RESUMO
Colorectal cancer (CRC) is among the most prevalent types of cancer globally. It is well established that the development of CRC primarily results from the sequential activation of oncogenes and the simultaneous inactivation of tumor suppressor genes. It has also been noted that after the initial oncogenic mutation, many subpopulations with different mutational profiles are created, causing heterogeneity among the tumors. This retrospective study analyzed 100 patients diagnosed with CRC through colectomy over an eighteen-month period at a tertiary referral center in mid-Kerala, India. Pathology records and histological slides were reviewed by two pathologists, and clinicopathological data were collected from pathology reports. Immunohistochemical analysis for BRAF mutation and possible microsatellite instability (MSI) (by mismatch repair (MMR) protein study) was conducted on tumor tissue blocks sent to an external center due to the lack of an automated platform at the hospital. The study utilized Roche's Benchmark XT platform for BRAF analysis and assessed MMR protein expression using antibodies for MLH1, MSH2, MSH6, and PMS2. The mean age of patients was 58.36 years, with a male predominance (58.0%). Most tumors were classified as T3 (71.0%, n-71) and T2/T4a (14.0% each, n-14), while nodal involvement included N0 (35.0%, n-35), N1 (26.0%, n-26), N2 (19.0%, n-19), and NX (20.0%, n-20). Histological examination revealed predominantly well-differentiated tumors (78.0%, n-78), with lymphatic invasion noted in 41.0% (n-41) and vascular invasion in 5.0% (n-5) of cases. Left-sided tumors predominated (33.0%, n-33), followed by rectal carcinoma (37.0%, n-37), and right-sided colon cancers (30.0%, n-30). Genetic profiling showed sparse BRAF mutations (1.0%, n-1) and MSI (1.0%, n-1), with some cases exhibiting loss of MMR proteins (MLH1, PMS2, MSH2, and MSH6) by immunohistochemistry (IHC). The study highlights the rarity of BRAF mutations in this cohort and emphasizes the diverse pathological and molecular characteristics observed. The discussion focuses on the implications of these findings, suggesting that CRC in this population exhibits unique clinicopathological features potentially influenced by factors beyond genetic mutations. Further multicentric studies are warranted to comprehensively explore these factors and refine risk stratification and treatment strategies for CRC patients in similar demographics.
RESUMO
Background The publication of scholarly work in peer-reviewed journals is a well-established method for disseminating knowledge and findings to a global audience. However, the publishing process is constantly evolving and encountering various obstacles that hinder progress. Despite a significant increase in the number of research projects undertaken, there are few studies evaluating the challenges faced by investigators in publishing their research. This study aims to identify the factors and elements that influence the publication process after the completion of research. Methods This study included 759 projects approved by the Institutional Ethics Committee (IEC) from 2016 to 2021 at a tertiary care centre in South India. A list of these approved projects was analysed for overall output in terms of publication and completion. Investigators were contacted and interviewed using a validated, 15-question survey to identify various factors influencing scientific publications. Results A total of 759 projects approved by the IEC from 2016 to 2021 were analyzed. It was found that only 36.72% of studies were completed by faculty members, and the publication conversion rate was 34.24%. A single-point analysis showed a statistically significant lower conversion rate for resident articles (p = 0.032). The 15-point analysis detailed the factors influencing publication conversion, revealing that the majority of researchers publish based on academic and research interests (68.89% and 72.12%, respectively). Various deterrents to publication, such as study design, statistical analysis, journal selection, and knowledge about journal submission, were identified. Notably, 98.4% of researchers expressed a desire to publish more in the future, highlighting the importance of this study. Conclusion The study highlights areas that require attention to facilitate and augment research. It identifies the real gaps in the publication process and suggests points of intervention needed to enhance the research environment, increase publication rates, and establish demand-based research support units in the medical education sector.