Colorectal cancer in Alexandria, Egypt;clinical profile,epidemiological characteristics,trend,and survival

Objective:During the past decades,the incidence of colorectal cancer was increased all around the world.In Egypt,colorectal cancer is the 7th most common cancer.The purpose of this study is to study the problem of colorectal cancer in Alexandria:trend,and survival.Methods:Two methodological strategies were adopted:Record reviewing for estimation of the annual incidence rates of colorectal cancer,and a retrospective cohort study to calculate the 5-year survival rates of colorectal cancer.Results:The annual incidence rates of CRC in Alexandria in 2007-2008 were 6.33 and 6.45 respectively per 100000 mid-year Alexandria population.The overall 5-years cumulative survival rate for CRC cases was 28.0%.Conclusion:This increase in incidence and mortality rates points toward a failed early detection and prevention strategy as well as failure to address lifestyle and dietary challenges of urbanization that affect most of the globe including Egypt.     

CLINICOPATHOLOGICAL CHARACTERISTICS OF ADVANCED COLORECTAL CANCER 30 mm OR SMALLER IN DIAMETER

Objective To investigate the clinicopathological characteristics of advanced colorectal cancer which was 30 mm or smaller in diameter. Methods Retrospective analysis documented 80 patients with small advanced colorectal cancer from May 1985 to May 2002. According to the diameter of tumors, all patients were divided into three groups: Group A (10 mm or less), Group B (11-20 mm), Group C (21-30 mm). Considering the number of patients in Group A was smaller, we combined Group A with Group B as Group D. Then various clinicopathological characteristics were compared between Group C and Group D. Results The most common site of small advanced colorectal cancer was sigmoid colon and rectum that accounted for 36.2% and 35.0% of all cases. The average diameter of total tumors was 23.3 mm. Type 2 was the most common macroscopic type (63.7%) and the moderate differentiation was seen in 77.5% of cases. Thirty-eight (47.5%) cases had lymph node metastasis. Three (3.8%) cases had liver metastasis and three (3.8%) cases had peritoneal metastasis. The frequency of lymph node metastasis was found significantly different between Group C and Group D (54.2% vs. 28.6%, P<0.05), as well as between the groups with different depth of invasion (P<0.05). Curability A resection was performed in 69 (86.2%) cases. Conclusions Tumor size and depth of invasion are related to lymph node metastasis in small advanced colorectal cancer. However, the small size of tumor may not always be a.reliable parameter for estimating the risk of lymph node metastasis. Small colorectal cancers also do not always mean the early stage. Surgeons should be aware of the features of small advanced colorectal cancers to select ideal management and perform perfect resection.     

Biodegradation of Complex Bacteria on Phenolic Derivatives in River Water

Objective To isolate, incubate, and identify 4-chlorophenol-degrading complex bacteria, determine the tolerance of these bacteria to phenolic derivatives and study their synergetic metabolism as well as the aboriginal microbes and co-metabolic degradation of mixed chlorophenols in river water. Methods Microbial community of complex bacteria was identified by plate culture observation techniques and Gram stain method. Bacterial growth inhibition test was used to determine the tolerance of complex bacteria to toxicants. Biodegradability of phenolic derivatives was determined by adding 4-chlorophenol-degrading bacteria in river water. Results The complex bacteria were identified as Mycopiana, Alcaligenes, Pseudomonas, and Flavobacterium. The domesticated complex bacteria were more tolerant to phenolic derivatives than the aboriginal bacteria from Qinhuai River. The biodegradability of chlorophenols, dihydroxybenzenes and nitrophenols under various aquatic conditions was determined and compared. The complex bacteria exhibited a higher metabolic efficiency on chemicals than the aboriginal microbes, and the final removal rate of phenolic derivatives was increased at least by 55% when the complex bacteria were added into river water. The metabolic relationship between dominant mixed bacteria and river bacteria was studied. Conclusion The complex bacteria domesticated by 4-chlorophenol can grow and be metabolized to take other chlorophenols, dihydroxybenzenes and nitrophenols as the sole carbon and energy source. There is a synergetic metabolism of most compounds between the aboriginal microbes in river water and the domesticated complex bacteria, 4- chlorophenol-degrading bacteria can co-metabolize various chlorophenols in fiver water.     

Biodegradation of Aniline and Abundance of Potential Degraders in River Waters

Total dissolved organic carbon(TOC),number of colony formin units(CFU),and total direct count(TDC)were compared to the biodegradation of aniline and the number of potential degraders in water samples from head waters to down stream of the Ina River and several other sites of fivers tratering Osaka city.The results indicate that aniline degrading populations of these various microbial communities exhibit different activites probably depending on the extent of adaptation to pollutants to which the microbes are exposed.The number of aniline degraders found in river water samples was in agreement with other parameters which were used to demonstrate the degree of pollution in river water even though higher biodegradability was evident in waters which show comparatively low TOC and CFU.These results suggest that biodegradation of aniline and enumeration of its potential degraders may serve as valuable indicators for the assessment of pollution in river waters.     

Gastrointestinal tract

<正>209172 Evaluation of the primary lesion detection in colorectal carcinoma with 18F-FDG PET-CT/Song Jianhua(Dept Nuclear Med,Shanghai 1st Peop Hosp,Shanghai Jiaotong Univ,Shanghai 200080)…∥Chin J Gastrointest Surg.-2009,2(2).-174~177Objective To explore the clinical value of detecting primary lesions of colorectal carcinoma with 18F-FDG PET-CT.Methods Clinical data of 23 cases of colorectal carcinoma collected from April 2007 to June 2008,including PET-CT,endoscopy,operation and pathology,were analyzed retrospectively.Results Of the 23 colorectal cancer patients,including 15 males and 8 females,11 received abdominal CT contrast examination,7 abdominal CT general examination and 5 chest CT examination.The lesions located in caecum in 5 cases,ascending colon 4 cases,transverse colon 2 cases,desending colon 2 cases,sigmoid colon 4 cases,rectum 6 cases.CT images showed local mass,incrassation and nodes in colon.PET images revealed intensely hypermetabolic lesions.The maximum of standard uptake value(SUVmax) was 11.7±9.5,and the delay SUVmax was 14.8±11.0.The bigger was the mass,the higher was the SUV.The highest SUV was 44.8.Metastatic lesions were found in 15 cases.More cases and more metastatic lesions were found by 18F-FDG PET-CT.Conclusion The primary and metastatic lesions of colorectal carcinoma can be deteted sensitively and exactly by 18F-FDG PET-CT,which is helpful in tumor staging and making the treatment plan.11 refs,3 figs.     

Nitrate in drinking water and bladder cancer: A meta-analysis

This study examined whether exposure to nitrate in drinking water is associated with increased risk for bladder cancer by conducting a comprehensive literature research. A meta-analysis was performed with and without adjustment for confounding factors. Three groups (reference, intermediate and high groups) were established in terms of different nitrate concentrations in each included study. Separate relative risk measures were calculated for intermediate and high groups. Heterogeneity was assessed by using the Q statistics. Publication bias was evaluated by Egger’s and Begg’s test. Quality assessment for studies was performed by using the Newcastle-Ottawa scale. Two cohorts, two case-controls, and one ecological study were included in this study. The adjusted data showed that the combined risk ratios (RRs) were 1.13 (95% CI: 0.81 to 1.57) and 1.27 (95% CI: 0.75 to 2.15) for inter-mediate and high groups respectively. For unadjusted data, the corresponding RRs were 1.18 (95% CI: 0.89 to 1.57) and 1.29 (95% CI: 0.81 to 2.07). Sensitivity test indicated that results were significantly underestimated when Ward’s study was included. No significant publication bias was found. There was heterogeneity among studies. The results suggested that there was no sufficient evidence that nitrate in drinking water is associated with increased risks for bladder cancer.     

Pharmacokinetics of aminophylline delivered to the small intestine and colon using remote controlled capsules

Background A patented remote controlled capsule （RCC） has recently been developed to provide noninvasive drug delivery to selected sites in the human gut that allows assessment of regional gastrointestinal （GI） drug absorption under a normal physiological environment. The objective of this study was to investigate the rate and extent of aminophylline absorption after site-specific delivery of the drug in the GI tract using RCC and a magnetic marker monitoring （MMM） technique. Methods This study was conducted in twelve healthy male subjects, in a three-treatment, randomized, crossover manner with a 7-day washout. Eligible subjects received a 150 mg aminophylline dose through an oral administration, or via a remote controlled capsule, delivered to the small bowel or ascending colon. MMM was employed to monitor the GI transit of the RCC, and the radio-frequency signal was used to activate capsules at target sites. Blood samples were obtained at regular intervals until 24 hours post dose/activation. Plasma theophylline concentrations were measured by a TDx~ System Analyzer. A comparison of the PK profile with the oral dosing route of aminophylline was performed after delivery to the small bowel and colon. Results The RCC was well tolerated in volunteers. The mean capsule activation time for the small bowel and ascending colon was 2.07 hours and 6.08 hours post dose. Aminophylline had similar absorption profiles from the small bowel compared with the stomach, with an area under the curve （AUCt） ratio of 92% vs. the stomach, but a lower absorption profile from the ascending colon, with an AUCt ratio of 47.2% vs. the stomach. Conclusions The proprietary of the RCC and MMM technique offer the opportunity to obtain data on the intestinal absorption of a drug in humans under noninvasive conditions. Aminophylline is rapidly and efficiently absorbed from the small bowel. While colonic absorption was limited by the poor water condition although effective absorption was observed from the ascending colon. This provides an opportunity for rational development of modified-release formulations as well as alternative dosage forms.     

Clinicopathological features of typical and nontypical hereditary non-polyposis colorectal cancer and their germline mutation of hMLH_1 and hMSH_2

Objective To study the clinicopathological features of the Chinese hereditary non-polyposis colorectal cancer and its germline mutation of hMLH1 and hMSH2. Methods Thirteen typical Chinese hereditary non-polyposis colorectal carcinoma (HNPC) C kindreds and 19 nontypical HNPCC families were registered and followed up. The germline mutation of the hMLH1 and hMSH2 of 12 index cases of 6 typical and 6 nontypical NHPCC were screened by PCR-SSCP. Samples with abnormal mobility were sequenced direcdy. Results The average age of typical HNPCC was 47, no difference existed between sexs. Location of the tumors of typical HNPCC represented 44.7% on the right half colon and non-typical HNPCC 65. 8% on the rectum. The rate of the metachronos cancer was 11.5%. The 3 - , 5 - and 10 -year survival rate was 64. 0%, 45. 3% and 31. 2% respectively. Among 12 cases, 8 showed abnormal mobility. Except for an intron polymorphinism, six exons abnormalities were found in 5 of 12 proband. Sequencing showed 4 missense,7 insertion     

Evaluation of oxidative stress in colorectal cancer patients

Objective To evaluate the oxidative stress in patients with colorectal cancer and to investigate the relationship between oxidative stress and colorectal cancer. Methods Seventy-six subjects were divided into two groups （36 colorectal cancer patients as the study group and 40 normal healthy individuals as the control group）. Their protein oxidation, DNA damage, lipid peroxidation and antioxidants, vitamin C, vitamin E, glutathione （GSH）, and antioxidative enzymes in serum were detected. Results The levels of protein carbonyl and advanced oxidation protein products （AOPP） were significantly higher in the study group than in the control group （P〈0.01）. Serum 8-OHdG was significantly increased in the study group compared to the control group （P〈0.01）. However, the mean serum level of MDA and conjugated diene was lower in the study group than in the control group （P〈0.01）. The activity of antioxidative enzymes was significantly decreased in the study group compared to the control group （P〈0.01）. Serum vitamins C and E concentrations were significantly reduced in the study group compared to the control group （P〈0.01）. Conclusion Colorectal cancer is associated with oxidative stress, and assessment of oxidative stress and given antioxidants is important for the treatment and prevention of colorectal cancer.     

Radioimmunolocalization of human malignant tumors with In-111 labeled monoclonal antibody.

An anti-human colon carcinoma monoclonal antibody 2C10 was radiolabeled with In-111 and studied in 15 patients with gastrointestinal and ovarian carcinoma. The labelling efficiency approached 100% and immunoactivity of the labeled antibody was over 75%. 2-3 mCi (1 mg) In-111-2C10 was given to the patients intravenously and scintigraphy was performed 72 hours after administration with a gamma camera. Specimens were also scanned in some of the patients. The resected tumors and remote margin were examined immunohistochemically. Positive scintigraphic images were obtained in 12/15 patients with colorectal cancer (10) and ovarian cancer (2). Negative results were seen in the two patients with gastric cancer. The scintigraphic results of 10 patients were confirmed surgically and pathologically. The remaining 5 were confirmed by endoscopy, B-ultrasonography or X-ray CT. Most patients had been definitely diagnosed before imaging except one patient with metastatic focus from ovarian cancer to colon and one with recurrent colon cancer were first detected with RIAD, showing the unique advantage the latfer. The high background radioactivity in the liver, however, is a conspicuous problem to be solved.

     

饮水类型及主食粮结构不同对肝癌高发区人群外周血淋巴细胞SCE的影响

对广西某肝癌高发区饮水类型和主食口粮不同的各组人群共122例进行了SCE检测.结果表明:长期饮用塘水、主食玉米占口粮50%以上人群与长期饮用自来水、主食大米人群的SCE频率相比较,均有显著性差异.提示:SCE频率升高可能与长期摄入黄曲霉毒素B_1和饮用塘水有关.     

广东省8172例大肠癌发病部位分析

目的 探讨广东地区大肠癌发病部位的分布特点及其变化趋势。 方法 总结分析广东四个地区五间医院1988～2008年收治的8 172例大肠癌患者的临床资料。结果 大肠癌分布于直肠、左半结肠和右半结肠分别占54.3%,23.6%,22.1%。其中2006～2008年段与1988～1990年段比较,直肠癌的比例从56.0%下降到51.8%,右半结肠癌从19.7%上升到25.8%。三个部位的性别比例差别无统计学意义。从≤40岁至71～年龄组,随着年龄增加,右半结肠癌的比例从20.7%上升到24.7%,直肠癌的比例从56.0%下降至51.0%。右半结肠癌中黏液腺癌和印戒细胞癌等低未分化腺癌的比例较高,Dukes C期和Dukes D期的比例较高。 结论 广东地区大肠癌的发病部位以直肠为主,随着年份推移直肠癌比例逐渐减少,右半结肠癌比例逐渐增加,提示应重视全结肠镜检查。性别、年龄等因素可对其产生一定的影响。不同部位大肠癌的病理特点有一定差异。     

Cytogenetic changes induced by the different types of drinking water in one HCC high incidence area of P.R of China

ＩｎｔｒｏｄｕｃｔｉｏｎＩｎＰ．Ｒ．ｏｆＣｈｉｎａ，ｔｈｅｍｏｒｔａｌｉｔｙｏｆＨＣＣｉｓｔｈｅｔｈｉｒｄｈｉｇｈｅｓｔｏｆｃａｎｃｅｒｄｅａｔｈｓ．ＴｈｅｄｉｓｔｒｉｂｕｔｉｏｎｓｏｎＨＣＣｉｎｗｉｔｈｔｈｅｓｔｒｉｃｔｅｐｉｄｅｍｉｃｉｔｙ．Ｆｕ...     

应用队列研究方法检验饮酒与肠癌发病的联系

目的:了解饮酒者与非饮酒者人群中肠癌发病情况,验证饮酒与肠癌发病之间的关系.方法:以1989年5月-1990年4月期间,参加浙江省嘉善县肠癌筛检的10个乡镇30岁及以上人口共64 102人为研究队列,其中29 044名饮酒者为暴露组,其余为非暴露组.随访时间为1990年5月1日至2001年12月1日,观察队列的肠癌发病情况,应用Cox回归模型计算两者的相对危险度(RR).结果:全队列64 102人,共观察658 100.24人年.暴露组29 044人,随访298 497.23人年;非暴露组35 328人,随访359 603.01人年.全队列中合计肠癌新发病例242例,其中暴露组新发病例108例,发病密度为36.18/10万,非暴露组新发134例,发病密度为37.26/10万,两者相比无显著性差异(Z＝0.52,P>0.05);饮酒与肠癌发病的粗RR值为0.97(95%CI为0.75～1.25),调整RR值为1.13(95%CI为0.87～1.48)无统计学显著意义.经计算,本研究的检验效能(1-β)为96.99%.结论:在嘉善县人群中,饮酒不是肠癌的危险因素.     

电子结肠镜检查4 000例分析

①目的观察结直肠疾病发病情况并探讨病变与临床症状的关系。②方法抽取经电子结肠镜检查病人4000例，统计结直肠病变的部位、形态、病理改变及临床表现。③结果结直肠病变主要集中于直肠和乙状结肠。结直肠病变的检出由高到低依次为结直肠息肉、结直肠的非特异性炎症、结直肠癌、溃疡性结直肠炎等。④结论直肠、乙状结肠是结直肠息肉、炎症、溃疡、肿瘤的主要发病部位。结直肠腺瘤性息肉是结直肠肿瘤的高危因素。黏液血便是结直肠恶性肿瘤和溃疡性结直肠炎的报警信号，肛诊对于直肠癌的诊断具有重要价值。中老年人宜每3～5年进行结肠镜的常规检查。     

hMSH2蛋白表达缺失在筛选遗传性非息肉病性大肠癌中的意义

目的　探讨hMSH2蛋白表达缺失在筛选遗传性非息肉病性大肠癌中的作用及其意义。方法　对收集的166例石蜡包埋的疑似遗传性非息肉病性大肠癌组织进行hMSH2蛋白免疫组化染色。结果　hMSH2蛋白表达阴性 ( 0分 ) 3 5例 ,占 2 1 1% ,阳性 ( 1～ 4分 ) 12 6例 ,占 75 9%。在右半、左半结肠和直肠表达缺失率分别为 3 3 3 % ( 15 / 45 ) ,15 4% ( 6/ 3 9)和 18 2 % ( 14 / 77)。右半结肠癌的表达缺失明显高于左半结肠癌 (P <0 0 5 )和直肠癌 (P <0 0 5 )。结论　hMSH2蛋白免疫组化染色做为一个简单易行的方法在今后检测和确定遗传性非息肉病性大肠癌中将发挥重要作用。     

不同发病部位结直肠癌患者的临床特点分析

目的比较不同发病部位结直肠癌患者的临床表现、病理学特征。方法采用Epidata软件建立大肠癌信息化数据库录入宁夏医科大学总医院2001年12月-2011年3月间收治的702例原发性结直肠癌住院患者临床资料,分析不同肿瘤部位患者的临床表现及肿瘤特征。结果本组资料近端结肠癌41.0%,远端结肠癌41.7%,直肠癌17.2%。不同发病部位结直肠癌患者的性别、年龄、城乡分布间的差异无统计学意义(P>0.05)。不同发病部位结直肠癌患者出现的食欲减退、贫血、腹痛、腹胀、血便、脓血便、便频、大便变细、肠梗阻等症状的差异有统计学意义(P均<0.05),不同发病部位结直肠癌患者出现的体重下降、腹泻、便秘、FOBT阳性、黏液便等症状的差异无统计学意义(P均>0.05)。近端结肠癌常出现腹痛、腹胀、食欲减退症状;远端结肠癌多见腹痛、血便、腹胀;直肠癌多见血便、便频、脓血便。不同发病部位结直肠癌间肿瘤浸润深度有差异(P=0.000),不同部位的结直肠肿瘤均浸及浆膜层最多。不同发病部位结直肠癌间肿瘤细胞分化程度差异有统计学意义(P<0.05),不同部位的结直肠癌均以中分化癌多见。淋巴组织增生在近端结肠癌最多(P=0.000)。淋巴、腹膜转移均在近端结肠癌最常见(P均<0.05)。结论不同发病部位结直肠癌的主要临床表现、分化程度、浸润深度、淋巴组织增生及转移途径不同,可为临床诊断及预后判断提供参考。     

肝癌高发区不同饮食类型人群的外周血淋巴细胞染色体畸变分析

用染色体畸变分析技术检测肝癌高发区112例不同饮食类型居民的外周血。发现长期主食玉米(AFB_1污染严重)、饮用污染塘水者其淋巴细胞染色体畸变率显著高于主食大米、饮用河水、自来水者。研究结果提示:该地区居民的肝癌高发病率与长期的AFB_1高摄入及饮用污染的塘水有关。     

直肠和结肠来源的侧向发育型肿瘤的临床病理特征差异

目的：研究直肠和结肠来源的侧向发育型肿瘤(laterally spreading tumor,LST)的临床病理特征之间的差 异。方法：回顾性分析中南大学湘雅二医院2012年1月至2017年1月确诊的198例LST患者(直肠116例,结肠82例)的临 床病理资料。结果：198例患者按内镜分型来看,结节混合型127例(64.1%),颗粒均一型13例(6.6%),扁平隆起型41 例(20.7%),假凹陷型17例(8.6%);结节混合型更常见于直肠(71.7%),扁平隆起型更常见于结肠(78.0%),两者差异有 统计学意义(P<0.01);直肠LST直径为(52.03±35.62) mm,结肠LST直径为(25.37±11.56) mm,两者比较差异有统计学意义 (P<0.01);直肠LST与结肠LST相比较,高级别上皮内瘤变的比例更高(分别为31.0%和18.3%),低级别上皮内瘤变的比 例则较低(分别为61.2%和75.6%)(均P<0.05);直肠LST与结肠LST相比较,结节混合型和颗粒均一型的直径更大,结 节混合型拥有更高的恶性潜能(高级别瘤变+浸润癌的百分率分别为41.8%和22.2%)(均P<0.05);结肠LST多采用内镜下 黏膜切除术治疗,直肠LST多采用内镜黏膜下剥离术治疗。结论：直肠LST与结肠LST表现出某些不同的临床病理特 征,结节混合型LST更常见于直肠,扁平隆起型LST更常见于结肠,直肠结节混合型LST可能具有更高的恶性潜能。     

Cancer of the colon and rectum in a Jamaican population: diagnostic implications of the changing frequency and subsite distribution

The aim of this study was to examine the clinical and pathological characteristics of colorectal cancer in Jamaica, to determine whether there was a change in the anatomic distribution and clinical presentation and to discuss the options for diagnosis and management. A comprehensive retrospective review of patients newly diagnosed with colorectal carcinoma was conducted at The University Hospital of the West Indies by reviewing both patient records and pathological data. These data were compared with previous reports of patients with colorectal cancer seen in Jamaica. One hundred and forty-seven patients were studied There were 85 females and 62 males with a female to male ratio of 1.37:1. The median age was 65.5 years (range 19 to 94 years). The predominant symptoms were abdominal pain in 91 patients, change in bowel habit in 77 patients and rectal bleeding in 74 patients. Sixty patients presented with weight loss and 28 with a rectal mass. The most common tumours were right-sided colonic cancers in 42 patients (28.5%) followed by sigmoid colon in 30 (20.4%) rectum in 34 (23.1%) and left and transverse colon accounting for 16 and 10 cases respectively. Most of the tumours were well or moderately differentiated adenocarcinomas. Only eight patients presented with Dukes' A disease, 50 with Dukes'B, 53 with Dukes'C disease and 34 with advanced disease. The findings showed that sigmoid and rectal tumours accounted for 43.5% of cancers. The colon/rectum ratio in this series was 3.3:1 indicating a significant proximal shift of colorectal cancers in this population in keeping with recent reports. The results of the current study suggest that the sub-site location of colorectal cancers seen is similar to that reported in high incidence countries such as the United States of America and parts of Europe but differs from the African continent which has a high proportion of rectal tumours. This right-sided preponderance also differs from previous studies in Jamaica, which report a higher incidence of rectal lesions The detection of early colorectal carcinoma will require screening at a stage when the disease is asymptomatic in order to improve the chance for cure. The data presented here imply that screening programmes should allow evaluation of the entire colon rather than the distal 25 cm.