Colon, rectal, and anal cancers

Factors affecting the survival of patients with colorectal cancer using random survival forest

PURPOSE

Colorectal cancer is one of the most common cancers and the leading cause of cancer death in Iran. This study aimed to develop and validate a random survival forest (RSF) to identify important risk factors on mortality in colorectal patients based on their demographic and clinical-related variables.

METHODS

In this retrospective cohort study, the information of 317 patients with colorectal cancer who were referred to Imam Khomeini Clinic of Hamadan during the years of 2002 to 2017 were examined. Patient survival was calculated from the time of diagnosis to death. In the present study, the RSF model was used to identify factors affecting patient survival. Also, the results of the RSF model were compared with the Cox model. The data were analyzed using R software (version 3.6.1) and survival packages.

RESULTS

One-, 2-, 3-, 4-, 5-, and 10-year survival rates of included patients were 81.4%, 63%, 57%, 52%, 45%, and 34%, respectively, and the median survival was obtained to be 53 months. The number of 150 patients was died at this time period. The four most important predictors of survival included metastasis to other organs, WBC count, disease stage, and number of lymphomas involved. RSF method predicted survival better than the conventional Cox proportional hazard model.

CONCLUSION

We found that metastasis to other organs, WBC count, disease stage, and number of lymphomas involved were the most four most important predictors of low survival for colorectal cancer patients.

Celastrus orbiculatus extract inhibits the migration and invasion of human glioblastoma cells in vitro

BACKGROUND

Gliomas are highly aggressive tumors of the nervous system, and current treatments fail to improve patient survival. To identify substances that can be used as treatments for gliomas, we examined the effect of Celastrus orbiculatus extract (COE) on the invasion and migration of human glioblastoma U87 and U251 cells in vitro.

METHODS

The effects of COE on cell viability and adhesion were tested using the 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide assay and cell adhesion assay, respectively. The effects of COE on cell migration and invasion were assessed by a wound-healing assay and transwell migration and invasion assays. The effects of COE on the expression of epithelial-mesenchymal transition (EMT)-related proteins and matrix metalloproteinases (MMPs) were evaluated using western blot and gelatin zymography, respectively. Finally, the effect of COE on actin assembly was observed using phalloidin-tetramethylrhodamine isothiocyanate labeling and confocal laser scanning microscopy.

RESULTS

We found that COE inhibited the adhesion, migration, and invasion of U87 and U251 cells in a dose-dependent manner. COE reduced N-cadherin and vimentin expression, increased E-cadherin expression, and reduced MMP-2 and MMP-9 expression in U87 and U251 cells. Furthermore, COE inhibited actin assembly in U87 and U251 cells.

CONCLUSIONS

COE attenuates EMT, MMP expression, and actin assembly in human glioblastoma cells, thereby inhibiting their adhesion, migration, and invasion in vitro.

Information needs across the colorectal cancer care continuum: scoping the literature

Because cancer care requires a multifaceted approach, providing useful and timely information to people with colorectal cancer may be fragmented and inconsistent. Our interest was in examining what has and has not captured the attention of researchers speaking to the information needs of people with colorectal cancer. We followed Arksey and O'Malley's framework for the methodology of scoping review. Focusing solely on colorectal cancer, we analysed 239 articles to get a picture of which information needs and sources of information, as well as the timing of providing information, were attended to. Treatment-related information received the most mentions (26%). Healthcare professionals (49%) were mentioned as the most likely source of information. Among articles focused on one stage of the care continuum, post-treatment (survivorship) received the most attention (16%). Only 27% of the articles consulted people with colorectal cancer and few attended to diet/nutrition and bowel management. This study examined the numerical representation of issues to which researchers attend, not the quality of the mentions. We ponder, however, on the relationship between the in/frequency of mentions and the actual information needs of people with colorectal cancer as well as the availability, sources and timing of information.

Vitamin C increases the apoptosis via up-regulation p53 during cisplatin treatment in human colon cancer cells

Vitamin C (VC) is an important antioxidant and enzyme co-factor that works by stimulating the immune system and protecting against infections. It is well known that melanoma cells are more susceptible to VC than any other tumor cells. However, the role of VC in the treatment of colon cancer has not been studied. Cisplatin (CDDP) is a DNA damaging agent and is widely used for treating cancer, while the role of p53 in CDDP-induced cell death has been stressed. Using cell growth assays, morphological methods, Western blotting, flow cytometry, and DNA fragmentation analysis, we measured the expression of p53 level involved in the effect of VC on CDDP-induced apoptosis of HCT116, a human colon cancer cell line. CDDP plus VC treatment resulted in significantly increased apoptosis along with upregulation of p53 compared to untreated cells and/or CDDP-treated cells. These results suggest that VC enhanced CDDP sensitivity and apoptosis via upregulation of p53.

[Mechanical obstruction as a cause of acute abdomen. Radiological differential diagnosis]

Mechanical obstruction is a common cause of acute abdomen. Besides the diagnosis of the obstruction itself it is crucial to recognize the cause of the obstruction for planning of conservative or operative treatment.This article gives a general overview of the methods available for imaging obstructions in the setting of an acute abdomen. In the second part the differential diagnoses of the most common causes of obstruction will be discussed.

Dose- and time-dependent effects of doxorubicin on cytotoxicity, cell cycle and apoptotic cell death in human colon cancer cells

The cytostatic drug doxorubicin is a well-known chemotherapeutic agent which is used in treatment of a wide variety of cancers. A key factor in the response of cancer cells to chemotherapeutic drugs is the activation of the apoptotic pathway, a pathway that is often impaired in chemoresistant colon cancer cells. The aim of the present study was to investigate the effects of doxorubicin in Hct-116 human colon carcinoma cells in order to clarify if a time/concentration range for optimal doxorubicin-induced apoptosis exists. We compared a treatment schedule were cells were bolus incubated for 3h with doxorubicin followed by 24h in drug-free medium, with a continuous doxorubicin treatment schedule for 24h. Bolus incubation was carried out to determine effects of doxorubicin accumulated during the first 3h, whereas continuous incubation allowed further (continuous) exposure to doxorubicin. We found that bolus (3h) treatment with doxorubicin resulted in a dose-dependent decrease of viable cells and concomitant increase of apoptosis. Additionally, bolus (3h) doxorubicin incubation led to phosphorylation of p53 at serine 392, induction of p21, G2 arrest and increase of proapoptotic protein Bax. In contrast, continuous (24h) treatment with doxorubicin reduced the number of living cells with no parallel raise in the amount of dead cells. Continuous (24h) treatment with 5 microM doxorubicin resulted in cell cycle arrest in G0/G1 phase that was neither accompanied by phosphorylation and activation of p53 nor enhanced expression of p21. These results suggest that doxorubicin is able to induce cell death by apoptosis only at particular dose and treatment conditions and imply a completely different cellular response following bolus or continuous exposure to doxorubicin.

Human defensins and LL-37 in mucosal immunity

Defensins are widespread in nature and have activity against a broad range of pathogens. Defensins have direct antimicrobial effects and also modulate innate and adaptive immune responses. We consider the role of human defensins and the cathelicidin LL-37 in defense of respiratory, gastrointestinal, and genitourinary tracts and the oral cavity, skin, and eye. Human beta-defensins (hBDs) and human defensins 5 and 6 (HD5 and -6) are involved most obviously in mucosal responses, as they are produced principally by epithelial cells. Human alpha-defensins 1-4 (or HNPs 1-4) are produced principally by neutrophils recruited to the mucosa. Understanding the biology of defensins and LL-37 is the beginning to clarify the pathophysiology of mucosal inflammatory and infectious diseases (e.g., Crohn's disease, atopic dermatitis, lung or urinary infections). Challenges for these studies are the redundancy of innate defense mechanisms and the presence and interactions of many innate defense proteins in mucosal secretions.

Physical activity and gastrointestinal cancer survivorship

Research examining physical activity in gastrointestinal cancer survivors is in its early stages and has focused primarily on colorectal cancer. Moreover, the majority of the research to date has been observational in nature, with very little interventional research. Though limited, the results of this research have been promising in nature, showing positive associations between physical activity and quality of life as well as disease outcomes, including improved disease-free and overall survival. The potential benefits of physical activity for gastrointestinal cancer survivors warrant further research on the underlying mechanisms of the relationship between physical activity and colorectal cancer disease outcomes, to determine if these associations extend to other gastrointestinal cancers, and to determine appropriate physical activity interventions to realize any potential supportive care benefits in various gastrointestinal cancer survivor groups.