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Kadari M, Subhan M, Saji Parel N, Krishna PV, Gupta A, Uthayaseelan K, Uthayaseelan K, Sunkara NABS. CT Colonography and Colorectal Carcinoma: Current Trends and Emerging Developments. Cureus 2022; 14:e24916. [PMID: 35719832 PMCID: PMC9191267 DOI: 10.7759/cureus.24916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2022] [Indexed: 12/24/2022] Open
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Salvatore L, Imperatori M, Arnoldi E, Carnaghi C, Cordio S, Cosimelli M, Cremolini C, Maiello E, Martinelli E, Normanno N, Sciallero S, Cannizzaro R, Musio D, Cinquini M, Moschetti I, Fittipaldo VA, Aprile G, Beretta GD. Management of patients with early-stage colon cancer: guidelines of the Italian Medical Oncology Association. ESMO Open 2020; 5:e001001. [PMID: 33262200 PMCID: PMC7709518 DOI: 10.1136/esmoopen-2020-001001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 01/14/2023] Open
Abstract
About 75% of colorectal cancers are diagnosed as early stage, in which radical surgery is achievable. In the last decade, in Italy, the overall incidence of colorectal cancer has remained stable, while mortality gradually decreased, which is attributable to early diagnosis and improved medical, surgical and locoregional treatments. The Italian Medical Oncology Association formulated guidelines to manage early-stage colon cancer, including screening, diagnosis, treatment and follow-up, which we herein present.
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Affiliation(s)
- Lisa Salvatore
- Medical Oncology, Comprehensive Cancer Center - Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Lazio, Italy.
| | | | - Ermenegildo Arnoldi
- Department of Oncology, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Lombardia, Italy
| | - Carlo Carnaghi
- Medical Oncology, Humanitas Istituto Clinico Catanese, Catania, Sicilia, Italy
| | | | - Maurizio Cosimelli
- Department of Colo-Rectal Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Lombardia, Italy
| | - Chiara Cremolini
- Department of Oncology, Medical Oncology, Hospital of Pisa, Pisa, Italy
| | - Evaristo Maiello
- Medical Oncology, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Puglia, Italy
| | - Erika Martinelli
- Medical Oncology, Department of Clinical and Experimental Medicine "F. Magrassi", Second University of Naples, Naples, Italy
| | - Nicola Normanno
- Biologia Cellulare e Bioterapie, INT-Fondazione Pascale, Napoli, Italy
| | - Stefania Sciallero
- Department of Oncology, Azienda Ospedaliera S.Martino IRCCS, IST, Genova, Italy
| | - Renato Cannizzaro
- Gastroenterologia Oncologica, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano (PN), Italy
| | - Daniela Musio
- Radiotherapy, Umberto I Policlinico di Roma, Roma, Lazio, Italy
| | - Michela Cinquini
- IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Ivan Moschetti
- IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | | | - Giuseppe Aprile
- Department of Oncology, Ospedale San Bortolo, Vicenza, Veneto, Italy
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Abstract
OBJECTIVE To examine the viability of colon cancer screening with computed tomography colonography, also known as virtual colonoscopy. DATA SOURCES Clinical guidelines, published medical research. CONCLUSION Virtual colonoscopy, under the right circumstances, is an accurate viable screening tool for patients who may not otherwise desire to or are not able to participate in traditional colonoscopy. IMPLICATIONS FOR NURSING PRACTICE Nurses should be aware that routine colon cancer screening is recommended starting at age 50. In addition to the traditional colonoscopy, there are other options if a patient is unwilling or unable to undergo optical colon screening. Nurses should discuss the positive and negative aspects of different types of colon screening and teach proper bowel preparation for colon screening.
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Detection of potentially relevant extracolonic and colorectal findings at CT colonography in a low-risk symptomatic patient population. Abdom Radiol (NY) 2017. [PMID: 28647771 DOI: 10.1007/s00261-017-1221-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE CT colonography (CTC) is a widely accepted examination tool for detection of colorectal lesions but evidence of the proportions of relevant extracolonic findings (ECF) in a large symptomatic but still relatively low-risk cohort is lacking, as well as their relationship to symptoms, age, and sex. METHODS All patients (n = 3208) with colorectal symptoms, imaged between January 2007 and September 2016 with first-time CTC, were retrospectively selected. The majority (96.7%) was examined with low-dose unenhanced protocol. The most relevant ECF and colorectal lesions (≥6 mm) were prospectively assessed according to C-RADS classifications. Follow-up was elaborated based on the electronic record review. Chi-square test was utilized for evaluating the associations between relevant findings and symptoms, age, and sex. RESULTS A total of 270 (8.4%) patients were classified as C-RADS E3, 63 (2.0%) patients as C-RADS E4, and 437 (13.6%) patients were assessed with colorectal lesions (C-RADS C2-4). At follow-up, two thirds of ECF turned out to be a malignancy or relevant disease that required further medical attention. The proportion of ECF was not related to specific colorectal symptoms. Patients aged ≥65 years and men had significantly higher proportions of ECF than younger patients (C-RADS E3 p = 0.005; C-RADS E4 p < 0.001) and women (C-RADS E3 p = 0.013; C-RADS E4 p = 0.009), respectively. CONCLUSION Proportions of relevant ECF and colorectal findings are relatively low in symptomatic low-risk patients. By use of CTC as a singular examination, especially in elderly patients, most colonoscopies can be avoided with the benefit of diagnosing relevant ECF without introducing substantial over-diagnosis.
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Peluso G, Incollingo P, Calogero A, Tammaro V, Rupealta N, Chiacchio G, Sandoval Sotelo ML, Minieri G, Pisani A, Riccio E, Sabbatini M, Bracale UM, Dodaro CA, Carlomagno N. Current Tissue Molecular Markers in Colorectal Cancer: A Literature Review. BIOMED RESEARCH INTERNATIONAL 2017; 2017:2605628. [PMID: 29214162 PMCID: PMC5682052 DOI: 10.1155/2017/2605628] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 09/18/2017] [Accepted: 10/03/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Colorectal cancer (CRC) is one of the most spread neoplasia types all around the world, especially in western areas. It evolves from precancerous lesions and adenomatous polyps, through successive genetic and epigenetic mutations. Numerous risk factors intervene in its development and they are either environmental or genetic. AIM OF THE REVIEW Alongside common screening techniques, such as fecal screening tests, endoscopic evaluation, and CT-colonography, we have identified the most important and useful biomarkers and we have analyzed their role in the diagnosis, prevention, and prognosis of CRC. CONCLUSION Biomarkers can become an important tool in the diagnostic and therapeutic process for CRC. But further studies are needed to identify a noninvasive, cost-effective, and highly sensible and specific screening test for their detection and to standardize their use in clinical practice.
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Affiliation(s)
- Gaia Peluso
- Department of Advanced Biomedical Science, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Paola Incollingo
- Department of Advanced Biomedical Science, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Armando Calogero
- Department of Advanced Biomedical Science, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Vincenzo Tammaro
- Department of Advanced Biomedical Science, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Niccolò Rupealta
- Department of Advanced Biomedical Science, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Gaetano Chiacchio
- Department of Advanced Biomedical Science, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Maria Laura Sandoval Sotelo
- Department of Advanced Biomedical Science, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Gianluca Minieri
- Department of Advanced Biomedical Science, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Antonio Pisani
- Department of Public Health, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Eleonora Riccio
- Department of Public Health, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Massimo Sabbatini
- Department of Public Health, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Umberto Marcello Bracale
- Department of Public Health, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Concetta Anna Dodaro
- Department of Advanced Biomedical Science, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Nicola Carlomagno
- Department of Advanced Biomedical Science, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
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Barták BK, Kalmár A, Péterfia B, Patai ÁV, Galamb O, Valcz G, Spisák S, Wichmann B, Nagy ZB, Tóth K, Tulassay Z, Igaz P, Molnár B. Colorectal adenoma and cancer detection based on altered methylation pattern of SFRP1, SFRP2, SDC2, and PRIMA1 in plasma samples. Epigenetics 2017; 12:751-763. [PMID: 28753106 DOI: 10.1080/15592294.2017.1356957] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Aberrant methylation is one of the most frequent epigenetic alterations that can contribute to tumor formation. Cell-free DNA can originate from tumor tissue; therefore, the evaluation of methylation markers in cell-free DNA can be a promising method for cancer screening. Our aim was to develop a panel of biomarkers with altered methylation along the colorectal adenoma-carcinoma sequence in both colonic tissue and plasma. Methylation of selected CpG sites in healthy colonic (n = 15), adenoma (n = 15), and colorectal cancer (n = 15) tissues was analyzed by pyrosequencing. MethyLight PCR was applied to study the DNA methylation of SFRP1, SFRP2, SDC2, and PRIMA1 gene promoters in 121 plasma and 32 biopsy samples. The effect of altered promoter methylation on protein expression was examined by immunohistochemistry. Significantly higher (P < 0.05) DNA methylation levels were detected in the promoter regions of all 4 markers, both in CRC and adenoma tissues compared with healthy controls. Methylation of SFRP1, SFRP2, SDC2, and PRIMA1 promoter sequences was observed in 85.1%, 72.3%, 89.4%, and 80.9% of plasma samples from patients with CRC and 89.2%, 83.8%, 81.1% and 70.3% from adenoma patients, respectively. When applied as a panel, CRC patients could be distinguished from controls with 91.5% sensitivity and 97.3% specificity [area under the curve (AUC) = 0.978], while adenoma samples could be differentiated with 89.2% sensitivity and 86.5% specificity (AUC = 0.937). Immunohistochemical analysis indicated decreasing protein levels of all 4 markers along the colorectal adenoma-carcinoma sequence. Our findings suggest that this methylation biomarker panel allows non-invasive detection of colorectal adenoma and cancer from plasma samples.
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Affiliation(s)
- Barbara Kinga Barták
- a 2nd Department of Internal Medicine , Semmelweis University , H-1088 Budapest , Hungary
| | - Alexandra Kalmár
- a 2nd Department of Internal Medicine , Semmelweis University , H-1088 Budapest , Hungary
| | - Bálint Péterfia
- a 2nd Department of Internal Medicine , Semmelweis University , H-1088 Budapest , Hungary
| | - Árpád V Patai
- a 2nd Department of Internal Medicine , Semmelweis University , H-1088 Budapest , Hungary
| | - Orsolya Galamb
- b Molecular Medicine Research Group, Hungarian Academy of Sciences , H-1088 Budapest , Hungary
| | - Gábor Valcz
- b Molecular Medicine Research Group, Hungarian Academy of Sciences , H-1088 Budapest , Hungary
| | - Sándor Spisák
- c Department of Medical Oncology , Dana-Farber Cancer Institute , Boston , Massachusetts , USA
| | - Barnabás Wichmann
- b Molecular Medicine Research Group, Hungarian Academy of Sciences , H-1088 Budapest , Hungary
| | - Zsófia Brigitta Nagy
- a 2nd Department of Internal Medicine , Semmelweis University , H-1088 Budapest , Hungary
| | - Kinga Tóth
- a 2nd Department of Internal Medicine , Semmelweis University , H-1088 Budapest , Hungary
| | - Zsolt Tulassay
- a 2nd Department of Internal Medicine , Semmelweis University , H-1088 Budapest , Hungary.,b Molecular Medicine Research Group, Hungarian Academy of Sciences , H-1088 Budapest , Hungary
| | - Péter Igaz
- a 2nd Department of Internal Medicine , Semmelweis University , H-1088 Budapest , Hungary.,b Molecular Medicine Research Group, Hungarian Academy of Sciences , H-1088 Budapest , Hungary
| | - Béla Molnár
- b Molecular Medicine Research Group, Hungarian Academy of Sciences , H-1088 Budapest , Hungary
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