• Title/Summary/Keyword: colorectal cancer patients

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Digestive Neuroendocrine Tumor Distribution and Characteristics According to the 2010 WHO Classification: a Single Institution Experience in Lebanon

  • Kourie, Hampig Raphael;Ghorra, Claude;Rassy, Marc;Kesserouani, Carole;Kattan, Joseph
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.5
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    • pp.2679-2681
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    • 2016
  • Background: Gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NEN) are relatively rare tumors, not equally distributed in gastro-intestinal system. In 2010, a revised version of the WHO classification of GEP-NENs was published. This study reports for the first time the distribution and characteristics of GEP-NEN in a Lebanese population. Materials and Methods: This descriptive retrospective study concerns all the digestive neuroendocrine tumors with their characteristics diagnosed in $H\hat{o}tel$ Dieu de France in Beirut, Lebanon from 2001 to 2012, all the pathology reports being reanalyzed according to the latest WHO 2010 classification. The characteristics and features of GEP-NEN analyzed in this study were age, gender, grade and site. Results: A total of 89 GEP-NENs were diagnosed, representing 28.2% of all neuroendocrine tumors. The mean age of GEP-NEN patients was 58.7 years and the M/F sex ratio was 1.2. The primary localization was as follows: 21.3%(19) pancreatic, 18% (16) gastric, 15.7% (14) duodenal, 11.2% (10) appendix, 10.1% (9) intestinal, 10.1% (9) colorectal (7.9% colonic and 2.2% rectal), 5.6% (4) hepatic, 2.2% (2) ampulla, 1.1% (1) esophageal and 7.9%(5) NOS digestive (metastatic with unknown primary). Of the 89 patients with GEP-NEN, 56.2% (50) were diagnosed as grade I, 11.2% (10) as grade II, 20.2% (18) as grade III and 12.4% (11) were considered as mixed adeno-neuroendocrine carcinomas (MANEC). Conclusions: This study, one of the rare examples based on the 2010 WHO classification of neuroendocrine tumors in the literature, indicates that in the Lebanese population, all duodenal and appendicular tumors are G1 and the majority of MANEC tumors are gastric and pancreatic tumors. Moreover, more duodenal tumors and fewer rectal tumors were encountered in our study compared to European reports.

IMMUNOHISTOCHEMICAL STUDY OF AURORA-2 KINASE IN THE ORAL SQUAMOUS CELL CARCINOMA (구강편평상피암종에서 Aurora-2 kinase 발현에 대한 면역조직화학적 연구)

  • Han, Se-Jin;Kim, Se-Woong;Kim, Kyung-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.2
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    • pp.112-117
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    • 2010
  • Aurora kinases represent a novel family of serine/threonine kinases crucial for cell cycle control. Aurora-2 kinase is mainly involved in centrosome function, mitotic entry, and spindle assembly. Aurora-2 kinase overexpression causes centrosome amplification and the formation of multipolar mitotic spindles, which leads to tumor aneuploidy and so it has been found to play an important role in tumorigenicity in many cancers such as colorectal cancer, breast cancer and cervical cancer. Hence, the goal of this study is to identify the correlation of clinicopathlogical factors and overexpression of Aurora-2 kinase in oral squamous cell carcinoma. We studied the immunohistochemical staining of Aurora-2 kinase in 20 specimens of 20 patients with oral squamous cell carcinoma and the relationships between Aurora-2 kinase over expression and each of the clinico-pathological parameters were analyzed by Pearson correlation analysis. Statistical significance was set at P < 0.05. The results were as follows. 1. In the immunohistochemical study of poorly differentiated and invasive oral squamous cell carcinoma, the high level staining of Aurora-2 kinase was observed. 2. The correlation between immunohistochemical Aurora-2 kinase expression and histopathological differentiation of specimens was significant. These findings suggest that overexpression of Aurora-2 kinase may play a important role in carcinogenesis of oral squamous cell carcinoma.

Comparison of Stereotactic Radiosurgery and Whole Brain Radiotherapy in Patients with Four or More Brain Metastases (4개 이상의 다발성 전이성 뇌종양의 정위적 방사선수술과 전뇌 방사선조사의 비교)

  • Kim, Cheol-Jin;Baek, Mi-Young;Park, Sung-Kwang;Ahn, Ki-Jung;Cho, Heung-Lae
    • Radiation Oncology Journal
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    • v.27 no.3
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    • pp.163-168
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    • 2009
  • Purpose: This study was a retrospective evaluation of the efficacy of stereotactic radiosurgery (SRS) in patients with >4 metastases to the brain. Materials and Methods: Between January 2004 and December 2006, 68 patients with $\geq$4 multiple brain metastases were included and reviewed retrospectively. Twenty-nine patients received SRS and 39 patients received whole brain radiotherapy (WBRT). Patients with small cell lung cancers and melanomas were excluded. The primary lesions were non-small cell lung cancer (69.0%) and breast cancer (13.8%) in the SRS group and non-small cell lung cancer (64.1%), breast cancer (15.4%), colorectal cancer (12.8%), esophageal cancer (5.1%) in the WBRT group. SRS involved gamma-knife radiosurgery and delivered 10~20 Gy (median, 16 Gy) in a single fraction with a 50% marginal dose. WBRT was delivered daily in 3 Gy fractions, for a total of 30 Gy. After completion of treatment, a follow-up brain MRI or a contrast-enhanced brain CT was reviewed. The overall survival and intracranial progression-free survival were compared in each group. Results: The median follow-up period was 5 months (range, 2~19 months) in the SRS group and 6 months (range, 4~23 months) in the WBRT group. The mean number of metastatic lesions in the SRS and WBRT groups was 6 and 5, respectively. The intracranial progression-free survival and overall survival in the SRS group was 5.1 and 5.6 months, respectively, in comparison to 6.1 and 7.2 months, respectively, in the WBRT group. Conclusion: SRS was less effective than WBRT in the treatment of patients with >4 metastases to the brain.

Comparison of Results between Cytogenetic Technique and Molecular Genetic Technique in Colorectal Carcinoma Patients (대장암환자의 염색체 결실에서 세포유전학적 기법과 분자유전학적 기법의 결과 비교)

  • Park, Cheolin;Lee, Jae Sik
    • Korean Journal of Clinical Laboratory Science
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    • v.49 no.3
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    • pp.285-293
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    • 2017
  • Globally, 1.3 million people develop colon cancer every year, and 600,000 people die each year it. In Korea, colorectal carcinoma was associated with the highest death rate, accounting for 8,380 people, among solid cancers in 2015. Among the various methods for the diagnosis and study of colorectal carcinoma, the results obtained by cytogenetic and molecular genetic methods were compared. Detection rate was 47% in 18q, 40% in 17p, 27% in 22q, and 17% in 10q via CGH; detection rate was 57% in D18S59, 50% in D18S68, 50% in TP53CA, 47% in D18S6940% in D22S274, 37% in D22S283, 27% in D10S187, and 23% in D10S541 with LOH. Microsatellite marker matching rates were 100% in D22S274, 100% in D22S283, 100% in D10S186, 100% in D10S187, 100% in D10S541, 93% in D18S69, 93% in D18S68, 92% in TP53CA, and 89% in D18S59. The agreement rate between the two methods was 94.4% based on positive results using CGH. Based on the advantages of CGH, which was the ability to obtain information regarding the entire tumor genome at once, this experiment could identify the region with significant deletion using CGH and the more limited region LOH, with a completely different approach. LOH in the recurrent high-risk group, 18q21, was helpful in the selection of treatment modalities and in prognostic estimation as well as making the most appropriate decision for treatment. Therefore, it is suggested that LOH with surgical site tissues could be one of the treatment methods for recurrent high-risk group among patients with colorectal carcinoma.

Lower Extremity Edema in Terminal Cancer Patients (말기 암 환자에서의 하지 부종)

  • Shim, Byoung-Yong;Hong, Seok-In;Park, Ji-Chan;Hong, Sug-Hui;Choi, Gang-Heun;Cho, Hong-Joo;Kim, Seon-Young;Han, Sun-Ae;Lee, Ok-Kyung;Kim, Hoon-Kyo
    • Journal of Hospice and Palliative Care
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    • v.8 no.2
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    • pp.152-155
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    • 2005
  • Purpose: The lower extremity edema (LEE) is a common distressful symptom in advanced cancer patients and is hard to manage. We analyze the characteristics of LEE in patients with advanced cancer to provide the basic information of causes and adequate management. Methods: Physical examination, assessment of the location and severity of edema, blood chemistry (albumin, creatinine), Doppler Sono for patients with suspecting deep vein thrombosis (DVT), and abdomen CT scan for patient with suspecting lymph edema were performed. Severity of edema was classified according to NCI lymph edema scaling and improvement was defined as lowering at least 1 grade of edema after management. Results: Among 154 patient who had been admitted to Hospice Ward from Mar 2003 to Jan 2004, 33 had LEE, and 6 had both upper extremity edema and LEE except generalized edema. Their underlying cancers were stomach (7), lung (6), biliary tract (5), liver (5), colorectal (5), pancreas (2), and others (9). There were 12 patient with grade I, 20 patients with grade II, and 7 patients with grade III edema. The causes were hypoalbuminemia (11), lymph edema (10), DVT (7), obstruction of inferior vena cava (IVC) or portal vein (6), and dependent edema (5). The common managements were including leg elevation and diuretics. Elastic stocking was applied for patients with DVT and leg massage and pneumatic compression was used for lymph edema. The 2/3 patients were improved after management. Conclusion: The incidence of LEE in terminal cancer pts was high (25.3%) and their causes were variable including lymph edema, DVT, hypoalbuminemia and dependent edema. Active noninvasive management according to causes could result in good palliation.

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Current Status and Future Perspective of PET (PET 이용 현황 및 전망)

  • Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.1
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    • pp.1-7
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    • 2002
  • Positron Emission Tomography (PET) is a nuclear medicine imaging modality that consists of systemic administration to a subject of a radiopharmaceutical labeled with a positron-emitting radionuclide. Following administration, its distribution in the organ or structure under study can be assessed as a function of time and space by (1) defecting the annihilation radiation resulting from the interaction of the positrons with matter, and (2) reconstructing the distribution of the radioactivity from a series of that used in computed tomography (CT). The nuclides most generally exhibit chemical properties that render them particularly desirable in physiological studies. The radionuclides most widely used in PET are F-18, C-11, O-15 and N-13. Regarding to the number of the current PET Centers worldwide (based on ICP data), more than 300 PET Centers were in operation in 2000. The use of PET technology grew rapidly compared to that in 1992 and 1996, particularly in the USA, which demonstrates a three-fold rise in PET installations. In 2001, 194 PET Centers were operating in the USA. In 1994, two clinical and research-oriented PET Centers at Seoul National University Hospital and Samsung Medical Center, was established as the first dedicated PET and Cyclotron machines in Korea, followed by two more PET facilities at the Korea Cancer Center Hospital, Ajou Medical Center, Yonsei University Medical Center, National Cancer Center and established their PET Center. Catholic Medical School and Pusan National University Hospital have finalized a plan to install PET machine in 2002, which results in total of nine PET Centers in Korea. Considering annual trends of PET application in four major PET centers in Korea in Asan Medical Center recent six years (from 1995 to 2000), a total of 11,564 patients have been studied every year and the number of PET studies has shown steep growth year upon year. We had 1,020 PET patients in 1995. This number increased to 1,196, 1,756, 2,379, 3,015 and 4,414 in 1996,1997,1998,1999 and 2000, respectively. The application in cardiac disorders is minimal, and among various neuropsychiatric diseases, patients with epilepsy or dementia can benefit from PET studios. Recently, we investigated brain mapping and neuroreceptor works. PET is not a key application for evaluation of the cardiac patients in Korea because of the relatively low incidence of cardiac disease and less costly procedures such as SPECT can now be performed. The changes in the application of PET studios indicate that, initially, brain PET occupied almost 60% in 1995, followed by a gradual decrease in brain application. However, overall PET use in the diagnosis and management of patients with cancer was up to 63% in 2000. The current medicare coverage policy in the USA is very important because reimbursement policy is critical for the promotion of PET. In May 1995, the Health Care Financing Administration (HCFA) began covering the PET perfusion study using Rubidium-82, evaluation of a solitary pulmonary nodule and pathologically proven non-small cell lung cancer. As of July 1999, Medicare's coverage policy expanded to include additional indications: evaluation of recurrent colorectal cancer with a rising CEA level, staging of lymphoma and detection of recurrent or metastatic melanoma. In December of 2001, National Coverage decided to expand Medicare reimbursement for broad use in 6 cancers: lung, colorecctal, lymphoma, melanoma, head and neck, and esophageal cancers; for determining revascularization in heart diseases; and for identifying epilepsy patients. In addition, PET coverage is expected to further expand to diseases affecting women, such as breast, ovarian, uterine and vaginal cancers as well as diseases like prostate cancer and Alzheimer's disease.

The Usefulness of F-18 FDG Whole Body PET in the Evaluation of Postoperative Recurrence of Cancer (수술 후 암 재발 판정에 있어서 전신 F-18 FDG-PET의 유용성)

  • Kang, Won-Jun;So, Young;Jeong, Jae-Min;Kwark, Cheol-Eun;Lee, Dong-Soo;Kang, Soon-Bem;Jung, Hee-Won;Kim, Kwang-Hyun;Park, Jae-Gahb;Lee, Myung-Chul;Koh, Chang-Soon;Chung, June-Key
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.3
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    • pp.372-380
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    • 1997
  • The purpose of this study was to evaluate the usefulness of whole body F-18 FDG PET scan for detecting postoperative recurrence of cancer. One hundred four cancer patients after operation were enrolled(14 brain tumor, 15 head and neck cancer, 23 gynecologic cancer, 16 gastrointestinal cancer, 16 thyroid cancer, and 20 other cancers). Besides conventional images(CI) including CT and MRI, F-18 FDG PET scan was obtained on ECAT EXACT 47 scanner(Siemens-CTI), beginning 60 minutes after injection of 370MBq(10mCi) of F-18 FDG. Regional scan was also obtained with emission image. Transmission images using Ge-68 were carried out for attenuation correction in both whole body and regional images. Findings of PET, and CI were confirmed by pathology or clinical follow up. The sensitivity and specificity of PET for detecting recurrence were 94% and 92%, respectively. Contrarily, the sensitivity and specificity of CI were 78% and 68%. CI results were negative and PET results were positive in 11 cases. The biopsy or clinical follow-up of those cases confirmed recurrence of tumor. False negative cases of CI were frequent in patients with gynecologic cancers. Also we measured the serum concentration of tumor markers in patients with gynecologic cancer(CA125), thyroid cancer(thyroglobulin), and colorectal cancer(CEA). The sensitivity and specificity of tumor markers were 71% and 84%, respectively, We conclude that F-18 FDG PET can be used valuably in detecting recurrent foci of a wide variety of malignancy compared to conventional diagnostic methods.

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Research of Colonoscope Robot With Rotary Inertia Type Locomotion Mechanism (회전관성형 주행 메커니즘을 가진 내시경 로봇의 연구)

  • Lee, Jaewoo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.6
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    • pp.521-526
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    • 2016
  • This paper suggests a new design that makes use of rotary inertia that can allow autonomous movement of an autonomous colonoscope robot in the colon of a patient as a locomotive mechanism. As commercial colonoscopy causes a lengthy time of pain and discomfort to the patients when colonoscopy patients are reluctant to receive surgery, there is a tendency to avoid the test in the early diagnosis of colorectal cancer. To solve this problem, research has been conducted on the next generation of robotic colonoscopes that can reduce the discomfort and pain by moving autonomously within the colon of the patients. In the driving mechanism utilizing the rotational inertia, a flywheel is driven by a motor to store energy and produce rotational inertia. By the energy stored and released by the flywheel, the stick phenomenon that occurs when the robot is running in the intestine can be overcome effectively. To do this, a controller that can control the velocity of the flywheel and is robust to high frequency noise was designed and implemented. The driving mechanism using the rotational inertia presented here showed that the structure is also effective and the experiment can be run easily compared to another mechanism.

Changes of Mouse Gut Microbiota Diversity and Composition by Modulating Dietary Protein and Carbohydrate Contents: A Pilot Study

  • Kim, Eunjung;Kim, Dan-Bi;Park, Jae-Yong
    • Preventive Nutrition and Food Science
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    • v.21 no.1
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    • pp.57-61
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    • 2016
  • Dietary proteins influence colorectal cancer (CRC) risk, depending on their quantity and quality. Here, using pyrosequencing, we compared the fecal microbiota composition in Balb/c mice fed either a normal protein/carbohydrate diet (ND, 20% casein and 68% carbohydrate) or a high-protein/low-carbohydrate diet (HPLCD, 30% casein and 57% carbohydrate). The results showed that HPLCD feeding for 2 weeks reduced the diversity and altered the composition of the microbiota compared with the ND mice, which included a decrease in the proportion of the family Lachnospiraceae and Ruminococcaceae and increases in the proportions of the genus Bacteroides and Parabacteroides, especially the species EF09600_s and EF604598_s. Similar changes were reported in patients with inflammatory bowel disease, and in mouse models of CRC and colitis, respectively. This suggests that HPLCD may lead to a deleterious luminal environment and may have adverse effects on the intestinal health of individuals consuming such a diet.

Gastrointestinal, Liver and Biliary Tract Pathology: A Histopathological and Epidemiological Perspective from Pakistan with a Review of the Literature

  • Ahmad, Zubair;Arshad, Huma;Fatima, Saira;Idrees, Romana;Ud-Din, Nasir;Ahmed, Rashida;Ahmed, Arsalan;Memon, Aisha;Minhas, Khurram;Arif, Muhammad;Fatima, Samia;Haroon, Saroona;Pervez, Shahid;Hasan, Sheema;Kayani, Naila
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6997-7005
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    • 2013
  • Aim: To present an epidemiological and histological perspective of diseases of the gastrointestinal tract (including liver and biliary tract) at the Section of Histopathology, Department of Pathology, AKUH, Karachi, Pakistan. Materials and Methods: All consecutive endoscopic biopsies and resections between October 1 and December 31, 2012 were included. Results: A total of 2,323 cases were included. Carcinoma was overwhelmingly the commonest diagnosis on esophageal biopsies (69.1%); chronic helicobacter gastritis (45.6%) followed by adenocarcinoma (23.5%) were the commonest diagnoses on gastric biopsies; adenocarcinoma (27.3%) followed by ulcerative colitis (13.1%) were the commonest diagnoses on colonic biopsies; acute appendicitis (59.1%) was the commonest diagnosis on appendicectomy specimens; chronic viral hepatitis (44.8%) followed by hepatocellular carcinoma (23.4%) were the commonest diagnoses on liver biopsies; chronic cholecystitis was the commonest diagnosis (over 89%) on cholecystectomy specimens. Conclusions: Squamous cell carcinoma comprised 88.8% of esophageal cancers. About 67% were in the lower third and 56.5% were moderately differentiated; mean ages 49.8 years for females and 55.8 years for males; 66% cases were from South West Pakistan. Over 67% patients with gastric adenocarcinoma were males; mean ages 59 and 44 years in males and females respectively, about 74% gastric carcinomas were poorly differentiated; and 62.2% were located in the antropyloric region. About 63% patients with colorectal adenocarcinoma were males; mean ages 46.1 and 50.5 years for males and females respectively; tumor grade was moderately differentiated in 54%; over 80% were located in the left colon. In 21.2% appendicectomies, no acute inflammation was found. Acute appendicitis was most common in young people. Hepatitis C (66.3%) was more common than hepatitis B (33.7%); about 78% cases of hepatocellular carcinoma occurred in males; females comprised 76.7% patients with chronic cholecystitis; and 77.8% patients with gall bladder carcinoma. All resection specimens showed advanced cancers. Most cancers occurred after the age of 50 years.