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Variability of clinical characteristic of colorectal cancer patients – analysis of selected parameters

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Copija A., Głogowski Ł., Walkiewicz K., Janion K., Nowakowska-Zajdel E.
OncoReview
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2018
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vol. 8
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issue 3
80-85
EN
Introduction: A steady increase of the incidence of colorectal cancer has been observed for over 30 years, particularly in well-developed countries. Colorectal cancer is one of the lifestyle-related neoplasms and depends on environmental factors. Aim: Aim of the study was to analyse selected clinical features of colorectal cancer patients. Material and methods: The study group consisted of 577 consecutive patients with colorectal cancer treated in the Department of Clinical Oncology in Bytom in 2006–2014. The patients were included into the study prospectively. The analysis of selected clinical, pathological and anthropometrical parameters was conducted. Results: The study group included 237 women and 341 men aged 26 to 86 years (mean age 64.3 ± 9.2 years). Primary tumours were mostly located in the colon and had histological grade 2. The surgical removal of the primary tumour was performed in 540 patients. 65 patients underwent preoperative radiotherapy, 201 – postoperative chemotherapy and 91 – postoperative radio-chemotherapy. 132 of patients obtained the first-line palliative chemotherapy. 88 of patients did not received oncological treatment. KRAS/RAS mutation were determined in 73 patients and the EGFR expression status in 53 patients. Conclusions: Colorectal cancer patients are a heterogeneous group with differential clinical, pathological and molecular features. 1. Therapeutic management of patients with colorectal cancer largely depends on its location, clinical and pathological stage, patients performance status and comorbidities. 2. Understanding the clinical features of patients with colorectal cancer becomes helpful in designing of screening, which take into account clinical profile of the patient, i.e. age, gender, comorbidities and anthropometric characteristics
2
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The role of activation of insulin-like growth factors in colorectal cancer

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Walkiewicz K., Nowakowska-Zajdel E., Strzelczyk J., Walczak M., Copija A., Janion K., Muc-Wierzgoń M.
OncoReview
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2017
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vol. 7
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issue 3
116-120
EN
Co-occurrence of metabolic disorders is a recognized risk factor for the development of colorectal cancer which is currently the leading cause of morbidity due to malignant neoplasms in the world. The pathogenesis of colorectal cancer is not well understood yet. Among the postulated neoplastic mechanisms is the activation of insulin-like growth factors, with both epidemiological and clinical observations of their role. In this paper, the authors synthesize the current knowledge about the importance of activation of insulin-like growth factors in the development of colorectal cancer.
3
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PTEN – clinical significance in colorectal cancer

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Copija A., Waniczek D., Walkiewicz K., Głogowski Ł., Augustyniak H., Nowakowska-Zajdel E.
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EN
Phosphatase and tensin homolog deleted on chromosome ten (PTEN) is a human suppressor gene. Its protein product is a bispecific phosphatase playing the complex role in the cell cycle regulating processes and apoptosis by the mechanism of signal transduction into the cell via tyrosine kinase B signaling pathway (PI3K/Akt/mTOR). Reduction or loss of PTEN function is implicated in the pathogenesis of many malignancies, including colorectal cancer. A gradual decrease in the function of PTEN in the sequence of transformations: normal tissue–polyp–adenocarcinoma – disseminated cancer was indicated. The relation between the PTEN loss and the higher clinical severity of colorectal cancer was observed, i.a. higher TNM status and higher tendency to form metastases, leading in some of the studies to shortened patients survival during the observation period. The potential predictive value of the PTEN function loss for the EGFR-targeted therapy in patients with advanced colorectal cancer is the subject of controversy. The potential application of PTEN assessment in clinical practice as a prognostic and/or predictive factor requires further well-designed prospective studies on larger patient population, using the unified methodology. The aim of the study is to summarize the current knowledge on the role of PTEN gene and PTEN protein in the pathogenesis of colorectal cancer and the role of PTEN in clinical practice.
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Mikulicz’S Procedure with Levator Muscle and External Anal Sphincter Plasty in the Treatment of Rectal Prolapse

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Waniczek D., Copija A., Janiszewska J., Maruszczak P., Raźnikiewicz A., Arendt J.
Polish Journal of Surgery
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2012
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vol. 84
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issue 12
626-631
EN
Rectal prolapse is the partial or complete protrusion of the rectal wall into the anal canal. The most common etiology consists in the insufficiency of the diaphragm of the lesser pelvis and anal sphincter apparatus. Methods of surgical treatment involve perineal or abdominal approach surgical procedures. The aim of the study was to present the method of surgical rectal prolapse treatment, according to Mikulicz’s procedure by means of the perineal approach, based on our own experience and literature review. Material and methods. The study group comprised 16 patients, including 14 women and 2 men, aged between 38 and 82 years admitted to the department, due to rectal prolapse, during the period between 2000 and 2012. Nine female patients, aged between 68 and 82 years (mean age-76.3 years) with fullthickness rectal prolapse underwent surgery by means of Mikulicz’s method with levator muscle and external anal sphincter plasty. The most common comorbidities amongst patients operated by means of Mikulicz’s method included cardiovascular and metabolic diseases. Results. Mean hospitalization was 14.4 days (ranging between 12 and 17 days). Despite advanced age and poor general condition of the patients, complications during the perioperative period were not observed. Good early and late functional results were achieved. The degree of anal sphincter continence was determined 6-8 weeks after surgery showing significant improvement, as compared to results obtained prior to surgery. One case of recurrence consisting in mucosal prolapse was noted, being treated surgically by means of Whitehead’s method. Good treatment results were observed. Conclusion. Transperineal rectosigmoidectomy using Mikulicz’s method with levator muscle and external anal sphincter plasty seems to be an effective, minimally invasive and relatively safe procedure that does not require general anesthesia. It is recommended in case of patients with significant comorbidities and high surgical risk.
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Ocena znaczenia białka YKL-40 jako biomarkera w raku jelita grubego oraz jego powiązań z wybranymi parametrami kliniczno-patologicznymi

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Nadbrzeżna-Barczyk D., Waniczek D., Świętochowska E., Nowakowska-Zajdel E., Copija A., Raźnikiewicz A., Rykaczewska-Czerwińska M., Lorenc Z.
Annales Academiae Medicae Silesiensis
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2021
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issue 75
136-146
EN
INTRODUCTION: Colorectal cancer (CRC) is one of the most common cancers in the world, accounting for 10% of the annual global cancer incidence. This malignant neoplasm can remain asymptomatic for a long time and, despite medical advances, is too frequently diagnosed too late. The YKL-40 protein is a growth factor that stimulates endothelial cell migration, and plays a role in inflammation and neoplasia. The aim of the study was to assess the significance of YKL-40 as a biomarker in CRC and to determine the correlation between the serum YKL-40 levels in CRC patients and selected clinical and pathological parameters. MATERIAL AND METHODS: In a prospective study involving 133 patients over the age of 50, the serum YKL-40 protein level concentration was determined by the ELISA method. The patients were divided into two groups: 91 with CRC and 42 healthy. For the statistical analysis Student's t-test for independent data, the Mann-Whitney U test, and logistics regression were used. RESULTS: The YKL-40 serum concentration was significantly higher in the CRC patients (163 ± 36 μg/l) than the healthy patients (54 ± 20 μg/l; p < 0.0001). There was a statistically significant difference in the serum YKL-40 concentration between the early and intermediate stages of CRC. There was no correlation between the clinical parameters, i.e. sex, age and BMI and the serum YKL-40 protein concentration in the people with CRC. CONCLUSIONS: The YKL-40 protein seems to be a promising CRC biomarker. Its serum concentration is correlated with the stage of the cancer depending on the depth of the growth relative to the submucosa and may be a prognostic factor for an adverse prognosis of this cancer.
PL
WSTĘP: Rak jelita grubego (colorectal cancer – CRC) jest jednym z najczęstszych nowotworów na świecie – odpowiada za 10% rocznej globalnej zapadalności na raka. Przez długi czas może pozostać bezobjawowy i mimo postępu medycyny zbyt często zostaje zdiagnozowany za późno. Białko YKL-40 jest czynnikiem wzrostu stymulującym migrację komórek śródbłonka, odgrywającym rolę w stanach zapalnych oraz nowotworowych. Celem pracy była ocena znaczenia YKL-40 jako biomarkera w CRC oraz określenie powiązań stężeń YKL-40 w surowicy u chorych na CRC z wybranymi parametrami kliniczno-patologicznymi. MATERIAŁ I METODY: W badaniu prospektywnym, obejmującym 133 osoby powyżej 50 roku życia, oznaczono stężenie białka YKL-40 w surowicy metodą ELISA. Pacjentów podzielono na dwie grupy: 91 osób chorujących na CRC oraz 42 osoby zdrowe. W analizie statystycznej wykorzystano testy t-Studenta dla danych niezależnych, U Manna-Whitneya i regresję logistyczną. WYNIKI: Stężenie YKL-40 w surowicy było znacznie wyższe u chorych na CRC (163 ± 36 μg/l) niż u osób zdrowych (54 ± 20 μg/l; p < 0,0001). U osób z CRC nie wykazano zależności między parametrami klinicznymi, tj. płcią, wiekiem i wskaźnikiem masy ciała (body mass index – BMI), a stężeniem białka YKL-40 w surowicy. U chorych z CRC stężenie YKL-40 w surowicy statystycznie istotnie różniło się we wczesnym i średniozaawansowanym stadium nowotworowym. WNIOSKI: Białko YKL-40 wydaje się obiecującym biomarkerem CRC. Jego stężenie w surowicy jest skorelowane ze stopniem zaawansowania nowotworu zależnie od głębokości nacieku w stosunku do błony podśluzowej i może być czynnikiem rokowniczo niepomyślnym dla tego nowotworu.
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