RESUMEN
Colorectal cancer is the third most common cancer worldwide, with 1.36 million people diagnosed in 2012. The prognosis of colorectal cancer is better with an earlier diagnosis. The outcome of colorectal cancer may also be improved by targeting pathways involved in colorectal cancer formation, such as anti-epidermal growth factor receptor (EGFR) therapy. An understanding of colorectal carcinogenesis is essential for the design of molecular targeting. Recent advances in the molecular subtypes of colorectal cancer, methylation of DNA in colorectal cancer, and micro-RNA biogenesis, and their involvement in colorectal cancer have resulted in the identification of many new colorectal biomarkers. Such biomarkers may be used for earlier diagnosis of, selection of 'personalised' therapy for, and prognosis of colorectal cancer. Many of these biomarkers appear promising in small-scale studies. However, validation of their effectiveness with large-scale clinical trials is needed before routine clinical application. To this end, the recently established consensus molecular subtypes of colorectal cancer would enable like-for-like comparisons of the treatment outcomes of clinical trials.
Asunto(s)
Biomarcadores de Tumor/genética , Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/tratamiento farmacológico , MicroARNs/genética , Ensayos Clínicos como Asunto , Neoplasias Colorrectales/genética , Metilación de ADN , Detección Precoz del Cáncer , Humanos , Terapia Molecular Dirigida , Medicina de PrecisiónRESUMEN
A 67-year-old lady presented to the surgical outpatient clinic with a 4 month history of recurrent purulent discharge from her left buttock. Four years and 4 months prior to this she underwent a posterior intravaginal slingoplasty for vaginal prolapse and urinary stress incontinence. An MRI demonstrated a long gluteo-vaginal fistula tract from the posterior wall of the vaginal vault through the left ischiorectal fossa to the skin. An examination under anaesthesia revealed that the fistulous tract was surrounding the intact mesh used for the posterior intravaginal slingoplasty. The mesh was removed, the fistula tract excised and the perineal wound marsupialised. The patient was discharged 5 days later. The wound healed within 4 weeks and she remains sepsis free 2 years on.
