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Jain S, Rana M, Choubey P, Kumar S. Schistosoma japonicum Associated Colorectal Cancer and Its Management. Acta Parasitol 2023; 68:723-734. [PMID: 37594685 DOI: 10.1007/s11686-023-00707-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 07/31/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND An association between Schistosoma japonicum and colorectal cancer in humans has been known since a long time; however, this association remains understudied and lacks comprehensive experimentation support. OBJECTIVE Various epidemiological and pathological studies have established the role of chronic inflammation as a major factor behind the induction of colorectal cancer. The aim of this review is to present the current knowledge on the association of Schistosoma japonicum with colorectal cancer. RESULT Mechanisms which lead to induction and progression of colorectal cancer are highlighted along with diagnosis and treatment for the same. Further, various methodologies, including mass drug administration, use of new drugs and vaccines, role of apoptosis, and histone-modifying enzymes, have been described which can either prevent the schistosomal infection itself or can check it from reaching an advanced stage. CONCLUSIONS Epidemiological, clinical, pathological and surgical studies suggest that Schistosoma japonicum is responsible for induction of colorectal cancer. However, thorough clinical studies are required to support and globally accept this notion. Further, methodologies highlighted in this work can be employed in order to take care of schistosomal infection or address the cancer induction and progression.
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Affiliation(s)
- Sidhant Jain
- Institute for Globally Distributed Open Research and Education (IGDORE), Rewari, Haryana, India.
| | - Meenakshi Rana
- Dyal Singh College, University of Delhi, Lodhi Road, Pragati Vihaar, New Delhi, 110003, India
| | - Pooja Choubey
- Department of Zoology, Gate No. 3, Chaatra Marg, University of Delhi, North Campus, Delhi, 110007, India
| | - Sahil Kumar
- Department of Pharmacology, ESIC Dental College and Hospital, Rohini, Sector-15, Delhi, 110089, India
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Zhang F, Wang X, Zhu Y, Xia P. Conjoint analysis of clinical, imaging, and pathological features of schistosomiasis and colorectal cancer. Pathol Oncol Res 2023; 29:1611396. [PMID: 38099242 PMCID: PMC10719402 DOI: 10.3389/pore.2023.1611396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 11/20/2023] [Indexed: 12/17/2023]
Abstract
This study aims to examine and compare clinical, radiological, and pathological data between colorectal cancer (CRC) patients with and without schistosomiasis and uncover distinctive CRC characteristics when accompanied by schistosomiasis. This retrospective study is based on data collected from 341 patients diagnosed with CRC post-surgery and pathology. Of these patients, 101 (Group A) were diagnosed with colorectal cancer co-occurring with schistosomiasis (CRC-S), while 240 patients (Group B) were diagnosed with colorectal cancer without concurrent schistosomiasis (CRC-NS). Both groups were compared and analyzed based on their clinical data, imaging-based TNM staging, lymph node metastasis, nerve invasion, vascular cancer thrombus, and histopathological differentiation. A Chi-squared test revealed a significant difference in gender distribution between the patients with CRC-S (Group A) and CRC-NS (Group B), with a p -value of 0.043 and χ2 = 4.115. Specifically, a higher incidence rate was observed among males in Group A. There was a difference in the overall distribution of TNM staging between the two groups (p = 0.034, χ2 = 6.764). After pairwise comparison, a statistically significant difference was observed in the T3 stage (p <0.05). The proportion of the T3 stage in Group A was significantly higher than that in Group B, indicating certain advantages. There was a difference in postoperative histopathological grading between the two groups (p = 0.005, χ2 = 10.626). After pairwise comparison, a statistically significant difference was observed between the well-differentiated adenocarcinoma and the moderately and poorly differentiated adenocarcinoma (p <0.05), with a higher proportion of welldifferentiated patients in Group A compared to Group B. There was no significant difference in age, lymph node metastasis, nerve invasion, and vascular invasion between the two groups of patients (p > 0.05). Among the 101 patients with CRC-S, 87 (86%) showed linear calcification on CT imaging. Patients with CRC-S are mainly male, with tumor staging mostly in the middle stage, high tumor differentiation, and low malignancy. CT imaging can help identify the presence of lumps and linear calcification indicative of schistosome deposits. MRI can early clarify TNM staging and determine the presence of lymph node metastasis and nerve and vascular invasion.
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Affiliation(s)
- Fang Zhang
- Department of Radiology, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, China
| | - XiaoShuang Wang
- Department of Radiology, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, China
| | - YuanTing Zhu
- Department of Pathology, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, China
| | - Peng Xia
- Department of Parasitology, School of Basic Medicine, Health Science Center, Yangtze University, Jingzhou, China
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Yang Y, Wang XY, Duan C, Wang ZJ, Sheng HY, Xu XL, Wang WJ, Yang JH. Clinicopathological characteristics and its association with digestive system tumors of 1111 patients with Schistosomiasis japonica. Sci Rep 2023; 13:15115. [PMID: 37704736 PMCID: PMC10500003 DOI: 10.1038/s41598-023-42456-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 09/11/2023] [Indexed: 09/15/2023] Open
Abstract
Schistosomiasis japonicum can cause different degrees of organ damage and complex human immune pathological reactions, which often invade the intestine and liver. The purpose of this study was to explore the pathological types and pathological changes of Schistosomiasis and their correlation with some digestive system tumors. Hematoxylin eosin staining was performed on the diseased tissues of 1111 Schistosomiasis cases. We counted the deposition sites of Schistosoma eggs, analyzed the pathological characteristics, and compared the clinicopathological characteristics of Schistosomiasis associated digestive system tumors and non-Schistosomiasis digestive system tumors. We found that Schistosoma japonicum can cause multi organ and multi system damage, with 469 cases of inflammation, 47 cases of adenoma, and 519 cases of adenocarcinoma. Other types include cysts, stromal tumors, malignant lymphomas, and neuroendocrine tumors. Schistosomiasis associated tumors, including gastric cancer, liver cancer, colon cancer and rectal cancer, were compared with non-Schistosomiasis tumors. There were significant differences in age, gender and tumor differentiation between the two groups. Our study shows Schistosomiasis is a systemic disease, causing multiple organ and system damage in the human body. Its clinicopathological types are diverse, and there may be a pathological change process of "Inflammation-adenoma-carcinoma". Schistosomiasis associated digestive system tumors differ from non-Schistosomiasis tumors in some clinicopathological features.
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Affiliation(s)
- Yang Yang
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, People's Republic of China
- Class1 Grade 2019, Department of Stomatology, Bengbu Medical College, Bengbu, Anhui, People's Republic of China
| | - Xiao-Yi Wang
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, People's Republic of China
| | - Chun Duan
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, People's Republic of China
| | - Zi-Jian Wang
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, People's Republic of China
| | - Hao-Yu Sheng
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, People's Republic of China
| | - Xiu-Liang Xu
- Department of Infectious Diseases, The People's Hospital of Chizhou, Chizhou, Anhui, People's Republic of China
| | - Wen-Jie Wang
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, People's Republic of China
| | - Jiang-Hua Yang
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, People's Republic of China.
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Burky M, Trembath D, Bookhout C. Rectal carcinoma arising in a patient with intestinal and hepatic schistosomiasis due to Schistosoma mekongi. IDCases 2022; 27:e01383. [PMID: 35036322 PMCID: PMC8749178 DOI: 10.1016/j.idcr.2022.e01383] [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: 12/13/2021] [Accepted: 01/05/2022] [Indexed: 11/15/2022] Open
Abstract
Schistosomiasis is a parasitic trematode infection spread by snails with multiple species causing human disease. Infection can cause liver disease, including fibrosis and portal hypertension, and has been linked to malignancies such as bladder and colorectal cancer. We describe a case of Schistosoma mekongi, a geographically limited form of schistosomiasis, in a Laotian immigrant who presented with both hepatic fibrosis and rectal cancer, with numerous schistosome eggs present in the patient’s rectal resection. We believe this case is the first report of a rectal carcinoma arising in the setting of S. mekongi infection.
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Affiliation(s)
- Matthew Burky
- Department of Pathology, Division of Surgical Pathology, Women's and Children's Hospitals, The University of North Carolina at Chapel Hill, 3rd Floor, Room 30149, 101 Manning Drive, Chapel Hill 27514, NC, USA
| | - Dimitri Trembath
- Department of Pathology, Division of Surgical Pathology, Women's and Children's Hospitals, The University of North Carolina at Chapel Hill, 3rd Floor, Room 30149, 101 Manning Drive, Chapel Hill 27514, NC, USA
| | - Christine Bookhout
- Department of Pathology, Division of Surgical Pathology, Women's and Children's Hospitals, The University of North Carolina at Chapel Hill, 3rd Floor, Room 30149, 101 Manning Drive, Chapel Hill 27514, NC, USA
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Qin X, Liu CY, Xiong YL, Bai T, Zhang L, Hou XH, Song J. The clinical features of chronic intestinal schistosomiasis-related intestinal lesions. BMC Gastroenterol 2021; 21:12. [PMID: 33407185 PMCID: PMC7789259 DOI: 10.1186/s12876-020-01591-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 12/21/2020] [Indexed: 02/06/2023] Open
Abstract
Background Chronic intestinal schistosomiasis has been reported to be associated with colonic polyps, colorectal cancer and ulcerative colitis. We aim to investigate the clinical characteristics of intestinal-related lesions caused by chronic intestinal schistosomiasis japonicum. Methods Patients with and without chronic intestinal schistosomiasis were retrospectively enrolled from the endoscopy center of Wuhan Union Hospital from September 1, 2014, to June 30, 2019 with a ratio of 4:1. The characteristics of infected intestinal segments were analyzed in patients with chronic intestinal schistosomiasis. We also compared the characteristics of intestinal-related lesions, including colorectal polyps, colorectal cancer (CRC), ulceration or erosion of the intestinal mucosa and hemorrhoids, between the two groups. Results A total of 248 patients with chronic intestinal schistosomiasis and 992 patients without chronic intestinal schistosomiasis were analyzed. The most common sites of chronic intestinal schistosomiasis were the sigmoid colon (79.0%) and rectum (84.7%). The frequency of intestinal polyps (64.5% vs. 42.8%, p < 0.001), especially rectal polyps (62.5% vs. 45.0%, p = 0.002), in the intestinal schistosomiasis group was significantly higher than that in the control group. Morphologically, type IIa polyps were more common in the schistosomiasis enteropathy group (68.5% vs. 60.7%, p = 0.001). Female patients with intestinal schistosomiasis had a higher detection rate of CRC than women in the control group (13.8% vs. 5.4%, p = 0.017). There was no significant difference in the incidence of ulcerative colitis between the two groups (0.8% vs. 0.6%, p = 0.664). In addition, the schistosomiasis enteropathy patients had a higher detection rate of internal hemorrhoids (58.9% vs. 51.0%, p = 0.027). Conclusions Chronic intestinal schistosomiasis mainly involved the rectum and sigmoid colon and was more likely to induce intestinal polyps, especially rectal polyps and internal hemorrhoids. Women with chronic schistosomiasis have a higher risk of colorectal cancer.
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Affiliation(s)
- Xian Qin
- Division of Gastroenterology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan, 430022, China
| | - Cai-Yuan Liu
- Division of Gastroenterology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan, 430022, China
| | - Yi-Lin Xiong
- Division of Gastroenterology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan, 430022, China
| | - Tao Bai
- Division of Gastroenterology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan, 430022, China
| | - Lei Zhang
- Division of Gastroenterology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan, 430022, China
| | - Xiao-Hua Hou
- Division of Gastroenterology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan, 430022, China
| | - Jun Song
- Division of Gastroenterology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan, 430022, China.
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Wang Z, Du Z, Liu Y, Wang W, Liang M, Zhang A, Yang J. Comparison of the clinicopathological features and prognoses of patients with schistosomal and nonschistosomal colorectal cancer. Oncol Lett 2020; 19:2375-2383. [PMID: 32194737 PMCID: PMC7039146 DOI: 10.3892/ol.2020.11331] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 11/26/2019] [Indexed: 12/14/2022] Open
Abstract
Patients with schistosomal colorectal cancer (CRC) and nonschistosomal CRC have different clinicopathological features, laboratory test results and survival rates. Long-term infection with schistosomiasis in patients with CRC may affect the pathogenesis and subsequently change the mechanisms of CRC in these patients, resulting in changes in the survival rates of patients with schistosomal and nonschistosomal CRC. In China, the most common type of schistosomiasis is S. japonicum. The present study aimed to investigate the clinicopathological features and prognostic factors of schistosomal and nonschistosomal CRC. A total of 253 patients with schistosomal CRC and 2,885 patients with nonschistosomal CRC were analyzed and their symptoms, clinicopathological features and laboratory test results were retrospectively evaluated. Patients with CRC in the present study underwent radical resection at The First Affiliated Yijishan Hospital of Wannan Medical College between January 2012 and December 2018. A total of 3,138 patients with CRC were enrolled, 253 of whom were patients with schistosomal CRC. Patients were followed-up to examine differences in the 5-year survival rates between patients with schistosomal and nonschistosomal CRC to determine whether schistosomiasis impacted the prognosis of CRC. There were significant differences in age, sex, fecal occult blood positive, pathological T stage, and CA19-9, WBC, RBC and PLT levels between patients with schistosomal CRC and nonschistosomal CRC. For residents in areas with higher levels of schistosomiasis infections, especially middle-aged and elderly males, serum tumor markers and digestive tract endoscopy should be regularly evaluated to detect the presence of digestive tract tumors as early as possible.
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Affiliation(s)
- Zijian Wang
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241001, P.R. China
| | - Zhixiang Du
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241001, P.R. China
| | - Yinhua Liu
- Department of Pathology, Wannan Medical College, Wuhu, Anhui 241001, P.R. China
| | - Wenjie Wang
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241001, P.R. China
| | - Manman Liang
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241001, P.R. China
| | - Aiping Zhang
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241001, P.R. China
| | - Jianghua Yang
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241001, P.R. China
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Valluru B, Zhou Z, Sah D, Du W, Ali MO, Adam AA, Zhang L, Wang JJ. Analysis of CT characteristics in the diagnosis of Schistosoma japonicum associated appendicitis with clinical and pathological correlation: a diagnostic accuracy study. Jpn J Radiol 2019; 38:178-191. [PMID: 31823157 PMCID: PMC7002366 DOI: 10.1007/s11604-019-00905-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 11/25/2019] [Indexed: 01/09/2023]
Abstract
PURPOSE To clarify unique non-contrast CT (NCCT) characteristics for early recognition of Schistosomal associated appendicitis (SAA) differentiating from Non-schistosomal associated appendicitis (NSA). MATERIAL AND METHODS Clinical and pathological data of 50 cases with SAA and 60 cases with NSA who underwent emergency appendectomy were retrospectively compared to pre-surgical NCCT features such as direct and indirect signs of acute appendicitis as well as appendicoliths, colon calcifications as diagnostic criteria. Statistical methods such as Chi-square (χ2), t-tests, Principal component analysis (PCA), Binary Logistic regression (LR) and Factor Analysis (FA) were utilized to observe differences and isolate recognizable CT features of SAA. Pre and post hoc diagnostic performance of all criteria was calculated as sensitivity, specificity, and the Odds Ratio (OR). RESULTS Age > 50 years, diameter > 13 mm, pneumatosis, peri appendiceal abscess, focal wall defect, perforation; Orbital, linear and point types of appendicular wall calcifications; sigmoid colon and cecal curvilinear calcifications were observed as unique characteristics with a sensitivity of 84-95% and specificity of 91-98% in predicting SAA by OR of 6.2 times. Pre and post hoc hypothetical analysis did not show any significance for all other factors. CONCLUSION Factors such as elderly age, CT features such as larger appendicular diameter, appendicular wall calcifications along with sigmoid colon, and cecal calcifications, signs of perforation or abscess are characteristic for early recognition of SAA.
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Affiliation(s)
- Bimbadhar Valluru
- The Department of Radiology and Interventional Surgery, The First Affiliated Hospital of Dali University, No- 32, Jiashi Bo Da Dao Road, Xiaguan, Dali, 671003, Yunnan, People's Republic of China
| | - Zhou Zhou
- The Department of Radiology and Interventional Surgery, The First Affiliated Hospital of Dali University, No- 32, Jiashi Bo Da Dao Road, Xiaguan, Dali, 671003, Yunnan, People's Republic of China
| | - Dineswar Sah
- The Department of Radiology and Interventional Surgery, The First Affiliated Hospital of Dali University, No- 32, Jiashi Bo Da Dao Road, Xiaguan, Dali, 671003, Yunnan, People's Republic of China
| | - Wei Du
- The Department of Radiology and Interventional Surgery, The First Affiliated Hospital of Dali University, No- 32, Jiashi Bo Da Dao Road, Xiaguan, Dali, 671003, Yunnan, People's Republic of China.
| | - Mahamed O Ali
- The Department of Radiology and Interventional Surgery, The First Affiliated Hospital of Dali University, No- 32, Jiashi Bo Da Dao Road, Xiaguan, Dali, 671003, Yunnan, People's Republic of China
| | - Ahmed A Adam
- The Department of Radiology and Interventional Surgery, The First Affiliated Hospital of Dali University, No- 32, Jiashi Bo Da Dao Road, Xiaguan, Dali, 671003, Yunnan, People's Republic of China
| | - Liang Zhang
- The Department of Radiology and Interventional Surgery, Dali Bai Autonomous Prefecture Hospital, The Third Affiliated Hospital of Dali University, Dali, People's Republic of China
| | - Juan J Wang
- The Department of Radiology and Interventional Surgery, The First Affiliated Hospital of Dali University, No- 32, Jiashi Bo Da Dao Road, Xiaguan, Dali, 671003, Yunnan, People's Republic of China
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Hamid HKS. Schistosoma japonicum-Associated Colorectal Cancer: A Review. Am J Trop Med Hyg 2019; 100:501-505. [PMID: 30560774 PMCID: PMC6402928 DOI: 10.4269/ajtmh.18-0807] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Accepted: 11/26/2018] [Indexed: 12/15/2022] Open
Abstract
Schistosoma japonicum is a digenetic blood fluke that has been implicated in the carcinogenesis of several human malignancies, notably liver and colorectal cancer (CRC). Schistosoma japonicum-associated colorectal cancer (SACC) is a distinct subtype with biological behavior analogous to colitis-induced CRC. The clinicopathological characteristics of SACC include young age at diagnosis, predominance among males, a strong predilection for the sigmoid colon and rectum, multifocal distribution, frequent mucinous histology, and poor prognosis. In addition to chronic inflammation, immunomodulation, and schistosomal toxins, bacterial coinfection appears to play an important role in the carcinogenic process. The present review provides the most recent updates on epidemiology, pathobiology, and clinical and prognostic features pertaining to SACC.
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