BACKGROUND/AIMS: An association between serum uric acid and cancer risk has been noted over the past few decades. There is ongoing debate about whether hyperuricemia represents an independent risk factor for colorectal neoplasm. We investigated the association between serum uric acid and prevalence of colorectal adenoma considering numerous confounding factors. METHODS: A cross-sectional study was performed with individuals who underwent a routine health check-up examination, including a screening colonoscopy and blood chemistry. The association between serum uric acid and prevalence of colorectal adenoma was estimated from the results of a logistic regression analysis. RESULTS: Of the 1,066 participants, 402 had colorectal adenoma (37.7%). In univariate models, the prevalence of colorectal adenoma was higher in participants in the fourth quartile uric acid level, compared to those in the first quartile uric acid level (OR, 1.67; 95% CI, 1.17-2.42; p=0.004). However, no significant association was detected between serum uric acid and prevalence of colorectal adenoma in multiple logistic regression analysis. A number of metabolic syndrome components exhibited a strong association with the prevalence of colorectal adenoma in the multivariate model (OR, 3.46 for highest vs. lowest; 95% CI, 1.30-9.20; p=0.021). Moreover, serum uric acid was strongly associated with metabolic syndrome-associated variables, including waist circumference, fasting blood glucose, systolic blood pressure, diastolic blood pressure, triglyceride, and high-density lipoprotein. CONCLUSIONS: Uric acid is not an independent risk factor for colorectal adenoma but is a risk indicator for metabolic syndrome-related colorectal adenoma.
Adenoma/*diagnosis/epidemiology/etiology ; Adult ; Asian Continental Ancestry Group ; Blood Glucose/analysis ; Blood Pressure ; Colonoscopy ; Colorectal Neoplasms/*diagnosis/epidemiology/etiology ; Cross-Sectional Studies ; Female ; Humans ; Logistic Models ; Male ; Metabolic Syndrome X/*diagnosis ; Middle Aged ; Odds Ratio ; Prevalence ; Republic of Korea ; Risk Factors ; Triglycerides/blood ; Uric Acid/*blood/urine ; Waist Circumference

BACKGROUND/AIMS: Helicobacter pylori is a well known precursor to gastric cancer and gastric mucosa-associated lymphoid tissue lymphoma. This study was to determine whether H. pylori was associated with colorectal neoplasms in Korean subjects undergoing routine checkup. METHODS: A total of 10,082 subjects underwent routine checkups from January 2004 to April 2005. A H. pylori IgG test and stool occult blood test were included in the routine checkup program. Colonoscopy was performed if the stool occult blood test was positive or under subject request. Patients who underwent colonoscopy and had histologically confirmed cases of colorectal neoplasms were designanted as the subject group and those without as the control group. RESULTS: Of the 10,082 subjects, 597 had full colonoscopy. The results identified 9 colorectal carcinomas and 118 adenomas. H. pylori seropositivity was identified in 6 (66%) subjects with colorectal carcinoma, 81 (68.6%) with colorectal adenoma and 248 (52.8%) controls. Subjects having colorectal neoplasms had a significantly higher H. pylori seropositivity rate compared with the controls (OR 1.94, 95% CI 1.28-2.95). This remained significant after adjusting for age, sex, body mass index, HbA1c and total cholesterol (OR 1.90, 95% CI 1.23-2.93). Patients with distal neoplasms also had a significantly higher H. pylori seroposivity rate (OR 1.88, 95% CI 1.17-3.01) which persisted after multivariate adjustment (OR 1.79, 95% CI 1.10-2.94). CONCLUSIONS: Subjects with colorectal neoplasms present an increased H. pylori seroprevalence compared with controls.
Adenoma/*diagnosis/etiology ; Adult ; Age Factors ; Aged ; Body Mass Index ; Cholesterol/blood ; Colonoscopy ; Colorectal Neoplasms/*diagnosis/epidemiology/etiology ; Female ; Helicobacter Infections/complications/*diagnosis ; Helicobacter pylori/*immunology ; Hemoglobin A, Glycosylated/analysis ; Humans ; Immunoglobulin G/analysis ; Male ; Middle Aged ; Occult Blood ; Odds Ratio ; Retrospective Studies ; Risk Factors ; Sex Factors

BACKGROUND/AIMS: Recent studies implicated inflammation playing an important role in the occurrence and advancement of colorectal cancer. Colorectal adenoma as the representative precursor lesion of colorectal cancer has meaningful association with inflammation. Accordingly, the purpose of this study was to evaluate the association between serum C-reactive protein (CRP) levels and the risk of colorectal adenoma METHODS: This study was undertaken on 5,487 subjects (3,478 men and 2,009 women) who underwent colonoscopy at the Health Promotion Center in Kangbuk Samsung Hospital and Samsung Medical Center. The subjects were allocated into 3,505 normal control subjects and 1,982 patients with colorectal adenoma. The mean level of CRP was compared between the two groups, and the correlations with other variables were analyzed by multiple regression analysis. Also, the risk of colorectal adenoma according to CRP level and difference of CRP level according to the characteristics of adenomas were analyzed. RESULTS: There was no significant difference in serum CRP level between normal and colorectal adenoma group. After adjusting for the clinically significant variables of colorectal adenoma, multiple logistic regression analysis of the risk of colorectal adenoma according to the CRP level (<1, 1-3, >3) and the CRP level according to characteristics of adenomas showed no significant difference. CONCLUSIONS: An inflammatory marker, CRP is not a risk factor for colorectal adenoma development.
Adenoma/blood/*etiology ; Adult ; Aged ; Aged, 80 and over ; C-Reactive Protein/*analysis ; Colonoscopy ; Colorectal Neoplasms/blood/*etiology ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Risk Factors

Animals ; Colorectal Neoplasms ; blood ; etiology ; Humans ; Hyperinsulinism ; blood ; complications ; Insulin ; blood ; Insulin Resistance ; Insulin-Like Growth Factor Binding Proteins ; blood ; Insulin-Like Growth Factor I ; metabolism ; Metabolic Syndrome ; blood ; complications ; Receptor, IGF Type 1 ; blood ; Receptor, Insulin ; blood

BACKGROUNDHypoxia-inducible factor 1 (HIF-1), a transcription factor, is overexpressed in common human cancers and their metastases. This study aimed at determining the expression levels of HIF-1alpha and vascular endothelial growth factor (VEGF) in SW480 cells and in colorectal adenocarcinoma tissue and ascertaining whether HIF-1alpha and VEGF play important roles in tumor angiogenesis.

METHODSHIF-1alpha mRNA expression was analyzed using in situ hybridization and RT-PCR. HIF-1alpha and VEGF protein were detected in SW480 cells and colorectal adenomas and adenocarcinomas by immunohistochemistry using streptavidin/peroxidase (SP). Western blot was used to detect HIF-1alpha protein extracted from SW480 cells. Microvessel density (MVD) in colorectal carcinomas was determined by anti-CD34 immunostaining in colorectal carcinomas.

RESULTSOptical density values representing HIF-1alpha mRNA expression levels were found to be significantly higher in SW480 cells in hypoxic conditions than in cells under normoxic conditions (P < 0.05) or in hypoxic conditions but treated with genistein (P < 0.05). The levels of HIF-1alpha and VEGF protein expression in SW480 cells were significantly higher in the hypoxia group than in the normoxia group (P < 0.01, P < 0.05, respectively) and hypoxia/genistein group (P < 0.01, P < 0.05, respectively). The positive expression rates of HIF-1alpha mRNA changed dramatically when comparing colorectal adenomas with adenocarcinomas of different Dukes' stages (P < 0.05). HIF-1alpha mRNA was also expressed at higher levels in adenocarcinomas than that in adenomas (P < 0.01). HIF-1alpha protein expression correlated significantly with VEGF protein expression and MVD.

CONCLUSIONSHypoxia induces the expression of HIF-1alpha and VEGF in colorectal adenocarcinomas. HIF-1alpha may play an important role in angiogenesis and tumor progression by regulating the expression of VEGF in human colorectal carcinomas.

Adenocarcinoma ; blood supply ; pathology ; Adult ; Aged ; Aged, 80 and over ; Cell Line, Tumor ; Colorectal Neoplasms ; blood supply ; pathology ; DNA-Binding Proteins ; analysis ; genetics ; physiology ; Humans ; Hypoxia-Inducible Factor 1 ; Hypoxia-Inducible Factor 1, alpha Subunit ; Middle Aged ; Neovascularization, Pathologic ; etiology ; Nuclear Proteins ; analysis ; genetics ; physiology ; RNA, Messenger ; analysis ; Transcription Factors ; analysis ; genetics ; physiology ; Vascular Endothelial Growth Factor A ; analysis ; physiology

OBJECTIVETo investigate the transcription level and protein expression of HIF-1alpha and VEGF in SW480 cell line and colorectal adenocarcinoma, and to determine whether HIF-1alpha plays a role in angiogenesis through its regulation of VEGF.

METHODSHIF-1alpha mRNA expression was analyzed by in situ hybridization. HIF-1alpha and VEGF protein expressions were determined by immunochemical streptavidin/peroxidase (SP) in SW480 cells and colorectal carcinoma tissue samples and Western blot, using proteins extracted from SW480 cells. Tumor tissue microvessel density (MVD) was determined by CD34 immunostaining of colorectal carcinomas.

RESULTSThe levels of HIF-1alpha mRNA changed significantly in response to different oxygen concentrations and an addition of genistein in SW480 cells. Immunocytochemistry revealed that the levels of HIF-1alpha, VEGF protein expression in SW480 cells were significantly higher under hypoxia than those in nomoxia (P < 0.01, P < 0.05 respectively). However, addition of genistein, an inhibitor of HIF-1alpha, suppressed such responses to hypoxia. Western blot analysis showed that SW480 cells exposed to hypoxia expressed a high level of HIF-1alpha protein, compared to a weak expression in nomoxia. The addition of genistein in hypoxia suppressed the over-expression of HIF-1alpha. The positive rates of HIF-1alpha mRNA by in situ hybridization in colorectal adenomas and adenocarcinomas were 38.9% (7/18) and 67.7% (42/62), respectively. The percentage of HIF-1alpha mRNA positive cells varied significantly from colorectal adenomas to adenocarcinomas at different Duke stages (P < 0.05), and HIF-1alpha mRNA was higher in adenocarcinomas than in adenomas (P < 0.01). The positive rates of HIF-1alpha and VEGF protein expression in adenocarcinomas were 43.5% (27/62) and 37.1% (23/62), respectively. The expression of VEGF elevated as the Duke tumor staging increased. The conformation rate of HIF-1alpha and VEGF was 74.2% (46/62). MVD was significantly higher in HIF-1alpha and/or VEGF positive tumors than those without (P < 0.01 and P < 0.05 respectively). Among the four groups, i.e. HIF-1alpha+/VEGF+, HIF-1alpha+/VEGF-, HIF-1alpha+/VEGF- and HIF-1alpha-/VEGF-, the difference of MVD was highly significant (P < 0.01). HIF-1alpha expression was correlated significantly with VEGF expression and microvessel density.

CONCLUSIONSThese findings suggest hypoxia induces the expression of HIF-1alpha and VEGF in colorectal adenocarcinoma. HIF-1alpha may play an important role in angiogenesis and tumor progression by regulating the expression of VEGF in human colorectal carcinoma.

Adenocarcinoma ; blood supply ; metabolism ; pathology ; Colorectal Neoplasms ; blood supply ; metabolism ; pathology ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; Microcirculation ; pathology ; Neovascularization, Pathologic ; etiology ; RNA, Messenger ; biosynthesis ; genetics ; Transcription Factors ; biosynthesis ; genetics ; Tumor Cells, Cultured ; Vascular Endothelial Growth Factor A ; biosynthesis ; genetics

Colorectal cancer is second only to lung cancer as a cause of cancer death in the United States. Studies have shown that fecal occult blood (FOB) tests are effective in detecting colorectal cancer in its early stages. To increase the participation in the FOB test among the working population, a randomized controlled trial was conducted. A total 278 federal employees 40 years or older in Washington State were randomly divided into a intervention group which received a Colorectal Cancer Risk Appraisal and a control group which received a simple information letter. After three months a follow-up questionnaire was sent to all participants to measure the effectiveness of the intervention. As a result of the study, the intervention group had a 4.3% higher compliance rate with the FOB test during the three month follow-up period (p = .10). The largest effect of the intervention was on the employees' intention to get a FOB test within the next year (62.6% in the intervention group vs. 36.2% in the control group, OR = 3.18, p less than .001).
Adult ; Colorectal Neoplasms/*diagnosis/etiology ; Female ; Follow-Up Studies ; Human ; Male ; Middle Aged ; *Occult Blood ; Occupational Health ; Patient Compliance ; Risk Factors ; Support, U.S. Gov't, P.H.S. ; United States ; Washington