Parasitic protozoans of the Cryptosporidium genus are intracellular intestinal parasites of mammals, causing cryptosporidiosis. Clinically, cryptosporidiosis manifests as chronic diarrhoea. Individuals with immune disorders, including those with neoplasms, are at risk of symptomatic invasion.The aim of the study was the evaluation of Cryptosporidium sp. prevalence in patients with diagnosed colorectal cancer.Material and methods. The studied group encompassed 87 patients with diagnosed colorectal cancer, undergoing surgery at the Department of General and Oncological Surgery, Pomeranian Medical University, in the years 2009-2010. Immunoenzymatic tests for Cryptosporidium sp. on faeces samples were performed with the use of commercial test kit, ProSpecT®Cryptosporidium Microplate Assay (Remel Inc).Results. The presence of Cryptosporidium sp. was found in 12.6% of studied patients with colorectal cancer. The performed statistical analysis did not reveal any correlation between Cryptosporidium sp. infection and gender, age, neoplasm advancement stage as per Astler-Coller scale, neoplasm differentiation grade, or neoplastic tumour localisation in relation to the splenic flexure.Conclusions. There was found high prevalence of Cryptosporidium sp. in patients with colorectal cancer. It was comparable to the prevalence reported for patients with immune deficiency.
Wstęp: Zakażenie miejsca operowanego występuje u 2,5–22,3% operowanych chorych. Jest ono wykładnikiem jakości leczenia na oddziałach zabiegowych i ma duży wpływ na jego koszt. Materiał i metodyka: Analizie poddano chorych, u których w obserwacji 30-dniowej wystąpiło zakażenie miejsca operowanego. Grupę wyjściową stanowiło 1581 chorych z rozpoznaniem raka jelita grubego poddanych zabiegowi operacyjnemu w jednym ośrodku. Kryteriami wyłączającymi z badania były: brak wiarygodnej dokumentacji leczenia (szpitalnego lub ambulatoryjnego) i zgon chorego przed 30. dniem po operacji bez rozpoznanego zakażenia miejsca operowanego. Analizę statystyczną wykonano przy użyciu programu Statistica 10. Wyniki: Powikłania pooperacyjne wystąpiły u 262 chorych (16,6%). Najczęściej występującym było zakażenie miejsca operowanego (198 pacjentów; 12,52%). Stwierdzono, że wystąpienie tego powikłania zależne było od zaawansowania klinicznego raka, wieku chorych, chorób współtowarzyszących (cukrzyca i choroby kardiologiczne). Ponadto zauważono, że powikłanie to występowało znamiennie częściej u chorych operowanych w trybie pilnym z powodu powikłań oraz u tych, u których wyłoniono stomię jelitową. Nie stwierdzono natomiast zależności wystąpienia tego powikłania od płci chorych i lokalizacji guza nowotworowego. Wniosek: U chorych po operacji raka jelita grubego największe zagrożenie wystąpienia zakażenia miejsca operowanego wystąpiło u chorych po 75. roku życia, obciążonych cukrzycą i chorobami kardiologicznymi, z dużym zaawansowaniem klinicznym raka, operowanych w trybie ostrego dyżuru, u których konieczne było wyłonienie stomii jelitowej (a szczególnie kolostomii).
In Poland there there are about 15‑16 thousand cases of colon cancer per year. The health care system allows the treatment of patients with colorectal cancer in highly specialized hospitals, oncology centers and district hospitals. The results of treatment within different reference level differ. The aim of the study was to evaluate the results of surgical treatment of patients with colorectal cancer at a district hospitals compared with the results of highly specialized center. Material and methods. A retrospective study. The material consisted of 171 consecutively operated patients diagnosed with colorectal cancer treated in the Department of Surgery, District Hospital in Wołomin. The control group consisted of 200 patients treated surgically at the Department of General and Colorectal Surgery, University Hospital in Łódź. In both centers, the patients were operated on by surgeons with experience in operations on the large bowel. The demographic data, information on the type of indication (elective vs emergent), and the severity of the disease by AJCC / TNM scale were collected. In the district hospital there were patients with more advanced disease (p <0.001), older (p = 0.0001), and often operated under emergent indication (p = 0.0001). The telephone survey collected data on survival or the date of death of the patient and set the percentage of five-year survival. Results. The proportion of five-year survival in the study group and control group was respectively 46% and 71% (p <0.0001). The percentage of five-year survival among patients undergoing elective procedure in both centers were respectively for Wołomin and Łódź 58% and 73% (p = 0.008). The proportion of 5-year survival among “younger” patients (<70) was respectively in Wołomin and Łódź 64% and 81% (p = 0.004) for “older” patients with (> 70) 50% and 60% (p = 0.6747) Conclusions. Overall results of surgical treatment of patients with colorectal cancer in the district hospital are inferior to treatment results in a highly specialized center. The population treated in the district hospital is statistically significantly different in comparison to patients treated in highly specialized center. The following differences were captured: severity of the disease, age and type of indication (elective vs emergent). The diffrences has an influence on the outcomes. The five years survival for patients > 70 years undergoing elective procedure is not statistically different between the district hospital and highly specialized center.
Due to increased colorectal cancer incidence there is a necessity of seeking new both prognostic and prediction factors that will allow to evolve new diagnostic tests. K-ras gene seems to be such a factor and its mutations are considered to be an early marker of progression of colorectal cancer. The aim of the study was to find a correlation between K-ras gene mutation in patients with diagnosed colorectal cancer and selected clinical parameters. Material and methods. A total of 104 patients (41 women and 63 men) with diagnosed colorectal cancer were included in this study. The average age of male group was 68.3 and in female group – 65.9. Samples were taken from paraffine blocks with tissue from diagnosed patients and K-ras gene mutation were identified. Afterwards the statistical analysis was made seeking the correlation betweenK-ras gene mutation incidence and clinical TNM staging system, tumour localisation, histological type, sex, age. Results. K-ras gene mutations were detected in 20.1% of all colorectal cancers. Significantly higher rate of K-ras gene mutations were diagnosed among patients classified at stage I (40%), stage IIC (50%) and stage IV (50%) according to the TNM classification. Conclusions. The results of our study are compatible with other studies and indicate the correlation between K-ras gene mutation and colorectal cancer incidence. Identification of K-ras gene mutation may complement other diagnostic methods at early stage of colorectal cancer.
Participation of DNA repair systems in the pathogenesis of cancer has been a suspected phenomenon for a long time. Decreased efficiency in DNA repair translates to their ability to fix and consequently leads to mutations and the process of carcinogenesis. Linking individual polymorphisms of DNA repair systems with an increased risk of colorectal cancer will allow the classification of patients to high-risk groups and their placement under preventive program. The aim of the study was to determine the effect of XPF gene polymorphism Ser835Ser on increasing the risk of colorectal cancer in the Polish population. Material and methods. as the material blood collected from 146 patients diagnosed with colon cancer was used. The control group consisted of 149 healthy subjects. Genotyping was performed by Taq- Man method. Results. The results indicate that genotype TCC/TCT is associated with an decreased risk of colorectal cancer (OR 0.574; CI 95% 0.335-0.984; p=0.043). Conclusions. Based on these results, we conclude that the XPF gene polymorphism Ser835Ser may be associated with a decreased risk of colorectal cancer
Colorectal cancer is one of the most commonly diagnosed cancer and a leading cause of death from cancer. DNA repair defects have been associated with an individual susceptibility to cancer. Therefore, polymorphisms of DNA repair genes, including XRCC1 gene, are suspected to may increase the risk of colorectal cancer.The aim of the study was to examine the association between Arg399Gln polymorphisms of XRCC1 gene and the occurrence of colorectal cancer. Research and understanding of the molecular basis of the formation of colorectal cancer will allow for typing of genetically loaded persons and qualifying them to a high-risk group.Material and methods. In case-control study we genotyped 150 colorectal cancer patients and 170 healthy subjects from Polish population. Analysis was performed by PCR-restriction fragment length polymorphism (PCR-RFLP).Results. We found that Gln/Gln genotype is associated with increased risk of colorectal cancer (OR 1.984; Cl 95% 1.070-3.677; p=0.029). We also found that Arg/Gln genotype is a risk factor for progression of tumor growth (OR 3.52; Cl 95% 1.157-10.707; p=0.023).Conclusions. The current state of research suggests a link between Arg399Gln XRCC1 polymorphism and increased risk of colorectal cancer. Therefore, we conclude that the Arg399Gln polymorphism of XRCC1 gene may underlie at the molecular basis of the causes of colorectal cancer.
The paper presents a case report of coexisting multifocal colorectal cancer and multifocal carcinoid of the small intestine. Our literature review did not demonstrate any report of such case. We emphasize necessity of careful inspection of abdominal cavity during any surgical procedure since small lesions, in particular in the small intestine, may be omitted - as was the case during the initial colectomy in our case. Current epidemiological data are also presented and standards of management for diagnosis and treatment of gastrointestinal carcinoid.
Colorectal cancer (CRC) is one of the deadliest cancers which lie in the incidence of morbidity in second place. Intensive research is to determine and confirm the genetic basis of this disease, which is believed may have a direct relationship with the reduced efficiency of DNA repair systems. The aim of this study was to determine the effect of APEX gene polymorphism Ile64Val on increasing the risk of colorectal cancer in the Polish population. Material and methods. The blood samples collected from 150 patients diagnosed with colon cancer was used. The control group consisted of 150 healthy subjects. Genotyping was performed by TaqMan method. Results. The results indicate that genotype Ile Val is associated with an increased risk of colorectal cancer (OR 2.069; 95% CI 1,205-3,552; p = 0.008). Conclusions. Based on these results, we conclude that the APEX gene polymorphism Ile64Val may be associated with an increased risk of colorectal cancer.
Colorectal cancer is the most common malignant neoplasm in elderly with peak of incidence in 7. and 8. decade of life. Elderly patients with colorectal cancer more often require surgery. Advanced age of patients seems to increase the risk of postoperative complications. The aim of the study was to compare the frequency of early complications in two groups of patients: under 75 and over 75, undergoing elective colorectal cancer surgery. Material and methods. 440 consecutive adult patients subjected to colorectal cancer surgery between 08.2006 to 10.2011 in Oncological Surgery Department, Gdynia Centre of Oncology. Group A (over 75 year-of-life): 109 patients, median 79 and group B (up to 75 year-of-life): 331 patients, median 65. Patients requiring emergency surgery were excluded from the study. Postoperative 30-day mortality, anastomotic leakage, wound infection, bowel obstruction, postoperative respiratory and circulatory insufficiency were among analyzed complications. Results. Symptomatic disease was observed in 81.6% of group A and in 83% of group B. Groups A and B were comparable concerning: BMI, gender, tumor staging, rate of curative and palliative resections, and duration of hospital stay. Accompanying diseases were more common in group A (83% vs 65%; p<0.0002). Early complications occurred in 21.1% of patients from group A and in 19.9% from group B. The rate of reoperation in early perioperative period didn’t differ (6.4% vs 5.7%). Features like: age, gender, additional illnesses, tumor location and staging did not influence the occurrence of perioperative complications. Conclusions. Age itself is not a risk factor for postoperative complications in spite of higher rate of accompanying diseases in elderly.
Cancer causes huge problems, physical and mental nature mainly. In particular, we cannot forget about the functioning of these patients in the social and spiritual spheres. The increasing trend of incidence of rectal cancer makes the disease is becoming a priority for doctors, nurses and psycho-oncologists. Despite the increasing quality of medical services, patients face a number of problems associated with cancer treatment, which may result in formation of a colostomy. The procedure, which is necessary to save the patient’s life, is often perceived by them as “mutilation”. Acceptance of the disease and satisfaction of life in patients with a stoma after the operation for rectal cancer are dependent on many factors. Social support, living conditions and the time elapsed since creation of the stoma have great impact. “Stoma nurse” plays an extremely important role. Seeing the difficulties in adapting the stoma she should verify the patient’s pessimism as to his/her own self, develops a sense of responsibility from minor to major issues and strengthen a sense of independence.
Background: Colorectal cancer (CRC) is one of the most common malignancies in the world. The cancer stem cell (CSC) markers are associated with aggressive cancer types and poor prognosis. The objective of the study was to evaluate the CD133 expression and to correlate it with clinicopathological features in patients with CRC. Material and Methods: Our study included ninety patients with CRC who underwent curative surgical resection from 2012 to 2017 at the University Clinic for Digestive Surgery, Skopje, North Macedonia. Tumor samples were first analyzed with standard histopathological methods and then the CD133 expression was investigated immunohistochemically. The level of expression of CD133 was classified semiquantitatively. Low positivity was defined as positive immunoreactivity in <50% of tumor glands, and high positivity was defined as positive immunoreactivity in ≥50% of tumor glands. Furthermore, clinicopathological features of patients were retrospectively reviewed. Results: High expression of CD133 was found in 47.8% of patients’ CRC samples. In 69.6% of patients with metastatic lesions in visceral organs we found high expression of CD133. We found statistically significant differences in the expression of CD133 between patients with and without visceral metastatic lesions (P = 0.0153), between patients with a different T category (P = 0.0119), N status (P = 0.0066) and grade (G) (P = 0.0115). Our results showed that the stage of disease has the greatest impact on expression of CD133 (P < 0.00001). Conclusion: High expression of CD133 is a useful marker for prediction of the clinically aggressive type of CRC and can be routinely implemented in standard pathohistological diagnostics.
Most patients diagnosed with gastrointestinal carcinomas are older people. The above-mentioned fact may lead to an erroneous finding that the problem does not concern patients aged between 20 and 30 years. Unfortunately, this assumption is often the reason for late diagnosis and delayed treatment of these malignancies. The study presented an example of three patients subject to surgical management of gastrointestinal carcinomas at the II Department of General and Gastroenterological Surgery, Medical University in Białystok.
Colorectal cancer, one of the most challenging malignancies, still has a limited number of recognized prognostic and predictive markers indicating appropriate treatment. MACC1 (metastasis-associated in colon cancer-1), a novel regulator of tumor growth and metastasis has recently been identified as an important prognostic factor of metastatic disease in colorectal cancer. The mechanism of MACC1 activity remains undetermined. Here we apply a combination of fold recognition and homology modeling algorithms to draft MACC1 function. The applied methods revealed that the MACC1 protein consists of four domains: ZU5, SH3, and two C-terminal death domains (DD). Previously a similar domain architecture (ZU5-DD) was observed in other proteins, involved mainly in signal transduction and apoptosis regulation. Based on the specific aspects of the closest homologues' biology functional hypotheses on MACC1 are proposed. A broad range of bioinformatic analyzes indicates that MACC1, besides its involvement in signal transduction from the MET receptor, links MET signaling and apoptosis.
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
The aim of the study: We evaluated the connection between the presence of the -2518 A/G MCP-1 as well as 190 G/A CCR2 polymorphic variants and colorectal cancer (CRC) occurrence. Material and methods: Study group consisted of subjects with different stages of CRC as well as healthy controls. Genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Results: W observed an association between the colorectal cancer and the GG genotype of the -2518 A/G MCP-1 single nucleotide polymorphism. No statistically significant correlation was found between CRC and the 190 G/A CCR2 polymorphism. Conclusion: The results of this study support the hypothesis that polymorphism in the MCP-1 gene may contribute to the etiology of colorectal cancer.
Hereditary mixed polyposis syndrome (HMPS) is a rare condition of unknown genetic origin. The paper presents 25-year clinical follow up in a female patient with multiple gastrointestinal tract polyps of varied histology. They most likely served as sites of multiple colorectal cancers development. The clinical course is interesting in terms of diagnostics and therapy. The patient required extended genetic testing, intensive conservative treatment and numerous surgical procedures. This is the first case of HMPS presented in Polish publications.
Colorectal carcinoma is one of the leading causes of death from cancer amongst adults. Considering its molecular background, cytokines are the key component of the inflammatory microenvironment of these tumors. Investigations that enable better understanding of colorectal cancer concerning the molecular level, may provide important tools for genetic screening of disease high-risk groups, as well as molecular diagnostics for the non-invasive detection of cancer in its early stages.The aim of the study was to evaluate the association between colorectal cancer and the -1112 C/T single nucleotide polymorphism (SNP) of the interleukin-13 gene.Material and methods. The study group comprised 150 cancer patients and 170 healthy subject genotypes from the Polish population. Analysis was performed by PCR-restriction fragment length polymorphism (PCR-RFLP).Results. We showed that the CT genotype is connected with a higher risk of colon cancer occurrence (OR 2.51; 95% CI 1.57-4.02; p < 0.0001). We also correlated the polymorphic variants of the IL-13 gene with the clinical characteristics of colorectal cancer patients. We observed no association between the investigated polymorphism and colorectal cancer progression, evaluated by tumor stage, as well as lymph node metastasis.Conclusions. The presented study suggested the possibility of a connection between the IL-13 gene polymorphism (-1112 C/T) and colorectal cancer risk in the Polish population.
Colorectal cancer (CRC) is a serious medical and economical problem of our times. It is the most common gastrointestinal cancer in the world. In Poland, the treatment and detection of CRC are poorly developed and the pathogenesis is still unclear. One hypothesis suggests a role of reactive oxygen species (ROS) in the pathogenesis of CRC. Experimental studies in recent years confirm the participation of ROS in the initiation and promotion of CRC.The aim of the study was to examine the effect of the following coordination compounds coordination compounds: dinitrate (V) tetra(3,4,5-trimethyl-N1-pyrazole-κN2) copper(II), dichloro di(3,4,5-trimethyl-N1-pyrazole-κN2) copper(II), dinitrate (V) di(1,4,5-trimethyl-N1-pyrazole-κN2) copper(II), dichloro di(1,3,4,5-tetramethyl-N1-pyrazole-κN2) copper(II) on the activity of antioxidant enzymes superoxide dismutase (SOD, ZnCu-SOD) and catalase (CAT) in a group of patients with colorectal cancer (CRC) and in the control group consisting of patients with minor gastrointestinal complaints.Material and methods. The study was conducted in 20 patients diagnosed with colorectal cancer at the age of 66.5±10.2 years (10 men and 10 women) versus the control group of 20 people (10 men and 10 women) aged 57.89±17.10 years without cancer lesions in the biological material - hemolysate prepared in a proportion of 1ml of water per 1 ml of blood. CAT activity was measured by the Beers method (1952), while SOD activity was measured by the Misra and Fridovich method (1972).Results. We found that patients with CRC showed a statistically significant decrease of SOD and CAT activity (CAT - 12,75±1.97 U/g Hb, SOD - 1111.52±155.52 U/g Hb) in comparison with the control group (CAT - 19.65±2,17 U/g Hb, SOD - 2046.26±507.22 U/g Hb). Simultaneously, we observed that the investigated coordination compounds of Cu(II) significantly increased the antioxidant activity of CAT and SOD in patients with CRC (mean: CAT 25.23±4.86 U/g Hb, SOD - 3075.96±940.20 U/g Hb).Conclusions. Patients with colorectal cancer are characterized by reduced activity of antioxidant enzymes catalase and superoxide dismutase which suggests impaired antioxidant barrier. Therefore, coordination compounds of Cu (II), which enhance the activity of CAT and SOD, may prove useful in the prevention and treatment of colorectal cancer.
One of the major causes of carcinogenesis is loss of genome stability. RAD51 in process of homologous recombination (HR) played crucial role in maintenance integrity of genome through initiate of DNA double strand breaks repair. Presence of single nucleotide polymorphism (SNP) in RAD51 gene could change the capacity of DNA repair and altered the response to damaging agents. Research on potential impact of genetic variability on development and progression CRC may contribute to setting new genetic markers or/and determined individual susceptibility to CRC.The aim of the study. This study was designed to evaluate the effect of 135 G/C (rs1801320) RAD51 polymorphism located in the 5' untraslated region on the risk and progression of CRC.Material and methods. The subjects consisted of histologically confirmed colorectal cancer (n = 200) and controls (n = 200) with lack of previous history of cancer. The distribution of genotypes was determined by restriction fragment length polymorphism PCR (RFLP - PCR). Statistical analysis was based on multivariate regression model.Results and conclusion. Our study reveal no significance association of 135 G/C RAD51 polymorphism with occurrence and progression of colorectal cancer.
Hereditary mixed polyposis syndrome (HMPS) is a rare condition of unknown genetic origin. The paper presents 25-year clinical follow up in a female patient with multiple gastrointestinal tract polyps of varied histology. They most likely served as sites of multiple colorectal cancers development. The clinical course is interesting in terms of diagnostics and therapy. The patient required extended genetic testing, intensive conservative treatment and numerous surgical procedures. This is the first case of HMPS presented in Polish publications.
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