Colorectal Neoplasms ; complications ; Humans ; Male ; Middle Aged ; Neck ; pathology ; Rectal Neoplasms ; complications ; Skin Neoplasms ; diagnosis ; pathology ; secondary ; Thorax ; pathology

Ulcerative colitis is an idiopathic chronic inflammatory bowel disease and its incidence in Korea has rapidly increased over the past two decades. Since ulcerative colitis is associated with increased risk for colorectal cancer, annual or biannual colonoscopy with four quadrant random biopsies at every 10 cm segments has been recommended for surveillance of colitic cancer in patients with long standing left-sided or extensive colitis. Recent epidemiologic data and meta-analysis suggest that the increment of colorectal cancer risk in ulcerative colitis was not larger than that of previous studies. Moreover, in addition to the extent and duration of colitis, other risk factors such as family history of colorectal cancer, primary sclerosing cholangitis, stricture, pseudopolyps, and histologic severity of inflammation have been recognized. As a result, updated guidelines provide surveillance strategies adjusted to the individual patient's risk for colitic cancer. Regarding surveillance method, target biopsy under panchromoendoscopy is preferentially recommended rather than random biopsy.
Cholangitis, Sclerosing/complications ; Colitis, Ulcerative/*complications ; Colon/pathology ; Colorectal Neoplasms/epidemiology/*etiology ; Humans ; Inflammatory Bowel Diseases/complications ; Polyps ; Risk Factors

OBJECTIVEthe aim of this study was to determine the clinicopathological characteristics of colorectal cancer (CRC) patients complicated with type 2 diabetes mellitus (T2DM ).

METHODSA total of 3, 202 patients with CRC confirmed pathologically in Tianjin Union Medicine Center from January 2005 to December 2009 were included in this study. We analyzed the differences in clinicopathological features between T2DM patients and non-diabetic patients according to age of diagnosis, gender, tumor site, stage, gross type, histological type, and differentiation.

RESULTSFrom 2005 to 2009, the number of CRC patients increased yearly. The high incidence age of all CRC patients was 51 to 80 years old. The male to female ratio was 1.18:1, showing that the number of female patients with CRC was increased significantly compared with males. The CRC distribution of T2DM patients and non-diabetic patients showed a predominance of rectal cancer (64.4%, 68.7%), followed by sigmoid colon cancer (12.5%, 13.0%), and moderately differentiated ulcer-type adenocarcinoma. Compared with non-diabetic patients, T2DM patients were older (66.2 years versus 62.7 years, P < 0.001) and had more multiple CRCs (3.5% versus 1.6%, P < 0.001). Moreover, the proportion of lymph node or organ metastasis in T2DM patients was higher than that in non-diabetic patients (52.6% versus 45.6%, P < 0.05). No significant differences were observed between both groups in terms of gender, gross type, histological type, and differentiation(P > 0.05 for all).

CONCLUSIONSCRC incidence shows an increasing trend with age. CRC patients with T2DM have an older age of onset, higher proportion of lymph node and distant organ metastasis than in non-diabetic patients.

Adenocarcinoma ; complications ; pathology ; Aged ; Colorectal Neoplasms ; complications ; pathology ; Diabetes Mellitus, Type 2 ; Female ; Humans ; Male ; Middle Aged

Ulcerative colitis is a non-specific colorectal inflammation of unknown causes. It is now known to complicate the dangers of colorectal cancer more than was previously thought. Macrophages are an important part of immune system and play a positive role in immune reaction. But it has been shown that the phenotype and the function of macrophages change in the tumor microenvironment. Through their interaction with colorectal cancer cells and by releasing large quantities of cytokines, macrophages promote colorectal cancer cells by inhibiting angiogenesis and inhibit apoptosis. But the macrophages are also affected by cancer, interact with other inflammatory cells, and become immune suppressed. Thus the changes of macrophages are inseparable with colitis-associated colorectal carcinogenesis.
Carcinogenesis ; Cell Transformation, Neoplastic ; immunology ; Colitis, Ulcerative ; complications ; immunology ; pathology ; Colorectal Neoplasms ; etiology ; immunology ; pathology ; Disease Progression ; Humans ; Macrophages ; pathology

To investigate the immunophenotypings of malignant epithelial mesothelioma (MEM), and to seek the valuable markers in distinguishing peritoneal MEM from peritoneal metastatic ovarian adenocarcinoma (OA) and colorectal adenocarcinoma (CA), immunohistochemical SP method was used to detect expressions of HBME-1, E-cadherin, CA19-9, MOC-31 and CK7 in paraffin-embedded tissues of 18 cases of MEM, 20 OA and 20 CA. The results showed that there was a significant difference in the expressions of E-cadherin, CA19-9 and MOC-31 between MEM and OA group (P<0.05). Similarly, the difference in the expression of HBME-1, E-cadherin, CA19-9, MOC-31 and CK7 between MEM and CA groups is significant (P<0.05). These results indicate that HBME-1 could be used as a positive marker in distinguishing MEM from CA. E-cadherin, CA19-9 and MOC-31 are considered to be useful negative markers in diagnostic distinction between MEM and metastatic adenocarcinomas, including OA and CA. CK7 is the best positive marker in distinguishing MEM from CA, but this marker appears to be valueless in discriminating MEM from OA.
Adenocarcinoma ; diagnosis ; pathology ; Colorectal Neoplasms ; complications ; diagnosis ; pathology ; Cystadenocarcinoma, Mucinous ; diagnosis ; pathology ; Cystadenocarcinoma, Serous ; diagnosis ; pathology ; Diagnosis, Differential ; Female ; Humans ; Immunophenotyping ; Male ; Mesothelioma ; diagnosis ; etiology ; pathology ; Ovarian Neoplasms ; complications ; diagnosis ; pathology ; Peritoneal Neoplasms ; diagnosis ; etiology ; pathology

BACKGROUND/AIMS: Colorectal adenoma and cancer are known to be associated with obesity. Leptin, an adipocyte-derived hormone that plays a crucial role in obesity has been suggested as a growth factor in colon cancer. However, the association between adenoma and leptin remains controversial. We evaluated the leptin expression in human colorectal adenoma and its correlation to clinicopathologic factors. METHODS: Leptin expression was assessed by immunohistochemistry in 91 samples of colorectal adenoma larger than 5 mm, which were removed by endoscopic polypectomy. All patients underwent colonoscopy for cancer screening at Seoul Paik Hospital from 2007 to 2008 and we only included the patients less than 50 years of age. Leptin expression and its relationship with clinicopathologic features were analyzed. RESULTS: Eighty samples were available for the interpretation of leptin expression and showed positive in 42 (52.5%) cases and negative in 38 (47.5%) cases. As body mass index (BMI) increased based on World Health Organization (WHO) classification the positivity of leptin expression also increased (p(trend)=0.02). In leptin positive group, the correlation of leptin expression with adenoma size and histological showed positive tendency without statistical significance. CONCLUSIONS: Leptin expression of colorectal adenoma was associated with BMI. The question of whether leptin contributes to colorectal adenoma development is unresolved and will require additional studies.
Adenoma/complications/metabolism/*pathology ; Adult ; Body Mass Index ; Colonoscopy ; Colorectal Neoplasms/complications/metabolism/*pathology ; Female ; Humans ; Leptin/*metabolism ; Male ; Middle Aged ; Obesity/complications

BACKGROUND/AIMS: The purpose of this study was to investigate the clinicopathologic features of double primary cancers of the stomach and colorectum, compared to colorectal cancer alone. METHODS: A retrospective analysis was made of 5,288 patients who underwent colorectal cancer surgery between January 2000 and December 2009 at Severance Hospital of Yonsei University. The clinicopathologic features were analyzed between 63 patients of double primary cancers and case-matched 126 patients of colorectal cancer alone. We classified double primary cancers into subgroups as premetachronous, synchronous and postmetachronous gastric cancer to identify differences between the three subgroups also. RESULTS: Double primary cancers group showed 4.3 year-older age, lower BMI, and higher percentage of peritoneal metastasis, compared to colorectal cancer alone group. Overall and colorectal cancer specific survival did not have any significant difference between two groups. In histologic type of gastric cancer, a high percentage of undifferentiated adenocarcinoma (55.6%) and signet ring cell carcinoma (30.2%) were noted. CONCLUSIONS: Double primary cancers of the stomach and colorectum had older-age onset, lower BMI and higher metastasis to peritoneum than colorectal cancer alone. Combined gastric cancer consisted of high percentage of undifferentiated and signet ring cell carcinomas.
Adenocarcinoma/pathology ; Age Factors ; Aged ; Body Mass Index ; Carcinoma, Signet Ring Cell/pathology ; Colorectal Neoplasms/complications/*pathology ; Female ; Humans ; Male ; Middle Aged ; Odds Ratio ; Peritoneal Neoplasms/secondary ; Polyps/pathology ; Retrospective Studies ; Stomach Neoplasms/complications/*pathology

PURPOSE: We investigated the effects of proteinuria and renal insufficiency on all-cause mortality in patients with colorectal cancer, with special emphasis on cancer staging and cancer-related deaths. MATERIALS AND METHODS: We retrospectively studied a cohort of patients with colorectal cancer. In protocol 1, patients were classified into four groups based on the operability of cancer and proteinuria: group 1, early-stage cancer patients (colorectal cancer stage < or =3) without proteinuria; group 2, early-stage cancer patients with proteinuria; group 3, advanced-stage cancer patients without proteinuria (colorectal cancer stage=4); and group 4, advanced-stage cancer patients with proteinuria. In protocol 2, patients were classified into four similar groups based on cancer staging and renal insufficiency (eGFR <60 mL/min/1.73 m2). Between January 1, 1998 and December 31, 2009, 3379 patients were enrolled in this cohort and followed until May 1, 2012 or until death. RESULTS: The number of patients with proteinuria was 495 (14.6%). The prevalence of proteinuria was higher in advanced-stage cancer (n=151, 22.3%) than in early-stage cancer patients (n=344, 12.7%). After adjusting for age, gender and other clinical variables, the proteinuric, early-stage cancer group was shown to be associated with an adjusted hazard ratio of 1.67 and a 95% confidence interval of 1.38-2.01, compared with non-proteinuric early-stage cancer patients. However, renal insufficiency was not associated with colorectal cancer mortality. CONCLUSION: Proteinuria is an important risk factor for cancer mortality, especially in relatively early colorectal cancer.
Aged ; Colorectal Neoplasms/complications/*mortality/pathology ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Prevalence ; Proteinuria/*complications/epidemiology ; Renal Insufficiency/complications ; Retrospective Studies ; Risk Factors

OBJECTIVETo investigate the independent predictors of postoperative mortality, morbidity, and long-term survival in patients with stage IV ( colorectal cancer.

METHODSClinical data of 189 patients with stage IV( colorectal cancer undergoing palliative resection of primary tumor in the presence of unresectable synchronous metastases were analyzed retrospectively.

RESULTSEighty-six (45.5%)patients developed postoperative complications. Preoperative predictors of medical complications included age(≥65, P=0.039) and emergency operations (P=0.001). Preoperative predictors of surgical complications included advanced local disease (T4, P=0.022) and lymph node spread (N2, P=0.009). Seventeen (9.0%) patients died in the postoperative period. Mortality was independently associated with age(P=0.013), peritoneal dissemination(P=0.010), emergency operations(P=0.001) and medical complications(P=0.008). The survival rates at 1-, 2-, and 3- year of 172 patients admitted in survival analysis were 41.2%, 22.7% and 7.7% respectively. Independent factors associated with poor overall survival included lymph node spread(N2, P=0.015) and poor tumor differentiation(P=0.038).

CONCLUSIONSEmergency operations should be avoid when palliative resection of primary tumor is considered for stage IV( colorectal cancer patients, especially for elderly patients and those with peritoneal dissemination. The significance of palliative resection is limited for stage IV ( colorectal cancer patients with lymph node spread and poor tumor differentiation.

Aged ; Colorectal Neoplasms ; pathology ; surgery ; Humans ; Lymph Nodes ; Neoplasm Staging ; Palliative Care ; Postoperative Complications ; Prognosis ; Retrospective Studies ; Survival Analysis

Colorectal cancer is one of the most common malignancies in the world. Many mouse models have been developed to evaluate features of colorectal cancer in humans. These can be grouped into genetically-engineered, chemically-induced, and inoculated models. However, none recapitulates all of the characteristics of human colorectal cancer. It is critical to use a specific mouse model to address a particular research question. Here, we review commonly used mouse models for human colorectal cancer.
Adenomatous Polyposis Coli ; genetics ; pathology ; Animals ; Colorectal Neoplasms ; chemically induced ; etiology ; genetics ; pathology ; Colorectal Neoplasms, Hereditary Nonpolyposis ; genetics ; pathology ; Disease Models, Animal ; Genetic Engineering ; Humans ; Inflammation ; complications ; Mice ; Mice, Transgenic ; Neoplasm Metastasis