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Khamees N, Al-Ani A, Tamimi TA, Sarhan O, Matouq Y, Laswi D, Arabiyat D, Rayyan N, Ali MR, Al-Slaimieh AI, Rayyan YM. Epidemiology and clinical characteristics of colorectal cancer and advanced adenoma: a single center experience in Jordan. BMC Gastroenterol 2025; 25:120. [PMID: 40016635 PMCID: PMC11866683 DOI: 10.1186/s12876-024-03531-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 11/21/2024] [Indexed: 03/01/2025] Open
Abstract
OBJECTIVES We evaluated the epidemiology and clinical characteristics of colorectal polyps to formulate an appropriate screening program. METHODS A retrospective chart review was conducted on all patients who underwent complete colonoscopy at Jordan University Hospital from January to September 2018. Demographics, comorbidities, lifestyle habits, medication history, family history of cancer, laboratory parameters, quality of bowel preparation, and polyp characteristics were evaluated. Binary logistic regression was utilized to find predictors of colorectal polyps. RESULTS A total of 965 patients were included in the study, with a mean age of 53.9 ± 17.1 years and a male predominance (52.7%). Polyps were detected in 28.1% of patients, with 18% having one polyp, 10.4% having two polyps, and 3.3% having more than two polyps. Multivariate analysis demonstrated that older age, high BMI, male gender, diabetes mellitus, dyslipidemia, ischemic heart disease, and family history of CRC were positive predictors of polyps. The right colon (cecum and ascending colon) was the most common location for polyps (51%), followed by the sigmoid colon (24.8%). The most common histologic subtype of polyps was tubular adenoma (48.2%). The prevalence of CRC was 18.65 per 1000 patients. CONCLUSION We highlight the fair prevalence of colorectal polyps and CRC in a Jordanian cohort. Awareness campaigns, screening strategies, and promotion of healthy lifestyles could help alleviate the burden of the disease, particularly among patients with classical risk factors for CRC.
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Affiliation(s)
- Nadia Khamees
- Department of Internal Medicine, Section of Gastroenterology, Jordan University Hospital, Amman, Jordan
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Abdallah Al-Ani
- School of Medicine, The University of Jordan, Amman, Jordan
- Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman, Jordan
- King Hussein Cancer Center, Amman, Jordan
| | - Tarek A Tamimi
- Department of Internal Medicine, Section of Gastroenterology, Jordan University Hospital, Amman, Jordan
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Omar Sarhan
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Yazan Matouq
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Dana Laswi
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Dima Arabiyat
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Nadin Rayyan
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Mustafa Rami Ali
- School of Medicine, The University of Jordan, Amman, Jordan
- Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman, Jordan
| | | | - Yaser M Rayyan
- Department of Internal Medicine, Section of Gastroenterology, Jordan University Hospital, Amman, Jordan.
- School of Medicine, The University of Jordan, Amman, Jordan.
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Tazinkeng NN, Pearlstein EF, Manda-Mapalo M, Adekunle AD, Monteiro JFG, Sawyer K, Egboh SMC, Bains K, Chukwudike ES, Mohamed MF, Asante C, Ssempiira J, Asombang AW. Incidence and risk factors for colorectal cancer in Africa: a systematic review and meta-analysis. BMC Gastroenterol 2024; 24:303. [PMID: 39251919 PMCID: PMC11382465 DOI: 10.1186/s12876-024-03385-7] [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: 11/22/2023] [Accepted: 08/26/2024] [Indexed: 09/11/2024] Open
Abstract
INTRODUCTION Colorectal cancer (CRC) is the second leading cause of cancer-related death worldwide. There is a significant burden of mortality from colorectal cancer in Africa. Due to the heterogeneity of dietary and lifestyle practices throughout Africa, our work sought to define risk factors for the development of CRC in the African continent. METHODS We systematically searched PubMed, Embase, Global Health, CINAHL, Cochrane CENTRAL, and African Index Medicus for studies written in English, examining the incidence and risk factors of CRC in Africa. A systematic analysis was done to compare different risk factors in constituent studies. A meta-analysis random effects model was fitted to estimate the pooled incidence of CRC. RESULTS Of 2471 studies screened, 26 were included for the quantitative analysis; 20 in the incidence analysis, and six in the risk factor analysis. The overall ASIR per 100,000 person-years of CRC for males and females was 7.51 and 6.22, respectively. The highest incidence rates were observed between 2012 and 2021. Risk factors for CRC in Africa include tobacco smoking, and consumption of red meat, butter, and alcohol. Protective factors included, regular consumption of fruits and regular physical activity. CONCLUSION The incidence of CRC in Africa is higher than that suggested by previous studies. Our study shows that nonmodifiable and modifiable factors contribute to CRC in Africa. High-quality studies conducted on generalizable populations that examine risk factors in a comprehensive fashion are required to inform primary and secondary prevention initiatives for CRC in Africa.
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Affiliation(s)
- Nkengeh N Tazinkeng
- Department of Internal Medicine, Newark Beth Israel Medical Center, Newark, New Jersey, USA.
- Department of Research, Pan-African Organization for Health Education and Research, Missouri, USA.
| | | | - Martha Manda-Mapalo
- Division of Hematology/Oncology, University of New Mexico, Albuquerque, NM, USA
| | | | | | - Kelsey Sawyer
- Department of Medicine, Brown University, Rhode Island, USA
| | | | - Kanwal Bains
- Department of Medicine, University of Arizona, Tucson, AZ, USA
| | | | | | - Comfort Asante
- Department of Medicine, Ndola Teaching Hospital, Lusaka, Zambia
| | | | - Akwi W Asombang
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, USA
- Department of Research, Pan-African Organization for Health Education and Research, Missouri, USA
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Rashad N, Eid Salem S, Meheissen MA, Refaat G, Mahmoud Sami H, Temerik A, Kordy N, Daniel MA, El-Kaffas M, Esam M, El Mansy H, Elkerm Y, Abdelaziz Elsaid A, Attia Ismail A, Saber Abdelhalim M, Moustafa Ahmad L, Akram Mahmoud M, El Desouky ED. Early-Onset Colorectal Cancer in Egypt: Pathological Characters, Patterns of Care, and Survival Compared to Average-Age Onset Colorectal Cancer: A Retrospective Multicenter Study. JCO Glob Oncol 2024; 10:e2300372. [PMID: 38547440 PMCID: PMC10994464 DOI: 10.1200/go.23.00372] [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: 09/30/2023] [Revised: 01/27/2024] [Accepted: 02/06/2024] [Indexed: 04/02/2024] Open
Abstract
PURPOSE Early-onset colorectal cancer (EOCRC) is a rising health problem. The incidence of EOCRC has increased over the past 2 decades all over the world. Reports from Egypt since the 1990s have reported a higher incidence among young populations with no identifiable risk factors. The aim of this study was to assess EOCRC in Egypt regarding incidence, characteristics, treatment pattern, and survival compared with average age onset and elderly patients. MATERIALS AND METHODS This was a retrospective, record-based, cohort study combining data from four different cancer centers in Egypt. We grouped patients according to age into three categories: the EOCRC group for patients age ≤45 years and the average age onset and elderly cancer group (for patients age ≥65 years). RESULTS The study included 1,310 patients with histopathologically proven colorectal cancer, representing four different geographical areas in Egypt. Patients with EOCRC represented 42.4% of the study population. Female patients were 50.6% among the EOCRC group and 52.5% among the average age group. Rectal tumors were significantly higher in EOCRC (54.7% v 40.6%; P < .001). There was no significant difference between both groups regarding the tumor stage at presentation, obstruction, or presence of metastases at presentation. Patients with EOCRC had a significantly higher rate of peritoneum/adnexa metastases than the average age ones (12.3% in EOCRC v 6.9% in the average age group; P < .001). No statistically significant differences between EOCRC and average age groups in both disease-free survival and overall survival were reported. CONCLUSION A comprehensive framework for the study of EOCRC is required in Egypt as well as a genomic analysis to identify possible underlying genetic alterations responsible for the high incidence of EOCRC.
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Affiliation(s)
- Noha Rashad
- Medical Oncology Department, Shefaa Al-Orman Oncology Hospital, Luxor, Egypt
- Clinical Oncology Department, Faculty of Medicine, Suez University, Suez, Egypt
| | - Salem Eid Salem
- Department of Medical Oncology, National Cancer Institute (NCI), Cairo University, Cairo, Egypt
| | - Mohamed A.M. Meheissen
- Clinical Oncology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
- Hope Cancer Center, Alexandria, Egypt
| | - Ghada Refaat
- Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Heba Mahmoud Sami
- Department of Medical Oncology, National Cancer Institute (NCI), Cairo University, Cairo, Egypt
| | - Abdelsalam Temerik
- Medical Oncology Department, Shefaa Al-Orman Oncology Hospital, Luxor, Egypt
| | - Nashwa Kordy
- Biostatistics, Epidemiology and Science Computing Department, Shefaa Al-Orman Oncology Hospital, Luxor, Egypt
| | - Mina A. Daniel
- Medical Oncology Department, Shefaa Al-Orman Oncology Hospital, Luxor, Egypt
| | - Mohamed El-Kaffas
- Medical Oncology Department, Shefaa Al-Orman Oncology Hospital, Luxor, Egypt
| | - Mohamed Esam
- Medical Oncology Department, Shefaa Al-Orman Oncology Hospital, Luxor, Egypt
| | - Hazem El Mansy
- Department of Cancer Management and Research, Medical Research Institute, University of Alexandria, Alexandria, Egypt
- Specialized Universal Network of Oncology (SUN), Alexandria, Egypt
| | - Yasser Elkerm
- Department of Cancer Management and Research, Medical Research Institute, University of Alexandria, Alexandria, Egypt
- Specialized Universal Network of Oncology (SUN), Alexandria, Egypt
| | - Amr Abdelaziz Elsaid
- Clinical Oncology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
- Specialized Universal Network of Oncology (SUN), Alexandria, Egypt
| | - Abdelsalam Attia Ismail
- Clinical Oncology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
- Specialized Universal Network of Oncology (SUN), Alexandria, Egypt
| | | | - Lamiaa Moustafa Ahmad
- Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mai Akram Mahmoud
- Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Eman D. El Desouky
- Department of Biostatistics and Epidemiology, National Cancer Institute, Cairo University, Cairo, Egypt
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Salim EI, Mosbah AM, Elhussiny FA, Hanafy NAN, Abdou Y. Preparation and characterization of cetuximab-loaded egg serum albumin nanoparticles and their uses as a drug delivery system against Caco-2 colon cancer cells. Cancer Nanotechnol 2023. [DOI: 10.1186/s12645-022-00153-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
AbstractTo avoid the harmful side effects of cetuximab and improve its therapeutic efficacy, egg serum albumin (ESA) was used as a targeting drug carrier moiety for cancer therapy against Caco-2 colon cancer cells. The simple improved desolvation method was used to synthesize ESA nanoparticles (ESA-NPs) and cetuximab-loaded albumin nanoparticles (CET-ANPs) with glutaraldehyde as a crosslinking agent. The ESA-NPs and CET-ANPs were spherically shaped, and their sizes and surface potentials were 100 and − 24 nm and 170 and − 20 nm, respectively, as determined using transmission electron microscopy (TEM) and a Zeta potential analyzer. The specific functional groups of the prepared nanoparticles were revealed by FTIR analysis. In the MTT (3-(4, 5-dimethylthiazolyl-2)-2, 5-diphenyltetrazolium bromide) assay, CET-ANPs exerted the highest antitumor activity after 24 h followed by CET, ESA-NPs, and pure ESA. Combination of CET + ESA-NPs at different IC50 concentrations at ratios of 1:1, 1:2, 2:1, 1:4, 4:1, 1:9, or 9:1 showed significant synergistic effects with a combination index (CI) > 1. Furthermore, the CET either loaded with ESA-NPs or administered in combination (CET + ESA NPs) caused significant apoptotic damage, as well as an S-phase or G2/M cell cycle arrest to the cancer cells, respectively. These were directly linked with a significant upregulation of mRNA expression of Caspase3 and Bax genes and an extreme downregulation of the mRNA expression of Bcl2, particularly in the combination treatment group, as compared to the untreated cells. Finally, ESA-NPs improved the effectiveness of cetuximab, strongly caused apoptotic and antiproliferative action with lower systemic toxicity, and could be suggested for the targeted administration of anticancer medications in various nanosystems.
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Shibel PEE, Abd Elmaogod EA. Immunohistochemical expression of CD155 in invasive female breast carcinoma and its correlation with tumor infiltrating natural killer cells. BENI-SUEF UNIVERSITY JOURNAL OF BASIC AND APPLIED SCIENCES 2023. [DOI: 10.1186/s43088-023-00370-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023] Open
Abstract
Abstract
Background
CD155 is an immune checkpoint protein that interacts with ligands on natural killer cells to regulate the tumor associated immunity. CD155 overexpression has been detected in many human cancer types. CD155 and its pathways are promising tumor immunotherapy targets. We aimed to evaluate the immunohistochemical expression of CD155 in invasive breast carcinomas and to correlate such expression with the pathological parameters of the tumors and also with natural killer - tumor infiltrating lymphocytes (NK-TILs) density in breast carcinomas tissue as highlighted by CD56 immunostaining. This study included 78 cases of breast carcinomas. Immunohistochemistry was performed using antibodies against CD155 which was detected on the tumor cells and CD56 as a marker for stromal NK cells.
Results
CD155 expression by the tumor cells was detected in 30.8% of the cases and correlated significantly with advanced prognostic stage, Estrogen receptor (ER) and Progesterone receptor (PR) negativity, high Ki-67 index and Human epidermal receptor 2 (HER2) enriched molecular subtype. High stromal TILs CD56 expression was detected in 28.2% of the cases and correlated significantly with high histologic grade, PR negativity, HER2 neu over-expression, high Ki-67 index, high stromal TILs and more aggressive molecular subtypes; triple negative breast cancer, HER2 enriched and Luminal B-HER2 positive. Finally, statistically significant direct correlation was detected between Tumor cells CD155 expression and high TILs CD56 expression.
Conclusions
Our results support tumor cell CD155 expression and TILs CD56 expression in breast cancers that are high grade, TILs rich and hormone receptors negative, highlighting those cases as possible candidates for CD155 targeted therapy.
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Ye X, Han P, Wu Z, Cui Y, Chen Y, Chen Z, Gao Q. New management of surveillance in patients with baseline serrated polyps: a large single-center retrospective cohort study in China. Eur J Gastroenterol Hepatol 2023; 35:181-190. [PMID: 36574309 DOI: 10.1097/meg.0000000000002494] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Serrate d polyps (SP) is associated with an increased risk of colorectal cancer. Patients with SP history tend to have SP recurrence. However, the risk factors for metachronous polyps (MP) in those patients are not well established. METHODS Data of colonoscopy were retrospectively reviewed from October 2012 to October 2021. The pathology database, electronic medical records and telephone follow-up data were also observed. RESULTS A total of 906 patients were studied including 278 patients with MPs and 628 patients without. The multiplicity of polyps (OR, 13.63; 95% CI, 8.80-21.75), older age (OR, 5.71; 95% CI, 1.87-20.63), abdominal obesity (OR, 2.46; 95% CI, 0.98-6.42), current smoker (OR, 2.93; 95% CI, 1.15-7.83) and sedentary lifestyle (OR, 1.41; 95% CI, 1.22-1.65) are significantly associated with the risk of MPs. Patients with baseline SP < 10 mm were more likely to develop higher or same risk-grade polyps (HSRGP) ( P = 0.0014). Patients with non-clinically significant SPs whether coexisted with adenoma or not were more likely to develop HSRGPs when compared to others ( P < 0.001). CONCLUSION Total number of polyps, older age, sedentary behavior, abdominal obesity and smoking status contributed to the risk of MPs at surveillance colonoscopy. Patients with grade 1 SPs might require closer surveillance. SPs coexisting with conventional adenoma did not increase the risk of MPs but may increase the risk of developing HSRGPs.
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Affiliation(s)
- Xiangxi Ye
- Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, State Key Laboratory for Oncogenes and Related Genes, Key Laboratory of Gastroenterology & Hepatology, Ministry of Health
| | - Peiyi Han
- Department of Clinical Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhijie Wu
- Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, State Key Laboratory for Oncogenes and Related Genes, Key Laboratory of Gastroenterology & Hepatology, Ministry of Health
| | - Yun Cui
- Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, State Key Laboratory for Oncogenes and Related Genes, Key Laboratory of Gastroenterology & Hepatology, Ministry of Health
| | - Yingxuan Chen
- Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, State Key Laboratory for Oncogenes and Related Genes, Key Laboratory of Gastroenterology & Hepatology, Ministry of Health
| | - Zhaofei Chen
- Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, State Key Laboratory for Oncogenes and Related Genes, Key Laboratory of Gastroenterology & Hepatology, Ministry of Health
| | - Qinyan Gao
- Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, State Key Laboratory for Oncogenes and Related Genes, Key Laboratory of Gastroenterology & Hepatology, Ministry of Health
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Yu L, Zhang MM, Hou JG. Molecular and cellular pathways in colorectal cancer: apoptosis, autophagy and inflammation as key players. Scand J Gastroenterol 2022; 57:1279-1290. [PMID: 35732586 DOI: 10.1080/00365521.2022.2088247] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Colorectal carcinogenesis (CRC) is one of the most aggressive forms of cancer, particularly in developing countries. It accounts for the second and third-highest reason for cancer-induced lethality in women and men respectively. CRC involves genetic and epigenetic modifications in colonic epithelium, leading to colon adenocarcinoma. The current review highlights the pathogenic mechanisms and multifactorial etiology of CRC, influenced by apoptosis, inflammation, and autophagy pathways. METHODS We have carried out a selective literature review on mechanisms contributing to the pathogenesis of CRC. RESULTS Resistance to senescence and apoptosis of the mesenchymal cells, which play a key role in intestinal organogenesis, morphogenesis and homeostasis, appears important for sporadic CRC. Additionally, inflammation-associated tumorigenesis is a key incident in CRC, supported by immune disruptors, adaptive and innate immune traits, environmental factors, etc. involving oxidative stress, DNA damage and epigenetic modulations. The self-digesting mechanism, autophagy, also plays a twin role in CRC through the participation of LC3/LC3-II, Beclin-1, ATG5, other autophagy proteins, and Inflammatory Bowel Disease (IBD) susceptibility genes. It facilitates the promotion of effective surveillance pathways and stimulates the generation of malignant tumor cells. The autophagy and apoptotic pathways undergo synergistic or antagonistic interactions in CRC and bear a critical association with IBD that results from the pro-neoplastic effects of persistent intestinal inflammation. Conversely, pro-inflammatory factors stimulate tumor growth and angiogenesis and inhibit apoptosis, suppressing anti-tumor activities. CONCLUSION Hence, research attempts for the development of potential therapies for CRC are in progress, primarily based on combinatorial approaches targeting apoptosis, inflammation, and autophagy.
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Affiliation(s)
- Lei Yu
- Department of Radiotherapy, The Second Hospital of Jilin University, Changchun, China
| | - Miao-Miao Zhang
- Department of Radiotherapy, The Second Hospital of Jilin University, Changchun, China
| | - Ji-Guang Hou
- Department of Radiotherapy, The Second Hospital of Jilin University, Changchun, China
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Alsadhan N, Almaiman A, Pujades-Rodriguez M, Brennan C, Shuweihdi F, Alhurishi SA, West RM. A systematic review of methods to estimate colorectal cancer incidence using population-based cancer registries. BMC Med Res Methodol 2022; 22:144. [PMID: 35590277 PMCID: PMC9118801 DOI: 10.1186/s12874-022-01632-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 05/04/2022] [Indexed: 11/14/2022] Open
Abstract
Background Epidemiological studies of incidence play an essential role in quantifying disease burden, resource planning, and informing public health policies. A variety of measures for estimating cancer incidence have been used. Appropriate reporting of incidence calculations is essential to enable clear interpretation. This review uses colorectal cancer (CRC) as an exemplar to summarize and describe variation in commonly employed incidence measures and evaluate the quality of reporting incidence methods. Methods We searched four databases for CRC incidence studies published between January 2010 and May 2020. Two independent reviewers screened all titles and abstracts. Eligible studies were population-based cancer registry studies evaluating CRC incidence. We extracted data on study characteristics and author-defined criteria for assessing the quality of reporting incidence. We used descriptive statistics to summarize the information. Results This review retrieved 165 relevant articles. The age-standardized incidence rate (ASR) (80%) was the most commonly reported incidence measure, and the 2000 U.S. standard population the most commonly used reference population (39%). Slightly more than half (54%) of the studies reported CRC incidence stratified by anatomical site. The quality of reporting incidence methods was suboptimal. Of all included studies: 45 (27%) failed to report the classification system used to define CRC; 63 (38%) did not report CRC codes; and only 20 (12%) documented excluding certain CRC cases from the numerator. Concerning the denominator estimation: 61% of studies failed to state the source of population data; 24 (15%) indicated census years; 10 (6%) reported the method used to estimate yearly population counts; and only 5 (3%) explicitly explained the population size estimation procedure to calculate the overall average incidence rate. Thirty-three (20%) studies reported the confidence interval for incidence, and only 7 (4%) documented methods for dealing with missing data. Conclusion This review identified variations in incidence calculation and inadequate reporting of methods. We outlined recommendations to optimize incidence estimation and reporting practices. There is a need to establish clear guidelines for incidence reporting to facilitate assessment of the validity and interpretation of reported incidence. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-022-01632-7.
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Affiliation(s)
- Norah Alsadhan
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia. .,School of Medicine, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
| | - Alaa Almaiman
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Mar Pujades-Rodriguez
- School of Medicine, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Cathy Brennan
- School of Medicine, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Farag Shuweihdi
- School of Medicine, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Sultana A Alhurishi
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Robert M West
- School of Medicine, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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El hanbuli HM, Galal RS, Darweesh MF, Elmahdi MH. Immunohistochemical Expression of Stanniocalcin 2 in Colorectal Cancer: A Retrospective Egyptian Study. IRANIAN JOURNAL OF PATHOLOGY 2022; 17:15-22. [PMID: 35096084 PMCID: PMC8794563 DOI: 10.30699/ijp.2021-.521799.2559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 07/11/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND & OBJECTIVE Colorectal cancer is the third most common cause of cancer death worldwide. Stanniocalcin 2 (STC2) is a glycoprotein hormone over-expressed in many human cancers where it regulates tumor progression and invasion. Evaluating its expression in colorectal cancer and its relation with different clinicopathological parameters can provide valuable information about its role in colorectal cancer progression and behavior. METHODS This retrospective study was conducted on tissue samples of colorectal cancer. The STC2 immunohistochemical expression was detected and evaluated in 60 cases of colorectal cancer tissue samples of formalin-fixed and paraffin-embedded blocks. Then statistical analysis was performed to assess the relationship between its expression level and several clinicopathological parameters in the studied cases. RESULTS Statistically significant associations were found between the high level of STC2 immunohistochemical expression and histological tumor grade (P<0.001), tumor depth of invasion (T stage) (P=0.004), lymph node metastasis (N stage) (P=0.001), tumor Dukes' stage (P<0.001), the presence of lymphovascular invasion (P<0.001), and perineural invasion (P<0.001). CONCLUSION STC2 over-expression in colorectal cancer may be associated with more aggressive tumor behavior including increased tumor invasion, higher histological grade, higher rate of nodal metastasis and increased incidence of lymphovascular and perineural invasions. These data suggest a potential role for STC2 as a predictive biomarker for tumor behavior in colorectal cancer patients.
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Affiliation(s)
- Hala M. El hanbuli
- Pathology Department, Faculty of Medicine, Fayoum University, Faiyum, Egypt,Corresponding Information: Hala M. El hanbuli, Assistant. Prof. of Pathology, Pathology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Rehab S. Galal
- Pathology Department, Faculty of Medicine, Fayoum University, Faiyum, Egypt
| | | | - Mohamed H. Elmahdi
- Pathology Department, Faculty of Medicine, Fayoum University, Faiyum, Egypt
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Makmun D, Simadibrata M, Abdullah M, Syam AF, Shatri H, Fauzi A, Renaldi K, Maulahela H, Utari AP, Pribadi RR, Muzellina VN, Nursyirwan SA. Colorectal cancer patients in a tertiary hospital in Indonesia: Prevalence of the younger population and associated factors. World J Clin Cases 2021; 9:9804-9814. [PMID: 34877319 PMCID: PMC8610908 DOI: 10.12998/wjcc.v9.i32.9804] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/15/2021] [Accepted: 09/22/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND An increasing trend in colorectal cancer (CRC) occurring at younger ages has been observed worldwide, even though incidence is declining in the general population. Most currently available guidelines still recommend CRC screening for older populations, despite an alarming rise in early-onset CRC incidence. Risk stratification is necessary to further determine the population most at risk for early-onset CRC. However, epidemiological data on related clinical characteristics and potential risk factors, especially in developing countries, have not been widely reported. AIM To investigate the prevalence, demographics, clinicopathologic features, and associated factors of young-onset CRC patients in a tertiary hospital in Indonesia. METHODS Patients undergoing colonoscopy examination between 2008 and 2019, yielding a diagnosis of CRC were identified from medical records. The subjects were classified into two groups according to their age at diagnosis, namely early-onset (18-49 years old) and late-onset (≥ 50-years-old). Demographic data, characteristics, and risk factors of both onset age groups were evaluated using the chi-square and Fisher's exact test. RESULTS Among 495 CRC patients confirmed by histopathology, 205 (41.4%) were classified as early-onset and 290 (58.6%) as late-onset. Most subjects in the early-onset CRC group were male (53.7%), with 89.8% displaying adenocarcinoma histopathology. A majority (78%) of the early-onset CRC patients had left-sided tumors, with the rectum (41%) and rectosigmoid (17.6%) being the most common sites. Abdominal pain was the most frequent symptom in the early-onset CRC patients (55.6%), which was significantly higher than that in the late-onset CRC patients (43.8%, P < 0.05). Early-onset CRC cases were more likely to be underweight (34.6% vs 20.0%, P < 0.001) compared to late-onset CRC cases. The proportion of subjects with suspected hereditary nonpolyposis colorectal cancer (HNPCC) was also higher in the early-onset CRC group than in the late-onset age group (9.3% vs 4.1%, P < 0.05). However, no difference was observed in the parental or family histories of CRC cases. CONCLUSION Early-onset CRC patients were more likely to have abdominal pain, underweight status, and HNPCC suspicion than late-onset CRC patients.
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Affiliation(s)
- Dadang Makmun
- Division of Gastroenterology, Pancreatobiliary & Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo National General Hospital, Jakarta 10430, Indonesia
| | - Marcellus Simadibrata
- Division of Gastroenterology, Pancreatobiliary & Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo National General Hospital, Jakarta 10430, Indonesia
| | - Murdani Abdullah
- Division of Gastroenterology, Pancreatobiliary & Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo National General Hospital, Jakarta 10430, Indonesia
| | - Ari F Syam
- Division of Gastroenterology, Pancreatobiliary & Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo National General Hospital, Jakarta 10430, Indonesia
| | - Hamzah Shatri
- Clinical Epidemiology Unit, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo National General Hospital, Jakarta 10430, Indonesia
| | - Achmad Fauzi
- Division of Gastroenterology, Pancreatobiliary & Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo National General Hospital, Jakarta 10430, Indonesia
| | - Kaka Renaldi
- Division of Gastroenterology, Pancreatobiliary & Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo National General Hospital, Jakarta 10430, Indonesia
| | - Hasan Maulahela
- Division of Gastroenterology, Pancreatobiliary & Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo National General Hospital, Jakarta 10430, Indonesia
| | - Amanda P Utari
- Division of Gastroenterology, Pancreatobiliary & Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo National General Hospital, Jakarta 10430, Indonesia
| | - Rabbinu R Pribadi
- Division of Gastroenterology, Pancreatobiliary & Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo National General Hospital, Jakarta 10430, Indonesia
| | - Virly N Muzellina
- Division of Gastroenterology, Pancreatobiliary & Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo National General Hospital, Jakarta 10430, Indonesia
| | - Saskia A Nursyirwan
- Division of Gastroenterology, Pancreatobiliary & Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo National General Hospital, Jakarta 10430, Indonesia
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11
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Hilal L, Hakim A, El-Chediak A, Temraz S, Mukherji D, El-Husseini Z, Shamseddine A. Rectal Cancer in Patients Younger than 40: Tumor Characteristics and Comparative Survival Based on a Single Institution. CURRENT CANCER THERAPY REVIEWS 2021. [DOI: 10.2174/1573394716999201113141003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Aim:
The aim of this study was to determine tumor characteristics and outcomes of patients
with rectal cancer <40 years old compared to those above that age at a single institution in
Lebanon.
Background:
The incidence of colorectal cancer is increasing in younger adults with limited data from the Middle East.
Objective:
Overall survival (OS) and disease-free survival (DFS) were estimated using Kaplan-Meier.
Methods:
We conducted a retrospective study of patients diagnosed with rectal cancer over 15 years. Data were collected
regarding demographics, stage, pathology, treatment, and outcomes. Patients were stratified by age with 40 years as the
cut-off. Descriptive statistics were conducted.
Results:
Data for 105 cases were reviewed, 18 patients were aged under 40 years old and 87 patients
were above 40 years old. Younger patients had more poorly differentiated tumors than older
patients and were more likely to have tumors with signet-ring features. 5-year DFS was 35% and
51.5% for patients below and above 40 years old, respectively (P=0.04). OS was similar in the two
age groups, with a median follow-up of 36 months.
Conclusion:
Further prospective studies with a larger sample size and molecular markers are needed to better understand
the characteristics of rectal cancer in the young age group. With worse DFS in our study and emerging evidence of a
correlation between younger age at diagnosis and poor outcomes, consideration should be given to more personalized
upfront intensification of treatment in the young.
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Affiliation(s)
- Lara Hilal
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Ayman Hakim
- Department of Internal Medicine, Lebanese American University Medical Center, Beirut, Lebanon
| | - Alissar El-Chediak
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Sally Temraz
- Department of Internal Medicine, Division of Hematology/Oncology, Naef K. Basile Cancer Institute - NKBCI, American University of Beirut Medical Center, Beirut, Lebanon
| | - Deborah Mukherji
- Department of Internal Medicine, Division of Hematology/Oncology, Naef K. Basile Cancer Institute - NKBCI, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ziad El-Husseini
- Department of Internal Medicine, Division of Hematology/Oncology, Naef K. Basile Cancer Institute - NKBCI, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ali Shamseddine
- Department of Internal Medicine, Division of Hematology/Oncology, Naef K. Basile Cancer Institute - NKBCI, American University of Beirut Medical Center, Beirut, Lebanon
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12
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Soliman AS, Chamberlain RM. Developing and Maintaining a Global Research Training Infrastructure for Cancer Education. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:41-49. [PMID: 34275093 DOI: 10.1007/s13187-021-02033-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/24/2021] [Indexed: 06/13/2023]
Abstract
This manuscript illustrates the 20-year process of establishing research sites that have been developed and maintained by the authors in collaboration with oncology colleagues at institutions in low- and middle-income countries. This infrastructure has been created for research training of US public health graduate students over the past 20 years for the Cancer Epidemiology Education in Special Populations (CEESP) Program funded by the US National Cancer Institute (R25 CA112383). We describe the history and resources that were utilized for developing and maintaining the research training infrastructure. We then define the elements needed for selecting and nurturing these global sites for education and research training of students. The elements include data and field resources, patient population, facilities for cancer management, laboratory resources, academic collaborators, and population parameters and cultural characteristics. These elements have also been essential in our US domestic training sites. We then emphasize the strengths and limitations of our global sites. Finally, we elaborate on our learning experience over the past 20 years. We believe that the material provided in this manuscript will serve as a useful toolkit for faculty, mentors, students, and trainees interested developing and/or utilizing research sites for cancer epidemiology and cancer prevention and control research training programs in global settings.
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Affiliation(s)
- Amr S Soliman
- City University of New York School of Medicine, 160 Convent Avenue - Harris Hall 313, New York, NY, 10031, USA.
| | - Robert M Chamberlain
- City University of New York School of Medicine, 160 Convent Avenue - Harris Hall 313, New York, NY, 10031, USA
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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13
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Metwally IH, Abdelkhalek M, Elbalka SS, Zuhdy M, Fareed AM, Eldamshity O. Clinico-epidemiologic criteria and predictors of survival of rectal cancer among Egyptians in Delta region. JOURNAL OF COLOPROCTOLOGY 2021. [DOI: 10.1016/j.jcol.2019.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Abstract
Background Colorectal cancer represents a global health problem. Rectal cancer in particular is increasing and is believed to carry a unique epidemiologic and prognostic criteria.
Method We herein study retrospectively the data of 245 patients from a tertiary center in Egypt. Clinico-epidemiologic criteria and predictors of survival are analyzed.
Results The disease affects younger population without sex predilection. Prognosis is affected by age, nodal status, metastasis, and bowel obstruction.
Conclusion Rectal cancer has unique criteria in the Egyptian population. A national population based registry is recommended to delineate the nature of the disease in Egypt.
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Affiliation(s)
- Islam H. Metwally
- Oncology Center Mansoura University (OCMU), Surgical Oncology Unit, Mansoura, Egypt
| | - Mohamed Abdelkhalek
- Oncology Center Mansoura University (OCMU), Surgical Oncology Unit, Mansoura, Egypt
| | - Saleh S. Elbalka
- Oncology Center Mansoura University (OCMU), Surgical Oncology Unit, Mansoura, Egypt
| | - Mohamed Zuhdy
- Oncology Center Mansoura University (OCMU), Surgical Oncology Unit, Mansoura, Egypt
| | - Ahmed M. Fareed
- Oncology Center Mansoura University (OCMU), Surgical Oncology Unit, Mansoura, Egypt
| | - Osama Eldamshity
- Oncology Center Mansoura University (OCMU), Surgical Oncology Unit, Mansoura, Egypt
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14
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Zuhdy M, Metwally IH, Eldamshety O, Roshdy S. Operative Feasibility and Short-Term Oncologic Outcome of Rigid Versus Flexible Platforms in Transanal Total Mesorectal Excision. Indian J Surg Oncol 2021; 12:222-228. [PMID: 33814857 DOI: 10.1007/s13193-021-01282-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 01/27/2021] [Indexed: 10/22/2022] Open
Abstract
Several transanal platforms were used to perform transanal total mesorectal excision (TaTME). They can be classified into rigid reusable platforms or flexible single-use platforms. The choice of transanal platform usually depends on the availability and the surgeon's discretion. To the best of our knowledge, this is the first study to compare the operative and oncologic outcome of flexible and rigid platforms during TaTME. This is a retrospective cohort study in which rectal cancer patients operated by TaTME in two tertiary centers from June 2013 to April 2019 were included. They were classified into two groups according to the platform used either the rigid platform group (n = 17) or the flexible platform (n = 14). Operative feasibility and short-term oncologic data were analyzed and reported. A total number of 31 patients were divided into either the rigid platform group (n = 17) versus the flexible platform one (n = 14). Shorter operating time, less blood loss, better TME specimens, and lymph node yield were reported in the flexible platform group. Flexible platforms were associated with better operative outcomes. Although there were no differences in circumferential and distal margins between the two groups, better TME specimens' quality and lymph node yield were reported in the flexible platform group. Future prospective trials are encouraged to provide better evidence.
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Affiliation(s)
- Mohammad Zuhdy
- Surgical Oncology Unit, Oncology Center Mansoura University (OCMU), Geehan Street, Mansoura, 35516 Egypt.,Department of Gastrointestinal Surgery, IRCCS San Raffaele, University Vita e Salute, San Raffaele Hospital and San Raffaele Vita-Salute University, Via Olgettina, 60 20132 Milan, Italy
| | - Islam H Metwally
- Surgical Oncology Unit, Oncology Center Mansoura University (OCMU), Geehan Street, Mansoura, 35516 Egypt
| | - Osama Eldamshety
- Surgical Oncology Unit, Oncology Center Mansoura University (OCMU), Geehan Street, Mansoura, 35516 Egypt
| | - Sameh Roshdy
- Surgical Oncology Unit, Oncology Center Mansoura University (OCMU), Geehan Street, Mansoura, 35516 Egypt
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15
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Bader El Din NG, Farouk S, Abdel-Salam LO, Khairy A. The potential value of miRNA-223 as a diagnostic biomarker for Egyptian colorectal patients. Eur J Gastroenterol Hepatol 2021; 33:25-31. [PMID: 33079781 DOI: 10.1097/meg.0000000000001961] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVES Colorectal cancer (CRC) is the third lethal malignancy worldwide. Dysregulation of microRNAs (miRNAs) mediates several growth factors signaling pathways and induces abnormal genes expression, which leads to colorectal carcinogenesis. We aimed to comprehensively assess the expression of miRNA-200c, miRNA-203a, miRNA-223 in Egyptian CRC tissue and their corresponding serum samples and to explore if they have any potential prognostic or diagnostic value for CRC patients. METHODS A total of 195 subjects (120 CRC patients and 75 healthy controls) participated in exploration and validation sets. The relative expression of miRNA-200c, miRNA-203a, and miRNA-223 was measured in both CRC tissue and serum samples, and the expressed miRNAs were compared in different CRC grades and types and the prognostic value was evaluated. RESULTS The expression levels of miRNA-200c and miRNA-203a were reduced in CRC tissue samples than adjacent noncancerous tissues. miRNA-223 level was significantly upregulated in both CRC tissue and serum samples with a positive association between them (r = 0.85, P = 0.001). The miRNA-223 can effectively discriminate CRC patients from controls and can significantly differentiate between colon and rectal cancer patients. The association between serum miRNA-223 expression and CRC development was validated in the second set and the ROC curve showed highly significant prognostic value with 90.1% sensitivity, 87% specificity, and area under the curve of 0.914 (95% confidence interval: 0.830-0.978, P = 0.0001). These results showed the association between miRNA-223 upregulation and the CRC carcinogenesis. CONCLUSION Circulating miRNA-223 can be a potential noninvasive prognostic biomarker for Egyptian CRC patients.
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Affiliation(s)
| | - Sally Farouk
- Department of Microbial Biotechnology, National Research Centre, Dokki
| | | | - Ahmed Khairy
- Endemic Medicine Department, Faculty of Medicine, Cairo University, Giza, Egypt
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16
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Hull R, Francies FZ, Oyomno M, Dlamini Z. Colorectal Cancer Genetics, Incidence and Risk Factors: In Search for Targeted Therapies. Cancer Manag Res 2020; 12:9869-9882. [PMID: 33116845 PMCID: PMC7553623 DOI: 10.2147/cmar.s251223] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 08/21/2020] [Indexed: 01/04/2023] Open
Abstract
Each year, colorectal cancers (CRCs) affect over a quarter of a million people. The risk of developing CRC in industrialized nations is approximately 5%. When the disease is localised, treatment success rates range from 70-90%; however, advanced CRC has a high mortality rate, consistently ranking in the top three causes of cancer-related deaths. There is a large geographic difference in global distribution, and CRC is predominantly associated with developed countries and a Western lifestyle and diet. As such, the developed world accounts for more than 63% of all cases of CRC. Geographic variations also predict cancer outcomes, which differ between racial and ethnic groups. This variation is due to inequalities in wealth, differences in the exposure to risk factors and barriers to high-quality cancer prevention, early detection and treatment. The aim of this paper was to review CRC in low- and middle-income countries such as South Africa, India, Brazil and China, and compare them with high-income countries such as the United States of America and the United Kingdom. It is important to note that these economically less developed countries, with historically low CRC rates, are experiencing an increased frequency of CRC. The review also discusses biological markers and genetic pathways involved in the development of colorectal cancer. Genes known to be responsible for the most common forms of inherited CRCs have also been identified but more remain to be identified. This would provide more candidate genes to be added to known biomarkers. CRC burden can be controlled through the widespread application of existing knowledge, such as reduced smoking habits, vaccination, early detection and promoting physical activity, accompanied by a healthy diet. An increased understanding of the molecular mechanisms and events underlying colorectal carcinogenesis will enable the development of new targets and therapeutic drugs.
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Affiliation(s)
- Rodney Hull
- SAMRC/UP Precision Prevention & Novel Drug Targets for HIV-Associated Cancers (PPNDTHAC) Extramural Unit, Pan African Cancer Research Institute (PACRI), University of Pretoria, Faculty of Health Sciences, Hatfield 0028, South Africa
| | - Flavia Zita Francies
- SAMRC/UP Precision Prevention & Novel Drug Targets for HIV-Associated Cancers (PPNDTHAC) Extramural Unit, Pan African Cancer Research Institute (PACRI), University of Pretoria, Faculty of Health Sciences, Hatfield 0028, South Africa
| | - Meryl Oyomno
- Department of Surgery, Faculty of Health Sciences, Steve Biko Academic Hospital and the University of Pretoria, Pretoria 0007, South Africa
| | - Zodwa Dlamini
- SAMRC/UP Precision Prevention & Novel Drug Targets for HIV-Associated Cancers (PPNDTHAC) Extramural Unit, Pan African Cancer Research Institute (PACRI), University of Pretoria, Faculty of Health Sciences, Hatfield 0028, South Africa.,Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Parktown 2193, South Africa
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17
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Salah M, Shaheen I, El-Shanawany P, Eid Saad N, Saad R, El Guibaly M, Momen N. Detection of miR-1246, miR-23a and miR-451 in sera of colorectal carcinoma patients: a case-control study in Cairo University hospital. Afr Health Sci 2020; 20:1283-1291. [PMID: 33402976 PMCID: PMC7751536 DOI: 10.4314/ahs.v20i3.33] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background Colorectal cancer (CRC) has high morbidity and mortality rates. Invasive techniques and other laboratory tests with variable sensitivity and specificity are currently used in diagnosis. Micro ribonucleic acids (miRNAs) have bio vital roles in cell proliferation and apoptosis. Dys-regulation of miRNAs is linked to tumour genesis. The objective of this study was to evaluate the specificity and sensitivity of serum non-invasive biomarkers (micro-RNAs), miR-1246, miR-23a, and miR-451in CRC patients. Methods Peripheral expression of three miRNAs (miR-1246, miR-23a and miR-451) was investigated in sera of 37 CRC Egyptian patients and 30 healthy controls, using quantitative real-time polymerase chain reaction trying to reach the optimal non-invasive combination of miRNAs. Results Serum miR-1246 was up-regulated in sera of CRC patients compared to normal controls (fold change = 3.55; P<0.001) and showed 100% sensitivity and 80% specificity in diagnosis of CRC. Serum miR-451 was significantly down-regulated in CRC patients (fold change = -4.86; p= 0.014), whereas, miR-23a was down-regulated but this was not statistically significant. Conclusion Up-regulation of miR-1246 and down-regulation of miR-451 in the sera of primary CRC Egyptian patients were confirmed with high sensitivity and specificity. Large-scale studies on a wider spectrum of miRNAs in Egyptian CRC patients are needed.
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18
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Hofseth LJ, Hebert JR, Chanda A, Chen H, Love BL, Pena MM, Murphy EA, Sajish M, Sheth A, Buckhaults PJ, Berger FG. Early-onset colorectal cancer: initial clues and current views. Nat Rev Gastroenterol Hepatol 2020; 17:352-364. [PMID: 32086499 PMCID: PMC10711686 DOI: 10.1038/s41575-019-0253-4] [Citation(s) in RCA: 238] [Impact Index Per Article: 47.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2019] [Indexed: 02/07/2023]
Abstract
Over the past several decades, the incidence of early-onset colorectal cancer (EOCRC; in patients <50 years old) has increased at an alarming rate. Although robust and scientifically rigorous epidemiological studies have sifted out environmental elements linked to EOCRC, our knowledge of the causes and mechanisms of this disease is far from complete. Here, we highlight potential risk factors and putative mechanisms that drive EOCRC and suggest likely areas for fruitful research. In addition, we identify inconsistencies in the evidence implicating a strong effect of increased adiposity and suggest that certain behaviours (such as diet and stress) might place nonobese and otherwise healthy people at risk of this disease. Key risk factors are reviewed, including the global westernization of diets (usually involving a high intake of red and processed meats, high-fructose corn syrup and unhealthy cooking methods), stress, antibiotics, synthetic food dyes, monosodium glutamate, titanium dioxide, and physical inactivity and/or sedentary behaviour. The gut microbiota is probably at the crossroads of these risk factors and EOCRC. The time course of the disease and the fact that relevant exposures probably occur in childhood raise important methodological issues that are also discussed.
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Affiliation(s)
- Lorne J Hofseth
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA.
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA.
- Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, USA.
| | - James R Hebert
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA
- Department of Epidemiology & Biostatistics, University of South Carolina, Columbia, SC, USA
| | - Anindya Chanda
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Hexin Chen
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Biology, College of Arts and Sciences, University of South Carolina, Columbia, SC, USA
| | - Bryan L Love
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Clinical Pharmacy and Outcomes Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, USA
| | - Maria M Pena
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Biology, College of Arts and Sciences, University of South Carolina, Columbia, SC, USA
| | - E Angela Murphy
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Pathology, Microbiology & Immunology, School of Medicine, University of South Carolina, Columbia, SC, USA
| | - Mathew Sajish
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, USA
| | - Amit Sheth
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Computer Science and Engineering, College of Engineering, University of South Carolina, Columbia, SC, USA
| | - Phillip J Buckhaults
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, USA
| | - Franklin G Berger
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Biology, College of Arts and Sciences, University of South Carolina, Columbia, SC, USA
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Sakr A, Elsherbiny M, Abdel Moneim R, Shaaban S, Aldaly M. Neoadjuvant FOLFIRINOX followed by Chemoradiotherapy for Middle and Lower Rectal Cancer. Asian Pac J Cancer Prev 2020; 21:1717-1723. [PMID: 32592369 PMCID: PMC7568879 DOI: 10.31557/apjcp.2020.21.6.1717] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Indexed: 01/02/2023] Open
Abstract
Objective: Neoadjuvant concomitant chemoradiotherapy followed by surgical resection is the standard of care in the treatment of rectal cancer. We are investigating the value of adding combination chemotherapy oxaliplatin, irinotecan, leucovorin and fluorouracil (FOLFIRINOX) before neoadjuvant chemoradiotherapy. Methods: Forty-one patients with middle and lower rectal cancer were included. FOLFORINOX were given every 2 weeks over 2 months (4 cycles) followed by concomitant chemoradiotherapy (CRT). Surgery was done 6-8 weeks after CRT and then adjuvant 4 months of FOLFOX or XELOX were given. The primary end point was sphincter preservation rate. Results: All patients received the four cycles of neoadjuvant chemotherapy FOLFORINOX, 38 patients completed CRT and only 29 patients underwent surgery. 32 patients were available for assessment (29 patients who underwent surgery and three patients who refuse surgery because of no evidence of disease by endoscopy, imaging and biopsy). Sphincter preservation was achieved in twenty-one patients (51.2%). Pathological complete response rate was 24.1%. After a median follow up of 24 months. Median PFS was 20 months and 2-years PFS was 62.3%. The median overall survival of all patients was not reached, while 2-years OS was 76.5%. Conclusion: Neoadjuvant FOLFIRINOX followed by CRT for middle and lower rectal cancer is feasible, tolerable with satisfactory sphincter preservation rate.
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Affiliation(s)
- Amr Sakr
- Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine (NEMROCK), Faculty of Medicine, Cairo University, Egypt
| | - Mamdouh Elsherbiny
- Clinical Oncology Department, Faculty of Medicine, Beni Suef University, Egypt
| | - Rabab Abdel Moneim
- Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine (NEMROCK), Faculty of Medicine, Cairo University, Egypt
| | - Saeed Shaaban
- Clinical Oncology Department, Faculty of Medicine, Beni Suef University, Egypt
| | - Moustafa Aldaly
- Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine (NEMROCK), Faculty of Medicine, Cairo University, Egypt
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20
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Gado A, Ebeid B, Abdelmohsen A, Axon A. Colorectal cancer in Egypt is commoner in young people: Is this cause for alarm? ALEXANDRIA JOURNAL OF MEDICINE 2019. [DOI: 10.1016/j.ajme.2013.03.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Ahmed Gado
- Department of Medicine, Bolak Eldakror Hospital, Giza, Egypt
| | - Basel Ebeid
- Department of Tropical Medicine and Infectious Diseases, Banysweef University, Banysweef, Egypt
| | - Aida Abdelmohsen
- Department of Community Medicine, National Research Center, Giza, Egypt
| | - Anthony Axon
- Department of Gastroenterology, The General Infirmary at Leeds, Leeds, United Kingdom
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21
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Aberration of Nrf2‑Bach1 pathway in colorectal carcinoma; role in carcinogenesis and tumor progression. Ann Diagn Pathol 2018; 38:138-144. [PMID: 30597358 DOI: 10.1016/j.anndiagpath.2018.11.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 11/18/2018] [Indexed: 12/30/2022]
Abstract
Nrf2 and Bach1 are important transcriptional factors that protect against reactive oxygen species (ROS). Although aberration of these molecules was associated with malignant transformation and progression, their aberration pattern in colorectal carcinoma (CRC) is not yet fully studied. In this study, Nrf2 and Bach1 were immunohistochemically examined in 93 formalin-fixed paraffin-embedded blocks of colonic tumors (65 carcinoma with their corresponding surgical margins and 28 adenomas). Nrf2 expression was gradually increased in the apparently normal mucosa (57 ± 41)-adenoma (90 ± 36)-carcinoma (198 ± 78) direction and only showed significant higher mean of expression in CRC with brisk inflammatory peritumoral response. The mean of Bach1 expression was highest in apparently normal colonic mucosa (267 ± 16), lowest in adenoma (53 ± 31) and high in carcinoma tissues (194 ± 93). Significant higher mean of expression was detected in carcinoma with: LN metastasis (p = 0.04), lymphovascular invasion (p = 0.024); perineural invasion (p = 0.03) and advanced pathological stage (p < 0.001). Significant higher mean of expression of Nrf2 and Bach1 was detected in adenoma specimens with high grade dysplasia (p = 0.016 and p = 0.024) respectively. In conclusion, Nfr2 and Bach1 expression are altered in CRC but in different way. Nrf2 is gradually increasing from normal mucosa to adenoma and was highest in carcinoma but was not associated with features of tumor invasiveness. Bach1 was highest in normal mucosa; less in adenoma then increased in carcinoma and was associated with features of tumor invasiveness and metastasis. This may indicate a possible role of Nrf2 in CRC carcinogenesis and a role of Bach1 in CRC progression.
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Zhang Q, Berger FG, Love B, Banister CE, Murphy EA, Hofseth LJ. Maternal stress and early-onset colorectal cancer. Med Hypotheses 2018; 121:152-159. [PMID: 30396471 DOI: 10.1016/j.mehy.2018.09.035] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 09/10/2018] [Accepted: 09/20/2018] [Indexed: 02/07/2023]
Abstract
Early-onset colorectal cancer (EOCRC) is defined as colorectal cancer (CRC) diagnosed before the age of 50. Alarmingly, there has been a significant increase in EOCRC diagnoses' worldwide over the past several decades. Emerging data suggest EOCRCs have distinguishing clinical, pathological, biological and molecular features; and thus, are a fundamentally different subtype of CRCs. Unfortunately, there is no simple explanation for the causes of EOCRC. Scientifically rigorous studies are needed to determine what may be driving the challenging epidemiology of EOCRC. We contend here that a reasonable hypothesis is that prenatal risk factors such as maternal stress and associated sleeping disorders influence offspring epigenetic make-up, and shape immune system and gut health contributing to an increased risk for EOCRC.
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Affiliation(s)
- Qi Zhang
- Department of Drug Discovery and Biomedical Science, College of Pharmacy, University of South Carolina, Columbia, SC, USA
| | - Franklin G Berger
- Department of Biology, College of Arts and Sciences, University of South Carolina, Columbia, SC, USA
| | - Bryan Love
- Department of Clinical Pharmacy & Outcomes Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, USA
| | - Carolyn E Banister
- Department of Drug Discovery and Biomedical Science, College of Pharmacy, University of South Carolina, Columbia, SC, USA
| | - Elizabeth A Murphy
- Department of Pathology, Microbiology and Immunology, University of South Carolina, Columbia, SC, USA
| | - Lorne J Hofseth
- Department of Drug Discovery and Biomedical Science, College of Pharmacy, University of South Carolina, Columbia, SC, USA.
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Asombang AW, Madsen R, Simuyandi M, Phiri G, Bechtold M, Ibdah JA, Lishimpi K, Banda L. Descriptive analysis of colorectal cancer in Zambia, Southern Africa using the National Cancer Disease Hospital Database. Pan Afr Med J 2018; 30:248. [PMID: 30627309 PMCID: PMC6307926 DOI: 10.11604/pamj.2018.30.248.12464] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 07/05/2018] [Indexed: 01/28/2023] Open
Abstract
Introduction Colon cancer is preventable. There is a plethora of data regarding epidemiology and screening guidelines, however this data is sparse from the African continent. Objective: we aim to evaluate the trends of colorectal cancer (CRC) in a native African population based on age at diagnosis, gender and stage at diagnosis. Methods We conducted a retrospective analysis of the Cancer Disease Hospital (CDH) registry in Zambia, Southern Africa. Results 377 charts were identified in the CDH registry between 2007 and 2015, of which 234 were included in the final analysis. The mean age at diagnosis was 48.6 years and 62% are males. Using descriptive analysis for patterns: mode of diagnosis was surgical in 195 subjects (84%), histology adenocarcinoma in 225 (96.5%), most common location is rectum 124 (53%) followed by sigmoid 31 (13.4%), and cecum 26 (11%). 122 subjects (54%) were stage 4 at diagnosis. Using the Spearman rank correlation, we see no association between year and stage at diagnosis (p = 0.30) or year and age at diagnosis (p = 0.92). Conclusion Colorectal cancer was diagnosed at a young age and late stage in the Zambian patients.
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Affiliation(s)
- Akwi Wasi Asombang
- Division of Gastroenterology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Richard Madsen
- Department of Statistics, University of Missouri-Columbia School of Medicine, Missouri, USA
| | - Michelo Simuyandi
- Center of Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia
| | | | - Matthew Bechtold
- Division of Gastroenterology and Hepatology, University of Missouri-Columbia School of Medicine, Missouri, USA
| | - Jamal Ahmad Ibdah
- Division of Gastroenterology and Hepatology, University of Missouri-Columbia School of Medicine, Missouri, USA
| | | | - Lewis Banda
- Cancer Disease Hospital (CDH), Lusaka, Zambia
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24
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Watany MM, Elmashad NM, Badawi R, Hawash N. Serum FBLN1 and STK31 as biomarkers of colorectal cancer and their ability to noninvasively differentiate colorectal cancer from benign polyps. Clin Chim Acta 2018; 483:151-155. [DOI: 10.1016/j.cca.2018.04.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 04/11/2018] [Accepted: 04/27/2018] [Indexed: 12/21/2022]
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25
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Kayamba V, Nicholls K, Morgan C, Kelly P. A seven-year retrospective review of colonoscopy records from a single centre in Zambia. Malawi Med J 2018; 30:17-21. [PMID: 29868154 PMCID: PMC5974381 DOI: 10.4314/mmj.v30i1.4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Introduction Colorectal disease is common throughout the world, but the spectrum of diagnoses across Africa remains largely unexplored. There is anecdotal evidence of changing colorectal disease but this has not been systematically investigated. The aim of this study was to enhance our insight into the spectrum of colonoscopic diagnoses in Zambia. Methods We retrieved written colonoscopy reports from January 2008 to December 2015. Collected data were coded by experienced endoscopists and analysed by age, sex, referral source, indication and diagnosis. Results Included in this analysis were 573 colonoscopy reports. The most common diagnosis was haemorrhoids (n=151, 26%), followed by tumours (n=96,17%). Over this time period, the proportion of normal colonoscopies decreased by 32% (P<0.001), presumably due to introduction of screening of all requests, while the rate of polyp detection increased from 5% to 10% (P=0.006). The detection of polyps was highest in patients less than 16 years (OR 8.4; 95% CI 2.4–26.2, P<0.001). Of those with colorectal tumours, 33/96 (35%) were less than 45 years although the occurrence was higher with advancing age (P=0.02). Diverticular disease was more common in older age groups (median (IQR) age 70 (60–75) years, versus 47 (34–62) years for those without the disease; P=0.0001). Conclusion This audit has shown that more than a third of colorectal tumours seen during colonoscopy are in patients below the age of 45 years, with the occurrence of polyps being highest in those below 16 years. Diverticular disease is most common in older age groups.
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Affiliation(s)
- Violet Kayamba
- Tropical Gastroenterology & Nutrition group, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia
| | - Kate Nicholls
- Blizard Institute, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark Street, London E1 2AT, United Kingdom
| | - Catrin Morgan
- Blizard Institute, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark Street, London E1 2AT, United Kingdom
| | - Paul Kelly
- Tropical Gastroenterology & Nutrition group, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia.,Blizard Institute, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark Street, London E1 2AT, United Kingdom
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26
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Ghorbanoghli Z, Jabari C, Sweidan W, Hammoudeh W, Cortas G, Sharara AI, Abedrabbo A, Hourani I, Mahjoubi B, Majidzadeh K, Tözün N, Ziada-Bouchaar H, Hamoudi W, Diab O, Khorshid HRK, Lynch H, Vasen H. A new hereditary colorectal cancer network in the Middle East and eastern mediterranean countries to improve care for high-risk families. Fam Cancer 2018; 17:209-212. [PMID: 28685475 PMCID: PMC5893664 DOI: 10.1007/s10689-017-0018-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Colorectal cancer (CRC) has a very high incidence in the western world. Data from registries in the Middle East showed that the incidence of CRC is relatively low in these countries. However, these data also showed that CRC incidence has increased substantially over the past three decades and that a high proportion of cases are diagnosed at an early age (<50 years). In view of these findings, more attention should be paid to prevention. Because of the often limited financial resources, focused screening of individuals with hereditary CRC, in particular those with Lynch syndrome, appears to be the most cost-effective strategy. During recent meetings of the Palestinian Society of Gastroenterology and the Mediterranean Task force for Cancer Control (MTCC) in Jericho, and the Patient's Friends Society of Jerusalem in Hebron the issue of hereditary CRC in the Middle East was discussed and the idea was conceived to establish a network on hereditary colorectal cancer (HCCN-ME) with the goal of improving care for high-risk groups in the Middle East and (Eastern) Mediterranean Countries.
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Affiliation(s)
- Zeinab Ghorbanoghli
- Department of Gastroenterology and Hepatology, Leiden University Medical Centre & Netherlands Foundation for the Detection of Hereditary Tumours, Leiden, The Netherlands
| | - Carol Jabari
- Patient's Friends Society, Jerusalem, Palestine
- Hebron University, Hebron, Palestine
| | - Walid Sweidan
- Department of Gastroenterology, Makased Islamic Charitable Hospital, Jerusalem, Palestine
| | - Wail Hammoudeh
- Department of Internal Medicine, Arabcare Hospital, Ramallah, Palestine
| | - George Cortas
- Department of Gastroenterology, St. George Hospital Medical Center, University of Balamand Medical School, Beirut, Lebanon
| | - Ala I Sharara
- Division of Gastroenterology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Amal Abedrabbo
- Department of Pediatrics, Makased Islamic Charitable Hospital, Jerusalem, Palestine
| | - Ijad Hourani
- Department of Surgery, Agusta Victoria Hospital, Jerusalem, Palestine
| | - Bahareh Mahjoubi
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Nurdan Tözün
- Department of Internal Medicine and Gastroenterology, University of Acibadem, Acibadem Kozyatagi Hospital, Istanbul, Turkey
| | - Hadia Ziada-Bouchaar
- Laboratory of Biology and Molecular Genetics, Faculty of Medicine, University 3, Constantine, Algeria
| | - Waseem Hamoudi
- Department of Gastroenterology, The Royal Hospital, Amman, Jordan
| | - Osama Diab
- Department of Internal Medicine, Creighton University, Omaha, USA
| | | | - Henry Lynch
- Creighton's Hereditary Cancer Center, Creighton University, Omaha, USA
| | - Hans Vasen
- Department of Gastroenterology & Hepatology, Leiden University Medical Centre, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
- Netherlands Foundation for the Detection of Hereditary Tumours, Leiden, The Netherlands.
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27
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Koriem KMM. Protective effect of natural products and hormones in colon cancer using metabolome: A physiological overview. Asian Pac J Trop Biomed 2017. [DOI: 10.1016/j.apjtb.2017.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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Motawi TK, Shaker OG, Ismail MF, Sayed NH. Peroxisome Proliferator-Activated Receptor Gamma in Obesity and Colorectal Cancer: the Role of Epigenetics. Sci Rep 2017; 7:10714. [PMID: 28878369 PMCID: PMC5587696 DOI: 10.1038/s41598-017-11180-6] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 08/14/2017] [Indexed: 12/23/2022] Open
Abstract
Peroxisome proliferator-activated receptor gamma (PPARγ) is a nuclear receptor that is deregulated in obesity. PPARγ exerts diverse antineoplastic effects. Attempting to determine the clinical relevance of the epigenetic mechanisms controlling the expression PPARγ and susceptibility to colorectal cancer (CRC) in obese subjects, this study investigated the role of some microRNAs and DNA methylation on the deregulation of PPARγ. Seventy CRC patients (34 obese and 36 lean), 22 obese and 24 lean healthy controls were included. MicroRNA levels were measured in serum. PPARγ promoter methylation was evaluated in peripheral blood mononuclear cells (PBMC). PPARγ level was evaluated by measuring mRNA level in PBMC and protein level in serum. The tested microRNAs (miR-27b, 130b and 138) were significantly upregulated in obese and CRC patients. Obese and CRC patients had significantly low levels of PPARγ. A significant negative correlation was found between PPARγ levels and the studied microRNAs. There was a significant PPARγ promoter hypermethylation in CRC patients that correlated to low PPARγ levels. Our results suggest that upregulation of microRNAs 27b, 130b and 138 is associated with susceptibility to CRC in obese subjects through PPARγ downregulation. Hypermethylation of PPARγ gene promoter is associated with CRC through suppression of PPARγ regardless of BMI.
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Affiliation(s)
- T K Motawi
- Biochemistry Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - O G Shaker
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - M F Ismail
- Biochemistry Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - N H Sayed
- Biochemistry Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt.
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Omran S, Barakat H, Muliira JK, McMillan S. Dietary and Lifestyle Risk Factors for Colorectal Cancer in Apparently Healthy Adults in Jordanian Hospitals. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:447-453. [PMID: 26700179 DOI: 10.1007/s13187-015-0970-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Colorectal cancer (CRC) is a frequently occurring cancer in Jordan. CRC risk is expected to continue rising due to dietary patterns, sedentary lifestyle, and other practices. The aim of this study was to describe the prevalence of dietary and lifestyle risk factors for CRC among patients attending outpatient gastroenterology clinics in Jordan. A descriptive, cross-sectional design was used to collect data from 713 asymptomatic participants. Data was collected using a self-report questionnaire measuring sociodemographic characteristics, dietary habits, physical activity, and lifestyle risk factors of CRC. The mean age of participants was 57.0 ± 8.56 years. The majority of participants were male (71.8 %) and with less than secondary school formal education (60.7 %). The commonest risk factors for CRC among the participants were overweight or obesity (76.1 %), lack of exercise (71.6 %), limited consumption of vegetables (70.8 %), smoking (60.6 %), over consumption of red meat (56.3 %), and diabetes mellitus (24.1 %). Dietary and lifestyle risk factors for CRC are prevalent in Jordan and likely to fuel an upsurge CRC if population-wide educational interventions are not implemented. There is need for greater attention and emphasis on strategies to educate the general population about healthy dietary and lifestyle habits as means of preventing CRC in Jordan.
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Affiliation(s)
- Suha Omran
- Adult Health Department/Faculty of Nursing, Jordan University of Science and Technology, PO Box 3030, Irbid, Jordan, 22110.
| | - Husam Barakat
- Gastroenterology Department/Ibn AlHaytham Hospital, Amman, Jordan
| | - Joshua Kanaabi Muliira
- Adult Health Department/ College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Susan McMillan
- College of Nursing, University of South Florida, Tampa, FL, USA
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30
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Elshafei A, Shaker O, Abd El-Motaal O, Salman T. The expression profiling of serum miR-92a, miR-375, and miR-760 in colorectal cancer: An Egyptian study. Tumour Biol 2017; 39:1010428317705765. [PMID: 28618945 DOI: 10.1177/1010428317705765] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Dysregulation in microRNA expression is a common feature in colorectal cancer. Due to the inconsistent results regarding serum miR-92a expression pattern and the insufficient studies on serum miR-375 and miR-760, we aimed in this study to investigate their expression profile and diagnostic and prognostic power in Egyptian colorectal cancer patients. The expression profile of miR-92a, miR-375, and miR-760 was determined in the sera of 64 colorectal cancer patients using quantitative real-time reverse transcription polymerase chain reaction in comparison to 27 healthy control subjects. The expression fold change of the studied microRNAs was correlated with patients' clinicopathological features. Receiver operating characteristic curve analysis was done to determine the role of these microRNAs in colorectal cancer diagnosis and follow-up according to the yielded area under the curve. The expression pattern of miR-92a was significantly upregulated (3.38 ± 2.52, p < 0.0001), while both of miR-375 and 760 were significantly downregulated (-1.250 ± 1.80, p< 0.0001; -1.710 ± 1.88, p < 0.0001, respectively) in colorectal cancer than the control. MiR-92a was positively correlated ( r = 0.671, p = 0.0001), while miR-375 and miR-760 were inversely correlated ( r = -0.414, p = 0.001; r = -0.644, p = 0.0001) with advanced colorectal cancer stages. Receiver operating characteristic curve analysis disclosed the highest diagnostic potential for miR-760 to discriminate colorectal cancer patients and early-stage colorectal cancer from the control (area under the curve = 0.922 and 0.875, respectively), while the highest prognostic potential for discrimination between colorectal cancer stages was for miR-92a. In conclusion, serum level of miR-92a, miR-375, and miR-760 may serve as biomarkers of colorectal cancer in Egyptian patients with high diagnostic power for miR-760 and high prognostic power for miR-92a.
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Affiliation(s)
- Ahmed Elshafei
- 1 Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt
| | - Olfat Shaker
- 2 Department of Medical Biochemistry, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ossama Abd El-Motaal
- 1 Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt
| | - Tarek Salman
- 1 Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt
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31
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Abou-Elwafa Abdallah M, Zaky AH, Covaci A. Levels and profiles of organohalogenated contaminants in human blood from Egypt. CHEMOSPHERE 2017; 176:266-272. [PMID: 28273534 DOI: 10.1016/j.chemosphere.2017.02.139] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 02/04/2017] [Accepted: 02/27/2017] [Indexed: 06/06/2023]
Abstract
Concentrations of polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCBs) and some organochlorine pesticides (OCPs) were determined in serum of Egyptian colorectal cancer patients (n = 35) and compared to a healthy control group (n = 32). p,p'-DDE (the major metabolite of DDT) was the most frequently detected contaminant with the highest concentration (median = 131 ng/g lw) in all studied serum samples. BDE-209 was the least frequently detected contaminant with a median concentration <0.3 ng/g lw. The contamination profile in patients and controls was almost identical with p,p'-DDE showing the highest median contribution (77%) and oxychlordane the lowest (1%). The low p,p'-DDT/p,p'-DDE ratio (3.7%) in serum implies bioaccumulation and past exposure to DDT (c.f. recent and ongoing intake). Statistical analysis revealed no significant differences (P > 0.05) between the levels of target contaminants in serum of patients and the control group. Gender, age and body mass index (BMI) were investigated as potential factors influencing serum contaminant levels. ΣDDT, hexachlorobenzene and pentachlorophenol concentrations showed significant positive associations with age and/or BMI of the participants. Comparison with other countries revealed concentrations of PBDEs and PCBs in Egyptian serum among the lowest reported worldwide.
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Affiliation(s)
- Mohamed Abou-Elwafa Abdallah
- Division of Environmental Health and Risk Management, School of Geography, Earth, and Environmental Sciences, University of Birmingham, Birmingham, B15 2TT, United Kingdom; Department of Analytical Chemistry, Faculty of Pharmacy, Assiut University, 71526, Assiut, Egypt.
| | - Amen Hamdy Zaky
- Medical Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Adrian Covaci
- Toxicological Center, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium
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Abdel-Rahman WM, Al-khayyal NA, Nair VA, Aravind SR, Saber-Ayad M. Role of AXL in invasion and drug resistance of colon and breast cancer cells and its association with p53 alterations. World J Gastroenterol 2017; 23:3440-3448. [PMID: 28596680 PMCID: PMC5442080 DOI: 10.3748/wjg.v23.i19.3440] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 03/11/2017] [Accepted: 04/21/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To characterize AXL receptor tyrosine kinase (AXL) expression in relationship to tumor protein P53 (TP53 gene, p53 protein) and its role in tumor invasion and response to therapy. METHODS We used 14 cell lines, including 3 isogenic pairs carrying mutant/knockout p53, to gain insight into the relationship between AXL and TP53. These included HCT116, HCT116.p53 mutant, RKO, and RKO.p53-/- lines (all from colon cancers) as well as breast cancer cell lines MCF7 and 1001 (MCF7-p53 mutant clone). HeLa cell line was used as a positive control for epithelial to mesenchymal transition (EMT). AXL expression was determined by Western blotting using rabbit monoclonal antibody clone C89E7. AXL siRNA silencing was performed and followed by collagen invasion assay. Cell viability analysis using the sulforhodamine B assay and the invasion assay were performed after exposure to chemotherapeutic agents (doxorubicin for breast cancer cells; 5FU or irinotecan for colon cancer cells). RESULTS We showed that the introduction of p53 mutations or knockout increased expression levels of AXL in isogenic cells compared to the matching p53 wild-type parental cells. Overall, we found a trend for correlation between the potential EMT candidate AXL, p53 alterations, and EMT markers in colorectal and breast cancers. The expression of AXL in RKO cells, a rare colon cancer cell line with inactive Wnt signaling, suggests that the AXL oncogene might provide an alternative genetic pathway for colorectal carcinogenesis in the absence of Wnt signaling activation and TP53 mutation. AXL silencing in the TP53 mutant isogenic cell lines 1001, HCT116.p53 mutant and RKO.P53-/- was > 95% efficient and the silenced cells were less invasive compared to the parental TP53 wild-type cells. AXL silencing showed a subtle trend to restore colon cancer cell sensitivity to 5FU or irinotecan. Importantly, AXL expressing cells developed more invasive potential after exposure to chemotherapy compared to the AXL-silenced cells. CONCLUSION AXL is influenced by p53 status and could cause the emergence of aggressive clones after exposure to chemotherapy. These findings could have applications in cancer management.
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Youssef MR, Attia ZI, El-Baz RA, Roshdy S, Settin A. Genetic polymorphisms of NFκB1-94ins/delATTG and NFκBIA-881A/G genes in Egyptian patients with colorectal cancer. Fam Cancer 2017; 16:517-524. [DOI: 10.1007/s10689-017-9992-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Cao DZ, Ou XL, Yu T. The association of p53 expression levels with clinicopathological features and prognosis of patients with colon cancer following surgery. Oncol Lett 2017; 13:3538-3546. [PMID: 28521456 PMCID: PMC5431169 DOI: 10.3892/ol.2017.5929] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 01/04/2017] [Indexed: 12/25/2022] Open
Abstract
The present study aimed to examine the association of p53 expression levels with clinicopathological features and prognosis of patients with colon cancer following surgery. The present study included 484 patients with colon cancer that underwent colon resection between December 2003 and December 2011. All follow-ups were censored in December 2013 with a median follow-up time of 43 months. Kaplan-Meier survival curves and Cox regression analysis were used to determine predictors for overall survival rate. p53 expression status (positive or negative) was significantly different between patient groups when categorized by age distribution, disease course, tumor location, maximum tumor diameter, depth of tumor invasion, Dukes' stage, distant metastasis and lymph node (LN) metastasis (P<0.05). Cox regression analysis revealed that age, surgery type, histological subtypes, tumor size, tumor location, LN metastasis, distant metastases, Dukes' stage and p53 expression status are independent factors influencing the survival rate of patients with colon cancer following surgery (P<0.05). Therefore, the present study revealed that the loss of p53 expression levels in tumors was associated with aggressive clinicopathological characteristics in patients with colon cancer.
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Affiliation(s)
- Da-Zhong Cao
- Department of Gastroenterology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, Jiangsu 210009, P.R. China
| | - Xi-Long Ou
- Department of Gastroenterology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, Jiangsu 210009, P.R. China
| | - Ting Yu
- Department of Gastroenterology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, Jiangsu 210009, P.R. China
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Katsidzira L, Gangaidzo I, Thomson S, Rusakaniko S, Matenga J, Ramesar R. The shifting epidemiology of colorectal cancer in sub-Saharan Africa. Lancet Gastroenterol Hepatol 2017; 2:377-383. [PMID: 28397702 DOI: 10.1016/s2468-1253(16)30183-2] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 11/04/2016] [Accepted: 11/07/2016] [Indexed: 02/07/2023]
Abstract
The perception that colorectal cancer is rare in sub-Saharan Africa is widely held; however, it is unclear whether this is due to poor epidemiological data or to lower disease rates. The quality of epidemiological data has somewhat improved, and there is an ongoing transition to western dietary and lifestyle practices associated with colorectal cancer. The impact of these changes on the incidence of colorectal cancer is not as evident as it is with other non-communicable diseases such as diabetes. In this Viewpoint, we discuss the epidemiology of colorectal cancer in sub-Saharan Africa. Colorectal cancer in this region frequently occurs at an early age, often with distinctive histological characteristics. We detail the crucial need for hypothesis-driven research on the risk factors for colorectal cancer in this population and identify key research gaps. Should colorectal cancer occur more frequently than assumed, then commensurate allocation of resources will be needed for diagnosis and treatment.
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Affiliation(s)
- Leolin Katsidzira
- Division of Gastroenterology, Department of Medicine, University of Cape Town, Cape Town, South Africa; Department of Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
| | - Innocent Gangaidzo
- Department of Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Sandie Thomson
- Division of Gastroenterology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Simbarashe Rusakaniko
- Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Jonathan Matenga
- Department of Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Raj Ramesar
- MRC/UCT Human Genetics Research Unit, Division of Human Genetics, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
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Kamal A, Darwish RK, Saad S, Salama M, El-Baradie TS, Mahmoud HGM, Elshiwy Y. Association of Osteopontin Gene Polymorphisms with Colorectal Cancer. Cancer Invest 2017; 35:71-77. [PMID: 28095066 DOI: 10.1080/07357907.2016.1247454] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
We investigated the association of the Osteopontin (OPN) (rs9138 and rs1126616) polymorphisms with colorectal cancer (CRC). One hundred CRC patients and 112 healthy individuals were subjected to OPN (rs9138 and rs1126616) genotyping and measurement of OPN protein plasma level. The C allele of OPN rs1126616 and the CC haplotype were significantly higher in CRC patient (p = 0.036, 0.003, respectively). In females, the C allele of OPN rs9318 (A/C) polymorphism was significantly associated with increased CRC risk (p = 0.036). The plasma OPN level >104.35 ng/mL was significantly associated with CRC. Our findings suggest a significant role played by OPN (rs9138 and rs1126616) in colorectal carcinogenesis.
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Affiliation(s)
- Asmaa Kamal
- a Department of Clinical & Chemical Pathology , Faculty of Medicine, Cairo University , Cairo , Egypt
| | - Rania Kamal Darwish
- a Department of Clinical & Chemical Pathology , Faculty of Medicine, Cairo University , Cairo , Egypt
| | - Samar Saad
- a Department of Clinical & Chemical Pathology , Faculty of Medicine, Cairo University , Cairo , Egypt
| | - Mohamed Salama
- b Department of Surgical Oncology , National Cancer Institute, Cairo Univeristy , Cairo , Egypt
| | - Tarek S El-Baradie
- b Department of Surgical Oncology , National Cancer Institute, Cairo Univeristy , Cairo , Egypt
| | - Heba G M Mahmoud
- b Department of Surgical Oncology , National Cancer Institute, Cairo Univeristy , Cairo , Egypt
| | - Yasmine Elshiwy
- a Department of Clinical & Chemical Pathology , Faculty of Medicine, Cairo University , Cairo , Egypt
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Kumar S, Burney IA, Zahid KF, D Souza PC, Belushi MAL, Mufti TD, Meki WAL, Furrukh M, Moundhri MSAL. Colorectal Cancer Patient Characteristics, Treatment and Survival in Oman--a Single Center Study. Asian Pac J Cancer Prev 2016; 16:4853-8. [PMID: 26163603 DOI: 10.7314/apjcp.2015.16.12.4853] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Colorectal cancer is the most common gastrointestinal cancer in Oman with an increasing incidence. We here report the presenting features, treatment outcomes and survival in a University hospital in Oman and compare our data with regional and international studies. MATERIALS AND METHODS Medical records of patients with colorectal cancer were reviewed retrospectively between June 2000 and December 2013 and were followed until June 2014. RESULTS A total of 162 patients were diagnosed with colorectal cancer. The majority were males (58.6%), with a median age of 56 years. Rectum was involved in 29.6% of patients, followed by ascending and sigmoid colon. The majority of patients had stage III (42.6%) and stage IV (32.7%) disease at presentation. K-Ras status was checked for 79 patients, and 41 (51.9%) featured the wild type. Median relapse free survival was 22 months. Median overall survival for all patients was 43 months. Observed 5 year overall survival (OS) for stages I, II and III was 100%, 60% and 60% respectively. On Log rank univariate analysis, age, BMI, diabetes, hypertension, metformin use, stage, clinical nodal status for rectal cancer, pathological T and nodal status, site of metastasis, surgical intervention, chemotherapy, radiotherapy, chemotherapy regimen, no of cycles of chemotherapy, response, RFS, site of recurrence and administration of 2nd line chemotherapy were significant factors affecting OS. On Cox regression multivariate analysis none of the factors independently affected the OS. CONCLUSIONS The majority of patients present with advanced disease and at young age. The survival rates are comparable to the published regional and international literature.
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Affiliation(s)
- Shiyam Kumar
- Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman E-mail :
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Fayaz MS, Demian GA, Fathallah WM, Eissa HES, El-Sherify MS, Abozlouf S, George T, Samir SM. Significance of Magnetic Resonance Imaging-Assessed Tumor Response for Locally Advanced Rectal Cancer Treated With Preoperative Long-Course Chemoradiation. J Glob Oncol 2016; 2:216-221. [PMID: 28717704 PMCID: PMC5497621 DOI: 10.1200/jgo.2015.001479] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Purpose To study the predictive and prognostic value of magnetic resonance imaging (MRI)–assessed tumor response after long-course neoadjuvant therapy for locally advanced rectal cancer. Methods This study included 79 patients who had T3 or T4 and/or N+ rectal cancer treated with long-course neoadjuvant chemoradiation. MRI-assessed tumor regression grade (mrTRG) was assessed in 64 patients. MRIs were reviewed by the study radiologist. Surgical and pathologic reports for those who underwent surgery were reviewed. Disease-free survival (DFS) was estimated. Progression during therapy, local relapse, metastasis, and death resulting from the tumor were classified as events. Statistical significance was calculated. Results In 11 patients, the tumor completely disappeared on MRI; that is, it had an mrTRG of 1. All but one patient, who chose deferred surgery, had a complete pathologic response (pCR), with a positive predictive value of nearly 100%. Of the 20 patients who had an mrTRG of 2 on MRI, six had a pCR. mrTRG 3, mrTRG 4, and mrTRG 5 were detected in 24, six, and three patients, respectively, of whom only one patient had a pCR. The 2-year DFS was 77%. The mrTRG was significant for DFS. The 2-year DFS was 88% for patients with a good response versus 66% for those with a poor response (P = .046). Conclusion MRI-assessed complete tumor response was strongly correlated with pCR and, therefore, can be used as a surrogate marker to predict absence of viable tumor cells. Our results can be used to implement use of mrTRGs in larger prospective correlative studies as a tool to select patients for whom deferred surgery may be appropriate. Also, those with a poor response may be offered further treatment options before definitive surgery.
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Affiliation(s)
| | | | | | | | | | - Sadeq Abozlouf
- All authors, Kuwait Cancer Control Center, Shuwaikh, Kuwait
| | - Thomas George
- All authors, Kuwait Cancer Control Center, Shuwaikh, Kuwait
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Smith BL, Ramadan M, Corley B, Hablas A, Seifeldein IA, Soliman AS. Measuring the effect of improvement in methodological techniques on data collection in the Gharbiah population-based cancer registry in Egypt: Implications for other Low- and Middle-Income Countries. Cancer Epidemiol 2015; 39:1010-4. [PMID: 26590335 DOI: 10.1016/j.canep.2015.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 09/24/2015] [Accepted: 11/01/2015] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to describe and quantify procedures and methods that maximized the efficiency of the Gharbiah Cancer Registry (GPCR), the only population-based cancer registry in Egypt. The procedures and measures included a locally-developed software program to translate names from Arabic to English, a new national ID number for demographic and occupational information, and linkage of cancer cases to new electronic mortality records of the Ministry of Health. Data was compiled from the 34,058 cases from the registry for the years 1999-2007. Cases and registry variables about demographic and clinical information were reviewed by year to assess trends associated with each new method or procedure during the study period. The introduction of the name translation software in conjunction with other demographic variables increased the identification of detected duplicates from 23.4% to 78.1%. Use of the national ID increased the proportion of cases with occupation information from 27% to 89%. Records with complete mortality information increased from 18% to 43%. Proportion of cases that came from death certificate only, decreased from 9.8% to 4.7%. Overall, the study revealed that introducing and utilizing local and culture-specific methodological changes, software, and electronic non-cancer databases had a significant impact on data quality and completeness. This study may have translational implications for improving the quality of cancer registries in LMICs considering the emerging advances in electronic databases and utilization of health software and computerization of data.
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Affiliation(s)
- Brittney L Smith
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198-4395, U.S.A
| | | | - Brittany Corley
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198-4395, U.S.A
| | | | | | - Amr S Soliman
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198-4395, U.S.A.
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Ramzy I, Hasaballah M, Marzaban R, Shaker O, Soliman ZA. Evaluation of microRNAs-29a, 92a and 145 in colorectal carcinoma as candidate diagnostic markers: An Egyptian pilot study. Clin Res Hepatol Gastroenterol 2015; 39:508-15. [PMID: 25736690 DOI: 10.1016/j.clinre.2014.12.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 12/07/2014] [Accepted: 12/15/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND Colorectal cancer (CRC) is one of the most common malignant neoplasms in Egypt, and interestingly in young age. Adenomatous polyps and inflammatory bowel diseases (IBD) are considered the commonest pre-malignant lesions for CRC. A possible diagnostic role for different microRNAs on CRC has been suggested by numerous studies. AIM OF WORK To assess the serum expression of 3 microRNA markers (miR-29a, miR-92a and miR-145) in pre-malignant and malignant colorectal lesions. PATIENTS AND METHODS The 60 patients studied were divided into 4 groups: CRC group (25 patients), IBD group (11 patients), adenomatous polyps group (14 patients) and control group (10 patients). The serum expression of the 3 markers (miR-29a, miR-92a and miR-145) has been assessed by RT-PCR. RESULTS All CRCs were sporadic cases. Significant downregulation of miR-145 in CRC group was reported at all levels, i.e. when compared to normal, among the 3 studied groups, and when compared between CRC and non-CRC groups. Significant upregulation of miR-29a in CRC was reported when compared to normal, but no significant difference existed either among the 3 studied groups or between CRC and the other 2 groups. All 3 miRNAs studied were positively inter-correlated. CONCLUSIONS miR-145 may be considered a promising non-invasive reliable diagnostic marker in CRC. Extended studies are needed to ascertain the diagnostic role of miRNAs in CRC.
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Affiliation(s)
- Iman Ramzy
- Endemic Medicine and Hepatogastroenterology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Maha Hasaballah
- Endemic Medicine and Hepatogastroenterology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Raghda Marzaban
- Endemic Medicine and Hepatogastroenterology, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Olfat Shaker
- Medical Biochemistry, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Zienab A Soliman
- Endemic Medicine and Hepatogastroenterology, Faculty of Medicine, Cairo University, Cairo, Egypt
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Elsamany SA, Alzahrani AS, Mohamed MM, Elmorsy SA, Zekri JE, Al-Shehri AS, Haggag RM, Alnagar AAR, El Taani HA. Clinico-pathological patterns and survival outcome of colorectal cancer in young patients: western Saudi Arabia experience. Asian Pac J Cancer Prev 2015; 15:5239-43. [PMID: 25040981 DOI: 10.7314/apjcp.2014.15.13.5239] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prognosis of young colorectal cancer (CRC) patients has been addressed by several studies but with contradictory results. The aim of the present study was to evaluate the clinico-pathological features of young Saudi patients with CRC in addition to displaying their survival outcome. MATERIALS AND METHODS In this retrospective study, young CRC patients (≤ 40 years) diagnosed between 2007 and 2011 from 4 centres in western Saudi Arabia, were included. Clinico-pathological features, tumor markers, dates of disease relapse and death were collected. Survival parameters were compared with those of older Saudi patients, reported in previous studies. RESULTS One hundred and sixteen young patients with CRC were identified (32.2% rectal, 67.8% colon). Some 44% were metastatic while 32.7% had stage III at diagnosis. Patients with grade 3 tumors made up 29.4% of the total while 49.5% had positive lymphovascular invasion (LVI), 56% had a lymph node (LN) ratio ≥ 0.2 and 40.2% were K-ras mutant. Median disease-free survival (DFS) and overall survival (OS) in non-metastatic cases were 22.8 and 49.6 months respectively with better median DFS in K-ras wild compared to mutant patients (28.5 vs 20.9 months, p=0.005). In metastatic cases, median OS was 19.5 months. These survival outcomes are inferior compared to those of older Saudi patients reported in prior studies. CONCLUSIONS Young CRC patients present more commonly with advanced stage and a high incidence of adverse prognostic factors such as LVI and high LN ratio. Young CRC patients seem to have worse survival compared to older Saudi patients.
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Affiliation(s)
- Shereef Ahmed Elsamany
- Department of Medical Oncology, Oncology centre, King Abdullah Medical City, Maddinah, Saudi Arabia E-mail :
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Cancer incidence in egypt: results of the national population-based cancer registry program. J Cancer Epidemiol 2014; 2014:437971. [PMID: 25328522 PMCID: PMC4189936 DOI: 10.1155/2014/437971] [Citation(s) in RCA: 357] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Revised: 09/01/2014] [Accepted: 09/07/2014] [Indexed: 12/15/2022] Open
Abstract
Background. This paper aims to present cancer incidence rates at national and regional level of Egypt, based upon results of National Cancer Registry Program (NCRP). Methods. NCRP stratified Egypt into 3 geographical strata: lower, middle, and upper. One governorate represented each region. Abstractors collected data from medical records of cancer centers, national tertiary care institutions, Health Insurance Organization, Government-Subsidized Treatment Program, and death records. Data entry was online. Incidence rates were calculated at a regional and a national level. Future projection up to 2050 was also calculated. Results. Age-standardized incidence rates per 100,000 were 166.6 (both sexes), 175.9 (males), and 157.0 (females). Commonest sites were liver (23.8%), breast (15.4%), and bladder (6.9%) (both sexes): liver (33.6%) and bladder (10.7%) among men, and breast (32.0%) and liver (13.5%) among women. By 2050, a 3-fold increase in incident cancer relative to 2013 was estimated. Conclusion. These data are the only available cancer rates at national and regional levels of Egypt. The pattern of cancer indicated the increased burden of liver cancer. Breast cancer occupied the second rank. Study of rates of individual sites of cancer might help in giving clues for preventive programs.
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Gamal el Din AA, Esmail RSE, Hareedy AA. Vascular Endothelial Growth Factor in Colonic Cancer, Ulcerative Colitis and Colonic Adenoma: An Immunohistochemical Study. Open Access Maced J Med Sci 2014. [DOI: 10.3889/oamjms.2014.075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND: Colon cancer is one of the most common malignancies worldwide. Colonic adenoma and ulcerative colitis (UC) are important precancerous lesions. Vascular Endothelial Growth Factor (VEGF) is a well-known pro-angiogenic factor plays important role in physiologic and pathologic conditions and in neovascularization in cancer and hence becomes a potential target for anti-angiogenic cancer therapy.AIM: This study investigated VEGF immunohistochemical expression in colon cancer and its precancerous lesions. MATERIAL AND METHODS:Â Paraffin blocks from two hospitals were collected in a year: Colon cancer: 20 cases, colonic adenoma: 15 cases, UC: 15 cases and 5 controls from normal mucosa. VEGF was assessed immunohistochemically using a primary anti-VEGF antibody (VG1, Dako, Denemark).RESULTS: Median age was 49 years (range 31-52) in cancer, 40 years (range 31-52) in adenomas and 33 years (range 27-43) in UC. VEGF expression was negative in control, significantly strongly positive in 90% of colonic adenocarcinoma (p= 0.001), significantly positive in adenomas (p= 0.002) - the weak positivity significantly seen in mild dysplasia (p= 0.001) - and significantly positive in 73.3% of UC cases (p=0.022).CONCLUSION: The significant increase in positivity of VEGF in precancerous to cancerous lesions may point to its potential role in the pathogenesis and progression of colonic neoplasia.
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Bishehsari F, Mahdavinia M, Vacca M, Malekzadeh R, Mariani-Costantini R. Epidemiological transition of colorectal cancer in developing countries: Environmental factors, molecular pathways, and opportunities for prevention. World J Gastroenterol 2014; 20:6055-6072. [PMID: 24876728 PMCID: PMC4033445 DOI: 10.3748/wjg.v20.i20.6055] [Citation(s) in RCA: 189] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Revised: 01/14/2014] [Accepted: 04/16/2014] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer (CRC) is one of the leading causes of cancer and cancer-related mortality worldwide. The disease has been traditionally a major health problem in industrial countries, however the CRC rates are increasing in the developing countries that are undergoing economic growth. Several environmental risk factors, mainly changes in diet and life style, have been suggested to underlie the rise of CRC in these populations. Diet and lifestyle impinge on nuclear receptors, on the intestinal microbiota and on crucial molecular pathways that are implicated in intestinal carcinogenesis. In this respect, the epidemiological transition in several regions of the world offers a unique opportunity to better understand CRC carcinogenesis by studying the disease phenotypes and their environmental and molecular associations in different populations. The data from these studies may have important implications for the global prevention and treatment of CRC.
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Albasri A, Yosef H, Hussainy A, Bukhari S, Alhujaily A. Profile of colorectal polyps: a retrospective study from King Fahad Hospital, Madinah, Saudi Arabia. Asian Pac J Cancer Prev 2014; 15:2669-73. [PMID: 24761882 DOI: 10.7314/apjcp.2014.15.6.2669] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
AIM To evaluate the predominant colorectal polyps in the Almadinah region of Saudi Arabia. MATERIALS AND METHODS In this iretrospective study, we analyzed pathology reports of colonoscopies performed in King Fahad Hospital, Madinah, Saudi Arabia during the period 2006 to 2013. Data based on patient age, gender, size, site and type of polyps and the degree of dysplasia were analyzed by software SPSS 17 and compared with other published studies from different geographic regions of the world. RESULTS During these years, 224 patients had colonic polyps, of whom 149 (66.5%) were men and 75 (33.5%) were women. The most common types of polyps were adenomatous (166), followed by hyperplastic polyps (24), juvenile (18), inflammatory (13), lipomatous (2) and one patient with Peutz-Jegher polyps. Tubulovillous adenoma was the commonest adenomatous polyp (102), followed by tubular (41) and villous (23) types. The sigmoid colon was the most commonly involved region (36.6%). Dysplasia was significantly associated with female patients who had large size tubulovillous polyps located in the left colon. CONCLUSIONS The type and distribution of colorectal polyps in Saudi Arabia is very similar to Western countries. Patient gender, and size, histological type and location of polyps are closely related to dysplastic change in colonic polyps.
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Affiliation(s)
- Abdulkader Albasri
- Department of Pathology, Taibah University, Madinah, Saudi Arabia E-mail :
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Bodalal Z, Bendardaf R. Colorectal carcinoma in a Southern Mediterranean country: The Libyan scenario. World J Gastrointest Oncol 2014; 6:98-103. [PMID: 24734155 PMCID: PMC3981974 DOI: 10.4251/wjgo.v6.i4.98] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 12/26/2013] [Accepted: 02/18/2014] [Indexed: 02/05/2023] Open
Abstract
AIM: To study the salient features of colorectal cancer (CRC) in Libya.
METHODS: Patients records were gathered at the primary oncology clinic in eastern Libya for the period of one calendar year (2012). Using this data, various parameters were analyzed and age-standardized incidence rates were determined using the direct method and the standard population.
RESULTS: During 2012, 174 patients were diagnosed with CRC, 51.7% (n = 90) male and 48.3% (n = 84) females. The average age was 58.7 (± 13.4) years, with men around 57.3 (± 13) years old and women usually 60.1 (± 13.8) years of age. Libya has the highest rate of CRC in North Africa, with an incidence closer to the European figures. The age-standardized rate for CRC was 17.5 and 17.2/100000 for males and females respectively. It was the second most common cancer, forming 19% of malignancies, with fluctuation in ranking and incidence in different cities/villages. Increasingly, younger ages are being afflicted and a higher proportion of patients are among the > 40 years subset. Nearly two-thirds presented at either stage III (22.4%) or IV (38.4%).
CONCLUSION: Cancer surveillance systems should be established in order to effectively monitor the situation. Likewise, screening programs are invaluable in the Libyan scenario given the predominance of sporadic cases.
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Hugen N, van Beek JJP, de Wilt JHW, Nagtegaal ID. Insight into mucinous colorectal carcinoma: clues from etiology. Ann Surg Oncol 2014; 21:2963-70. [PMID: 24728741 DOI: 10.1245/s10434-014-3706-6] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Indexed: 12/17/2022]
Abstract
The prognostic impact of mucinous carcinoma (MC) in colorectal cancer (CRC) has been subject to debate ever since the introduction of the classification of tumors according to their histological differentiation. MC is a distinct clinical and pathological entity within the spectrum of CRC and accounts for approximately 10-15 % of cases. Factors involved in MC development have not been completely understood, but clinical observations may lead to a better insight into the etiology of MC. In this article, we provide an in-depth review of the literature regarding etiological aspects of MC. We show that there are worldwide differences in the prevalence of MC, with low rates in Asian countries and higher rates in the western world. Moreover, MC is more commonly diagnosed in patients suffering from inflammatory bowel diseases or Lynch syndrome and an increased rate of MC is observed in patients with radiotherapy-induced CRCs. These findings are suggestive of a different oncogenic development. Identification of conditions that are associated with MC generates insight into the etiological pathways leading to the development of this special subtype.
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Affiliation(s)
- Niek Hugen
- Department of Surgery, Radboud University Medical Center, HB, Nijmegen, The Netherlands,
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Moore MA. Overview of Cancer Registration Research in the Asian Pacific from 2008-2013. Asian Pac J Cancer Prev 2013; 14:4461-84. [DOI: 10.7314/apjcp.2013.14.8.4461] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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