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Zhou G, Xie RF, Li SN, Chen SX, Feng YM, Xiang N, Tan ZY, Zhou X. Synergic effects and possible mechanism of emodin and stilbene glycosides on colorectal cancer. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 132:155821. [PMID: 39004030 DOI: 10.1016/j.phymed.2024.155821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 05/25/2024] [Accepted: 06/11/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND Polygonum multiflorum (PM) is a core herb that enhances immunity. It can also detoxify, reduce swelling, and intercept malaria. Its main components, emodin (EMD) and 2,3,5,4'-Tetrahydroxy stilbene-2-O-β-D-glucoside (stilbene glycoside, TSG), have good anti-cancer potential. PURPOSE The study aims to investigate synergic effects of EMD and TSG on CRC and its possible mechanism. METHODS Network pharmacology and bioinformatics were used to identify targets. HPLC was used to analyze the effective ingredients in PM and to determine the content of the main ingredients. HT-29 cells were used for in vitro experiments. Cell Counting Kit-8 (CCK8) and scratch test were used to detect the effects of various chemical components of PM on the proliferation and migration of HT-29 cells, and Western Bolt (WB) test was used to evaluate the effects of EMD and TSG on P53 pathway. In vivo experiments, the effects of EMD and TSG were evaluated by measuring tumor weight and tumor volume in CRC mice model and histological analysis were carried out with HE staining. The expressions of HSP90, P53, COX2, and ROS were detected by quantitative reverse transcription polymerase chain reaction (PCR), and IL-1β, IL-4, IL-6, IL-10, TGF-β and IFN-γ were detected by enzyme linked immunosorbent assay (ELISA). WB and Immunohistochemistry (IHC) were used to detect the expression of P53 related proteins. RESULTS Network pharmacology showed PM closely related to colorectal cancer pathway and the core targets included STAT3 and P53; bioinformatics indicated P53 played an important role in the development and prognosis of CRC; chemical analysis showed identified and quantified gallic acid (GA), cis-TSG, trans-TSG, Emodin glucoside(EMDG), physcion glucoside (PHYG), EMD in PM; EMD induced apoptosis and TSG inhibited migration of HT-29 cells; EMD and TSG could coordinately shrink tumor size of CRC mice, elevate expressions of F4/80, decrease the content of IL-6 and TGF-β, promote tumor oxidized and reduce expression of P53 and STAT3 in the tumor. CONCLUSIONS In vitro experiments showed that TSG inhibited cancer cell migration and EMD induced apoptosis. EMD and TSG had synergic effects on CRC, whose possible mechanism might be to regulate the expression of cytokines and inhibit P53 pathway.
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Affiliation(s)
- Gui Zhou
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Rui-Fang Xie
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Shan-Ni Li
- Shanghai Nanyang Model Private High School, Shanghai, China
| | - Shi-Xiu Chen
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Yi-Ming Feng
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Nan Xiang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Ze-Ye Tan
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Xin Zhou
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China.
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Fenwick A, Black C, Linehan V, Gala-Lopez BL, Costa AF. Resection of colorectal carcinoma liver metastases: A population-based study in outcomes and factors associated with recurrent disease. Curr Probl Diagn Radiol 2024; 53:481-487. [PMID: 38702281 DOI: 10.1067/j.cpradiol.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/15/2024] [Accepted: 04/18/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVE To assess the hepatic disease-free survival (HDFS) and overall survival (OS) of patients who underwent resection of colorectal cancer liver metastases (CRCLM) in our population, and evaluate what factors are associated with these outcomes. METHODS Patients with resected non-mucinous CRCLM between January 2013-February 2020 were retrospectively identified. Dates of diagnosis, surgery, and, if applicable, death were recorded. HDFS and OS were calculated using a census date of 24 September 2022. Separate Cox multivariate regression analyses were performed to evaluate for association between HDFS and OS and the following factors: pre-operative imaging interval (<4 weeks vs. ≥4 weeks); pre-operative imaging modality (CT only vs. MRI+CT); extrahepatic disease at time of hepatectomy (yes vs. no); tumor burden score (TBS, where TBS2 = (largest axial dimension of CRCLM)2 + (number of CRCLM)2); pT and pN; and neoadjuvant chemotherapy. RESULTS 137 subjects (mean age, 61 ± 11 years, 86 males) were included. Associations with recurrent hepatic disease were found with chemotherapy (HR 2.11[95 % CI = 1.13-3.92]), TBS (HR 1.30[95 % CI = 1.17-1.45]), MRI+CT (HR 2.12[95 % CI = 1.29-3.48]), and extrahepatic disease at hepatectomy (HR 2.16[95 % CI = 1.08-4.35]). For mortality, associations were found with TBS (HR 1.22[95 % CI = 1.09-1.37]), pT (HR 1.45[95 % CI = 1.05-2.00]), and extrahepatic disease at hepatectomy (HR 2.10[95 % CI = 1.31-3.36]). CONCLUSION In our population, non-imaging related factors TBS, neoadjuvant chemotherapy, pT and presence of extrahepatic disease at time of hepatectomy were associated with HDFS and/or OS. The preoperative imaging interval and use of preoperative MRI were not associated with improved patient outcomes.
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Affiliation(s)
- Andrew Fenwick
- Department of Diagnostic Radiology, Queen Elizabeth II Health Sciences Centre and Dalhousie University. Victoria General Building, 3rd floor, 1276 South Park Street, Halifax, Nova Scotia, Canada B3H 2Y9
| | - Curtis Black
- Department of Diagnostic Radiology, Queen Elizabeth II Health Sciences Centre and Dalhousie University. Victoria General Building, 3rd floor, 1276 South Park Street, Halifax, Nova Scotia, Canada B3H 2Y9
| | - Victoria Linehan
- Department of Diagnostic Radiology, Queen Elizabeth II Health Sciences Centre and Dalhousie University. Victoria General Building, 3rd floor, 1276 South Park Street, Halifax, Nova Scotia, Canada B3H 2Y9
| | - Boris L Gala-Lopez
- Department of Surgery, Queen Elizabeth II Health Sciences Centre and Dalhousie University. Victoria General Building, 3rd floor, 1276 South Park Street, Halifax, Nova Scotia, Canada B3H 2Y9; Beatrice Hunter Cancer Research Institute. Suite 2L-A2, Tupper Link, 5850 College Street P.O. Box 15000 Halifax, NS B3H 4R2
| | - Andreu F Costa
- Department of Diagnostic Radiology, Queen Elizabeth II Health Sciences Centre and Dalhousie University. Victoria General Building, 3rd floor, 1276 South Park Street, Halifax, Nova Scotia, Canada B3H 2Y9..
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Garcia-Carbonero R, González Astorga B, Vidal Tocino R, Contreras Toledo D, Pericay C, Fernández Montes A, Falcó E, González Cordero M, Reina Zoilo JJ, Alonso V, Rodríguez Salas N, Gil-Raga M, Santos C, Páez D, Anton-Pascual B, Aguilar F, Morales P. Real-world study on microsatellite instability and mismatch repair deficiency testing patterns among patients with metastatic colorectal cancer in Spain. Clin Transl Oncol 2024; 26:864-871. [PMID: 37651021 PMCID: PMC10981578 DOI: 10.1007/s12094-023-03309-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 08/11/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE Clinical practice guidelines recommend that all patients with metastatic colorectal cancer (mCRC) should be tested for mismatch repair deficiency (dMMR) or microsatellite instability-high (MSI-H). We aimed to describe the dMMR/MSI-H testing practice in patients with mCRC in Spanish centers. METHODS Multicenter, observational retrospective study that included patients newly diagnosed with mCRC or who progressed to a metastatic stage from early/localized stages. RESULTS Three hundred patients were included in the study from May 2020 through May 2021, with a median age of 68 years, and two hundred twenty-five (75%) had stage IV disease at initial diagnosis; two hundred eighty-four patients received first-line treatment, and dMMR/MSI-H testing was performed in two hundred fifty-one (84%) patients. The results of the dMMR/MSI-H tests were available in 61 (24%) of 251 patients before the diagnosis of metastatic disease and in 191 (81%) of 236 evaluable patients for this outcome before the initiation of first-line treatment. Among the 244 patients who were tested for dMMR/MSI-H with IHC or PCR, 14 (6%) were MMR deficient. The most frequent type of first-line treatment was the combination of chemotherapy and biological agent, that was received by 71% and 50% of patients with MMR proficient and deficient tumors, respectively, followed by chemotherapy alone, received in over 20% of patients in each subgroup. Only 29% of dMMR/MSI-H tumors received first-line immunotherapy. CONCLUSION Our study suggests that a high proportion of patients with mCRC are currently tested for dMMR/MSI-H in tertiary hospitals across Spain. However, there is still room for improvement until universal testing is achieved. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Rocio Garcia-Carbonero
- Medical Oncology Department, Hospital Universitario 12 de Octubre, IIS Imas12, UCM, Av Cordoba S/N, 28041, Madrid, Spain.
| | | | - Rosario Vidal Tocino
- Medical Oncology Department, Complejo Asistencial Universitario de Salamanca, IBSAL, Salamanca, Spain
| | - Débora Contreras Toledo
- Medical Oncology Department, Hospital Universitario Central de Asturias, ISPA, Programa Doctorado en Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain
| | - Carles Pericay
- Medical Oncology Department, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - Ana Fernández Montes
- Medical Oncology Department, Complexo Hospitalario Universitario de Ourense, Ourense, Spain
| | - Esther Falcó
- Medical Oncology Department, Hospital Son Llatzer, Palma, Spain
| | | | | | - Vicente Alonso
- Medical Oncology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - Mireia Gil-Raga
- Medical Oncology Department, Hospital General Universitario de Valencia, Valencia, Spain
| | - Cristina Santos
- Medical Oncology Department, Institute Català d'Oncologia IDIBELL, L'Hospitalet, Barcelona, Spain
| | - David Páez
- Medical Oncology Department, U705 (CIBERER), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Beatriz Anton-Pascual
- Medical Oncology Department, Hospital Universitario 12 de Octubre, IIS Imas12, UCM, Av Cordoba S/N, 28041, Madrid, Spain
| | - Fernando Aguilar
- Medical Affairs Department, MSD Spain, C/Josefa Valcarcel, 38, 28027, Madrid, Spain.
| | - Pilar Morales
- Medical Affairs Department, MSD Spain, C/Josefa Valcarcel, 38, 28027, Madrid, Spain
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Ding H, Lin J, Xu Z, Wang HHX, Huang L, Huang J, Wong MCS. The association between organised colorectal cancer screening strategies and reduction of its related mortality: a systematic review and meta-analysis. BMC Cancer 2024; 24:365. [PMID: 38515013 PMCID: PMC10958856 DOI: 10.1186/s12885-024-12054-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 02/26/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND To assess the long-term association between organised colorectal cancer (CRC) screening strategies and CRC-relate mortality. METHODS We systematically reviewed studies on organised CRC screening through PubMed, Ovid Medline, Embase and Cochrane from the inception. We retrieved characteristics of organised CRC screening from included literature and matched mortality (over 50 years) of those areas from the International Agency for Research on Cancer in May 2023. The variations of mortality were reported via the age-standardised mortality ratio. A random-effects model was used to synthesis results. RESULTS We summarised 58 organised CRC screening programmes and recorded > 2.7 million CRC-related deaths from 22 countries where rollout screening programmes were performed. The CRC screening strategy with faecal tests (guaiac faecal occult blood test (gFOBT) or faecal immunochemical tests (FIT)) or colonoscopy as the primary screening offer was associated with a 41.8% reduction in mortality, which was higher than those offered gFOBT (4.4%), FIT (16.7%), gFOBT or FIT (16.2%), and faecal tests (gFOBT or FIT) or flexible sigmoidoscopy (16.7%) as primary screening test. The longer duration of screening was associated with a higher reduction in the pooled age-standardised mortality ratio. In particular, the pooled age-standardised mortality ratio became non-significant when the screening of FIT was implemented for less than 5 years. CONCLUSIONS A CRC screening programme running for > 5 years was associated with a reduction of CRC-related mortality. Countries with a heavy burden of CRC should implement sustainable, organised screening providing a choice between faecal tests and colonoscopy as a preferred primary test.
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Affiliation(s)
- Hanyue Ding
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Room 407, 4/F, Postgraduate Education Centre, Prince of Wales Hospital, 30-32 Ngan Shing Street, N. T., Shatin, Hong Kong, China
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jiaye Lin
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Room 407, 4/F, Postgraduate Education Centre, Prince of Wales Hospital, 30-32 Ngan Shing Street, N. T., Shatin, Hong Kong, China
| | - Zijun Xu
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Room 407, 4/F, Postgraduate Education Centre, Prince of Wales Hospital, 30-32 Ngan Shing Street, N. T., Shatin, Hong Kong, China
| | - Harry H X Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Liwen Huang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Room 407, 4/F, Postgraduate Education Centre, Prince of Wales Hospital, 30-32 Ngan Shing Street, N. T., Shatin, Hong Kong, China
| | - Junjie Huang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Room 407, 4/F, Postgraduate Education Centre, Prince of Wales Hospital, 30-32 Ngan Shing Street, N. T., Shatin, Hong Kong, China
| | - Martin C S Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Room 407, 4/F, Postgraduate Education Centre, Prince of Wales Hospital, 30-32 Ngan Shing Street, N. T., Shatin, Hong Kong, China.
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
- School of Public Health, Peking University, Beijing, China.
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Shelton J, Zotow E, Smith L, Johnson SA, Thomson CS, Ahmad A, Murdock L, Nagarwalla D, Forman D. 25 year trends in cancer incidence and mortality among adults aged 35-69 years in the UK, 1993-2018: retrospective secondary analysis. BMJ 2024; 384:e076962. [PMID: 38479774 PMCID: PMC10935512 DOI: 10.1136/bmj-2023-076962] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/19/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVE To examine and interpret trends in UK cancer incidence and mortality for all cancers combined and for the most common cancer sites in adults aged 35-69 years. DESIGN Retrospective secondary data analysis. DATA SOURCES Cancer registration data, cancer mortality and national population data from the Office for National Statistics, Public Health Wales, Public Health Scotland, Northern Ireland Cancer Registry, NHS England, and the General Register Office for Northern Ireland. SETTING 23 cancer sites were included in the analysis in the UK. PARTICIPANTS Men and women aged 35-69 years diagnosed with or who died from cancer between 1993 to 2018. MAIN OUTCOME MEASURES Change in cancer incidence and mortality age standardised rates over time. RESULTS The number of cancer cases in this age range rose by 57% for men (from 55 014 cases registered in 1993 to 86 297 in 2018) and by 48% for women (60 187 to 88 970) with age standardised rates showing average annual increases of 0.8% in both sexes. The increase in incidence was predominantly driven by increases in prostate (male) and breast (female) cancers. Without these two sites, all cancer trends in age standardised incidence rates were relatively stable. Trends for a small number of less common cancers showed concerning increases in incidence rates, for example, in melanoma skin, liver, oral, and kidney cancers. The number of cancer deaths decreased over the 25 year period, by 20% in men (from 32 878 to 26 322) and 17% in women (28 516 to 23 719); age standardised mortality rates reduced for all cancers combined by 37% in men (-2.0% per year) and 33% in women (-1.6% per year). The largest decreases in mortality were noted for stomach, mesothelioma, and bladder cancers in men and stomach and cervical cancers and non-Hodgkin lymphoma in women. Most incidence and mortality changes were statistically significant even when the size of change was relatively small. CONCLUSIONS Cancer mortality had a substantial reduction during the past 25 years in both men and women aged 35-69 years. This decline is likely a reflection of the successes in cancer prevention (eg, smoking prevention policies and cessation programmes), earlier detection (eg, screening programmes) and improved diagnostic tests, and more effective treatment. By contrast, increased prevalence of non-smoking risk factors are the likely cause of the observed increased incidence for a small number of specific cancers. This analysis also provides a benchmark for the following decade, which will include the impact of covid-19 on cancer incidence and outcomes.
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Affiliation(s)
| | - Ewa Zotow
- University College London, London, UK
| | - Lesley Smith
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | | | | | | | | | | | - David Forman
- Faculty of Medicine and Health, University of Leeds, Leeds, UK
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Lin P, Jiang F, Li X, Zhao Y, Shi Y, Liang Z. International trends in pulmonary hypertension mortality between 2001 and 2019: Retrospective analysis of the WHO mortality database. Heliyon 2024; 10:e26139. [PMID: 38384545 PMCID: PMC10879023 DOI: 10.1016/j.heliyon.2024.e26139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/06/2024] [Accepted: 02/08/2024] [Indexed: 02/23/2024] Open
Abstract
Background There are limited published data on mortality trends in pulmonary hypertension (PH) worldwide. The objective of this study was to assess the PH-related mortality and time trends in the general population over the past 20 years. Material and methods We used country-level PH mortality data from the World Health Organization (WHO) mortality database (2000-19), using the International Classification of Diseases, tenth revision (ICD-10) codes (I27.0, I27.2, I27.8, or I27.9). The average annual percentage changes (AAPCs) were calculated to describe mortality trends. Results Fifty-four countries were included in this study. Between 2017 and 2019, the average age-standardized death rates (per 100,000) were 0.80 and 0.87 for males and females, respectively. Joinpoint analyses revealed a decreasing PH mortality trend for the overall population from 2000 to 2019 (AAPC -3.2 [95% confidence interval (CI) -4.1 to -2.4]), which was consistent between males and females (males: AAPC -5.3 [95% CI -6.2 to -4.4], females: AAPC -1.7 [95% CI -2.4 to -0.9]). When the estimates were stratified by etiology, we found that the mortality rates from idiopathic pulmonary arterial hypertension (I27.0) and pulmonary heart disease (unspecified, I27.9) had decreased significantly, while the mortality rates in other secondary PH (I27.2) and other specified pulmonary heart diseases (I27.8) had significantly increased. In addition, there were substantial differences in mortality rates and time trends across countries. Conclusion Although an overall decrease in PH mortality trends over the past two decades, there were substantial differences across countries. For countries with high or rising mortality rates, more efforts are needed to reduce the mortality.
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Affiliation(s)
- Ping Lin
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Faming Jiang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Xiaoqian Li
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yuean Zhao
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Yujun Shi
- Institute of Clinical Pathology, Key Laboratory of Transplant Engineering and Immunology, NHC, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Zongan Liang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
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Luo CY, Su WC, Jiang HF, Luo LT, Shen DY, Su GQ. DPY30 promotes colorectal carcinoma metastasis by upregulating ZEB1 transcriptional expression. Cancer Cell Int 2023; 23:333. [PMID: 38115111 PMCID: PMC10731791 DOI: 10.1186/s12935-023-03126-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/06/2023] [Indexed: 12/21/2023] Open
Abstract
DPY30 belongs to the core subunit of components of the histone lysine methyltransferase complex, which is implicated in tumorigenesis, cell senescence, and other biological events. However, its contribution to colorectal carcinoma (CRC) progression and metastasis has yet to be elucidated. Therefore, this study aimed to investigate the biological function of DPY30 in CRC metastasis both in vitro and in vivo. Herein, our results revealed that DPY30 overexpression is significantly positively correlated with positive lymph nodes, epithelial-mesenchymal transition (EMT), and CRC metastasis. Moreover, DPY30 knockdown in HT29 and SW480 cells markedly decreased EMT progression, as well as the migratory and invasive abilities of CRC cells in vitro and lung tumor metastasis in vivo. Mechanistically, DPY30 increased histone H3K4me3 level and promoted EMT and CRC metastasis by upregulating the transcriptional expression of ZEB1. Taken together, our findings indicate that DPY30 may serve as a therapeutic target and prognostic marker for CRC.
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Affiliation(s)
- Chun-Ying Luo
- Medical College, Guangxi University, Nanning, 530004, Guangxi Province, People's Republic of China
- Department of Pathology, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, 533000, Guangxi Province, People's Republic of China
| | - Wei-Chao Su
- Fujian Psychiatric Center, Fujian Clinical Research Center for Mental Disorders, Xiamen Xianyue Hospital, Xianyue Hospital Affiliated With Xiamen Medical College, No. 55 Zhenhai Road, Xiamen, 361003, Fujian Province, People's Republic of China
| | - Hai-Feng Jiang
- Department of Colorectal Tumor Surgery, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University, No. 55 Zhenhai Road, Xiamen, 361003, Fujian Province, People's Republic of China
| | - Ling-Tao Luo
- Department of Colorectal Tumor Surgery, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University, No. 55 Zhenhai Road, Xiamen, 361003, Fujian Province, People's Republic of China
| | - Dong-Yan Shen
- Xiamen Cell Therapy Research Center, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University, Xiamen, 361003, Fujian Province, People's Republic of China.
| | - Guo-Qiang Su
- Medical College, Guangxi University, Nanning, 530004, Guangxi Province, People's Republic of China.
- Department of Colorectal Tumor Surgery, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University, No. 55 Zhenhai Road, Xiamen, 361003, Fujian Province, People's Republic of China.
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Anderson SM, Sears CL. The Role of the Gut Microbiome in Cancer: A Review, With Special Focus on Colorectal Neoplasia and Clostridioides difficile. Clin Infect Dis 2023; 77:S471-S478. [PMID: 38051969 PMCID: PMC10697667 DOI: 10.1093/cid/ciad640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Indexed: 12/07/2023] Open
Abstract
The gut microbiome has coevolved with humans to aid in physiologic functions and prevent disease. An increasing prevalence of gut dysbiosis in modern society exists and has strong linkages to multiple disease processes common in the developed world. Mechanisms for microbiome-human interactions that impact host homeostasis include bacterial metabolite/toxin production, biofilm formation with mucous layer infiltration, and host immune system modulation. Most of this crosstalk occurs at the epithelial layer of the gut, and as such the role of these interactions in the induction of colorectal cancer-a highly prevalent disease globally and one undergoing significant epidemiologic shifts-is under increasing scrutiny. Although multiple individual gut bacteria have been hypothesized as possible driver organisms in the oncogenic process, no bacterium has been definitively identified as a causal agent of colorectal cancer, suggesting that host lifestyle factors, microbiome community interactions, and the mucosal and/or systemic immune response may play a critical role in the process. Recent evidence has emerged implicating the ubiquitous human pathogen Clostridioides difficile as a possible promoter of colorectal cancer through chronic toxin-mediated cellular changes. Although much remains to be defined regarding the natural history of infections caused by this pathogen and its potential for oncogenesis, it provides a strong model for the role of both individual bacteria and of the gut microbial community as a whole in the development of colorectal cancer.
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Affiliation(s)
- Sean M Anderson
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Cynthia L Sears
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Veziant J, Bouché O, Aparicio T, Barret M, El Hajbi F, Lepilliez V, Lesueur P, Maingon P, Pannier D, Quero L, Raoul JL, Renaud F, Seitz JF, Serre AA, Vaillant E, Vermersch M, Voron T, Tougeron D, Piessen G. Esophageal cancer - French intergroup clinical practice guidelines for diagnosis, treatments and follow-up (TNCD, SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, ACHBT, SFP, RENAPE, SNFCP, AFEF, SFR). Dig Liver Dis 2023; 55:1583-1601. [PMID: 37635055 DOI: 10.1016/j.dld.2023.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 08/29/2023]
Abstract
INTRODUCTION This document is a summary of the French intergroup guidelines regarding the management of esophageal cancer (EC) published in July 2022, available on the website of the French Society of Gastroenterology (SNFGE) (www.tncd.org). METHODS This collaborative work was conducted under the auspices of several French medical and surgical societies involved in the management of EC. Recommendations were graded in three categories (A, B and C), according to the level of evidence found in the literature until April 2022. RESULTS EC diagnosis and staging evaluation are mainly based on patient's general condition assessment, endoscopy plus biopsies, TAP CT-scan and 18F FDG-PET. Surgery alone is recommended for early-stage EC, while locally advanced disease (N+ and/or T3-4) is treated with perioperative chemotherapy (FLOT) or preoperative chemoradiation (CROSS regimen) followed by immunotherapy for adenocarcinoma. Preoperative chemoradiation (CROSS regimen) followed by immunotherapy or definitive chemoradiation with the possibility of organ preservation are the two options for squamous cell carcinoma. Salvage surgery is recommended for incomplete response or recurrence after definitive chemoradiation and should be performed in an expert center. Treatment for metastatic disease is based on systemic therapy including chemotherapy, immunotherapy or combined targeted therapy according to biomarkers testing such as HER2 status, MMR status and PD-L1 expression. CONCLUSION These guidelines are intended to provide a personalised therapeutic strategy for daily clinical practice and are subject to ongoing optimization. Each individual case should be discussed by a multidisciplinary team.
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Affiliation(s)
- Julie Veziant
- Department of Digestive and Oncological Surgery, Claude Huriez Hospital, CHU Lille, University of Lille, Lille F-59000, France.
| | - Olivier Bouché
- Department of Digestive Oncology, CHU Reims, Reims, France
| | - T Aparicio
- Department of Gastroenterology and Digestive Oncology, AP-HP, Saint-Louis Hospital, Paris, France
| | - M Barret
- Gastroenterology Department, Cochin Hospital, APHP, Paris, France
| | - F El Hajbi
- Department of Oncology, Centre Oscar Lambret, Lille, France
| | - V Lepilliez
- Gastroenterology Department, Jean Mermoz Private Hospital, Ramsay Santé, Lyon, France
| | - P Lesueur
- Department of Radiation Oncology, Centre Guillaume le Conquérant, Le Havre, France
| | - P Maingon
- Department of Radiation Oncology, La Pitié-Salpêtrière, APHP, Sorbonne University, Paris, France
| | - D Pannier
- Department of Oncology, Centre Oscar Lambret, Lille, France
| | - L Quero
- Department of Radiation Oncology, Saint-Louis Hospital, APHP, Paris, France
| | - J L Raoul
- Department of Medical Oncology, Institut de Cancérologie de l'Ouest, Saint-Herblain, France
| | - F Renaud
- Department of Pathology, La Pitié-Salpêtrière, APHP, Sorbonne University, Paris, France
| | - J F Seitz
- Department of Digestive Oncology, La Timone, Aix Marseille Université, Marseille, France
| | - A A Serre
- Department of Radiotherapy, Centre Léon Bérard, Lyon, France
| | | | - M Vermersch
- Medical Imaging Department, Valencienne Hospital Centre, Valencienne 59300, France
| | - T Voron
- Department of General and Digestive Surgery, Sorbonne Université, AP-HP, Hôpital Saint Antoine, 184 rue du faubourg Saint-Antoine, Paris 75012, France
| | - D Tougeron
- Department of Gastro-Enterology and Hepatology, Poitiers University Hospital, Poitiers, France
| | - Guillaume Piessen
- Department of Digestive and Oncological Surgery, Claude Huriez Hospital, CHU Lille, University of Lille, Lille F-59000, France
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Kumarasamy G, Mohd Salim NH, Mohd Afandi NS, Hazlami Habib MA, Mat Amin ND, Ismail MN, Musa M. Glycoproteomics-based liquid biopsy: translational outlook for colorectal cancer clinical management in Southeast Asia. Future Oncol 2023; 19:2313-2332. [PMID: 37937446 DOI: 10.2217/fon-2023-0704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023] Open
Abstract
Colorectal cancer (CRC) signifies a significant healthcare challenge in Southeast Asia. Despite advancements in screening approaches and treatment modalities, significant medical gaps remain, ranging from prevention and early diagnosis to determining targeted therapy and establishing personalized approaches to managing CRC. There is a need to expand more validated biomarkers in clinical practice. An advanced technique incorporating high-throughput mass spectrometry as a liquid biopsy to unravel a repertoire of glycoproteins and glycans would potentially drive the development of clinical tools for CRC screening, diagnosis and monitoring, and it can be further adapted to the existing standard-of-care procedure. Therefore this review offers a perspective on glycoproteomics-driven liquid biopsy and its potential integration into the clinical care of CRC in the southeast Asia region.
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Affiliation(s)
- Gaayathri Kumarasamy
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Pulau Pinang, 11800, Malaysia
| | - Nurul Hakimah Mohd Salim
- Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia
| | - Nur Syafiqah Mohd Afandi
- Analytical Biochemistry Research Centre, Universiti Sains Malaysia, Bayan Lepas, Pulau Pinang, 11900, Malaysia
| | - Mohd Afiq Hazlami Habib
- Analytical Biochemistry Research Centre, Universiti Sains Malaysia, Bayan Lepas, Pulau Pinang, 11900, Malaysia
| | - Nor Datiakma Mat Amin
- Analytical Biochemistry Research Centre, Universiti Sains Malaysia, Bayan Lepas, Pulau Pinang, 11900, Malaysia
- Nature Products Division, Forest Research Institute Malaysia, Kepong, Selangor, 52109, Malaysia
| | - Mohd Nazri Ismail
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Pulau Pinang, 11800, Malaysia
- Analytical Biochemistry Research Centre, Universiti Sains Malaysia, Bayan Lepas, Pulau Pinang, 11900, Malaysia
| | - Marahaini Musa
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia
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11
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Fang G, Xu D, Zhang T, Qiu L, Gao X, Wang G, Miao Y. Effects of hsa_circ_0074854 on colorectal cancer progression, construction of a circRNA-miRNA-mRNA network, and analysis of immune infiltration. J Cancer Res Clin Oncol 2023; 149:15439-15456. [PMID: 37644235 PMCID: PMC10620273 DOI: 10.1007/s00432-023-05315-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE Circular RNAs have been demonstrated to be closely associated with the onset and metastasis of colorectal cancer. However, the roles and clinical diagnostic value of most circRNAs in colorectal cancer remain unclear. METHODS We detected the differential expression of circRNAs in CRC tissues and cells and investigated their relationship in conjunction with clinical pathological features. Additionally, we performed cellular functional experiments in CRC cell lines to explore the functions of circRNAs. To further validate the potential ceRNA network, qPCR was performed to assess the expression of miRNA and mRNA in CRC cells after differential expression of circRNAs knockdown. Furthermore, database analysis was utilized to explore the relationship between the predicted mRNAs and immune infiltration in CRC. RESULTS Our research findings indicate a positive correlation between hsa_circ_0074854 expression and advanced clinical pathological features, as well as an unfavorable prognosis. Knockdown of hsa_circ_0074854 was observed to inhibit proliferation and migration capabilities of colorectal cancer cells, affecting the cell cycle progression, and simultaneously promoting apoptosis. A competing endogenous RNA mechanism may exist among circRNAs, miRNAs, and mRNAs. Furthermore, the expression of target genes displayed correlations with the abundance of certain immune cells. CONCLUSION We propose a novel ceRNA network and evaluate the interplay between target genes and immune cells, providing novel insights for the diagnosis and targeted therapy of CRC.
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Affiliation(s)
- Guida Fang
- Department of Gastrointestinal Surgery, Clinical College of Lianyungang Second People's Hospital, Bengbu Medical College, Lianyungang, 222002, Jiangsu, China
| | - Dalai Xu
- Department of Gastrointestinal Surgery, Clinical College of Lianyungang Second People's Hospital, Bengbu Medical College, Lianyungang, 222002, Jiangsu, China
- Department of Gastrointestinal Surgery, The Second People's Hospital of Lianyungang City, Kangda College of Nanjing Medical University, Lianyungang, 222002, Jiangsu, China
| | - Tao Zhang
- Department of Gastrointestinal Surgery, Clinical College of Lianyungang Second People's Hospital, Bengbu Medical College, Lianyungang, 222002, Jiangsu, China
| | - Lei Qiu
- Department of Gastrointestinal Surgery, Clinical College of Lianyungang Second People's Hospital, Bengbu Medical College, Lianyungang, 222002, Jiangsu, China
- Department of Gastrointestinal Surgery, The Second People's Hospital of Lianyungang City, Kangda College of Nanjing Medical University, Lianyungang, 222002, Jiangsu, China
| | - Xuzhu Gao
- Department of Gastrointestinal Surgery, The Second People's Hospital of Lianyungang City, Kangda College of Nanjing Medical University, Lianyungang, 222002, Jiangsu, China
- Institute of Clinical Oncology, The Second People's Hospital of Lianyungang City (Cancer Hospital of Lianyungang), Lianyungang, 222002, Jiangsu, China
| | - Gang Wang
- Department of Gastrointestinal Surgery, Clinical College of Lianyungang Second People's Hospital, Bengbu Medical College, Lianyungang, 222002, Jiangsu, China.
- Department of Gastrointestinal Surgery, The Second People's Hospital of Lianyungang City, Kangda College of Nanjing Medical University, Lianyungang, 222002, Jiangsu, China.
| | - Yongchang Miao
- Department of Gastrointestinal Surgery, Clinical College of Lianyungang Second People's Hospital, Bengbu Medical College, Lianyungang, 222002, Jiangsu, China.
- Department of Gastrointestinal Surgery, The Second People's Hospital of Lianyungang City, Kangda College of Nanjing Medical University, Lianyungang, 222002, Jiangsu, China.
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12
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Fernandes DCR, Nelson D, Siriwardena AN, Law G, Andreyev HJN. Understanding colorectal cancer patient follow-up: a qualitative interview study. Support Care Cancer 2023; 31:634. [PMID: 37843671 DOI: 10.1007/s00520-023-08108-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/06/2023] [Indexed: 10/17/2023]
Abstract
PURPOSE There are increasing numbers of patients who have been treated for colorectal cancer (CRC) who struggle with ongoing physical and psychological symptoms. 'Cancer survivor' is often used to describe these patients but this terminology remains controversial. This study sought to understand the follow-up experience of CRC patients in the UK and identify the terminology they prefer following diagnosis and treatment. METHODS Purposeful sampling of patients from specialist CRC follow-up clinics was performed until data saturation was achieved. Two 1:1 semi-structured qualitative interviews were performed for each participant. Data were analysed thematically. RESULTS Seventeen participants, median age = 62, 53% male were interviewed. Several themes were identified. Of note, fear of cancer recurrence dominates patients' agendas at follow-up appointments. There are also clinical and administrative barriers to discussing symptoms including being embarrassed, feeling that their symptoms were not relevant or not having enough time to discuss issues. However, there are several methods which may improve this, such as through the use of video consultations and questionnaires. In addition, patients identified inadequate holistic support despite significant psychological and social distress. Our data suggest that labelling a diverse group of patients as 'cancer survivors' can be problematic. CONCLUSION It is important that clinicians systematically screen patients for symptoms that are known to occur following treatment. Clinicians and patients should have routine access to pathways and programmes that can support patients in navigating their life after cancer therapy.
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Affiliation(s)
- Darren C R Fernandes
- The Department of Gastroenterology, United Lincolnshire NHS Trust, Lincoln County Hospital, Lincoln, UK.
- Community and Health Research Unit, University of Lincoln, Lincoln, UK.
| | - David Nelson
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK
- Macmillan Cancer Support, London, UK
| | | | - Graham Law
- Lincoln Clinical Trials Unit, University of Lincoln, Lincoln, UK
- School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - H Jervoise N Andreyev
- The Department of Gastroenterology, United Lincolnshire NHS Trust, Lincoln County Hospital, Lincoln, UK
- The Biomedical Research Centre, Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, UK
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13
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Shin JK, Kang D, Kim S, Choi Y, Lee WY, Yun SH, Cho YB, Huh JW, Park YA, Cho J, Kim HC. Association Between Distress at Diagnosis and Disease-free Survival Among Patients With Resectable Colon Cancer: A Large Cohort Study. Ann Surg 2023; 278:e534-e539. [PMID: 36728535 DOI: 10.1097/sla.0000000000005791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study aimed to evaluate the association between distress at initial diagnosis and disease-free survival in patients with resectable colon cancer. SUMMARY BACKGROUND DATA Considerable research has examined the psychological impact of having a confirmed diagnosis of cancer, but relatively limited research has examined the impact of distress during the diagnostic phase on oncological outcomes. METHODS This is a retrospective cohort study. We included newly diagnosed colon cancer patients who had resectable surgery and underwent distress screening between July 2014 and July 2021 (N=1,362). The Korean versions of the Distress Thermometer were used to assess distress and related problems. Patients were categorized into 3 groups based on distress score: low (<4), moderate (4-7), and severe (≥8). The primary outcome was disease-free survival. RESULTS The mean distress was 5.1 (SD=2.4) and 61%, and 15% of patients had moderate and severe distress at diagnosis, respectively. The severe distress group was more likely to report fear, sadness, and concerns regarding insurance/finance, work, and childcare than the low distress group. Compared with the low distress group, the severe distress group had worse disease-free survival (Hazard Ratio=1.84, 95% CI=1.03, 3.29). The association was more evident in patients with stage IV disease (Hazard Ratio=2.53, 95% CI=1.02, 6.25). CONCLUSIONS A substantial number of patients with colon cancer experience distress at diagnosis, and severe distress has a negative impact on oncologic outcomes. Active monitoring and appropriate management of distress at diagnosis should be adopted at clinical settings.
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Affiliation(s)
- Jung Kyong Shin
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Danbee Kang
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Soohyun Kim
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Youngeun Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Woo Yong Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seong Hyeon Yun
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yong Beom Cho
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Wook Huh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon Ah Park
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Juhee Cho
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hee Cheol Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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14
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Shen Y, Wang D, Yuan T, Fang H, Zhu C, Qin J, Xu X, Zhang C, Liu J, Zhang Y, Wen Z, Tang J, Wang Z. Novel DNA methylation biomarkers in stool and blood for early detection of colorectal cancer and precancerous lesions. Clin Epigenetics 2023; 15:26. [PMID: 36803423 PMCID: PMC9938553 DOI: 10.1186/s13148-023-01443-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/07/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND Early detection and prevention of precancerous lesions can significantly reduce the morbidity and mortality of colorectal cancer (CRC). Here, we developed new candidate CpG site biomarkers for CRC and evaluated the diagnostic value of their expression in blood and stool samples of CRC and precancerous lesions. METHODS We analyzed 76 pairs of CRC and adjacent normal tissue samples, 348 stool samples, and 136 blood samples. Candidate biomarkers for CRC were screened using a bioinformatics database and identified using a quantitative methylation-specific PCR method. The methylation levels of the candidate biomarkers were validated using blood and stool samples. The divided stool samples were used to construct and validate a combined diagnostic model and to analyze the independent or combined diagnostic value of candidate biomarkers in stool samples of CRC and precancerous lesions. RESULTS Two candidate CpG site biomarkers for CRC, cg13096260 and cg12993163, were identified. Although both biomarkers demonstrated diagnostic performance to a certain extent when using blood samples, they showed better diagnostic value for different stages of CRC and AA with stool samples. CONCLUSIONS cg13096260 and cg12993163 detection in stool samples could be a promising approach for screening and early diagnosis of CRC and precancerous lesions.
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Affiliation(s)
- Yuguang Shen
- Department of Gastrointestinal Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dongyang Wang
- Department of Gastrointestinal Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tianli Yuan
- Department of Gastrointestinal Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongsheng Fang
- Department of Gastrointestinal Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chen Zhu
- Shanghai Biotechnology Corporation, Shanghai, China
| | - Juan Qin
- Shanghai Biotechnology Corporation, Shanghai, China
| | - Xiaojing Xu
- Shanghai Biotechnology Corporation, Shanghai, China
| | - Cheng Zhang
- Department of Gastrointestinal Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiahua Liu
- Department of Gastrointestinal Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuanruohan Zhang
- Department of Gastrointestinal Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhoujin Wen
- Department of Gastrointestinal Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian Tang
- Department of Gastrointestinal Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Zheng Wang
- Department of Gastrointestinal Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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15
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Hu H, Gong X, Xu K, Luo S, Gao W, Li B, Jing D. Risk factor analysis of malignant adenomas detected during colonoscopy. Front Med (Lausanne) 2023; 10:1106272. [PMID: 36844218 PMCID: PMC9945521 DOI: 10.3389/fmed.2023.1106272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 01/13/2023] [Indexed: 02/10/2023] Open
Abstract
Background Several studies have shown that colorectal adenomas are the most important precancerous lesions. The colonoscopic identification of groups with the high risk of malignant colorectal adenomas remains a controversial issue for clinicians. Aims To evaluate the basic characteristics of colorectal adenomas with malignancy risk using high-grade dysplasia (HGD) as an alternative marker for malignant transformation. Methods Data from Shanghai General Hospital between January 2017 and December 2021 were retrospectively analyzed. The primary outcome was the incidence of HGD in adenomas, which was used as a surrogate marker for the risk of malignancy. Odds ratios (ORs) for the HGD rate in adenomas were analyzed in relation to adenoma-related factors. Results A total of 9,646 patients identified with polyps during 57,445 screening colonoscopies were included in the study. Patients with flat polyps, sessile polyps, and pedunculated polyps represented 27.3% (N = 2,638), 42.7% (N = 4,114), and 30.0% (N = 2,894) of the total number, respectively. HGD was found in 2.41% (N = 97), 0.92% (N = 24), and 3.51% (N = 98) of sessile adenomas, flat adenomas, and pedunculated adenomas, respectively (P < 0.001). Multivariable logistic regression showed that polyp size (P < 0.001) but not shape (P > 0.8), was an independent predictor of HGD. Contrast to the diameter ≤1 cm, the OR value for diameters 1-2, 2-3, and >3 cm was 13.9, 49.3, and 161.6, respectively. The HGD incidence also increased in multiple adenomas (>3 vs. >1, ORs 1.582) and distal adenomas (distal vs. proximal adenomas, OR 2.252). Adenoma morphology (pedunculated vs. flat) was statistically significant in univariate analysis but not when size was included in the multivariate analysis. Besides, the incidence of HGD was also significantly higher in older patients (>64 vs. <50 years old, OR = 2.129). Sex (P = 0.681) was not statistically significant. All these associations were statistically significant (P < 0.05). Conclusion The malignant potential of polyps is mostly affected by their size but not by their shape. In addition, distal location, multiple adenomas, and advanced age were also correlated with malignant transformation.
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Affiliation(s)
- Hong Hu
- Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoyuan Gong
- Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kai Xu
- Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shenzheng Luo
- Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Gao
- Department of General Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Baiwen Li
- Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dadao Jing
- Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,*Correspondence: Dadao Jing,
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Onar O, Telkoparan-Akillilar P, Yildirim O. Clitocybe nebularis extract and 5‑fluorouracil synergistically inhibit the growth of HT-29 colorectal cancer cells by inducing the S phase arrest. 3 Biotech 2023; 13:48. [PMID: 36647531 PMCID: PMC9839933 DOI: 10.1007/s13205-023-03471-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/05/2023] [Indexed: 01/15/2023] Open
Abstract
Although 5-fluorouracil (5-FU) is an important anticancer agent for the treatment of colorectal cancer, drug resistance, and dose-related side effects limit the effectiveness of the treatment. Therefore, developing new pharmaceuticals with effective and low toxicity is critically necessary for cancer therapy. This study aimed to investigate the cytotoxic activity of the Clitocybe nebularis mushroom extract (CN) on HT-29 human colon cancer cells. A series of in vitro experiments were performed on the HT-29, Caco-2, and HEK-293 cells, which includes cytotoxicity, drug interaction, colony formation, cell cycle, and migration assays. In addition, qRT-PCR experiment was also performed to investigate the potential molecular mechanisms of action of CN on the proliferation of colon cancer cell line. Our results show that CN exhibited selective cytotoxic activity on HT-29 and Caco-2 colon cancer cells, whereas no cytotoxic effect was observed on normal HEK-293 cells. With the combination of CN and 5‑FU, their cytotoxic activity on HT-29 cells was significantly increased compared to their use alone. In addition, the combination of CN and 5-FU also showed synergistic anticancer activity through cell cycle arrest in the S phase. The results also show that p21, p27, and p53 expression levels increased as a result of CN treatment. Our in vitro findings show that CN has a synergistic effect with 5-FU by inhibiting cell proliferation of colon cancer cells and inducing cell cycle arrest in the S phase.
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Affiliation(s)
- Okan Onar
- Department of Biology, Faculty of Science, Ankara University, Ankara, Turkey
| | | | - Ozlem Yildirim
- Department of Biology, Faculty of Science, Ankara University, Ankara, Turkey
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Elmaghraby DA, Alshalla AA, Alyahyan A, Altaweel M, Al ben Hamad AM, Alhunfoosh KM, AlJuwaysim MF, Aljumah DJ, Albahrani MA. Public Knowledge, Practice, and Attitude Regarding Cancer Screening: A Community-Based Study in Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1114. [PMID: 36673870 PMCID: PMC9859105 DOI: 10.3390/ijerph20021114] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/01/2023] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
(1) Background: Cancer screening tests discover cancer at early stages, even before symptoms appear. When abnormal tissues or a malignant mass is found early, treatment and cure rates are improved. In late stages, the cancer may have grown and metastasized. This can negatively affect cancer treatment and reduce the overall survival rate. Screening tests are performed when a person is asymptomatic. Public awareness about cancer screening is crucial for the success of cancer screening programs and for consequently decreasing the morbidity and mortality rate due to cancer. (2) Aim: Assess the knowledge and perception of the community regarding cancer screening in Saudi Arabia. (3) Methodology: A descriptive cross-sectional study targeting the general population of Saudi Arabia was conducted from January to June 2022. The data were collected using a structured validated electronic questionnaire. The study questionnaire covered participants' personal data, medical history, source of data, and participants' knowledge, attitude, and practice items. The questionnaire was used as a digital survey and was distributed electronically to the target population. (4) Results: A total of 1313 participants completed the study questionnaire. The participants' ages ranged from 18 to 67 years, with a mean age of 28.3 ± 11.4 years old. Overall, 60.4% of the study participants knew about cancer screening. Regarding the benefits of cancer screening, 91.8% of the participants reported knowing that the early detection of cancer helps treatment, and 81.1% knew that the early detection of cancer improves treatment outcomes. Moreover, 441 (33.6%) of the participants had good knowledge regarding cancer and cancer screening, while 872 (66.4%) had poor levels of knowledge. Furthermore, 106 (8.1%) of the participants underwent cancer screening. (5) Conclusions: The study results revealed that participants' awareness regarding cancer and cancer screening was low, especially for approaches to reduce cancer risk. Additionally, the study participants' practice regarding cancer screening was low. The health care authority should plan for population-based efficacious cancer screening programs. In addition, cancer screening information and the benefits of early detection can be disseminated through social media to target the desired populations.
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Affiliation(s)
- Dalia Ahmed Elmaghraby
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al Hofuf 31982, Saudi Arabia
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18
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Tominaga T, Nonaka T, Oyama S, Takamura Y, Hashimoto S, Shiraishi T, Sawai T, Nagayasu T. Efficacy of Neutrophil-to-Lymphocyte Ratio for Cancer-Specific Survival in Elderly Patients with Localized Colon Cancer: A Single Center Propensity Score-Matched Analysis. Clin Exp Gastroenterol 2023; 16:1-9. [PMID: 36636228 PMCID: PMC9830562 DOI: 10.2147/ceg.s385207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/22/2022] [Indexed: 01/06/2023] Open
Abstract
Purpose The prognostic value of neutrophil-to-lymphocyte ratio (NLR) has been studied for colorectal cancer. Elderly patients in general tend to have comorbidities and decreased organ function that potentially influence the NLR score. The aim of this study was to investigate the relationship between NLR and cancer-specific survival in elderly patients with colon cancer, using a propensity score-matched analysis. Patients and Methods A total of 203 patients aged over 75 years who underwent curative resection for colon cancer and were diagnosed pathologically with stage II/III disease were eligible for entry to the study. Patients were divided into two groups according to NLR score: NLR-High (NLR≥4.5) group (NLR-H, n=60) and NLR-Low (NLR<4.5) group (NLR-L, n=143). After propensity score matching, 57 patients in each group were matched. Results Before matching, Charlson comorbidity index was significantly higher in the NLR-H group (4 vs 2, p<0.001). After matching, all factors were similar between the groups. The median follow-up period was 43 months (range, 1-160 months). Five-year relapse-free-survival (69.8% vs 87.3%, p=0.030) and cancer-specific survival (83.0% vs 96.0%, p=0.042) were significantly lower in the NLR-H group. Conclusion NLR appears to be a cancer-specific prognostic marker in elderly patients with colon cancer.
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Affiliation(s)
- Tetsuro Tominaga
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan,Correspondence: Tetsuro Tominaga, Department of Surgical Oncology, Nagasaki University Graduate School of Biological Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan, Tel +81-95-819-7304, Fax +81-95-819-7306, Email
| | - Takashi Nonaka
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Shosaburo Oyama
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Yuma Takamura
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Shintaro Hashimoto
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Toshio Shiraishi
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Terumitsu Sawai
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Takeshi Nagayasu
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
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Giannakou K, Lamnisos D. Small-Area Geographic and Socioeconomic Inequalities in Colorectal Cancer in Cyprus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:341. [PMID: 36612661 PMCID: PMC9819875 DOI: 10.3390/ijerph20010341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
Colorectal cancer (CRC) is one of the leading causes of death and morbidity worldwide. To date, the relationship between regional deprivation and CRC incidence or mortality has not been studied in the population of Cyprus. The objective of this study was to analyse the geographical variation of CRC incidence and mortality and its possible association with socioeconomic inequalities in Cyprus for the time period of 2000-2015. This is a small-area ecological study in Cyprus, with census tracts as units of spatial analysis. The incidence date, sex, age, postcode, primary site, death date in case of death, or last contact date of all alive CRC cases from 2000-2015 were obtained from the Cyprus Ministry of Health's Health Monitoring Unit. Indirect standardisation was used to calculate the sex and age Standardise Incidence Ratios (SIRs) and Standardised Mortality Ratios (SMRs) of CRC while the smoothed values of SIRs, SMRs, and Mortality to Incidence ratio (M/I ratio) were estimated using the univariate Bayesian Poisson log-linear spatial model. To evaluate the association of CRC incidence and mortality rate with socioeconomic deprivation, we included the national socioeconomic deprivation index as a covariate variable entering in the model either as a continuous variable or as a categorical variable representing quartiles of areas with increasing levels of socioeconomic deprivation. The results showed that there are geographical areas having 15% higher SIR and SMR, with most of those areas located on the east coast of the island. We found higher M/I ratio values in the rural, remote, and less dense areas of the island, while lower rates were observed in the metropolitan areas. We also discovered an inverted U-shape pattern in CRC incidence and mortality with higher rates in the areas classified in the second quartile (Q2-areas) of the socioeconomic deprivation index and lower rates in rural, remote, and less dense areas (Q4-areas). These findings provide useful information at local and national levels and inform decisions about resource allocation to geographically targeted prevention and control plans to increase CRC screening and management.
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20
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Li W, Yang G, Dong H, Zhu J, Liu T. A prognostic signature based on cuprotosis-related long non-coding RNAs predicts the prognosis and sensitivity to chemotherapy in patients with colorectal cancer. Front Med (Lausanne) 2022; 9:1055785. [PMCID: PMC9709405 DOI: 10.3389/fmed.2022.1055785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 10/17/2022] [Indexed: 11/17/2022] Open
Abstract
Cuprotosis, a newly proposed mechanism of cell death, can trigger acute oxidative stress that leads to cell death by mediating protein lipidation in the tricarboxylic acid cycle. However, cuprotosis-related long non-coding RNAs (CRLNCs) and their relationship with prognosis and the immunological landscape of colorectal cancer (CRC) are unclear. We have developed a lncRNA signature to predict survival time, immune infiltration, and sensitivity to chemotherapy. CRLNCs were screened using the Cor function of the R software and the differentially expressed lncRNAs were collected with the limma package. Differentially expressed long non-coding RNAs (lncRNAs) associated with prognosis were selected using univariate regression analysis. A prognostic signature was developed using the least absolute shrinkage and selection operator (LASSO) and multivariate regression analysis. Patients with CRC were divided into two groups based on the risk score. The low-risk group had a more favorable prognosis, higher expression of immune checkpoints, and a higher level of immune cell infiltration compared with the high-risk group. Furthermore, there was a close association between the risk score and the clinical stage, tumor mutational burden, cancer stem cell index, and microsatellite instability. We also assessed chemotherapy response in the two risk groups. Our study analyzed the role of CRLNCs in CRC and provided novel targets and strategies for CRC chemotherapy and immunotherapy.
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Affiliation(s)
- Wei Li
- Department of Colorectal and Anal Surgery, The Second Hospital of Jilin University, Changchun, China
| | - Guiyun Yang
- Department of Operating Room, The Second Hospital of Jilin University, Changchun, China
| | - Hao Dong
- Department of Gastrointestinal Nutrition and Hernia Surgery, The Second Hospital of Jilin University, Changchun, China
| | - Jiajing Zhu
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, China
- *Correspondence: Jiajing Zhu,
| | - Tongjun Liu
- Department of Colorectal and Anal Surgery, The Second Hospital of Jilin University, Changchun, China
- Tongjun Liu,
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21
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Rottoli M, Gori A, Pellino G, Flacco ME, Martellucci C, Spinelli A, Poggioli G. Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy. JAMA Netw Open 2022; 5:e2243119. [PMID: 36409496 PMCID: PMC9679872 DOI: 10.1001/jamanetworkopen.2022.43119] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95% CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95% CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95% CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients.
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Affiliation(s)
- Matteo Rottoli
- Surgery of the Alimentary Tract, IRCCS Azienda Ospedaliero–Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Alice Gori
- Surgery of the Alimentary Tract, IRCCS Azienda Ospedaliero–Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Gianluca Pellino
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
- Colorectal Surgery, University Hospital Vall d’Hebron, Barcelona, Spain
| | - Maria Elena Flacco
- Department of Environmental and Preventive Sciences, University of Ferrara, Ferrara, Italy
| | - Cecilia Martellucci
- Department of Environmental and Preventive Sciences, University of Ferrara, Ferrara, Italy
| | - Antonino Spinelli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Colorectal Surgery, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Gilberto Poggioli
- Surgery of the Alimentary Tract, IRCCS Azienda Ospedaliero–Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
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22
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Rao HB, Sastry NB, Venu RP, Pattanayak P. The role of artificial intelligence based systems for cost optimization in colorectal cancer prevention programs. Front Artif Intell 2022; 5:955399. [PMID: 36248620 PMCID: PMC9563712 DOI: 10.3389/frai.2022.955399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 08/16/2022] [Indexed: 11/13/2022] Open
Abstract
Colorectal Cancer (CRC) has seen a dramatic increase in incidence globally. In 2019, colorectal cancer accounted for 1.15 million deaths and 24.28 million disability-adjusted life-years (DALYs) worldwide. In India, the annual incidence rates (AARs) for colon cancer was 4.4 per 100,000. There has been a steady rise in the prevalence of CRC in India which may be attributed to urbanization, mass migration of population, westernization of diet and lifestyle practices and a rise of obesity and metabolic risk factors that place the population at a higher risk of CRC. Moreoever, CRC in India differs from that described in the Western countries, with a higher proportion of young patients and more patients presenting with an advanced stage. This may be due to poor access to specialized healthcare and socio-economic factors. Early identification of adenomatous colonic polyps, which are well-recognized pre-cancerous lesions, at the time of screening colonoscopy has been shown to be the most effective measure used for CRC prevention. However, colonic polyps are frequently missed during colonoscopy and moreover, these screening programs necessitate man-power, time and resources for processing resected polyps, that may hamper penetration and efficacy in mid- to low-income countries. In the last decade, there has been significant progress made in the automatic detection of colonic polyps by multiple AI-based systems. With the advent of better AI methodology, the focus has shifted from mere detection to accurate discrimination and diagnosis of colonic polyps. These systems, once validated, could usher in a new era in Colorectal Cancer (CRC) prevention programs which would center around “Leave in-situ” and “Resect and discard” strategies. These new strategies hinge around the specificity and accuracy of AI based systems in correctly identifying the pathological diagnosis of the polyps, thereby providing the endoscopist with real-time information in order to make a clinical decision of either leaving the lesion in-situ (mucosal polyps) or resecting and discarding the polyp (hyperplastic polyps). The major advantage of employing these strategies would be in cost optimization of CRC prevention programs while ensuring good clinical outcomes. The adoption of these AI-based systems in the national cancer prevention program of India in accordance with the mandate to increase technology integration could prove to be cost-effective and enable implementation of CRC prevention programs at the population level. This level of penetration could potentially reduce the incidence of CRC and improve patient survival by enabling early diagnosis and treatment. In this review, we will highlight key advancements made in the field of AI in the identification of polyps during colonoscopy and explore the role of AI based systems in cost optimization during the universal implementation of CRC prevention programs in the context of mid-income countries like India.
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Affiliation(s)
- Harshavardhan B. Rao
- Department of Gastroenterology, M.S. Ramaiah Medical College, Ramaiah University of Applied Sciences, Bangalore, Karnataka, India
- *Correspondence: Harshavardhan B. Rao
| | - Nandakumar Bidare Sastry
- Department of Gastroenterology, M.S. Ramaiah Medical College, Ramaiah University of Applied Sciences, Bangalore, Karnataka, India
| | - Rama P. Venu
- Department of Gastroenterology, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Preetiparna Pattanayak
- Department of Gastroenterology, M.S. Ramaiah Medical College, Ramaiah University of Applied Sciences, Bangalore, Karnataka, India
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23
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Liu Y, Li X, Pen R, Zuo W, Chen Y, Sun X, Gou J, Guo Q, Wen M, Li W, Yu S, Liu H, Huang M. Targeted delivery of irinotecan to colon cancer cells using epidermal growth factor receptor-conjugated liposomes. Biomed Eng Online 2022; 21:53. [PMID: 35918704 PMCID: PMC9344698 DOI: 10.1186/s12938-022-01012-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 05/02/2022] [Indexed: 12/31/2022] Open
Abstract
Background CPT-11 (irinotecan) is one of the most efficient agents used for colorectal cancer chemotherapy. However, as for many other chemotherapeutic drugs, how to minimize the side effects of CPT-11 still needs to be thoroughly described. Objectives This study aimed to develop the CPT-11-loaded DSPE-PEG 2000 targeting EGFR liposomal delivery system and characterize its targeting specificity and therapeutic effect on colorectal cancer (CRC) cells in vitro and in vivo. Results The synthesized liposome exhibited spherical shapes (84.6 ± 1.2 nm to 150.4 nm ± 0.8 nm of estimated average sizes), good stability, sustained release, and enough drug loading (55.19%). For in vitro experiments, SW620 cells treated with CPT-11-loaded DSPE-PEG2000 targeting EGFR liposome showed lower survival extended level of intracellular ROS production. In addition, it generated an enhanced apoptotic cell rate by upregulating the protein expression of both cleaved-caspase-3 and cleaved-caspase-9 compared with those of SW620 cells treated with free CPT-11. Importantly, the xenograft model showed that both the non-target and EGFR-targeted liposomes significantly inhibited tumor growth compared to free CPT-11. Conclusions Compared with the non-target CPT-11-loaded DSPE-PEG2000 liposome, CPT-11-loaded DSPE-PEG2000 targeting EGFR liposome treatment showed much better antitumor activity in vitro in vivo. Thus, our findings provide new assets and expectations for CRC targeting therapy. Supplementary Information The online version contains supplementary material available at 10.1186/s12938-022-01012-8.
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Affiliation(s)
- Yongwei Liu
- Department of Infection, Rongchang District People's Hospital of Chongqing, No.11 Changyuan St Square North Rd, Rongchang District, Chongqing, 402460, China.
| | - Xinghui Li
- Department of Digestion, Rongchang District People's Hospital of Chongqing, No.11 Changyuan St Square North Rd, Rongchang District, Chongqing, 402460, China
| | - Renqun Pen
- Department of Digestion, Rongchang District People's Hospital of Chongqing, No.11 Changyuan St Square North Rd, Rongchang District, Chongqing, 402460, China
| | - Wei Zuo
- Department of Digestion, Rongchang District People's Hospital of Chongqing, No.11 Changyuan St Square North Rd, Rongchang District, Chongqing, 402460, China
| | - Ya Chen
- Department of Digestion, Rongchang District People's Hospital of Chongqing, No.11 Changyuan St Square North Rd, Rongchang District, Chongqing, 402460, China
| | - Xiuying Sun
- Department of Digestion, Rongchang District People's Hospital of Chongqing, No.11 Changyuan St Square North Rd, Rongchang District, Chongqing, 402460, China
| | - Juhua Gou
- Department of Digestion, Rongchang District People's Hospital of Chongqing, No.11 Changyuan St Square North Rd, Rongchang District, Chongqing, 402460, China
| | - Qianwen Guo
- Department of Digestion, Rongchang District People's Hospital of Chongqing, No.11 Changyuan St Square North Rd, Rongchang District, Chongqing, 402460, China
| | - Maoling Wen
- Department of Digestion, Rongchang District People's Hospital of Chongqing, No.11 Changyuan St Square North Rd, Rongchang District, Chongqing, 402460, China
| | - Wuqi Li
- Department of Digestion, Rongchang District People's Hospital of Chongqing, No.11 Changyuan St Square North Rd, Rongchang District, Chongqing, 402460, China
| | - Shuangjiang Yu
- Department of Neurosurgery, The First Hospital Affiliated to Army Military Medical University (Southwest Hospital), Chongqing, 400038, China
| | - Hao Liu
- Department of Digestion, Rongchang District People's Hospital of Chongqing, No.11 Changyuan St Square North Rd, Rongchang District, Chongqing, 402460, China.
| | - Min Huang
- Department of Digestion, The Affiliated Hospital of North Sichuan Medical College, No.1, MaoYuan South Rd, Shunqing District, Nanchong, 637000, Sichuan, China.
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24
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Weng X, Liu H, Ruan J, Du M, Wang L, Mao J, Cai Y, Lu X, Chen W, Huang Y, Zhi X, Shan J. HOTAIR/miR-1277-5p/ZEB1 axis mediates hypoxia-induced oxaliplatin resistance via regulating epithelial-mesenchymal transition in colorectal cancer. Cell Death Dis 2022; 8:310. [PMID: 35798695 PMCID: PMC9263107 DOI: 10.1038/s41420-022-01096-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 06/03/2022] [Accepted: 06/20/2022] [Indexed: 01/19/2023]
Abstract
The hypoxic microenvironment contributes to the chemoresistance of many malignant tumors including colorectal cancer (CRC). Accumulating studies have indicated that long non-coding RNAs (lncRNAs) play important roles in chemotherapy resistance. In this study, we aimed to determine the effect of lncRNAs in hypoxia-mediated resistance in CRC and its potential mechanism. Here, we discovered that hypoxia-induced oxaliplatin resistance and HOX transcript antisense RNA (HOTAIR) expression was increased in hypoxia-treated CRC cell lines and CRC tumors. Knockdown of HOTAIR by siRNA reduced the viability and proliferation of CRC cells treated with oxaliplatin and reversed hypoxia-induced resistance. Mechanically, we found that HOTAIR modulates zinc finger E-box binding homeobox 1 (ZEB1) expression by negative regulations of miR-1277-5p. When miR-1277-5p was silenced, knockdown of HOTAIR was unable to reduce the oxaliplatin resistance in CRC cells. In mouse models of CRC, HOTAIR knockdown markedly inhibited the tumor growth when treated with oxaliplatin. Thus, HOTAIR/miR-1277-5p/ZEB1 axis appears a promising therapeutic target for improving the oxaliplatin efficacy in CRC.
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Affiliation(s)
- Xingyue Weng
- Department of Medical Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Hao Liu
- Cancer Institute of Integrated Traditional Chinese and Western Medicine, Zhejiang Academy of Traditional Chinese Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang, China
| | - Jian Ruan
- Department of Medical Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Miaoyan Du
- Department of Medical Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Lingjie Wang
- Department of Medical Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Jiayan Mao
- Cancer Institute of Integrated Traditional Chinese and Western Medicine, Zhejiang Academy of Traditional Chinese Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang, China
| | - Ying Cai
- Cancer Institute of Integrated Traditional Chinese and Western Medicine, Zhejiang Academy of Traditional Chinese Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang, China
| | - Xuemei Lu
- Cancer Institute of Integrated Traditional Chinese and Western Medicine, Zhejiang Academy of Traditional Chinese Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang, China
| | - Wei Chen
- Cancer Institute of Integrated Traditional Chinese and Western Medicine, Zhejiang Academy of Traditional Chinese Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang, China
| | - Yaqing Huang
- Reproductive Medicine Center, Department of Gynecology and Obstetrics, Zhejiang Provincial Peoples Hospital, Affiliated Peoples Hospital, Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China
| | - Xiao Zhi
- Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
| | - Jianzhen Shan
- Department of Medical Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
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25
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Sharma R. A comparative examination of colorectal cancer burden in European Union, 1990-2019: Estimates from Global Burden of Disease 2019 Study. Int J Clin Oncol 2022; 27:1309-1320. [PMID: 35590123 DOI: 10.1007/s10147-022-02182-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 04/25/2022] [Indexed: 12/13/2022]
Abstract
AIM This study examines the burden of colorectal cancer (CRC) in European Union (EU) countries in the last 3 decades. METHODS The data pertaining to CRC burden were procured from the Global Burden of Disease 2019 Study for 28 EU countries (including United Kingdom) for the period 1990-2019. The age-standardized rates of CRC were utilized to compare the country-wise burden and joinpoint regression models were applied to examine the trends. RESULTS In EU, CRC incident cases increased by 70.2% from 261,306 to 444,872 and deaths increased by 36.8% from 155,823 to 213,174 between 1990 and 2019. The age-standardized incidence rate (ASIR) increased by 11.9% from 37.8/100,000 to 42.3/100,000 between 1990 and 2019; in contrast, the age-standardized mortality rate (ASMR) decreased by 16.9% (1990: 22.4/100,000; 2019: 18.6/100,000) and age-standardized DALYs rate (ASDALR) decreased by 18.6% (1990: 472.9/100,000; 2019: 385.1/100,000) in the study period. In 2019, Hungary was the leading country in terms of ASMR (28.6/100,000) and ASDALR (630.3/100,000), and Lithuania (29.2/100,000) had the lowest ASIR, whereas Finland had the lowest ASMR (12.3/100,000) and ASDALR (253.6/100,000) in 2019. CONCLUSION CRC incidence is increasing in EU and mortality rates, although decreasing, are still unacceptably high. CRC control efforts must be focused around early detection using screening and prevention through reduction of modifiable risk factors. Increasing CRC incidence rates in young adults in recent years requires more research to pinpoint risk factors, and there must be more awareness of this recent development among general public and clinicians.
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Affiliation(s)
- Rajesh Sharma
- University School of Management and Entrepreneurship, Delhi Technological University, East Delhi Campus, Room No. 305, Vivek Vihar Phase II, Delhi, 110095, India.
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26
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Zou Y, Liu L, Meng J, Dai M. Circular RNA circ_0068464 combined with microRNA-383 regulates Wnt/β-catenin pathway to promote the progression of colorectal cancer. Bioengineered 2022; 13:5113-5125. [PMID: 35168468 PMCID: PMC8974116 DOI: 10.1080/21655979.2022.2036905] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/26/2022] [Accepted: 01/26/2022] [Indexed: 01/25/2023] Open
Abstract
This study was to clarify the influence and mechanism of circular RNA hsa_circ_0068464 (circ_0068464) on the development of colorectal cancer (CRC). First, we combined bioinformatics analysis and the high-throughput sequencing to determine the expression profile of circRNAs in CRC dataset, and screened out the differentially expressed circ_0068464. Subsequently, qRT-PCR was utilized to measure circ_0068464 expression in CRC and normal cancer-adjacent tissues, CRC cell lines (SW480, SW620, HT29, LS174T and HCT116) and human fetal intestinal epithelial cell (FHC). The results revealed that circ_0068464 was abnormally up-regulated in CRC cells and tissues. Knockdown of circ_0068464 could inhibit CRC cell migration and proliferation and promoted apoptosis while suppressing the expression of Wnt/β-catenin pathway-related proteins (β-catenin, cyclin D1, C-myc and LEF-1). In addition, tumorigenic assays in nude mice confirmed that circ_0068464 downregulation significantly inhibited tumor growth and lung metastasis. Further, the binding interaction between circ_0068464 and microRNA-383 (miR-383) was verified by dual-luciferase assay and RNA immunoprecipitation assay. And miR-383 was significantly down-regulated in CRC tissues and cells. Interfering with miR-383 expression reversed the inhibitory effect of circ_0068464 knockdown on CRC cells. In conclusion, circ_0068464 targets miR-383 to regulate Wnt/β-catenin pathway activation, thereby promoting the development of CRC.
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Affiliation(s)
- Yan Zou
- Medical Science Laboratory, The Fourth Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | - Limin Liu
- Medical Science Laboratory, The Fourth Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | - Jie Meng
- Medical Science Laboratory, The Fourth Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | - Meiyu Dai
- Medical Science Laboratory, The Fourth Affiliated Hospital of Guangxi Medical University, Guangxi, China
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27
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Quintana JM, Anton-Ladislao A, Lázaro S, Gonzalez N, Bare M, Fernandez-de-Larrea N, Redondo M, Escobar A, Sarasqueta C, Garcia-Gutierrez S, Aguirre U. Effect of comorbidities on long-term outcomes of colorectal cancer patients. Eur J Cancer Care (Engl) 2022; 31:e13561. [PMID: 35174571 DOI: 10.1111/ecc.13561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 09/09/2021] [Accepted: 01/26/2022] [Indexed: 01/20/2023]
Abstract
OBJECTIVE The objective of this work is to evaluate the association of comorbidities with various outcomes in patients diagnosed with colon or rectal cancer. METHODS We conducted a prospective cohort study of patients diagnosed with colon or rectal cancer who underwent surgery. Data were gathered on sociodemographic, clinical characteristics, disease course, and the EuroQol EQ-5D and EORTC QLQ-C30 scores, up to 5 years after surgery. The main outcomes of the study were mortality, complications, readmissions, reoperations, and changes in PROMs up to 5 years. Multivariable multilevel logistic regression models were used in the analyses. RESULTS Mortality at some point during the 5-year follow-up was related to cardiocerebrovascular, hemiplegia and/or stroke, chronic obstructive pulmonary disease (COPD), diabetes, cancer, and dementia. Similarly, complications were related to cardiovascular disease, COPD, diabetes, hepatitis, hepatic or renal pathologies, and dementia; readmissions to cardiovascular disease, COPD, and hepatic pathologies; and reoperations to cerebrovascular and diabetes. Finally, changes in EQ-5D scores at some point during follow-up were related to cardiocerebrovascular disease, COPD, diabetes, pre-existing cancer, hepatic and gastrointestinal pathologies, and changes in EORTC QLQ-C30 scores to cardiovascular disease, COPD, diabetes, and hepatic and gastrointestinal pathologies. CONCLUSIONS Optimising the management of the comorbidities most strongly related to adverse outcomes may help to reduce those events in these patients.
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Affiliation(s)
- José M Quintana
- Unidad de Investigación, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, 48960, Spain.,Instituto de Salud Carlos III, Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, 48960, Spain
| | - Ane Anton-Ladislao
- Unidad de Investigación, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, 48960, Spain.,Instituto de Salud Carlos III, Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, 48960, Spain
| | - Santiago Lázaro
- Instituto de Salud Carlos III, Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, 48960, Spain.,Servicio de Cirugía General, Hospital Basurto, Bilbao, Bizkaia, Spain
| | - Nerea Gonzalez
- Unidad de Investigación, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, 48960, Spain.,Instituto de Salud Carlos III, Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, 48960, Spain
| | - Marisa Bare
- Instituto de Salud Carlos III, Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, 48960, Spain.,Unidad de Epidemiología Clínica, Corporacio Parc Tauli, Barcelona, Spain
| | - Nerea Fernandez-de-Larrea
- Centro Nacional de Epidemiología, ISCIII, Madrid, Spain.,Instituto de Salud Carlos III, CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Maximino Redondo
- Instituto de Salud Carlos III, Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, 48960, Spain.,Unidad de Investigación, Hospital Costa del Sol, Malaga, Spain
| | - Antonio Escobar
- Instituto de Salud Carlos III, Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, 48960, Spain.,Unidad de Investigación, Hospital Basurto, Bilbao, Bizkaia, Spain
| | - Cristina Sarasqueta
- Instituto de Salud Carlos III, Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, 48960, Spain.,Unidad de Investigación, Hospital Donostia/BioDonostia, Donostia, Guipuzkoa, Spain
| | - Susana Garcia-Gutierrez
- Unidad de Investigación, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, 48960, Spain.,Instituto de Salud Carlos III, Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, 48960, Spain
| | - Urko Aguirre
- Unidad de Investigación, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, 48960, Spain.,Instituto de Salud Carlos III, Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, 48960, Spain
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Dissecting the Mechanism of Action of Spiperone-A Candidate for Drug Repurposing for Colorectal Cancer. Cancers (Basel) 2022; 14:cancers14030776. [PMID: 35159043 PMCID: PMC8834219 DOI: 10.3390/cancers14030776] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/25/2022] [Accepted: 01/29/2022] [Indexed: 02/05/2023] Open
Abstract
Simple Summary Despite advances in primary and adjuvant treatments, approximately 50% of colorectal cancer (CRC) patients still die from recurrence and metastatic disease. Thus, alternative and more effective therapeutic approaches are expected to be developed. Drug repurposing is increasing interest in cancer therapy, as it represents a cheaper and faster alternative strategy to de novo drug synthesis. Psychiatric medications are promising as a new generation of antitumor drugs. Here, we demonstrate that spiperone—a licensed drug for the treatment of schizophrenia—induces apoptosis in CRC cells. Our data reveal that spiperone’s cytotoxicity in CRC cells is mediated by phospholipase C activation, intracellular calcium homeostasis dysregulation, and irreversible endoplasmic reticulum stress induction, resulting in lipid metabolism alteration and Golgi apparatus damage. By identifying new targetable pathways in CRC cells, our findings represent a promising starting point for the design of novel therapeutic strategies for CRC. Abstract Approximately 50% of colorectal cancer (CRC) patients still die from recurrence and metastatic disease, highlighting the need for novel therapeutic strategies. Drug repurposing is attracting increasing attention because, compared to traditional de novo drug discovery processes, it may reduce drug development periods and costs. Epidemiological and preclinical evidence support the antitumor activity of antipsychotic drugs. Herein, we dissect the mechanism of action of the typical antipsychotic spiperone in CRC. Spiperone can reduce the clonogenic potential of stem-like CRC cells (CRC-SCs) and induce cell cycle arrest and apoptosis, in both differentiated and CRC-SCs, at clinically relevant concentrations whose toxicity is negligible for non-neoplastic cells. Analysis of intracellular Ca2+ kinetics upon spiperone treatment revealed a massive phospholipase C (PLC)-dependent endoplasmic reticulum (ER) Ca2+ release, resulting in ER Ca2+ homeostasis disruption. RNA sequencing revealed unfolded protein response (UPR) activation, ER stress, and induction of apoptosis, along with IRE1-dependent decay of mRNA (RIDD) activation. Lipidomic analysis showed a significant alteration of lipid profile and, in particular, of sphingolipids. Damage to the Golgi apparatus was also observed. Our data suggest that spiperone can represent an effective drug in the treatment of CRC, and that ER stress induction, along with lipid metabolism alteration, represents effective druggable pathways in CRC.
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Machado P, Morgado M, Raposo J, Mendes M, Silva CG, Morais N. Effectiveness of exercise training on cancer-related fatigue in colorectal cancer survivors: a systematic review and meta-analysis of randomized controlled trials. Support Care Cancer 2022; 30:5601-5613. [PMID: 35107601 DOI: 10.1007/s00520-022-06856-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 01/19/2022] [Indexed: 10/19/2022]
Abstract
PURPOSE To investigate the effects of exercise training on cancer-related fatigue (CRF) in colorectal cancer survivors. METHODS Randomized controlled trials published between 1 January 2010 and 19 October 2020, selected through online search conducted in PubMed, Scopus, Web of Science, SPORTDiscus and PEDro databases, were included. Eligible trials compared the effect of exercise training interventions, versus non-exercise controls on CRF, in colorectal cancer survivors, during or after treatment. The methodological quality of individual studies was analysed using the Physiotherapy Evidence Database (PEDro) scale. Standardized mean differences (SMD) that were pooled using random-effects models were included as the effect size. In addition, 95% prediction intervals (PI) were calculated. RESULTS Six trials involving 330 colorectal cancer patients met the inclusion criteria and presented reasonable to good methodological quality. An overall small-to-moderate effect of exercise training on CRF was found (SMD = - 0.29: 95% CI: [- 0.53; - 0.06]; p = 0.01; PI: [- 0.63; 0.04]; low-quality evidence). Subgroup analysis revealed moderate effects of exercise interventions performed during chemotherapy (SMD = - 0.63; 95% CI: [- 1.06; - 0.21]; p = 0.003) and small, non-significant effects, when exercise training was performed after cancer treatment (SMD = - 0.14; 95% CI: [- 0.43; 0.14]; p = 0.32). Steady improvements were achieved when a combination of aerobic plus resistance exercise was used, in interventions lasting 12 to 24 weeks. CONCLUSION Exercise training could be regarded as a supportive therapy for the clinical management of CRF in colorectal cancer patients undergoing chemotherapy, but further studies are necessary to clarify the effects of exercise interventions on CRF after cancer treatment.
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Affiliation(s)
- Pedro Machado
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Leiria, Portugal. .,University of Coimbra, Research Unit for Sport and Physical Activity (CIDAF, UID/PTD/04213/2019), Faculty of Sport Sciences and Physical Education, Coimbra, Portugal. .,School of Health Sciences (ESSLei), Polytechnic of Leiria, Leiria, Portugal.
| | - Miguel Morgado
- School of Health Sciences (ESSLei), Polytechnic of Leiria, Leiria, Portugal
| | - João Raposo
- School of Health Sciences (ESSLei), Polytechnic of Leiria, Leiria, Portugal
| | - Marco Mendes
- School of Health Sciences (ESSLei), Polytechnic of Leiria, Leiria, Portugal
| | - Cândida G Silva
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Leiria, Portugal.,School of Health Sciences (ESSLei), Polytechnic of Leiria, Leiria, Portugal.,Coimbra Chemistry Centre, Institute of Molecular Sciences (CQC-IMS), Department of Chemistry, University of Coimbra, Coimbra, Portugal
| | - Nuno Morais
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Leiria, Portugal.,Saúde Positiva, Clínica de Saúde Física e Mental, Aveiro, Portugal.,School of Health Sciences (ESSLei), Polytechnic of Leiria, Leiria, Portugal.,Centre for Rapid and Sustainable Product Development (CDRSP), Polytechnic of Leiria, Marinha Grande, Portugal
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30
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Danil de Namor AF, Al Hakawati N, Farhat SY. Targeting Colorectal Cancer Cells with a Functionalised Calix[4]arene Receptor: Biophysical Studies. Molecules 2022; 27:510. [PMID: 35056825 PMCID: PMC8779440 DOI: 10.3390/molecules27020510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/23/2021] [Accepted: 01/10/2022] [Indexed: 01/06/2023] Open
Abstract
Colorectal cancer (CRC) is a disease which is causing a high degree of mortality around the world. The present study reports the antiproliferative impact of the thioacetamide calix[4]arene, CAII receptor on a highly differentiated Caco-2 cell line. This statement is corroborated by the MTT assay results which revealed a reduction in the cell viability with an IC50 value of 19.02 ± 0.04 µM. Microscopic results indicated that at the starting amount of 10 µM of CAII, a decrease in cells confluency can already be observed in addition to changes in cells morphology. Cell metabolic pathway changes were also investigated. 1H NMR findings showed downregulation in lactate, pyruvate, phosphocholine, lipids, and hydroxybutyrate with the upregulation of succinate, indicating a decline in the cells proliferation. Some biochemical alterations in the cells as a result of the CAII treatment were found by Raman spectroscopy.
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Affiliation(s)
- Angela F Danil de Namor
- Laboratory of Thermochemistry, Department of Chemistry, University of Surrey, Guildford GU2 7XH, Surrey, UK
| | - Nawal Al Hakawati
- Department of Biological Sciences, Faculty of Science, Beirut Arab University, Tripoli 1107-2809, Lebanon;
| | - Sami Y Farhat
- Dr. Suliman Habib Hospital, Dubai P.O. Box 500001, SZR, United Arab Emirates;
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Blood Bacterial DNA Load and Profiling Differ in Colorectal Cancer Patients Compared to Tumor-Free Controls. Cancers (Basel) 2021; 13:cancers13246363. [PMID: 34944982 PMCID: PMC8699505 DOI: 10.3390/cancers13246363] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 11/24/2022] Open
Abstract
Simple Summary In colorectal cancer patients, epithelial barrier dysfunction can lead to increased intestinal permeability, and gut microbiome was found to vary compared to healthy subjects. We conducted a study to investigate whether bacterial translocation from gastrointestinal tract to bloodstream is associated to intestinal adenoma and/or colorectal cancer. In particular, an epidemiological and metagenomic approach was used to evaluate the relation of the bacterial DNA load and the bacterial taxonomic groups—assessed by 16S rRNA profiling—in blood with the risks of intestinal adenoma and colorectal cancer. These findings can confirm the presence of bacterial DNA in blood in healthy adults and serve as a basis to evaluate new non-invasive techniques for an early CRC diagnosis through the analyses of bacterial DNA circulating in peripheral blood. Abstract Inflammation and immunity are linked to intestinal adenoma (IA) and colorectal cancer (CRC) development. The gut microbiota is associated with CRC risk. Epithelial barrier dysfunction can occur, possibly leading to increased intestinal permeability in CRC patients. We conducted a case-control study including 100 incident histologically confirmed CRC cases, and 100 IA and 100 healthy subjects, matched to cases by center, sex and age. We performed 16S rRNA gene analysis of blood and applied conditional logistic regression. Further analyses were based on negative binomial distribution normalization and Random Forest algorithm. We found an overrepresentation of blood 16S rRNA gene copies in colon cancer as compared to tumor-free controls. For high levels of gene copies, community diversity was higher in colon cancer cases than controls. Bacterial taxa and operational taxonomic unit abundances were different between groups and were able to predict CRC with an accuracy of 0.70. Our data support the hypothesis of a higher passage of bacteria from gastrointestinal tract to bloodstream in colon cancer. This result can be applied on non-invasive diagnostic tests for colon cancer control.
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Leonard NA, Reidy E, Thompson K, McDermott E, Peerani E, Tomas Bort E, Balkwill FR, Loessner D, Ryan AE. Stromal Cells Promote Matrix Deposition, Remodelling and an Immunosuppressive Tumour Microenvironment in a 3D Model of Colon Cancer. Cancers (Basel) 2021; 13:cancers13235998. [PMID: 34885111 PMCID: PMC8656544 DOI: 10.3390/cancers13235998] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary Colorectal cancer is the third most common type of cancer in the world. Immune cells and normal supporting cells (MSCs) within a tumour affect patient survival and change how well treatments work. This research aimed to develop a more relevant 3D cancer model that combines MSCs and immune cells with cancer cells to test the effects of multiple cell types on tumour growth. We successfully developed a 3D model that shows that MSCs and immune cells can change the cancer-supporting environment around the tumour cells. We show that combining MSCs and immune cells with cancer cells can increase the level of immune-suppressing molecules they release and change immunotherapeutic drug targets on the cancer cells, similar to changes seen in human tumours. Using this 3D model for research may be better for testing new drugs than traditional 2D methods and could enable the identification of new drug targets. Abstract Colorectal cancer (CRC) is the third leading cause of cancer-related deaths worldwide. CRC develops in a complex tumour microenvironment (TME) with both mesenchymal stromal cells (MSCs) and immune infiltrate, shown to alter disease progression and treatment response. We hypothesised that an accessible, affordable model of CRC that combines multiple cell types will improve research translation to the clinic and enable the identification of novel therapeutic targets. A viable gelatine-methacrloyl-based hydrogel culture system that incorporates CRC cells with MSCs and a monocyte cell line was developed. Gels were analysed on day 10 by PCR, cytokine array, microscopy and flow cytometry. The addition of stromal cells increased transcription of matrix remodelling proteins FN1 and MMP9, induced release of tumour-promoting immune molecules MIF, Serpin E1, CXCL1, IL-8 and CXCL12 and altered cancer cell expression of immunotherapeutic targets EGFR, CD47 and PD-L1. Treatment with PD153035, an EGFR inhibitor, revealed altered CRC expression of PD-L1 but only in gels lacking MSCs. We established a viable 3D model of CRC that combined cancer cells, MSCs and monocytic cells that can be used to research the role the stroma plays in the TME, identify novel therapeutic targets and improve the transitional efficacy of therapies.
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Affiliation(s)
- Niamh A. Leonard
- Lambe Institute for Translational Research, School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, H91 V4AY Galway, Ireland;
- Regenerative Medicine Institute (REMEDI), School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, H91 W2TY Galway, Ireland
- Discipline of Pharmacology and Therapeutics, School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, H91 W2TY Galway, Ireland
- Correspondence: (N.A.L.); (A.E.R.)
| | - Eileen Reidy
- Lambe Institute for Translational Research, School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, H91 V4AY Galway, Ireland;
- Regenerative Medicine Institute (REMEDI), School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, H91 W2TY Galway, Ireland
- Discipline of Pharmacology and Therapeutics, School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, H91 W2TY Galway, Ireland
| | - Kerry Thompson
- Centre for Microscopy and Imaging, Anatomy, School of Medicine, National University of Ireland Galway, H91 W2TY Galway, Ireland; (K.T.); (E.M.)
| | - Emma McDermott
- Centre for Microscopy and Imaging, Anatomy, School of Medicine, National University of Ireland Galway, H91 W2TY Galway, Ireland; (K.T.); (E.M.)
| | - Eleonora Peerani
- Barts Cancer Institute, Queen Mary University of London, London EC1M 6BQ, UK; (E.P.); (E.T.B.); (F.R.B.); (D.L.)
| | - Elena Tomas Bort
- Barts Cancer Institute, Queen Mary University of London, London EC1M 6BQ, UK; (E.P.); (E.T.B.); (F.R.B.); (D.L.)
| | - Frances R. Balkwill
- Barts Cancer Institute, Queen Mary University of London, London EC1M 6BQ, UK; (E.P.); (E.T.B.); (F.R.B.); (D.L.)
| | - Daniela Loessner
- Barts Cancer Institute, Queen Mary University of London, London EC1M 6BQ, UK; (E.P.); (E.T.B.); (F.R.B.); (D.L.)
- Faculty of Engineering and Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3800, Australia
- Leibniz-Institut für Polymerforschung Dresden e.V., 01069 Dresden, Germany
| | - Aideen E. Ryan
- Lambe Institute for Translational Research, School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, H91 V4AY Galway, Ireland;
- Regenerative Medicine Institute (REMEDI), School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, H91 W2TY Galway, Ireland
- Discipline of Pharmacology and Therapeutics, School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, H91 W2TY Galway, Ireland
- Correspondence: (N.A.L.); (A.E.R.)
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Wekha G, Ssewante N, Iradukunda A, Jurua M, Nalwoga S, Lanyero S, Olum R, Bongomin F. Colorectal Cancer in Uganda: A 10-Year, Facility-Based, Retrospective Study. Cancer Manag Res 2021; 13:7697-7707. [PMID: 34675666 PMCID: PMC8504868 DOI: 10.2147/cmar.s334226] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 09/21/2021] [Indexed: 12/15/2022] Open
Abstract
Introduction Colorectal cancer (CRC) is the most common type of gastrointestinal malignancies and the third leading cause of cancer-related deaths for both sexes worldwide. Although the burden of CRC is highest in developed countries, reports are indicating a rise in the incidence of early-onset CRC in developing countries. In this study, we aimed to determine the prevalence of CRC among patients hospitalized with lower gastrointestinal complaints at a tertiary health facility in Uganda. Methods We conducted a 10-year retrospective chart review of patients admitted to Mulago National Referral Hospital in Kampala, Uganda, between 1st January 2010 and 31st December 2020. We reviewed all charts of patients admitted to the lower gastrointestinal tract (GIT) ward. Charts with grossly missing data, pediatric patients, and those from other non-lower GIT specialties were excluded. Results Data of 1476 unique eligible patients were analyzed. Of these,138 had a diagnosis of CRC (prevalence: 9.3%, 95% confidence interval (95% CI): 6.5-11.7%). Among patients with CRC, the female:male ratio was 1:1. The most common site for CRC was the rectum (59.8%, n= 79). For the 138 participants with CRC, 44 had staging data with 72.8% (n=32) having advanced disease, that is, stage 3 or 4. Factors independently associated with CRC were age ≥50 years (adjusted odds ratio (aOR): 4.3, 95% CI: 2.6-7.1, p < 0.001), female sex (aOR: 1.8, 95% CI: 1.2 -2.8, p = 0.005), being widowed (aOR: 2.5, 95% CI: 1.3-5.0, p = 0.006), and presence of any risk factor for CRC (aOR: 5.3, 95% CI: 2.9-9.9, p < 0.001). Conclusion CRC is relatively common among patients hospitalized with lower GIT complaints, particularly among women and those with known risk factors for CRC. Awareness creation and screening programs should be instituted to allow early diagnosis of CRC in our setting.
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Affiliation(s)
- Godfrey Wekha
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Nelson Ssewante
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Angelique Iradukunda
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Micheal Jurua
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Shadia Nalwoga
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Sharon Lanyero
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Ronald Olum
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Felix Bongomin
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda.,Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
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Liu K, Song S, Fu T, Liu Y, Zhang H, Yan M, He Z, Zhang W, Su H, Li Z, Ji Z, Shao Z. Spatiotemporal Trends in the Incidence of Gastrointestinal Neoplasms in Wuwei City of Northwestern China From 1995 to 2016: A Hospital-Based Retrospective Observational Study. Front Oncol 2021; 11:712857. [PMID: 34552871 PMCID: PMC8452457 DOI: 10.3389/fonc.2021.712857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/09/2021] [Indexed: 11/13/2022] Open
Abstract
Objective To determine the characteristics and spatiotemporal distribution of major gastrointestinal (GI) neoplasms in inpatients from 1995 to 2016 in Wuwei city, northwestern China. Method Data from all paper and electronic medical records entered between 1995 and 2016 at 12 major public hospitals in Wuwei city were retrospectively collected. Patients with GI neoplasms were identified and classified according to the International Classification of Diseases (ICD)-10. Trends in the incidence of major GI neoplasms were expressed as an annual percentage change (APC), and the Z test was used to assess the time fluctuation trends. Age-standardized incidence rates (ASIRs) were also calculated and the corresponding APC was estimated by the Joinpoint software for long-term trend analysis. Thematic maps of annual incidence at the township level were produced. Results Among the 19,137 new inpatients identified with GI neoplasms in Wuwei, gastric cancer was the leading cause of morbidity, followed by cancers of the esophagus, colorectum, gastric cardia, liver, and pancreas with ASIRs of 21.8, 11.0, 5.8, 5.7, 4.4, and 1.7 per 100,000 person-years, respectively. Overall, there was a steady increase in the ASIR for all GI neoplasms, and male cases were 2.1 times more frequent than female cases. The ASIR significantly increased by 12.2% per year from 1995 to 2009 for all GI neoplasms, and the increase rates ranged 9.4%-16.7% per year for the individual GI neoplasm. Despite an increase by 1.4% per year from 2009 to 2016, the ASIR decreased for esophageal and gastric cardia cancers by 4.6% and 17.3% per year, respectively. The annual incidence of all GI neoplasms showed significantly differential geographic distributions among different townships of the city during the study period.
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Affiliation(s)
- Kun Liu
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, China
| | - Shuxuan Song
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, China
| | - Ting Fu
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, China
| | - Yiwen Liu
- Department of Immunization Program, Wuwei Municipal Center for Disease Control and Prevention, Wuwei, China
| | - Hui Zhang
- Department of Prevention of Infectious Diseases, Xi'an Center for Disease Control and Prevention, Xi'an, China
| | - Min Yan
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, China
| | - Zhen He
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, China
| | - Weilu Zhang
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, China
| | - Haixia Su
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, China
| | - Zhao Li
- Health Commission of Wuwei, Wuwei, China
| | - Zhaohua Ji
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, China
| | - Zhongjun Shao
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, China
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Kværner AS, Birkeland E, Bucher-Johannessen C, Vinberg E, Nordby JI, Kangas H, Bemanian V, Ellonen P, Botteri E, Natvig E, Rognes T, Hovig E, Lyle R, Ambur OH, de Vos WM, Bultman S, Hjartåker A, Landberg R, Song M, Blix HS, Ursin G, Randel KR, de Lange T, Hoff G, Holme Ø, Berstad P, Rounge TB. The CRCbiome study: a large prospective cohort study examining the role of lifestyle and the gut microbiome in colorectal cancer screening participants. BMC Cancer 2021; 21:930. [PMID: 34407780 PMCID: PMC8371800 DOI: 10.1186/s12885-021-08640-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 07/27/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) screening reduces CRC incidence and mortality. However, current screening methods are either hampered by invasiveness or suboptimal performance, limiting their effectiveness as primary screening methods. To aid in the development of a non-invasive screening test with improved sensitivity and specificity, we have initiated a prospective biomarker study (CRCbiome), nested within a large randomized CRC screening trial in Norway. We aim to develop a microbiome-based classification algorithm to identify advanced colorectal lesions in screening participants testing positive for an immunochemical fecal occult blood test (FIT). We will also examine interactions with host factors, diet, lifestyle and prescription drugs. The prospective nature of the study also enables the analysis of changes in the gut microbiome following the removal of precancerous lesions. METHODS The CRCbiome study recruits participants enrolled in the Bowel Cancer Screening in Norway (BCSN) study, a randomized trial initiated in 2012 comparing once-only sigmoidoscopy to repeated biennial FIT, where women and men aged 50-74 years at study entry are invited to participate. Since 2017, participants randomized to FIT screening with a positive test result have been invited to join the CRCbiome study. Self-reported diet, lifestyle and demographic data are collected prior to colonoscopy after the positive FIT-test (baseline). Screening data, including colonoscopy findings are obtained from the BCSN database. Fecal samples for gut microbiome analyses are collected both before and 2 and 12 months after colonoscopy. Samples are analyzed using metagenome sequencing, with taxonomy profiles, and gene and pathway content as primary measures. CRCbiome data will also be linked to national registries to obtain information on prescription histories and cancer relevant outcomes occurring during the 10 year follow-up period. DISCUSSION The CRCbiome study will increase our understanding of how the gut microbiome, in combination with lifestyle and environmental factors, influences the early stages of colorectal carcinogenesis. This knowledge will be crucial to develop microbiome-based screening tools for CRC. By evaluating biomarker performance in a screening setting, using samples from the target population, the generalizability of the findings to future screening cohorts is likely to be high. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01538550 .
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Affiliation(s)
- Ane Sørlie Kværner
- Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway
| | - Einar Birkeland
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Cecilie Bucher-Johannessen
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Department of Tumor Biology, Institute for Cancer Research, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Elina Vinberg
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Jan Inge Nordby
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Harri Kangas
- Institute for Molecular Medicine Finland, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Vahid Bemanian
- Department of Multidisciplinary Laboratory Science and Medical Biochemistry, Genetic Unit, Akershus University Hospital, Lørenskog, Norway
| | - Pekka Ellonen
- Institute for Molecular Medicine Finland, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Edoardo Botteri
- Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Erik Natvig
- Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway
| | - Torbjørn Rognes
- Department of Informatics, Centre for Bioinformatics, University of Oslo, Oslo, Norway
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Eivind Hovig
- Department of Tumor Biology, Institute for Cancer Research, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
- Department of Informatics, Centre for Bioinformatics, University of Oslo, Oslo, Norway
| | - Robert Lyle
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo, Norway
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Ole Herman Ambur
- Department of Microbiology and Infection Control, Akershus University Hospital, Lørenskog, Norway
- Department of Natural Sciences and Health, Oslo Metropolitan University, Oslo, Norway
| | - Willem M de Vos
- Laboratory of Microbiology, Wageningen University, Wageningen, The Netherlands
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Scott Bultman
- Department of Genetics and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | | | - Rikard Landberg
- Department of Biology and Biological Engineering, Division of Food and Nutrition Science, Chalmers University of Technology, Gothenburg, Sweden
| | - Mingyang Song
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Hege Salvesen Blix
- Department of Drug Statistics, Norwegian Institute of Public Health, Oslo, Norway
- School of Pharmacy, University of Oslo, Oslo, Norway
| | | | | | - Thomas de Lange
- Medical Department, Sahlgrenska University Hospital-Mölndal, Mölndal, Sweden
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Medical Research, Bærum Hospital, Bærum, Norway
| | - Geir Hoff
- Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway
- Department of Research, Telemark Hospital, Skien, Norway
| | - Øyvind Holme
- Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway
- Department of Medicine, Sorlandet Hospital Kristiansand, Kristiansand, Norway
- Institute for Health and Society, University of Oslo, Oslo, Norway
| | - Paula Berstad
- Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway.
| | - Trine B Rounge
- Department of Research, Cancer Registry of Norway, Oslo, Norway.
- Department of Informatics, Centre for Bioinformatics, University of Oslo, Oslo, Norway.
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Lu PW, Semeniv S, Shabat G, Welten V, Pylypchuk VI, Galyuk V, Fields AC, Melnitchouk N. Barriers to Evidence-Based Colorectal Cancer Care in Ukraine. World J Surg 2021; 45:3288-3294. [PMID: 34342687 DOI: 10.1007/s00268-021-06267-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The incidence of colorectal cancer (CRC) is increasing in many low- to middle-income countries, including Ukraine. Ukraine reports high mortality rates in CRC patients. To identify potential areas for targeted interventions to improve CRC care in Ukraine, we investigated Ukrainian clinician perspectives on evidence-based CRC treatment guidelines. METHODS An explanatory sequential mixed-methods study design was used. A survey was administered to attendees of a regional surgical conference. Semi-structured interviews were subsequently performed with practicing clinicians in Ukraine. Interviews were coded to identify prominent themes. RESULTS Quantitative: 105 clinicians completed the survey. 76% of respondents reported using guidelines in daily practice. Lack of English proficiency was cited by 28.6% of respondents as a barrier to guideline use. Improved knowledge and additional financial resources were reported as factors that would be helpful in providing evidence-based care. QUANTITATIVE 15 clinicians were interviewed. Two major themes were identified: limitations in access to the medical literature resources (language barriers and financial barriers), and sense of clinician initiative and willingness to learn despite hardships. CONCLUSIONS Clinicians in Ukraine have positive perspectives on utilization of evidence-based CRC treatment guidelines. However, they face major barriers in accessing resources needed to keep up-to-date on the current literature. Fortunately, there exists both willingness and initiative on the clinician level to pursue continuing education. Efforts should be made on the international society level to improve open-access and foreign language translation availability to support physicians in Ukraine and other low- to middle-income countries.
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Affiliation(s)
- Pamela W Lu
- Department of Surgery, Division of Colorectal Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.,Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Solomiia Semeniv
- National Children's Specialized Hospital "Ohmatdyt", Kyiv, Ukraine
| | - Galyna Shabat
- Department of Surgery, Division of Colorectal Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.,Department of Surgery, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Vanessa Welten
- Department of Surgery, Division of Colorectal Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.,Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Volodymyr I Pylypchuk
- Department of Surgery, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Volodymyr Galyuk
- Department of Surgery, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Adam C Fields
- Department of Surgery, Division of Colorectal Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Nelya Melnitchouk
- Department of Surgery, Division of Colorectal Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA. .,Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
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Del Vecchio Blanco G, Dwairi R, Giannelli M, Palmieri G, Formica V, Portarena I, Grasso E, Di Iorio L, Benassi M, Giudice EA, Nardecchia A, Rossi P, Roselli M, Sica G, Monteleone G, Paoluzi OA. Clinical care pathway program versus open-access system: a study on appropriateness, quality, and efficiency in the delivery of colonoscopy in the colorectal cancer. Intern Emerg Med 2021; 16:1197-1206. [PMID: 33555540 PMCID: PMC8310505 DOI: 10.1007/s11739-020-02565-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 11/06/2020] [Indexed: 12/15/2022]
Abstract
Open-access colonoscopy (OAC), whereby the colonoscopy is performed without a prior office visit with a gastroenterologist, is affected by inappropriateness which leads to overprescription and reduced availability of the procedure in case of alarming symptoms. The clinical care pathway (CCP) is a healthcare management tool promoted by national health systems to organize work-up of various morbidities. Recently, we started a CCP dedicated to colorectal cancer (CRC), including a colonoscopy session for CRC diagnosis and prevention. We aimed to evaluate the appropriateness, the quality, and the efficiency in the delivery of colonoscopy with the open-access system and a CCP program in the CRC. Quality indicators for colonoscopy in subjects in the CCP were compared to referrals by general practitioners (OAC) or by non-gastroenterologist physicians (non-gastroenterologist physician colonoscopy, NGPC). Attendance rate to colonoscopy was greater in the CCP group and NGPC group than in the OAC group (99%, 99%, and 86%, respectively). Waiting time in the CCP group was shorter than in the OAC group (3.88 ± 2.27 vs. 32 ± 22.31 weeks, respectively). Appropriateness of colonoscopy prescription was better in the CCP group than in the OAC group (92 vs. 50%, respectively). OAC is affected by the lack of timeliness and low appropriateness of prescription. A CCP reduces the number of inappropriate colonoscopies, especially for post-polypectomy surveillance, and improves the delivery of colonoscopy in patients requiring a fast-track examination. The high rate of inappropriate OAC suggests that this modality of healthcare should be widely reviewed.
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Affiliation(s)
| | - Rami Dwairi
- Department of Internal Medicine, University of Mutah, Karak, Jordan
| | - Mario Giannelli
- Department of Systems Medicine, Gastroenterology Unit, University of Rome "Tor Vergata", Rome, Italy
| | - Giampiero Palmieri
- Department of Biomedicine and Prevention, Anatomic Pathology Unit, University "Tor Vergata", Rome, Italy
| | - Vincenzo Formica
- Department of Oncohematology, Oncology Unit, University Tor Vergata, Rome, Italy
| | - Ilaria Portarena
- Department of Oncohematology, Oncology Unit, University Tor Vergata, Rome, Italy
| | - Enrico Grasso
- Department of Systems Medicine, Gastroenterology Unit, University of Rome "Tor Vergata", Rome, Italy
| | - Laura Di Iorio
- Department of Systems Medicine, Gastroenterology Unit, University of Rome "Tor Vergata", Rome, Italy
| | - Michela Benassi
- Department of Diagnostic Imaging, Interventional Radiology and Radiotherapy, University "Tor Vergata", Rome, Italy
| | - Emilia Anna Giudice
- Department of Diagnostic Imaging, Interventional Radiology and Radiotherapy, University "Tor Vergata", Rome, Italy
| | - Antonella Nardecchia
- Department of Diagnostic Imaging, Interventional Radiology and Radiotherapy, University "Tor Vergata", Rome, Italy
| | - Piero Rossi
- Department of Surgery, University Tor Vergata, Rome, Italy
| | - Mario Roselli
- Department of Oncohematology, Oncology Unit, University Tor Vergata, Rome, Italy
| | - Giuseppe Sica
- Department of Surgery, University Tor Vergata, Rome, Italy
| | - Giovanni Monteleone
- Department of Systems Medicine, Gastroenterology Unit, University of Rome "Tor Vergata", Rome, Italy
| | - Omero Alessandro Paoluzi
- Department of Systems Medicine, Gastroenterology Unit, University of Rome "Tor Vergata", Rome, Italy
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Kumar R, Harilal S, Carradori S, Mathew B. A Comprehensive Overview of Colon Cancer- A Grim Reaper of the 21st Century. Curr Med Chem 2021; 28:2657-2696. [PMID: 33106132 DOI: 10.2174/0929867327666201026143757] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 09/18/2020] [Accepted: 09/18/2020] [Indexed: 12/09/2022]
Abstract
A few decades ago, the incidence of colorectal cancer (CRC) was low and is now the fourth in the list of deadly cancers producing nearly a million deaths annually. A population that is aging along with risk factors such as smoking, obesity, sedentary lifestyle with little or no physical activity, and non-healthy food habits of developed countries can increase the risk of colorectal cancer. The balance in gut microbiota and the metabolites produced during bacterial fermentation within the host plays a significant role in regulating intestinal diseases as well as colorectal cancer development. Recent progress in the understanding of illness resulted in multiple treatment options such as surgery, radiation, and chemotherapy, including targeted therapy and multitherapies. The treatment plan for CRC depends on the location, stage and grade of cancer as well as genomic biomarker tests. Despite all the advancements made in the genetic and molecular aspects of the disease, the knowledge seems inadequate as the drug action as well as the wide variation in drug response did not appear strongly correlated with the individual molecular and genetic characteristics, which suggests the requirement of comprehensive molecular understanding of this complex heterogeneous disease. Furthermore, multitherapies or a broad spectrum approach, which is an amalgamation of the various promising as well as effective therapeutic strategies that can tackle heterogeneity and act on several targets of the disease, need to be validated in clinical studies. The latest treatment options have significantly increased the survival of up to three years in the case of advanced disease. The fact that colorectal cancer is developed from a polypoid precursor, as well as the symptoms of the disease that occur at an advanced stage, underlines how screening programs can help early detection and decrease mortality as well as morbidity from CRC.
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Affiliation(s)
- Rajesh Kumar
- Department of Pharmacy, Kerala University of Health Sciences, Thrissur, Kerala, India
| | - Seetha Harilal
- Department of Pharmacy, Kerala University of Health Sciences, Thrissur, Kerala, India
| | - Simone Carradori
- Department of Pharmacy, "G. d'Annunzio" University of Chieti-Pescara, via dei Vestini 31, 66100 Chieti, Italy
| | - Bijo Mathew
- Department of Pharmaceutical Chemistry, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi-682 041, India
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Colorectal Cancer in Elderly Patients with Surgical Indication: State of the Art, Current Management, Role of Frailty and Benefits of a Geriatric Liaison. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116072. [PMID: 34199923 PMCID: PMC8200127 DOI: 10.3390/ijerph18116072] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/26/2021] [Accepted: 05/29/2021] [Indexed: 12/24/2022]
Abstract
Six out of every 10 new colorectal cancer (CRC) diagnoses are in people over 65 years of age. Current standardized surgical approaches have proved to be tolerable on the elderly population, although post-operative complications are more frequent than in the younger CRC population. Frailty is common in elderly CRC patients with surgical indication, and it appears to be also associated with an increase of post-operative complications. Fast-track pathways have been developed to assure and adequate post-operative recovery, but comprehensive geriatric assessments (CGA) are still rare among the preoperative evaluation of elderly CRC patients. This review provides a thorough study of the effects that a CGA assessment and a geriatric intervention have in the prognosis of CRC elderly patients with surgical indication.
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Alqudah MAY, Al-Samman RM, Mukattash TL, Abu-Farha RK. Knowledge and attitudes of pharmacists towards colorectal cancer health education in Jordan: A cross-sectional study. Int J Clin Pract 2021; 75:e13986. [PMID: 33400341 DOI: 10.1111/ijcp.13986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 01/03/2021] [Indexed: 12/24/2022] Open
Abstract
AIMS OF THE STUDY The purpose of this study was to assess pharmacists' knowledge and attitude towards early detection of colorectal cancer (CRC) in Jordan and to explore potential predictor variables of such knowledge and attitude. METHODS USED TO CONDUCT THE STUDY An electronic, self-reported questionnaire was used to collect data about demographics, knowledge and attitude regarding early detection of CRC. Both content and face validity were tested in a panel of experts. The participants' responses were analysed using descriptive statistics and multiple linear regressions. RESULTS OF THE STUDY The 352 pharmacists (78% females, 94% Jordanian) had a median age of 28 years and graduated mostly (83%) from public universities. Surprisingly, 90% were not able to identify carcinoembryonic antigen (CEA) as a non-accurate diagnostic method and almost one-third did not identify the correct screening tests. On a scale of 5, the majority of participants (59%) had moderate knowledge scores (3 or 4) in case scenarios. The median knowledge Percent of Maximum Possible (POMP) score was 67% and higher scores were associated with more years since graduation, pharmacists with MSc degree and higher, working in urban areas, studying oncology course and received oncology training (P < .05). Most participants showed a positive attitude towards early detection of CRC (median attitude POMP score was 78%). However, none of the analysed variables predicted their level of attitude. CONCLUSIONS DRAWN FROM THE STUDY AND CLINICAL IMPLICATIONS Although the majority of pharmacists demonstrated a positive attitude towards early detection of CRC, their knowledge was inadequate. The study highlighted the importance of optimising the education programmes to improve the pharmacists' knowledge about CRC early detection and preparing the pharmacists for participating in future national screening initiatives.
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Affiliation(s)
- Mohammad A Y Alqudah
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Raneem M Al-Samman
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Tareq L Mukattash
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Rana K Abu-Farha
- Department of Therapeutics and Clinical Pharmacy, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
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Song W, Chen Z, Zheng Z, Zhang Z, Chen Y, He X, Lan P, Hu J, He X. Risk factors for metachronous adenoma in patients with stage I/II colorectal cancer after radical surgery. J Gastrointest Oncol 2021; 12:535-543. [PMID: 34012647 DOI: 10.21037/jgo-20-386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background It is important to implement a preventive strategy for early detection and endoscopic removal of metachronous adenoma in patients with colorectal cancer (CRC). Here, we retrospectively explored the associated factors of metachronous adenoma in these patients. Methods This study recruited 551 patients with stage I and II CRC who underwent radical surgery between January 1, 2012 and July 1, 2017 with postoperative colonoscopic surveillance. Data on clinicopathological characteristics and surveillance colonoscopies were obtained from medical records. Univariate analysis by Kaplan-Meier method and multivariate analysis by Cox proportional hazards model were used to identify the factors associated with metachronous adenoma. Results Metachronous adenoma was detected in 110 (20.0%) patients. In these patients, 94.5% (104/110) had metachronous adenoma within 3 years postoperatively. Age, synchronous adenoma, hypertension, tumor stage, and surgical resection were correlated with metachronous adenoma in patients with stage I-II CRC after radical resection (log rank test, P<0.05). Multivariate analyses showed that synchronous adenoma (HR =2.515, 95% CI: 1.691-3.742, P<0.01); stage II (HR =2.066, 95% CI: 1.329-3.210, P<0.01); and left-side colorectal resection (HR =2.207, 95% CI: 1.292-3.772, P<0.01) were independent risk factors. Conclusions Synchronous adenoma, left-side colorectal resection, and stage II cancer are independent risk factors of metachronous adenoma in patients with previous stage I and II CRC. In patients with risk factors, an enhanced colonoscopic strategy might be needed for early detection and timely endoscopic removal of metachronous adenoma.
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Affiliation(s)
- Wenli Song
- Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Gastrointestinal Surgery, the Eighth Affiliated hospital, Sun Yat-sen University, Shenzhen, China
| | - Zexian Chen
- Department of Gastrointestinal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zheyu Zheng
- Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zongjin Zhang
- Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yongle Chen
- Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaosheng He
- Department of Gastrointestinal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ping Lan
- Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jiancong Hu
- Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaowen He
- Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Liu Y, Wang X. Tumor microenvironment-associated gene C3 can predict the prognosis of colorectal adenocarcinoma: a study based on TCGA. Clin Transl Oncol 2021; 23:1923-1933. [PMID: 33765255 DOI: 10.1007/s12094-021-02602-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 03/16/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Colorectal cancer is one of the most common malignancies. With continuous exploration of the interaction between tumor cells and the immune system, tumor immunotherapy has become a revolution. However, CRC remains one of the less effective tumors for immunotherapy. The tumor microenvironment plays an important role in tumorigenesis and progression. The aim of this study is to explore tumor microenvironment-related genes that can predict the prognosis of colorectal adenocarcinoma, and also to provide new ideas for the mechanism of tumor development as well as immunotherapy. METHODS After estimating Stromalscore and Immunescore of colorectal adenocarcinoma tumor samples according to RNA-Seq expression data downloaded from TCGA, we screened for TME-related differential genes. We filtered prognosis-related core genes by constructing protein-protein interaction networks and making one-factor cox analysis for prognosis. Finally, the relative content of 22 immune cells in tumor tissues was evaluated, and then immune cells associated with core genes were identified. RESULTS We screened 773 differential genes related to the TME. Then we identified C3 as a core gene associated with prognosis. Single gene analysis showed that C3 expression was significantly higher in tumor tissues than in normal tissues (p < 0.001). High C3 expression was associated with lower overall survival (p = 0.046). Tumor immune cell analysis showed that mast cells resting, mast cells activated, T cells CD4 memory activated, eosinophils, and macrophages M0 were C3-associated immune cells. CONCLUSIONS C3 has potential as a biomarker for colorectal adenocarcinoma and could provide new research ideas for the diagnosis and treatment of colorectal adenocarcinoma, especially for immunotherapy.
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Affiliation(s)
- Y Liu
- Department of Medical Oncology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - X Wang
- Department of Medical Oncology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
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Characterization of the fatty acid metabolism in colorectal cancer to guide clinical therapy. MOLECULAR THERAPY-ONCOLYTICS 2021; 20:532-544. [PMID: 33738339 PMCID: PMC7941088 DOI: 10.1016/j.omto.2021.02.010] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 02/14/2021] [Indexed: 02/07/2023]
Abstract
Colorectal cancer (CRC) is one of the most common malignant tumors, with the second-highest mortality of all 36 cancers worldwide. The roles of fatty acid metabolism in CRC were investigated to explore potential therapeutic strategies. The data files were downloaded from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. Univariate and least absolute shrinkage and selection operator (LASSO) Cox regression analyses were used to construct a prognostic risk score model with fatty acid metabolism-related genes for predicting prognosis in CRC. Patients with a high-risk score had a poorer prognosis in TCGA cohort than those with a low-risk score and were confirmed in the GEO cohort. Further analysis using the "pRRophetic" R package revealed that low-risk patients were more sensitive to 5-fluorouracil. A comprehensive evaluation of the association between prognostic risk score model and tumor microenvironment (TME) characteristics showed that high-risk patients were suitable for activating a type I/II interferon (IFN) response and inflammation-promoting function. Tumor Immune Dysfunction and Exclusion (TIDE) and SubMap algorithm results also demonstrated that high-risk patients are more suitable for anti-CTLA4 immunotherapy. Therefore, the evaluation of the fatty acid metabolism pattern promotes our comprehension of TME infiltration characteristics, thus guiding effective immunotherapy regimens.
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Reif de Paula T, Augestad KM, Kiran RP, Keller DS. Management of the positive pathologic circumferential resection margin in rectal cancer: A national cancer database (NCDB) study. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2021; 47:296-303. [PMID: 32800594 DOI: 10.1016/j.ejso.2020.07.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 06/11/2020] [Accepted: 07/23/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND The circumferential resection margin (CRM) is a primary predictor of local recurrence and survival in rectal cancer, and an important consideration in guiding treatment. CRM is usually predicted preoperatively, so optimal management of an unexpected pathologic positive CRM involvement is debatable. We aimed to investigate the postoperative management of T3N0 rectal cancers with a positive pathologic CRM, and the impact of each strategy on survival. METHODS The NCDB was reviewed for pathological T3N0 rectal cancer cases from 2010 to 2015, that received neoadjuvant chemotherapy, had surgical resection with pathological clear margins, but a positive pathologic CRM(disease≤2 mm from radial margin). The main outcomes were the incidence, treatment modalities used, and impact of each modality on survival. Univariate analysis evaluated the demographic and provider characteristics across treatment groups. Kaplan-Meier and Cox regression analysis assessed survival and factors associated with overall survival (OS). RESULTS Of 1607 cases with a positive CRM, 65% (1045) received no adjuvant treatment and 35% (n = 562) received adjuvant chemotherapy (AC). After matching, the 1-, 3-, and 5-year OS rates were 98.5%, 88.6% and 76.6% for AC and 96.9%, 84.6% and 68.4% for with no treatment (p = .027). Factors independently associated with improved OS were treatment at an academic/research facility (p = .009), minimally invasive approach (p = .005), well and moderately differentiated tumor (p < .001), absence of perineural invasion (p = .015) and AC administration (p = .047). CONCLUSION In T3N0 rectal cancers resected with local clear margins but a positive pathologic CRM, AC improved OS. However, only a third received this option. Further study is needed to investigate the disparities in AC use in these patients with unexpected pathologic results.
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Affiliation(s)
- Thais Reif de Paula
- Division of Colorectal Surgery, Department of Surgery, Columbia University Medical Center, New York, NY, USA.
| | - Knut Magne Augestad
- Department of Digestive Surgery, Akershus University Hospital, University of Oslo, Lorenskog, Norway.
| | - Ravi P Kiran
- Division of Colorectal Surgery, Department of Surgery, Columbia University Medical Center, New York, NY, USA.
| | - Deborah S Keller
- Division of Colorectal Surgery, Department of Surgery, Columbia University Medical Center, New York, NY, USA.
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Golding H, Webber CE, Groome PA. Factors contributing to time to diagnosis in symptomatic colorectal cancer: A scoping review. Eur J Cancer Care (Engl) 2020; 30:e13397. [PMID: 33377574 DOI: 10.1111/ecc.13397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 07/11/2020] [Accepted: 10/14/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Colorectal cancer (CRC) is the third most common cancer worldwide (Ferlay et al., 2015, International Journal of Cancer, 136, E359), and delayed diagnosis is associated with mortality (Tørring et al., 2011, British Journal of Cancer, 104, 934; Tørring et al., 2012, Journal of Clinical Epidemiology, 65, 669). The purpose of this review was to determine the factors associated with time to diagnosis in symptomatic CRC using scoping review methods. METHODS We performed database and citation searches to identify studies which examine the length of any interval from symptom presentation to diagnosis. Study selection was conducted by two independent reviewers. Factors contributing to time to diagnosis were extracted from selected articles and mapped onto a conceptual framework consisting of four levels: patient and disease factors, provider factors, organisation/setting factors and sectors of influence. RESULTS From the 31 studies included in this review, we identified 138 unique factors, 17 of which were investigated by at least three studies and 11 of which had consistent results. Patient and disease factors were most commonly studied. Patient perception that their symptoms were benign, a non-urgent referral, female sex and rectal tumour location were each associated with a longer time to diagnosis. CONCLUSION Thus far, the literature has focused on patient or disease-related factors, while other levels of influence have been relatively understudied.
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Affiliation(s)
- Haley Golding
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - Colleen E Webber
- Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
| | - Patti A Groome
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada.,Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Queen's University, Kingston, ON, Canada
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Improvement of Survival over Time for Colorectal Cancer Patients: A Population-Based Study. J Clin Med 2020; 9:jcm9124038. [PMID: 33327538 PMCID: PMC7765021 DOI: 10.3390/jcm9124038] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 11/24/2020] [Accepted: 12/08/2020] [Indexed: 01/04/2023] Open
Abstract
Purpose: In this study, we analyzed the mortality and survival of colorectal cancer patients in Lithuania. Methods: This was a national cohort study. Population-based data from the Lithuanian Cancer Registry and period analyses were collected. Overall, 20,980 colorectal cancer patients were included. We examined the changes in colorectal cancer mortality and survival rates between 1998 and 2012 according to cancer anatomical sub-sites and stages. We calculated the 5-year relative survival estimates using period analysis. Results: Overall, 20,980 colorectal cancer cases reported from 1998 to 2012 were included in the study. The total number of newly diagnosed colorectal cancers increased from 1998–2002 to 2008–2012 by 12.1%. The highest number of colorectal cancers was localized and increased from 33.9% to 42.0%. The number of cancers with regional metastases and advanced cancers decreased by 11.1% and 15.5%, respectively. An increased number of new cases was observed for almost all colon cancer sub-sites. The overall 5-year relative survival rate increased from 37.9% in 1998–2002 to 51.5% in 2008–2012. We showed an increase in survival rates for all stages and all sub-sites. In the most recent period, patients with a localized disease had a 5-year survival rate of 78.6%, while survival estimates for advanced cancer patients remained low at 6.6%. Conclusion: Although survival rates variated in colorectal cancer patients according to disease stages and sub-sites, we showed increased survival rates for all patients.
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Cayuela L, Rodríguez-Domínguez S, Giráldez Á, Cayuela A. Regional differences in colorectal cancer mortality trends, Spain (1980-2018). REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2020; 113:570-575. [PMID: 33261500 DOI: 10.17235/reed.2020.7183/2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION the aim of this study was to describe the trends of colorectal cancer (CRC) mortality by autonomous communities (ACs) and gender in Spain (1980-2018). METHODS the age-standardized mortality rates (ASMRs) for CRC (per 100,000) were calculated by direct standardization, using the world standard population. Mortality trends were described by ACs using a joinpoint regression model in both sexes. The annual percent changes and average annual percentage of change were computed for trends using the joinpoint regression analysis. RESULTS during the most recent five-year period (2014-2018), the rates decreased among both males and females and were more pronounced in males (-2.3 %) than in females (-1.1 %), although with differences by ACs. ASMRs decrease in both sexes in the Basque Country, Canary Islands, Catalonia, Castile and Leon, Andalusia, Balearic Islands, Madrid, Murcia and Valencia. Whereas in other ACs, it only increases in males (Navarre, Castile-La Mancha, Extremadura and La Rioja) or females (Aragon, Asturias and Galicia). CONCLUSION this updated analysis of temporal patterns of CRC mortality in Spain from 1980-2018, divided by ACs and sex, shows gender differences in CRC mortality trends. Despite the favorable trends in both sexes, the gender gap is widening.
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Affiliation(s)
| | | | - Álvaro Giráldez
- Clinical Management Unit of Digestive Diseases, Hospital Universitario Virgen del Rocío, España
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Hull MA, Rees CJ, Sharp L, Koo S. A risk-stratified approach to colorectal cancer prevention and diagnosis. Nat Rev Gastroenterol Hepatol 2020; 17:773-780. [PMID: 33067592 PMCID: PMC7562765 DOI: 10.1038/s41575-020-00368-3] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/08/2020] [Indexed: 02/06/2023]
Abstract
Population screening and endoscopic surveillance are used widely to prevent the development of and death from colorectal cancer (CRC). However, CRC remains a major cause of cancer mortality and the increasing burden of endoscopic investigations threatens to overwhelm some health services. This Perspective describes the rationale for and approach to improved risk stratification and decision-making for CRC prevention and diagnosis. Limitations of current approaches will be discussed using the UK as an example of the challenges faced by a particular health-care system, followed by discussion of novel risk biomarker utilization. We explore how risk stratification will be advantageous to current health-care providers and users, enabling more efficient use of limited colonoscopy resources. We discuss risk stratification in the setting of population screening as well as the surveillance of high-risk groups and investigation of symptomatic patients. We also address challenges in the development and validation of risk stratification tools and identify key research priorities.
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Affiliation(s)
- Mark A Hull
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.
| | - Colin J Rees
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Sara Koo
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
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Gorfine M, Keret N, Ben Arie A, Zucker D, Hsu L. Marginalized Frailty-Based Illness-Death Model: Application to the UK-Biobank Survival Data. J Am Stat Assoc 2020. [DOI: 10.1080/01621459.2020.1831922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Malka Gorfine
- Department of Statistics and Operations Research, Tel Aviv University, Tel Aviv, Israel
| | - Nir Keret
- Department of Statistics and Operations Research, Tel Aviv University, Tel Aviv, Israel
| | - Asaf Ben Arie
- Department of Statistics and Operations Research, Tel Aviv University, Tel Aviv, Israel
| | - David Zucker
- Statistics and Data Science, The Hebrew University, Jerusalem, Israel
| | - Li Hsu
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
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Xu T, Wang X, Jia X, Gao W, Li J, Gao F, Zhan P, Ji W. Overexpression of protein regulator of cytokinesis 1 facilitates tumor growth and indicates unfavorable prognosis of patients with colon cancer. Cancer Cell Int 2020; 20:528. [PMID: 33292244 PMCID: PMC7603724 DOI: 10.1186/s12935-020-01618-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 10/20/2020] [Indexed: 02/07/2023] Open
Abstract
Background Protein regulator of cytokinesis 1 (PRC1) has been reported to play important role in the pathogenesis of various cancers. However, its role in colon cancer has not been studied. Here, we aimed to investigate the biological functions and potential mechanism of PRC1 in colon cancer. Methods The expression level of PRC1 in colon cancer tissues and cell lines was detected by quantitative real-time polymerase chain reaction (qRT-PCR), Western blotting, and immunohistochemical (IHC) staining of a tissue microarray (TMA). Furthermore, colon cancer cell lines HCT116 and SW480 were treated with short hairpin RNAs against PRC1. The biological function of PRC1 was determined by MTT proliferation, colony formation assay, cell cycle, and apoptosis assays. Then, an in vivo tumor formation assay was conducted to explore the effects of PRC1 on tumor growth. Results The mRNA and protein expression levels of PRC1 were highly expressed in colon cancer tissues and cell lines. PRC1 expression was associated with clinicopathological characteristics and overall survival of patients with colon cancer. Knockdown of PRC1 could decrease proliferation and colony forming ability of colon cancer cells, as well as arrested more cells at G2/M phase and promoted cell apoptosis. In cancer cells, the expression pattern of protein regulators included in cell cycle and apoptosis progress were reverted by PRC1 down-regulation. Additionally, PRC1 down-regulation could suppress colon tumor growth and differentiation. Conclusions We confirmed that PRC1 was overexpressed in colon cancer and was associated with poor prognosis of colon cancer patients. PRC1 down-regulation could arrest cell cycle at G2/M stage, inhibit proliferation, and elicit apoptosis. These findings showed the potential of PRC1 to be used for therapeutic approaches in colon cancer.
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Affiliation(s)
- Tianxiang Xu
- Center of Tumor, Inner Mongolia People's Hospital, Hohhot, 010017, Inner Mongolia Autonomous Region, China
| | - Xiaoxia Wang
- Intensive Care Unit, Inner Mongolia People's Hospital, Hohhot, 010017, Inner Mongolia Autonomous Region, China
| | - Xiangdong Jia
- Center of Tumor, Inner Mongolia People's Hospital, Hohhot, 010017, Inner Mongolia Autonomous Region, China
| | - Weishi Gao
- Center of Tumor, Inner Mongolia People's Hospital, Hohhot, 010017, Inner Mongolia Autonomous Region, China
| | - Junhua Li
- Center of Tumor, Inner Mongolia People's Hospital, Hohhot, 010017, Inner Mongolia Autonomous Region, China
| | - Fengying Gao
- Center of Tumor, Inner Mongolia People's Hospital, Hohhot, 010017, Inner Mongolia Autonomous Region, China
| | - Ping Zhan
- Department of Respiratory Medicine, Jinling Hospital, 305 East Zhongshan Road, Nanjing, 210002, Jiangsu, China. .,Department of General Surgery, Jinling Hospital, Southern Medical University , Nanjing, 210002, Jiangsu, China.
| | - Wu Ji
- Department of General Surgery, Jinling Hospital, Southern Medical University , Nanjing, 210002, Jiangsu, China.
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