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Jul 2026 DOI 10.14302/issn.2471-7061.jcrc-26-6320
R. Chao ChunCorresponding author
Background The incidence of early-onset colorectal cancer (eoCRC), diagnosed at age <50 years, is increasing in the United States. Prior studies using national and state cancer databases have observed higher eoCRC mortality after diagnosis among non-Hispanic Black (NHB) patients. These studies, however, often did not account for insurance status, access to care, and comorbidity burden, which may contribute to the observed disparities. We examined the associations between race and ethnicity and neighborhood-level socioeconomic status (measured by the neighborhood deprivation index (NDI)) and survival among persons with eoCRC in a large integrated healthcare delivery system whose racially/ethnically diverse members have standardized access to care. Methods We included Kaiser Permanente Southern California (KPSC) members diagnosedwith eoCRC (age 15-49 years) between 2009-2020 and followed them through 12/31/2023. Patients with <12 months of prior KPSC membership, an unspecific CRC site, or other/unknown race/ethnicity were excluded. Bivariate and multivariable Cox models were used to estimate hazard ratios (HRs) for the associations between race/ethnicity and NDI and all-cause and CRC-specific mortality. Multivariable models were adjusted for age at diagnosis, sex, Charlson comorbidity score, obesity, stage at diagnosis, cancer site, and histologic subtype. Subgroup analyses were conducted by stage at diagnosis (localized vs. advanced). Results Of 1,695 eoCRC cases included, we observed 465 deaths (among those with known cause, 417 (90.3%) were CRC-specific). The mean follow-up time was 6.8 years. In the adjusted models, NHB and non-Hispanic Asian/Pacific Islander (NH API) patients, but not Hispanic patients, had significantly higher all-cause mortality (HR=1.62, 95% CI: 1.14-2.29; HR=1.44 (1.08-1.93), respectively) compared with non-Hispanic White (NHW) patients. In the subgroup analyses, race and ethnicity were not associated with all-cause mortality among patients with localized disease. However, among patients diagnosed with advanced disease, NHB patients had a significantly higher risk of all-cause mortality compared with NHW patients (HR=1.54, 95% CI: 1.07-2.22, p=0.02). Similar findings were observed for CRC-specific mortality, overall and by cancer stage. NDI was not significantly associated with all-cause or CRC-specific mortality. Conclusions In this insured population, NHB race and ethnicity were associated with increased risk of CRC-specific mortality among those diagnosed with advanced stage eoCRC. However, the number of NHB patients diagnosed at distant stages was small. Therefore, future research is needed to confirm these findings and better understand potential survival disparities.
Jan 2024 DOI 10.14302/issn.2641-4538.jphi-23-4856
Rashid AlKalbani SalmaCorresponding author
Colorectal cancer (CRC) is a major public health problem worldwide, as it is the third most common disease and the second leading cause of cancer-related fatalities. In recent years, Oman, like many other countries, has seen an epidemiological shift from communicable diseases to noncommunicable diseases, including colorectal cancer, necessitating comprehensive planning to address the root cause of the problem as well as a comprehensive screening program to detect diseases at an early stage and thus improve health outcomes. Colorectal cancer is the second most frequent cancer in Oman, with the highest mortality rate, inflicting considerable public health and economic consequences; nevertheless, there is no population-based CRC screening programme in place to minimise the disease's incidence, mortality, and severe health outcomes. This review highlights the epidemiology of colorectal cancer in Oman, the Wilson and Junger criteria, operational readiness, and recommendations for implementing a population-based colorectal cancer screening program.
Oct 2021 DOI 10.14302/issn.2379-7835.ijn-21-3908
B. Oluwole OluwatoyinCorresponding author
Food Technology Department, Federal Institute of Industrial Research, Oshodi, Lagos, Nigeria
Colorectal cancer (CRC) is a menace in the global public health system. According to GLOBOCAN reports, colorectal cancer is the second most diagnosed cancer in the world with more than 1.9 million cases and 935,000 deaths in 2020 alone. Diet plays a key role in exposing humans to environmental carcinogens and anti-carcinogens, consequently mitigating or aiding in the development of various cancers. CRC is most prevalent in western countries with a high intake of saturated fats, refined carbohydrates, and processed meat. CRC was an extremely rare disease in Africa some decades ago, but the situation is fast changing. The traditional African diet consists of leafy, roots and cruciferous vegetables, fruits, roots, tubers and plantains, legumes, whole grains, and spices, all of which have been shown to possess protective effects against CRC. However, the effect of urbanization has contributed to the shift of dietary choices among the African population to consuming more ultra-processed foods with high levels of unhealthy components that have originated from colorectal cancer prevalent regions. This review evaluates the current nutritional challenges of the African diet to colorectal cancer and the potential roles of the traditional African diets and lifestyle modification in the prevention and management of colorectal cancer.
Jan 2019 DOI 10.14302/issn.2471-7061.jcrc-18-2446
Youssef HaneyCorresponding author
Consultant Colorectal Surgeon, University Hospital Birmingham Good Hope Hospital
Introduction: Cardiac complications are a major cause of perioperative morbidity and mortality in patients undergoing colorectal cancer surgery. A quick and reliable system for predicting postoperative cardiac morbidity is needed to predict cardiac events in order to improve outcome in surgery. The aim of this study was to investigate the role of the biochemical marker NT-proBNP in the prediction of postoperative all-cause mortality, cardiac-related mortality and cardiovascular events in patients undergoing colorectal cancer resections. Methods: 100 consecutive patients undergoing colorectal cancer surgery were prospectively recruited. Blood samples were taken preoperatively, 24h, 48h and 5-7 postoperative days to measure NT-proBNP levels. The predictive power of NT-proBNP levels was assessed using Receiver Operating Characteristics (ROC) curves. Results: Cardiac-related morbidity and mortality was 9%. Of eleven deaths, 5 were cardiac-related. Preoperative NT-proBNP was a good predictor of death with ROC area under curve (AUC) of 0.83 (95% C.I. 0.673, 0.993) a strong predictor of cardiac death with AUC of 0.914 (95% C.I. 0.823, 1.000) and a good predictor of cardiac complications with AUC of 0.875 (95% C.I. 0.757, 0.993). NT-proBNP levels 24 hours and 48 hours postoperatively were also strongly predictive of postoperative cardiac morbidity and mortality. Conclusion: Pre- and postoperative NT-proBNP have a role in predicting postoperative death and cardiac complications. This may have significant implications in the planning of postoperative care for high-risk patients.
Nov 2017 DOI 10.14302/issn.2576-6694.jbbs-17-1744
Mahjoubi FrouzandehCorresponding author
Department of Clinical Genetics, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
Aim: Colorectal cancer is one of the most commonly diagnosed cancers in the world. Cell adhesion molecules play an important role in the progression of various cancers. It has been shown that the high level expression of some Cell adhesion molecule could be a new diagnostic factor for several cancers. Vascular cell adhesion molecule 1(VCAM1) is a cell surface glycoprotein that is expressed in the endothelium activated by cytokine. Generally, VCAM-1 expression level is very poor in normal adult tissue endothelial cells. According to the above explanation, this study was conducted to investigate the expression of VCAM-1 in tumoral tissues and adjacent normal tissues in Iranian colorectal cancer patients to its relation with clinicopathological Features in patients with cancer. Methods: In this study, 60 tumoral tissues and 39 adjacent normal tumor tissues were evaluated using reverse transcription-polymerase chain reaction (RT-PCR) technique. Conclusion: A significant correlation was found between VCAM-1 expression level and the stage, lymph nodes involvement, tumor progression factor of cancer and sex. Interestingly, VCAM-1 expression not observed in tumors with stage0. No association was seen between VCAM-1 expression and other clinical features such as age, size of the tumor, metastasis and the number of lymph nodes. These findings suggest that VCAM-1 expression level may reflected disease progression and elevation in VCAM-1 has prognostic significance in patients with colorectal carcinoma.
Aug 2017 DOI 10.14302/issn.2471-7061.jcrc-17-1624
Claudia PieperCorresponding author
Institute for Medical Informatics, Biometry und Epidemiology, University Hospital of Essen, Hufelandstraße 55, 45122 Essen, Germany,
Background Despite the existence of the statutory early cancer detection program in Germany and the removal of financial barriers, which is frequently reported in the literature to be the main obstacle in screening, uptake of colorectal cancer screening remains quite low. The campaign for colorectal cancer screening in German companies reported in this article started in 2010. It was initiated because of the low compliance with opportunistic public colorectal cancer screening efforts. Its goal is to improve participation by offering an organized screening program using a simple test (FIT). Methods An offer for company employees is publicized through posters, company newsletters and the intranet. The difference between the positivity rates of those who returned the kits within 20 days and later than 20 days was assessed using the Z-test. The average time between a positive result and colonoscopy was estimated using the Poincaré plot method. The positive predictive values were calculated for carcinomas, advanced adenomas or any lesions. The sensitivity and specificity of immoCare-C published by Vogel et al. and Hundt et al. were used to derive the confidence intervals for the positive likelihood ratio (for carcinoma and any kind of adenoma). Results A total of 312,147 kits were returned and analyzed (return rate 70.2%). 5.6% gave a positive result. The PPV for cancer aged between 55 and 74 was 4.6% for men and women (95% CI: 2.38%-6.76% and 1.28%-7.99%, respectively), but 22% for men (95% CI: 17.93%-26.65%) and 8% for women (95%CI: 3.63%-12.26%) for advanced adenomas. The PPV for any lesion was higher for those with familial risk (49.3%) and 42.6% for those without familial risk (95% CI: 40.2%-45.0%), but with overlapping confidence intervals. Conclusions The reported sample is not representative. Although, offering CRC screening in companies may be an effective way of increasing uptake in the target population. Differences in the test performance between men and women need further evaluation.
Nov 2016
Wan Kim YoungCorresponding author
Division of Colorectal Surgery, Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
This practical overview lists prerequisites for emergent laparoscopic colorectal cancer surgery, including team readiness, equipment, and perioperative protocols to optimize patient safety.
Aug 2016 DOI 10.14302/issn.2474-9273.jbtm-16-1105
J. Siembida ElizabethCorresponding author
Department of Human Development and Family Studies, University of Connecticut, USA
An often neglected factor in the examination of the mental quality of life of survivors of colorectal cancer is the role of family and community level resources and support. The aim of this study was to develop a deeper understanding of the influence of family and community level resources over and above previously examined mental health variables. A survey-based pilot study was conducted with 101 colorectal cancer survivors. Four multiple linear regression models were developed to examine the associations between demographic, health-related, individual psychosocial, family and community level factors, and specific dimensions of mental quality of life (measured using the mental health subscales of the SF-12). In addition to examining all of the correlates of mental quality of life, the unique role of family and community level factors over and above previously examined factors was examined. Analyses found that family and community level factors, as a whole, explained a significant portion of the variance in role emotional health, mental health, and social functioning over and above demographic, health-related, and individual psychosocial factors. Family cohesion was a significant, unique predictor of role limitations due to mental health, and family and community social support was a significant, unique predictor of role limitations due to mental health and overall mental health. These results suggest the potential importance of considering family and community level resources when conducting research and designing interventions to improve mental quality of life in colorectal cancer survivors.
Mar 2016 DOI 10.14302/issn.2326-0793.jpgr-16-941
Chan ChristinaCorresponding author
Cell and Molecular Biology Program, Michigan State University, 567 Wilson Road, Rm 2240A, East Lansing, Michigan 48824, USA
In contrast to approaches that compare pair-wise control (i.e. normal) to treated (i.e. disease) samples, we compared colorectal cancer samples not only to a set of control samples but also against a wide range of samples and conditions to collect the differentially expressed genes and identify target genes. We identified specific genes for colorectal cancer and showed that they are significantly associated with colorectal cancer in the literature. Analysis of independent datasets revealed a significantly distinct expression pattern for glucocorticoid receptor (GR) and ring finger protein 43 (RNF43) in colorectal cancer samples. GR was downregulated whereas RNF43 was upregulated in colorectal cancer with respect to various conditions in different datasets. In HCT116 colorectal cancer cell line, knock-down of GR levels with siRNA resulted in increased RNF43 levels, suggesting that GR might be a negative regulator of RNF43. Our study suggests that the downregulation of GR might be involved in the upregulation of RNF43 in colorectal cancer.
Mar 2016 DOI 10.14302/issn.2471-7061.jcrc-15-899
K. Shin LewisCorresponding author
Department of Radiology, VA Palo Alto Health Care System, 3801 Miranda Ave. MC 114, Palo Alto, CA 94304
Missed cancers have been reported at higher frequencies in the right colon despite optical colonoscopy screening. The purpose of this study was to determine if there are regional differences in haustral fold height between the ascending, transverse, and descending colon using CT colonography (CTC). 50 supine CTC datasets from 50 asymptomatic, adult patients were analyzed (NCI-CBIIT instance of the National Biomedical Imaging Archive). At least 5 consecutive, pairs of unobscured haustral folds in each colonic segment were necessary to be included in this study. Of an initial 201 patients, 151 were excluded due to suboptimal colonic distension, retained fluid, tortuosity, and diverticulosis. For each dataset, the heights of the non-dependent haustral folds were measured in the ascending, transverse, and descending colon on 2D multiplanar reformations. Differences in mean HFHs were assessed using a hierarchical generalized linear mixed model. A total of 2079 colonic folds were measured: 625 in the ascending colon (including the cecum), 687 in the transverse colon, and 767 in the descending colon. The mean number of folds measured per segment was 6.87 ± 2.11. Mean HFHs were significantly taller in the ascending colon (14.62 ± 5.47 mm) than in the transverse (9.49 ± 3.65mm) or descending (6.53 ± 3.12mm) colon; mean HFHs were also significantly taller in the transverse than the descending colon, (P<0.0001, for all comparisons). In conclusion, taller colonic haustral folds are present in the proximal colon and may contribute to more frequently missed lesions (e.g. polyps) in the right colon by conventional, optical colonoscopy.
Jan 2015 DOI 10.14302/issn.2471-7061.jcrc-14-394
C. Papagiorgis PetrosCorresponding author
Technological Educational Institute of Athens, Faculty of Health and Caring Professions
This review synthesizes evidence on NSAIDs and colorectal cancer prevention. It balances chemopreventive efficacy against gastrointestinal and cardiovascular risks, and considers selective COX‑2 inhibitors, dosing, and candidate populations for risk‑benefit.
Dec 2014 DOI 10.14302/issn.2326-0793.jpgr-14-598
YC Fung KimCorresponding author
CSIRO Preventative Health National Research Flagship, Australia
Colorectal cancer is one of the most commonly diagnosed cancers worldwide and its prevalence can be reduced by changes to lifestyle and diet. Fermentation of dietary fibre by the gut microbiota and formation of short chain fatty acids, in particular butyrate, is widely thought to play a role in preventing development of the disease. Despite butyrate’s known pro-apoptotic effects, a subpopulation of cancer cells is able to overcome these anti-neoplastic effects of colonic luminal butyrate to proliferate and establish tumours in vivo. In this study, a time course analysis of HT29 and HT29-BR cells treated with butyrate was conducted and global gene expression analysis was used to identify novel mechanisms associated with butyrate-induced apoptosis and in the acquisition of butyrate resistance. Bioinformatic analysis of the data identified deregulated O-GlcNAcylation activity and disruption to gene transcription by BRD4 as possible factors involved with butyrate-induced apoptosis. EGF signalling was identified as being potentially involved in the acquisition of butyrate resistance. Furthermore, the expression of the minichromosome maintenance protein family was significantly reduced in the HT29-BR cell line reflecting disruptions to the DNA replication process. Together, this may confer a unique survival advantage for cells with acquired butyrate resistance.
Oct 2020 DOI 10.14302/issn.2379-7835.ijn-20-3418
E. Ahmed FaridCorresponding author
GEM Tox Labs, Institute for Research in Biotechnology, 2905 South Memorial Drive, Greenville, NC 27834, USA
Isolation methods that employ readily-available inexpensive supplies on the open market, which are reliable, as well as economical, such as nucleic acid amplification techniques (NAAT) based on microfluidic technology in low-resource research settings (LRRS) that meets the ASSURED guidelines are essential to develop a noninvasive diagnostic colon cancer screen in stool using micro(mi)RNA molecules. A combination of a microfluidic-based MiRNA stool test with a reliable rolling circle amplification/detection method applied to the quantification of miRNA molecules, result in an affordable sensitive and specific isothermal method for the noninvasive quantitative detection of miRNAs in LRRS. Scientists and engineers have become interested in miRNAs, and they have intensified their efforts to apply emerging simple detection tools to the important bioanalytical challenge of quantifying these small 18-26 nt long molecules. Some of the proposed approaches incorporate novel material, such as simple centrifuges and methods based on microfluidic technology, while others utilize the interesting biological properties of these molecules, such as forming branched RCA structures, allowing for the detection of these biomarker molecules at an attomolar "aM" concentration level, using low cost extraction and isothermal amplification methods in LRRS. We have been interested in studying colorectal cancer (CRC) because it is the 3rd most common malignancy worldwide, and stool can be obtained noninvasively from the patients. We have focused in this research on colon cancer (CC) because it is more common in the USA than rectal cancer (RC). The innovation of our approach lies in the exploratory use of an affordable, quantitative miRNA profiling in noninvasive stool samples in LRRS, whose extracted fragile total RNA is stabilized shortly after excretion from stool by commercially available kits, so it does not ever fragment, followed by quantitative standardized analytical tests that are neither labor intensive, nor require expensive instrumentation, in order to develop apanel of novel miRNA genes for the noninvasive diagnostic screening of early left and right sporadic colon cancers, more economically, and with higher sensitivity and specificity than any other colon cancer screening test currently available on the market. To show the clinical sensitivity and specificity of the proposed quantitative miRNA test using simple methodologies in LRRS,the miRNA results are to be correlated with FOBT, colonoscopy, and pathology data. Standardization establishes test’s performance criteria (sample selection, optimal sample running conditions, preservation and storage), in order to ensure that the assay will perform the same way in any laboratory, by any trained personnel, anywhere in low-resource laboratory settings worldwide.
Jun 2020 DOI 10.14302/issn.2379-7835.ijn-19-3123
E. Ahmed FaridCorresponding author
GEM Tox Labs, Institute for Research in Biotechnology, 2905 South Memorial Drive, Greenville, NC 27834, USA
Isolation methods that employ readily-available inexpensive supplies on the open market, which are reliable, as well as economical, such as nucleic acid amplification techniques (NAAT) based on microfluidic technology in low-resource research settings (LRRS) that meets the ASSURED guidelines are essential to develop a noninvasive diagnostic colon cancer screen in stool using micro(mi)RNA molecules. A combination of a microfluidic-based MiRNA stool test with a reliable rolling circle amplification/detection method applied to the quantification of miRNA molecules, result in an affordable sensitive and specific isothermal method for the noninvasive quantitative detection of miRNAs in LRRS. Scientists and engineers have become interested in miRNAs, and they have intensified their efforts to apply emerging simple detection tools to the important bioanalytical challenge of quantifying these small 18-26 nt long molecules. Some of the proposed approaches incorporate novel material, such as simple centrifuges and methods based on microfluidic technology, while others utilize the interesting biological properties of these molecules, such as forming branched RCA structures, allowing for the detection of these biomarker molecules at an attomolar "aM" concentration level, using low cost extraction and isothermal amplification methods in LRRS. We have been interested in studying colorectal cancer (CRC) because it is the 3rd most common malignancy worldwide, and stool can be obtained noninvasively from the patients. We have focused in this research on colon cancer (CC) because it is more common in the USA than rectal cancer (RC). The innovation of our approach lies in the exploratory use of an affordable, quantitative miRNA profiling in noninvasive stool samples in LRRS, whose extracted fragile total RNA is stabilized shortly after excretion from stool by commercially available kits, so it does not ever fragment, followed by quantitative standardized analytical tests that are neither labor intensive, nor require expensive instrumentation, in order to develop apanel of novel miRNA genes for the noninvasive diagnostic screening of early left and right sporadic colon cancers, more economically, and with higher sensitivity and specificity than any other colon cancer screening test currently available on the market. To show the clinical sensitivity and specificity of the proposed quantitative miRNA test using simple methodologies in LRRS,the miRNA results are to be correlated with FOBT, colonoscopy, and pathology data. Standardization establishes test’s performance criteria (sample selection, optimal sample running conditions, preservation and storage), in order to ensure that the assay will perform the same way in any laboratory, by any trained personnel, anywhere in low-resource laboratory settings worldwide.
Aug 2016 DOI 10.14302/issn.2471-7061.jcrc-14-426
Mountifield RémeCorresponding author
Dept Gastroenterology and Hepatology, Flinders Medical Centre, South Australia,
Background: Colorectal cancer (CRC) screening by Fecal Immunohistochemical Testing (FIT) followed by colonoscopy reduces colorectal cancer mortality. Barriers to colonoscopy should be minimised. Objective: To compare psychological “risks” of colonoscopy in FIT positive (FIT+) subjects and those with Inflammatory Bowel Disease (IBD). Method: IBD patients undergoing colonoscopic CRC surveillance were age and gender matched with FIT+ individuals awaiting colonoscopy. Subjects completed Spielberger State and Trait Scales for current levels of anxiety, depression, anger and curiosity, versus long term personality tendencies. Results: 70 IBD respondents were matched with 70 FIT+ respondents, (57% male, mean age 57.6 years). FIT+ subjects demonstrated greater scores for state Anxiety (22.3 vs 20.3 p=0.024), Curiosity (24.3 vs 21.8 p=0.036), Anger (13.7 vs11.5 p=0.037) and Depression (23.8 vs21.2 p=0.002). Conclusion: FIT+ patients experience more anxiety and depression prior to their colonoscopy than IBD patients, which may reduce colonoscopy uptake and is important to address.
Jul 2016 DOI 10.14302/issn.2574-4526.jddd-16-1203
Mark R. BorgaonkarCorresponding author
Background: Iron deficiency is a common reason for referral to a gastroenterologist. Objective: To identify predictors of colorectal cancer in patients referred to a gastroenterologist for iron deficiency. Methods: This was a retrospective review of consecutive patients referred to one of two gastroenterologists for assessment of iron deficiency. The office files and electronic health records were reviewed for all patients. Clinical data, such as hemoglobin level, and clinical symptoms were recorded. The final diagnosis was that of the attending gastroenterologist. Variables associated with a diagnosis of colorectal cancer by univariate analysis were entered into a multivariate logistic regression model to identify variables independently associated with the diagnosis of colorectal cancer. Results: Two hundred and seventy eight patients were included in this study. One hundred and fifty-eight (56.8%) were female. Mean age was 60.7 years (± 16.7 years). The most common causes of iron deficiency were: menorrhagia 16.2%, colorectal cancer 14%, use of aspirin or non-steroidal agents 11.2% and regular blood donation 7.2%. In 11.5% of patients, no cause was found. In univariate analysis, lower hemoglobin, greater age, shorter duration of iron deficiency, weight loss, symptoms from anemia and NSAID use were associated with colorectal cancer. In multivariate analysis, only older age (OR=1.06; 95% CI 1.04-1.09) and symptoms from anemia (OR=2.19; 95% CI 1.20-4.0) were independently associated with colorectal cancer. Conclusions: Colorectal cancer was found in 14% of patients referred to a gastroenterologist because of iron deficiency. Older age, and symptomatic anemia may help predict a diagnosis of colorectal cancer.
Jul 2016 DOI 10.14302/issn.2471-7061.jcrc-14-575
V. Roig JoséCorresponding author
Consorcio Hospital General Universitario de Valencia, Department of General and Digestive Surgery.
Aim: To analyze the factors involved in and the results of stoma reversal after an emergency Hartmann's operation. Methods: A multicenter retrospective study from the Valencian Society of Surgery of patients who had undergone an emergent Hartmann’s operation from 2004 to 2008. An analysis of the reversal rate and related factors, delay, and morbidity of reconstruction was performed. Results: Three hundred sixty-two patients were studied. The most frequent initial diagnosis was colorectal cancer, followed by complicated acute diverticulitis; the primary surgical indication was acute peritonitis. After a median follow-up of 52 months, 151 patients (41.7%) underwent surgery to reverse the stoma at a median of 10 months after initial surgery. Diagnosis of diverticulitis or trauma, peritonitis as the surgical indication, and non-advanced tumors were associated with reversal. Multivariate analysis showed that only age and tumor stage were predictive of reversal. Postoperative complications occurred in 44% of the cases, and wound infection was the most common. There were 9 (6%) anastomotic leaks. Thirteen patients (8.6%) retained a permanent or temporary stoma after the attempted reconstruction. Conclusion: Hartmann’s reversal after emergency surgery is performed in less than half of all such patients and has significant morbidity.
May 2015 DOI 10.14302/issn.2471-7061.jcrc-14-574
B. Irby RosalynCorresponding author
Department of Medicine Penn State Hershey Cancer Institute, Penn State College of Medicine, Hershey, PA 17033. &Denotes equal contribution
Colon cancer has a five-year survival of 64.7%, and about 50,000 people are expected to die from colon cancer this year. Patients with metastatic colorectal cancer have a significantly worse prognosis, a 12.9% five-year survival. This emphasizes the need for strategies to inhibit the growth and metastases of colorectal cancer. Prostate apoptosis response protein 4 (Par-4) is a pro-apoptotic protein that has been shown to mediate apoptosis in response to stimuli, such as chemotherapeutics and radiation. Recombinant Par-4 protein has been shown to reduce the occurrence of Lewis lung carcinoma metastases in-vivo; however, the mechanism by which Par-4 can inhibit metastasis has not been elucidated. In this study, human colon cancer cell lines - SW480 and SW620 - were transfected with Par-4 plasmid or anti-Par-4 shRNA, and the effect on metastasis was examined. Par-4 overexpression inhibited cell migration and invasion, while Par-4 knockdown promoted it. Moreover, the morphology of SW620 cells was altered when Par-4 levels were increased. The change was characteristic of a mesenchymal-to-epithelial transition (MET) in these cells. MET can be induced by upregulation of E-cadherin expression, and RT-PCR and Western blot analyses showed that E-cadherin mRNA and protein levels, respectively, were increased in the Par-4 overexpressing cells concomitant with a decrease in vimentin. The results of this study demonstrate the potential of Par-4 in colon cancer therapy, not only in primary tumors but also in metastatic cells.
Jan 2015 DOI 10.14302/issn.2471-7061.jcrc-13-375
Savas NurtenCorresponding author
Baskent University Faculty of Medicine, Department of Gastroenterology, Oymaci sok. No:7 Altunizade / İstanbul - Turkey
Colorectal polyps were traditionally classified as hyperplastic or adenomatous polyps. Adenomatous polyps were thought to be the precursor lesions of most of the colorectal cancers, but later serrated lesions were recognized as precursors of nearly one-third of colorectal cancers. Serrated lesions are a distinct group of polyps with special morphologic and histologic properties and a different carcinogenesis pathway to colorectal cancers. They are pale, flat or depressed lesions which may result in failure of detection on colonoscopy. So the endoscopist should be aware of these lesions and should follow the patients according to the surveillance guidelines.