ABSTRACT
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Subject(s)
Humans , Male , Middle Aged , Adenoma/pathology , Stomach Neoplasms/pathology , Metaplasia/pathology , Adenoma/diagnostic imaging , Colonoscopy/methodsABSTRACT
INTRODUCTION: Few studies have been conducted to establish the relationship between colorectal cancer screening programmes and survival adjusting by stage and, to determine whether there are differences, at a biological level, between the tumours of asymptomatic and symptomatic patients. Accordingly, the aim of this study is to evaluate clinical, biological and survival differences between symptomatic colorectal tumours and those detected by screening. STUDY METHOD: A prospective cohort study was performed of patients subjected to surgical intervention during the period 2010-2012, at different hospitals in Spain. In every case, clinical, pathological, biological and survival-related variables were obtained. RESULTS: A total of 2634 patients from the CARESS-CCR cohort were analysed; of these, 220 were diagnosed through screening. The asymptomatic patients were younger, had a higher Body Mass Index (BMI), a lower degree of perineural invasion and a less advanced T stage and nodular stage, and the tumour was frequently located on the right side of the colon. All of these differences were statistically significant. The serum tumour marker carbohydrate antigen 19.9 (CA 19.9) was found more frequently in the symptomatic patients (pâ¯<â¯0.05). However, no significant differences were found regarding the markers of tumour biology: Ki67 (proliferation), CD105 (angiogenesis) and the Terminal deoxynucleotidyl transferase (TdT) dUTP Nick-End Labeling (TUNEL) assay (apoptosis). The patients with asymptomatic tumours had a lower mortality at five years than those diagnosed presenting symptoms. CONCLUSIONS: The detection method employed influenced the survival of patients with colorectal cancer and there were no significant biological differences between the study groups.
Subject(s)
Colorectal Neoplasms/diagnosis , Early Detection of Cancer/methods , Mass Screening , Neoplasm Staging , Aged , Biomarkers, Tumor/metabolism , Colorectal Neoplasms/epidemiology , Colorectal Neoplasms/metabolism , Female , Follow-Up Studies , Humans , Immunohistochemistry , Incidence , Male , Middle Aged , Prospective Studies , Spain/epidemiology , Survival Rate/trendsABSTRACT
We investigate the clinical and pathological features related to variations in colorectal tumour apoptosis, proliferation and angiogenesis and the influence of the latter in short-term mortality (2 years); 551 tumour samples from a prospective cohort of patients with colorectal cancer were examined and tumour biology markers were determined as follows: percentage of apoptotic cells, by the terminal deoxynucleotidyl transferase (TdT) dUTP Nick-End Labeling technique; Ki-67 antigen, as a cell proliferation marker and density of microvessels (as a marker of angiogenesis). An increase in the percentage of cellular apoptosis is significantly related to the presence of poorly differentiated tumours, with vascular invasion (p < 0.001). The CD105 angiogenesis marker is not related to any clinical-pathological parameter except that of higher frequency in older patients (p = 0.03). Ki-67 is more frequently expressed in tumours with less nervous invasion (p = 0.05). Neither apoptosis nor angiogenesis present any significant association with short-term survival. The only marker clearly related to 2-year survival is Ki-67, which is shown to be a good prognostic factor in the multivariate analysis (hazard ratio = 0.49; 95% confidence interval = 0.27-0.90). Therefore, in a prospective cohort of colorectal cancer patients, only Ki-67 is a marker of good prognosis in short-term follow-up.
Subject(s)
Biomarkers, Tumor/genetics , Colorectal Neoplasms/genetics , Ki-67 Antigen/genetics , Neovascularization, Pathologic/genetics , Adult , Aged , Apoptosis/genetics , Cell Proliferation/genetics , Colorectal Neoplasms/epidemiology , Colorectal Neoplasms/pathology , Disease-Free Survival , Endoglin/genetics , Female , Follow-Up Studies , Humans , Male , Middle Aged , Neovascularization, Pathologic/epidemiology , Neovascularization, Pathologic/pathology , PrognosisABSTRACT
A 51 years-old male with several family history of gastric cancer, who was studied one year before for dyspepsia. A new gastroscopy was done that objectified in the greater curvature, a sessile polyp with slightly depressed center and a villous crypt pattern with Narrow Band Imaging. The histopathology study shown a horizontalization of the basal glands and basal dysplasia, compatible with serrated adenoma. A 51 year-old male with a family history of gastric cancer was studied for one year due to dyspepsia. A new gastroscopy was performed that identified a sessile polyp with a slightly depressed center and a villous crypt pattern in the greater curvature via narrow band imaging. The histopathology study showed horizontal basal glands and basal dysplasia, which was compatible with serrated adenoma.
Subject(s)
Adenoma/diagnostic imaging , Gastroscopy , Stomach Neoplasms/diagnostic imaging , Adenoma/pathology , Humans , Male , Middle Aged , Stomach Neoplasms/pathologyABSTRACT
Introducción: describir un cuadro poco habitual como es la leishmaniasis visceral con afectación colónica. Caso clínico: presentamos el caso de un paciente VIH positivo con leishmaniasis visceral. Se describe el caso clínico, con los procedimientos realizados, el tratamiento y su evolución. Se adjunta tabla comparativa de los casos publicados de leishmaniasis con afectación de colon. Discusión: la afectación intestinal en la leishmaniasis visceral es un proceso infrecuente, que debe incluirse en el diagnóstico diferencial en todo paciente inmunodeprimido con clínica de diarrea y que requiere un diagnóstico precoz y tratamiento adecuado, del que depende el pronóstico del paciente (AU)
Background: To describe an unusual clinical presentation of visceral leishmaniasis affecting the colon. Case report: We report the case of an HIV-positive patient with visceral leishmaniasis. We describe the clinical case, the procedures performed, the treatment provided and the patients evolution. A comparative table of previously reported similar cases is shown. Discussion: Visceral leishmaniasis with intestinal involvement is an uncommon process. Nevertheless, this possibility should be taken into consideration in the differential diagnosis of immunosuppressed patients with symptoms of diarrhea, as a favorable prognosis depends on early diagnosis and appropriate treatment (AU)
Subject(s)
Humans , Male , Middle Aged , HIV/pathogenicity , Leishmaniasis, Visceral/complications , Leishmaniasis, Visceral/drug therapy , Leishmaniasis, Visceral/pathology , Early Diagnosis , Clostridioides difficile , Clostridioides difficile/isolation & purification , Amphotericin B/therapeutic use , Immunocompromised Host , Prognosis , Splenomegaly/complications , Splenomegaly/pathology , Anti-Retroviral Agents/therapeutic use , Renal Insufficiency/complicationsABSTRACT
BACKGROUND: To describe an unusual clinical presentation of visceral leishmaniasis affecting the colon. CASE REPORT: We report the case of an HIV-positive patient with visceral leishmaniasis. We describe the clinical case, the procedures performed, the treatment provided and the patient's evolution. A comparative table of previously reported similar cases is shown. DISCUSSION: Visceral leishmaniasis with intestinal involvement is an uncommon process. Nevertheless, this possibility should be taken into consideration in the differential diagnosis of immunosuppressed patients with symptoms of diarrhea, as a favorable prognosis depends on early diagnosis and appropriate treatment.
