non-significant trend towards more proximal adenoma and CRC. CONCLUSIONS The present study suggests no distal-to-proximal shift of colorectal adenoma and CRC among the Chinese population in Shanghai over the past 12 years. The distribution pattern of colorectal adenoma and CRC of Chinese patients is different from that of Western patients, who had more colorectal lesions located in the distal part.
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Affiliation(s)
- Yu Bai
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China
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Gupta S, Bhattacharya D, Acharya AN, Majumdar S, Ranjan P, Das S. Colorectal carcinoma in young adults: a retrospective study on Indian patients: 2000-2008. Colorectal Dis 2010; 12:e182-9. [PMID: 20128837 DOI: 10.1111/j.1463-1318.2010.02223.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
AIM To highlight an increased incidence of colorectal cancer (CRC) amongst young Indian adults. METHOD A retrospective study of 305 cases of CRC admitted to SSKM Hospital, Kolkata, India during 2000-2008 was carried out. RESULTS The ratio (0.64) of under-40 to above-40 CRC patients reported in this study is comparable to those from premier Oncology Centers in India (∼0.52) and is higher than those in the Indian National Cancer Registry (∼0.20) and international average (0.07). Distinctive tumour characteristics in younger patients including left-sided lesion (69.7%), presentation at an advanced (III/IV) stage (60%), poor histological differentiation (50%) and predominance of mucin-secreting adenocarcinoma (80%) are similar to those reported in the international literature. Some features are suggestive of hereditary non polyposis colorectal cancer syndrome, which may be a possible reason for the high proportion of young CRC patients. CONCLUSION A high index of suspicion for CRC among young Indian adults is necessary.
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Affiliation(s)
- S Gupta
- Department of Surgery, IPGMER, Kolkata, India.
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Yip KT, Das PK, Suria D, Lim CR, Ng GH, Liew CC. A case-controlled validation study of a blood-based seven-gene biomarker panel for colorectal cancer in Malaysia. J Exp Clin Cancer Res 2010; 29:128. [PMID: 20846378 PMCID: PMC2949823 DOI: 10.1186/1756-9966-29-128] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Accepted: 09/16/2010] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Colorectal cancer (CRC) screening is key to CRC prevention and mortality reduction, but patient compliance with CRC screening is low. We previously reported a blood-based test for CRC that utilizes a seven-gene panel of biomarkers. The test is currently utilized clinically in North America for CRC risk stratification in the average-risk North American population in order to improve screening compliance and to enhance clinical decision making. METHODS In this study, conducted in Malaysia, we evaluated the seven-gene biomarker panel validated in a North American population using blood samples collected from local patients. The panel employs quantitative RT-PCR (qRT-PCR) to analyze gene expression of the seven biomarkers (ANXA3, CLEC4D, TNFAIP6, LMNB1, PRRG4, VNN1 and IL2RB) that are differentially expressed in CRC patients as compared with controls. Blood samples from 210 patients (99 CRC and 111 controls) were collected, and total blood RNA was isolated and subjected to quantitative RT-PCR and data analysis. RESULTS The logistic regression analysis of seven-gene panel has an area under the curve (AUC) of 0.76 (95% confidence interval: 0.70 to 0.82), 77% specificity, 61% sensitivity and 70% accuracy, comparable to the data obtained from the North American investigation of the same biomarker panel. CONCLUSIONS Our results independently confirm the results of the study conducted in North America and demonstrate the ability of the seven biomarker panel to discriminate CRC from controls in blood samples drawn from a Malaysian population.
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Affiliation(s)
- Kok-Thye Yip
- Hospital Lam Wah Ee, 141 Jalan Tan Sri Teh Ewe Lim, 11600 Jelutong, Penang Malaysia
| | - Prashanta K Das
- Hospital Lam Wah Ee, 141 Jalan Tan Sri Teh Ewe Lim, 11600 Jelutong, Penang Malaysia
| | - David Suria
- GeneNews (M) Sdn Bhd, Mount Miriam Cancer Hospital, 23 Jalan Bulan, 11200 Tanjong Bungah, Penang, Malaysia
- Research Department, GeneNews Ltd, 2 East Beaver Creek Road, Building 2, Richmond Hill, Ontario, L4B 2N3, Canada
| | - Chun-Ren Lim
- GeneNews (M) Sdn Bhd, Mount Miriam Cancer Hospital, 23 Jalan Bulan, 11200 Tanjong Bungah, Penang, Malaysia
| | - Guey-Hooi Ng
- GeneNews (M) Sdn Bhd, Mount Miriam Cancer Hospital, 23 Jalan Bulan, 11200 Tanjong Bungah, Penang, Malaysia
| | - Choong-Chin Liew
- Research Department, GeneNews Ltd, 2 East Beaver Creek Road, Building 2, Richmond Hill, Ontario, L4B 2N3, Canada
- Department of Hematology, Brigham and Women's Hospital, Harvard Medical School, Karp Research Building, Sixth Floor, 75 Francis Street, Boston, MA, 02115, USA
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Implication of the Galectin-3 in colorectal cancer development (about 325 Tunisian patients). Bull Cancer 2010; 97:E1-8. [PMID: 20080461 DOI: 10.1684/bdc.2010.1032] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Galectin-3 is a specific soluble lectin of the beta-galactoside family. It plays an important role in cell adherence, proliferation, and differentiation. It has also been shown that galectin-3 expression correlates with tumor progression in several types of cancers. We investigated the involvement of galectin-3 in colorectal cancer development. We performed a comparative immunohistochemical analysis of galectin-3 expression in term of intensity and distribution in normal mucosa, in primary tumor and in metastasis from 200 patients with colorectal cancer selected among 325 cases. We also compared the galectin-3 staining according to the histological subtype (mucinous vs non mucinous), tumoral differentiation and stage of tumor. We showed a strong and diffuse positive staining of galectin-3 in both adjacent and distanced normal mucosa, in well differentiated adenocarcinoma and in metastasis. However, we note a progressive decrease of galectin-3 staining according to the decreasing degree of tumoral differentiation. We also observed a loss of this protein in adenocarcinoma with mucinous component < 50%, where the positive staining was limited only to the well differentiated areas of tumor. These data suggest that galectin-3 play an important role in colorectal cancer progression concerning the non mucinous carcinoma and can be used as a prognostic factor to predict poor outcome of patients. In mucinous subtype, galectin-3 might be implicated in one or many step of its genesis perhaps through the control of cellular adhesion and interaction with mucin produced. Adenocarcinoma with mucinous component <50% would be integrate to mucinous carcinoma, not to non mucinous ones. These investigations could open perspectives for therapeutic means targeted to improve the prognosis of this neoplasm.
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Abdullah M, Karim AA, Goh KL. Late presentation of esophageal cancer: observations in a multiracial South-East Asian population. J Dig Dis 2010; 11:28-33. [PMID: 20132428 DOI: 10.1111/j.1751-2980.2009.00410.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Esophageal cancer (ECA) is an important cancer in Malaysia. The aim of the study is to review the demographic data and clinical presentation of patients with ECA seen at the University of Malaya Medical Centre, Kuala Lumpur. METHODS Patients with histologically proven ECA were recruited for the study. Patients' case notes, endoscopy and operating theater records were reviewed. All cases were histologically confirmed. RESULTS A total of 143 patients with ECA was diagnosed between 1998 and 2003. The mean age of the patients was 63.1 +/- 12.1 years with a male : female ratio of 1.8:1. Of these 50.3 percent were Indians, 32.9 percent, Chinese and 16.8 percent Malays. The overall hospital-based prevalence rates per 100 000 admissions according to races were: Malay; 23.5, Chinese; 57.4 and Indian; 134.1. The location of the tumors was: upper; 16 (11.2%) middle; 52 (36.4%) and lower; 75 (52.4%). The histological type of ECA were: squamous cell carcinomas; 113 (79.0%) and adenocarcinomas; 30 (21.0%). The ECA stage at diagnosis, was: II; 18 (12.6%), III; 23 (16.1%) and IV; 102 (71.3%). Only 24 (16.8%) patients underwent surgery and13 (9.1%) were considered curative. Overall 114 (79.7%) patients underwent palliative endoscopic stenting and six (4.2%) were given other palliative therapy including radiotherapy. CONCLUSIONS Squamous cell cancer was the predominant type. ECA presents late in our patients and only a minority of patients underwent curative surgery.
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Affiliation(s)
- Muhammad Abdullah
- Department of Surgery, Faculty of Medicine, University of Malaya, Malaysia
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Lambert R, Kudo SE, Vieth M, Allen JI, Fujii H, Fujii T, Kashida H, Matsuda T, Mori M, Saito H, Shimoda T, Tanaka S, Watanabe H, Sung JJ, Feld AD, Inadomi JM, O'Brien MJ, Lieberman DA, Ransohoff DF, Soetikno RM, Zauber A, Teixeira CR, Rey JF, Jaramillo E, Rubio CA, Van Gossum A, Jung M, Jass JR, Triadafilopoulos G. Pragmatic classification of superficial neoplastic colorectal lesions. Gastrointest Endosc 2009; 70:1182-99. [PMID: 19879563 DOI: 10.1016/j.gie.2009.09.015] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2009] [Accepted: 09/21/2009] [Indexed: 12/12/2022]
Affiliation(s)
- René Lambert
- Screening Group, International Agency for Research on Cancer, Lyon, France
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Peedikayil MC, Nair P, Seena SM, Radhakrishnan L, Sadasivan S, Naryanan VA, Balakrishnan V. Colorectal cancer distribution in 220 Indian patients undergoing colonoscopy. Indian J Gastroenterol 2009; 28:212-5. [PMID: 20425641 DOI: 10.1007/s12664-009-0087-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2009] [Revised: 10/23/2009] [Accepted: 11/05/2009] [Indexed: 02/04/2023]
Abstract
AIM Colorectal cancer is one of the major cancers in the developed world. The incidence of colorectal cancer is low in India. The aim of the present study was to describe the anatomical distribution and age at diagnosis of colorectal cancer in India. METHODS Retrospective descriptive analysis of anatomical distribution, age at diagnosis and demography of 220 cases (149 [67.7%] men) of adenocarcinoma of the colon or rectum diagnosed at colonoscopy over a period of five years. RESULTS The mean age at diagnosis was 58.4 years (SD 13.3; range 23-85 years). Twenty-eight (12.7%) cases were below the age of 40 years. The majority (31.8%) cases were aged between 61-70 years. Most of the tumors (n=163, 74%) were located distal to the splenic flexure. Multivariate logistic regression analysis showed that bleeding per rectum (OR 2.8; 95% CI 1.2-6.2) was associated with distal cancer, and palpable mass (OR 3.9; 95% CI 1.7-8.6) was associated with proximal cancer. CONCLUSIONS Almost one-third of the colorectal cancers in this series occurred in the seventh decade and were located distal to the splenic flexure.
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Affiliation(s)
- Musthafa Chalikandy Peedikayil
- Department of Gastroenterology, Amritha Institute of Medical Sciences And Research Center, Kochi, Kerala, 682 041, India.
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Silibinin modulates biotransforming microbial enzymes and prevents 1,2-dimethylhydrazine-induced preneoplastic changes in experimental colon cancer. Eur J Cancer Prev 2009; 18:385-94. [PMID: 19654488 DOI: 10.1097/cej.0b013e32832d1b4f] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Chemoprevention directed towards the control of colon carcinogenesis in its early stages should ultimately provide a higher quality of life for people than waiting to treat end-stage disease. Silibinin is a major bioactive compound that is present in the widely consumed dietary supplement Silymarin. The current investigation aimed to explore the effect of the phytochemical silibinin on the suppression of 1,2-dimethylhydrazine-induced colonic preneoplastic changes in a long-term preclinical model. Wistar male rats were divided into six groups: group 1 were control rats, group 2 were control rats that received silibinin alone (50 mg/kg body weight orally everyday), rats in group 3 were injected once weekly with 1,2-dimethylhydrazine (20 mg/kg body weight, subcutaneously 15 times), in addition, group 4 (initiation), group 5 (post initiation) and group 6 (entire period) received silibinin as in group 2. At the end of 32 weeks, the activities of the colonic and faecal biotransforming microbial enzymes were analysed. Modulatory effects were also evaluated using aberrant crypt foci (ACF), dysplastic ACF and tumour incidence as endpoint markers. Silibinin markedly reduced tumour incidence, as compared with the rats treated with unsupplemented 1,2-dimethylhydrazine. The most pronounced inhibition of ACF and dysplastic ACF development was observed in the rats fed with silibinin for the entire period and also during the post initiation period. Silibinin administration also significantly (P<0.05) modulated the biotransforming activity of microbial enzymes. The results of our study suggest that silibinin suppresses 1,2-dimethylhydrazine-induced colon carcinogenesis at various stages and exerts a potential chemopreventive action against colon cancer.
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Norwood MGA, Mann CD, Hemingway D, Miller AS. Colorectal cancer: presentation and outcome in British South Asians. Colorectal Dis 2009; 11:745-9. [PMID: 19708093 DOI: 10.1111/j.1463-1318.2008.01675.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
AIM Colorectal cancer (CRC) has a lower incidence in patients of South Asian origin compared with British Caucasians. There are however little data available regarding the demographics of these patients, their presentation and outcome. Leicester has a high South Asian immigrant population, and we aim to define any potential differences in presentation, pathogenesis and outcome between our Caucasian and South Asian ethnic groups. METHOD All patients of South Asian origin were identified from the Leicester CRC database between June 1998 and April 2007. Data were analysed regarding the patients' demographics, the presentation and treatment details, tumour characteristics and clinical outcome. Data were compared with Caucasian patients from the same database. Patients from an ethnic background other than South Asia or Caucasians were excluded from analysis. RESULTS 3435 patients were included in the analysis, of which 134 (3.9%) were of South Asian ethnicity. 61.9% of South Asian patients were male compared with 56% of Caucasians. South Asians were significantly younger at presentation (61.4 vs 70.6 years, P < 0.001). South Asian patients had significantly more rectal tumours than their Caucasian counterparts (P = 0.002). South Asian patients were more likely to require initial oncological therapy, and were less likely to have resectional surgery than Caucasians (P = 0.006). Of the patients undergoing resectional surgery, the ASA grade, mode of surgery, tumour characteristics and Dukes' stage were similar. There was no difference in 5-year survival between the South Asian and Caucasian patients. CONCLUSION Patients of South Asian ethnicity are younger at their age of presentation and have a higher proportion of rectal tumours compared with British Caucasian patients. They are more likely to require initial oncological treatment and are less likely to undergo resectional surgery, therefore suggesting more advanced disease at presentation. Overall 5-year survival is the similar.
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Affiliation(s)
- M G A Norwood
- Department of Surgery, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK.
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