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1.
Cancer Med ; 10(9): 2987-2995, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33797856

RESUMO

BACKGROUND: The incidence of early-onset colorectal cancer (EOCRC) is rising. Left-sided colorectal cancer (LCC) is associated with better survival compared to right-sided colon cancer (RCC) in metastatic disease. NCCN guidelines recommend the addition of EGFR inhibitors to KRAS/NRAS WT metastatic CRC originating from the left only. Whether laterality impacts survival in locoregional disease and EOCRC is of interest. METHODS: 65,940 CRC cases from the National VA Cancer Cube Registry (2001-2015) were studied. EOCRC (2096 cases) was defined as CRC diagnosed at <50 years. Using ICD codes, RCC was defined from the cecum to the hepatic flexure (C18.0-C18.3), and LCC from the splenic flexure to the rectum (C18.5-18.7; C19 and C20). RESULTS: EOCRC is more likely to originate from the left side (66.65% LCC in EOCRC vs. 58.77% in CRC). Overall, LCC has better 5-year Overall Survival (OS) than RCC in stages I (61.67% vs. 58.01%) and III (46.1% vs. 42.1%) and better 1-year OS in stage IV (57.79% vs. 49.49%). Stage II RCC has better 5-year OS than LCC (53.39% vs. 49.28%). In EOCRC, there is no statistically significant difference between LCC and RCC in stages I-III. Stage IV EOCRC patients with LCC and RCC have a 1-year OS of 73.23% and 59.84%, respectively. CONCLUSION: In EOCRC, LCC is associated with better OS than RCC only stage IV. In the overall population, LCC is associated with better OS in all stages except stage II. The better prognosis of stage II RCC might be due to the high incidence of mismatch repair deficient tumors in this subpopulation.


Assuntos
Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/patologia , Adulto , Idoso , Colo Ascendente/patologia , Colo Descendente/patologia , Colo Transverso/patologia , Neoplasias do Colo/etnologia , Neoplasias do Colo/mortalidade , Neoplasias do Colo/patologia , Neoplasias Colorretais/etnologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Neoplasias Retais/etnologia , Neoplasias Retais/mortalidade , Neoplasias Retais/patologia , Sistema de Registros/estatística & dados numéricos , Estudos Retrospectivos , Estados Unidos/epidemiologia , Veteranos
3.
Indian J Pathol Microbiol ; 64(1): 168-170, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33433433

RESUMO

Lymphomas are hematological malignancies with a wide variety of histological subtypes, varied clinical manifestations and behaviour and have a wide range of organ involvement. About 40 per cent of lymphomas are extra nodal. The most common extra nodal site is gastrointestinal tract (GIT). In the GIT, stomach is the most common organ involved accounting for 50-60 per cent of the lesions. Colorectal lymphomas are rare and account for 15-20 per cent of GIT lymphomas. They constitute 1 per cent of colorectal malignancies. Most common histological type of lymphoma involving GIT is diffuse large B-cell lymphoma, followed by MALT lymphoma; T-cell lymphomas are very rare and have an incidence of 3 per cent of Non Hodgkins Lymphoma (NHL). We report a case of anaplastic large cell lymphoma in the caecum and ascending colon with review of literature.


Assuntos
Ceco/patologia , Colo Ascendente/patologia , Neoplasias Colorretais/diagnóstico por imagem , Linfoma Anaplásico de Células Grandes/diagnóstico , Colo Ascendente/diagnóstico por imagem , Neoplasias Colorretais/classificação , Neoplasias Colorretais/tratamento farmacológico , Tratamento Farmacológico , Feminino , Técnicas Histológicas , Humanos , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Adulto Jovem
5.
Eur J Surg Oncol ; 47(4): 842-849, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33011004

RESUMO

BACKGROUND AND AIMS: We aimed to investigate the impact of the site of the primary on postoperative and oncological outcomes in patients undergone simultaneous approach for colon (CC) and rectal cancer (RC) with synchronous liver metastases (SCRLM). PATIENTS AND METHODS: Of the 220 patients with SCRLM operated on between Mar 2006 and Dec 2017, 169 patients (76.8%) were treated by a simultaneous approach and were included in the study. Two groups were considered according to the location of primary tumor RC-Group (n = 47) and CC-group (n = 122). RESULTS: Multiple liver metastases were observed in 70.2% in RC-Group and 77.0% in CC-Group (p = 0.233), whilst median Tumor Burden Score (TBS) was 4.7 in RC-Group and 5.4 CC-Group (p = 0.276). Severe morbidity (p = 0.315) and mortality at 90 days (p = 0.520) were comparable between RC-Group and CC-Group. The 5-year overall survival (OS) rate was similar comparing RC-Group and CC-Group (48.2% vs. 45.3%; p = 0.709), but it was significantly different when considering left-CC, right-CC and RC separately (54.5% vs. 35.2% vs. 48.2%; p = 0.041). Primary tumor location (right-CC, p = 0.001; RC, p = 0.002), microscopic residual (R1) disease at the primary (p < 0.001), TBS ≥6 (p = 0.012), bilobar metastases (p = 0.004), and chemotherapy strategy (preoperative ChT, p = 0.253; postoperative ChT, p = 0.012; and perioperative ChT, p < 0.001) resulted to be independent prognostic factors at multivariable analysis. CONCLUSION: In patients with SCRLM, simultaneous resection of the primary tumor and liver metastases seems feasible and safe and allows satisfactory oncological outcomes both in CC and RC. Right-CC shows a worse prognosis when compared to left-CC and RC.


Assuntos
Neoplasias do Colo/terapia , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/cirurgia , Neoplasias Retais/terapia , Idoso , Antineoplásicos/uso terapêutico , Quimioterapia Adjuvante , Colo Ascendente/patologia , Colo Descendente/patologia , Colo Sigmoide/patologia , Neoplasias do Colo/patologia , Feminino , Humanos , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Estadiamento de Neoplasias , Neoplasia Residual , Complicações Pós-Operatórias/etiologia , Radioterapia Adjuvante , Neoplasias Retais/patologia , Taxa de Sobrevida , Fatores de Tempo , Resultado do Tratamento , Carga Tumoral
6.
Eur J Surg Oncol ; 47(4): 834-841, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33032866

RESUMO

BACKGROUND: Despite recent studies suggest that, among patients operated on for colorectal liver metastases (CLM), the primary tumor location may impact on postoperative survivals, results are still contrasting. OBJECTIVE: evaluating survivals (overall (OS) and (DFS)) following liver resection of CLM from Right colon Cancer (RcC-CLM) versus Left colon Cancer (LcC-CLM), among patients undergoing preoperative chemotherapy (pCHT), identifying survival predictors, and investigating impact of recurrent disease pattern and management on survival. METHODS: Among 727 patients operated for CLM(1989-2016), after excluding patients with primary transverse colon/rectum tumor and patients not receving pCHT, 297 patients were identified. Among them, 81 with RcC-CLM were matched 1:1 with LcC-CLM, according to CLM number and diameter, disease-free interval between primary tumor and CLM diagnosis, primary tumor N-status, and the presence of extrahepatic disease. RESULTS: Overall, 66.7% of patients had multiple CLM, 21% had CLM>5 cm, 82.7% had DFI<12 months, 67.9% had N+ primary tumor, and 11.1% had extrahepatic disease at time of hepatectomy. RcC-CLM patients were similar to LcC-CLM in terms of demographic, clinical, perioperative, and pathologic characteristics. Patients operated for RcC-CLM, compared to LcC-CLM, had significantly shorter 5y-DFS(18% versus 39%) and 5y-OS(38% vs 65%). At multivariate analysis, being operated for RcC-CLM, compared to LcC-CLM, was the strongest predictor of recurrence (Hazard Ratio:2.265,p < .001) and death (HR:2.234,p = .001). Among 107 patients experiencing recurrent disease, curative recurrence resection was associated with higher 5y-OS(64% vs 17%; p < .001). However, recurrence resection was less frequently feasible among RcC-CLM(26%) patients, compared to LcC-CLM(44%,p = .05). CONCLUSIONS: resection of RcC-CLM, compared to LcC-CLM, is associated with worse survivals, probably related to a different pattern of recurrence precluding recurrence resection among RcC-CLM patients.


Assuntos
Neoplasias do Colo/patologia , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/cirurgia , Recidiva Local de Neoplasia/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Colo Ascendente/patologia , Colo Descendente/patologia , Colo Sigmoide/patologia , Intervalo Livre de Doença , Feminino , Hepatectomia , Humanos , Neoplasias Hepáticas/secundário , Metástase Linfática , Masculino , Metastasectomia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/cirurgia , Estadiamento de Neoplasias , Fatores de Risco , Taxa de Sobrevida , Carga Tumoral , Adulto Jovem
7.
Clin Transl Oncol ; 23(4): 827-839, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32789773

RESUMO

OBJECTIVE: To provide guidance for the management of RAS wild-type (wt) metastatic colorectal cancer (mCRC) in daily practice. METHODS: Nominal group and Delphi techniques were used. A steering committee of seven experts analyzed the current management of RAS wt mCRC, through which they identified controversies, critically analyzed the available evidence, and formulated several guiding statements for clinicians. Subsequently, a group of 30 experts (the expert panel) was selected to test agreement with the statements, through two Delphi rounds. The following response categories were established in both rounds: 1 = totally agree, 2 = basically agree, 3 = basically disagree, 4 = totally disagree. Agreement was defined if ≥ 75% of answers were in categories 1 and 2 (consensus with the agreement) or 3 and 4 (consensus with the disagreement). RESULTS: Overall, 71 statements were proposed, which incorporated the following areas: (1) overarching principles; (2) tumor location; (3) triplets; (4) maintenance; (5) second-line and beyond treatments; (6) Rechallenge and liquid biopsy. After the two Delphi rounds, only six statements maintained a lack of clear consensus. CONCLUSIONS: This document aims to describe the expert's attitude when dealing with several common clinical questions regarding patients with RAS wt mCRC.


Assuntos
Comitês Consultivos , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/genética , Consenso , Técnica Delfos , Genes ras/genética , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Bevacizumab/uso terapêutico , Camptotecina/análogos & derivados , Camptotecina/uso terapêutico , Colo Ascendente/patologia , Colo Transverso/patologia , Neoplasias do Colo/tratamento farmacológico , Neoplasias do Colo/genética , Neoplasias do Colo/patologia , Neoplasias Colorretais/patologia , Receptores ErbB/antagonistas & inibidores , Fluoruracila/uso terapêutico , Genótipo , Humanos , Leucovorina/uso terapêutico , Biópsia Líquida , Quimioterapia de Manutenção/métodos , Compostos Organoplatínicos/uso terapêutico , Proteínas Proto-Oncogênicas B-raf/genética , Retratamento
8.
Niger J Clin Pract ; 23(8): 1048-1053, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32788480

RESUMO

Aims: To describe the clinical characteristics, colonoscopic features, histological findings, dysplasia patterns, and clinical outcome of endoscopically detected colonic polyps in the Saudi population. Methods: This retrospective record review was conducted at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, on patients who underwent colonoscopy between 2005 and 2015. Patients with colorectal cancer were excluded. Data were analyzed using SPSS software. Results: Among 211 patients recruited, 66.8% were males and 66.2% were Saudi. Single polyps were detected in 45.5% of cases, while 29.9%, 18%, and 6.6% had 2, 3, and 4 polyps, respectively. Regarding the size, 81%, 17%, and 2% of the polyps were <1 cm, 1-2 cm, and >2 cm, respectively. The endoscopic examination revealed that 16.4% of the polyps were pedunculated, 82.6% were sessile, and 1% were sessile and pedunculated. About 45%, 30%, 21%, and 6.6% of the polyps were located at the rectum/sigmoid, left colon, right colon, and transverse/ascending colon, respectively. Histologically, 68.6% of polyps were adenomatous and 21.3% were non-adenomatous. Mild dysplasia was detected in almost half of the studied sample (42.3%) while moderate and severe grades of dysplasia were demonstrated in 19.2% and 38.5% of the examined polyps. Surgical intervention was required in 8.1% of cases. Conclusion: Single small-sized sessile polyps of adenomatous type and mild dysplasia are the most common polyps in the Saudi population. Sigmoid/rectum is the most common site affected, and the outcome of polyps is generally favorable.


Assuntos
Adenoma/patologia , Colo Ascendente/diagnóstico por imagem , Neoplasias do Colo/patologia , Pólipos do Colo/patologia , Colonoscopia/métodos , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Colo Ascendente/patologia , Neoplasias do Colo/epidemiologia , Pólipos do Colo/epidemiologia , Endoscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Lesões Pré-Cancerosas/diagnóstico por imagem , Lesões Pré-Cancerosas/epidemiologia , Estudos Retrospectivos , Arábia Saudita , Distribuição por Sexo
9.
BMC Gastroenterol ; 20(1): 269, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32799796

RESUMO

BACKGROUND: Cancer patients are at increased risk of novel coronavirus disease 2019 (COVID-19). Currently, surgeries for cancer patients with COVID-19 are generally suggested to be properly delayed. CASE PRESENTATION: We presented a 69-year-old Chinese female colon cancer patient with COVID-19, the first case accepted the surgical treatment during the pandemic in China. The patient developed a fever on January 28, 2020. After treatments with Ceftriaxone and Abidol, her fever was not moderated yet. A repeat chest computed tomography (CT) scan showed significantly exacerbated infectious lesions with a positive result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid. An abdomen CT scan indicated the tumor of ascending colon with local wrapped changes. She was diagnosed with 'Severe novel coronavirus pneumonia' and 'Incomplete bowel obstruction: Colon cancer?'. After actively anti-inflammatory and anti-viral therapies, a right colectomy with lymph node dissection was performed on March 11, followed by a pathological examination. The patient successfully recovered from COVID-19 pneumonia and incomplete bowel obstruction after surgery without any postoperative related complications and was discharged on the 9th day after operation. Significant degeneration, necrosis and slough of focal intestinal and colonic mucosal epithelial cells were observed under microscope. No surgeons, nurses or anesthetists in our team were infected with SARS-CoV-2. CONCLUSIONS: It is meaningful and imperative to share our experience of protecting health care personnels from SARS-CoV-2 infection and providing references for optimizing treatment of cancer patients, at least for the operative intervention with absolute necessity or surgical emergency, during the outbreak of COVID-19.


Assuntos
Betacoronavirus/isolamento & purificação , Colectomia/métodos , Neoplasias do Colo , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Idoso , COVID-19 , Colo Ascendente/diagnóstico por imagem , Colo Ascendente/patologia , Neoplasias do Colo/diagnóstico , Neoplasias do Colo/patologia , Neoplasias do Colo/fisiopatologia , Neoplasias do Colo/cirurgia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Feminino , Humanos , Controle de Infecções/métodos , Obstrução Intestinal/diagnóstico , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/fisiopatologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia , Pneumonia Viral/virologia , SARS-CoV-2 , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
10.
J Gastrointestin Liver Dis ; 29(2): 175-179, 2020 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-32530984

RESUMO

BACKGROUND AND AIMS: The importance of sessile serrated lesions (SSLs) in the pathogenesis of colorectal carcinoma has been recently established. These are supposed to cause the so-called "interval cancer", having a rapidly progressive growth and being difficult to detect and to obtain an endoscopic complete resection. We aimed to establish the most important metabolic risk factors for sessile serrated lesions. METHODS: We performed a retrospective case-control study, on a series of 2918 consecutive patients who underwent colonoscopy in Gastroenterology and Endoscopy Unit, County Clinical Emergency Hospital, Târgu-Mureș, Romania between 1 st of January 2015-31 th of December 2017. In order to evaluate the metabolic risk factors for polyps' development, enrolled participants were stratified in two groups, a study group, 33 patients with SSLs lesions, and a control group, 138 patients with adenomatous polyps, selected by systematic sampling for age and anatomical site. Independent variables investigated were: gender, smoking, alcohol consumption, obesity, arterial hypertension, diabetes, hypercholesterolemia, hypertriglyceridemia, hyperuricemia, nonalcoholic liver disease. RESULTS: For SSLs the most common encountered localization was the right colon in 30.55% of cases. By comparative bivariate analysis between SSLs group and control group, it was observed that hypertension (p=0.03, OR 2.33, 95 %CI 1.03-5.24), obesity (p=0.03, OR 2.61, 95 %CI 1.08-6.30), hyperuricemia (p=0.04, OR 2.72, 95 %CI 1.28-7.55), high cholesterol (p=0.002, OR 3.42; 95 %CI 1.48-7.87), and high triglycerides level (p=0.0006, OR 5.75; 95 %CI 1.92-17.2) were statistically associated with SSLs development. By multivariate analysis hypertension and hypertriglyceridemia retained statistical significance. CONCLUSIONS: Our study showed that the highest prevalence of SSLs was in the right colon and hypertension and increased triglycerides levels were associated with the risk of SSLs development. These risk factors are easy to detect in clinical practice and may help identifying groups with high risk for colorectal cancer, where screening is recommended.


Assuntos
Pólipos Adenomatosos , Carcinogênese/metabolismo , Colo Ascendente/patologia , Pólipos do Colo , Neoplasias Colorretais/diagnóstico , Hipertensão/epidemiologia , Hipertrigliceridemia/metabolismo , Pólipos Adenomatosos/diagnóstico , Pólipos Adenomatosos/epidemiologia , Pólipos Adenomatosos/metabolismo , Estudos de Casos e Controles , Pólipos do Colo/diagnóstico , Pólipos do Colo/epidemiologia , Pólipos do Colo/metabolismo , Colonoscopia/métodos , Colonoscopia/estatística & dados numéricos , Correlação de Dados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Fatores de Risco , Romênia/epidemiologia
11.
Chirurgia (Bucur) ; 115(1): 102-111, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32155405

RESUMO

Goblet cell carcinoids (GCC) are extremelyrare neuroendocrine tumours, and characterised by their unique combination of two types of cancer cells âÃÂ" neuroendocrine (carcinoid) and epithelial (adeno-carcinoma). In spite of the fact that GCC is regarded as Neuro-Endocrine Tumour (NET), it does not illicit carcinoid syndrome. GCC usually arises in the appendix and accounting for less than 14% of all appendiceal tumours.Primary extra-appendiceal GCC have been reported as stomach, duodenum, small intestine, colon and rectum. The paper presents a rare case of GCC of the ascending colon in a 57-year-old male.


Assuntos
Tumor Carcinoide/patologia , Tumor Carcinoide/cirurgia , Colo Ascendente/patologia , Neoplasias do Colo/patologia , Colectomia , Colo Ascendente/cirurgia , Neoplasias do Colo/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade
12.
Zhonghua Wei Chang Wai Ke Za Zhi ; 22(12): 1105-1109, 2019 Dec 25.
Artigo em Chinês | MEDLINE | ID: mdl-31874523

RESUMO

Colon cancer is one of the most common malignancies of the alimentary tract, and one main metastatic route is lymph node metastasis. Thorough dissections of regional lymph nodes is one of the core surgical treatment of right colon cancer. D3 lymphadenectomy and complete mesocolic excision (CME) are generally accepted surgical methods for right colon cancer, which can improve the standardization of surgery, improve the quality of tumor resection, and provide more lymph nodes dissectal. Colon cancer of hepatic flexure is likely to have metastasis of the infrapyloric lymph nodes (No.206), which are not regional lymph nodes. Lymph node dissection of No.206 group belongs to extended right hemicolectomy, which involves many vascular variations and complicated peripheral anatomical structure. The theory of fascial surgery provides surgeons with anatomic basis and a clear understanding of the anatomical structure of the infrapyloric region, which is an important theoretical basis for the thorough dissection of lymph nodes in No.206 group, and can completely remove the mass, regional lymph nodes and adipose connective tissue, so as to achieve the goal of non-bleeding surgery. Lymph nodes in No.206 group were dissected, not just the visible lymph nodes, but the entire lymph nodes and lymphatic vessels in the region, including adipose tissue. Extended right hemicolectomy requires higher surgical techniques. The survival benefits of extended right hemicolectomy are not supported by high-level evidence. It is still controversial whether the infrapyloric lymph node dissection should become routine for colon cancer of hepatic flexure. In this article, the metastasis and dissection of infrapyloric lymph node in colon cancer of hepatic flexure is elucidated.


Assuntos
Colo Ascendente/patologia , Neoplasias do Colo/patologia , Excisão de Linfonodo/métodos , Linfonodos/patologia , Mesocolo/patologia , Colectomia , Colo Ascendente/cirurgia , Neoplasias do Colo/cirurgia , Humanos , Linfonodos/cirurgia , Metástase Linfática , Mesocolo/cirurgia
13.
Med Arch ; 73(5): 316-320, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31819304

RESUMO

Introduction: Colorectal Cancer (CRC) is the third most common malignant disease and the fourth most common cause of death associated with malignancy. Adenocarcinomas account for 95% of all cases of colon cancer. Treatment usually includes a surgical resection which is preceded or followed by chemotherapy and radiotherapy depending on the stage. There is constant interest in the microbiological ecosystem of the intestine, which is considered to be crucial for the onset and progression of the disease as well as the development of postoperative complications. Iatrogenic factors associated with the treatment of CRC may result in pronounced expression of virulence of the bacterial intestinal flora and fulminant inflammatory response of the host which ultimately leads to adverse treatment results. The modulation of intestinal microflora by probiotics seems to be an effective method of reducing complications in surgical patients. The question is whether ordering probiotics can lead to more favourable treatment outcomes for our patients who are operated due to colorectal adenocarcinoma, and whether this should become common practice. Aim: To demonstrate the clinical significance of probiotic administration in patients treated for colorectal adenocarcinoma and the results compared with relevant studies. Patients and Methods: In a randomized controlled prospective study conducted at the Clinic of General and Abdominal Surgery of the UCCS in the period of 01 January 2017 until 31 December 2017, there were a total of 78 patients with colorectal adenocarcinoma. Patients were divided into two groups: a group treated with oral probiotics (n = 39) according to the 2x1 scheme starting from the third postoperative day lasting for the next thirty days, followed by 1x1 lasting for two weeks in each subsequent month to one year, and the control group (n = 39) which was not routinely treated with probiotics. Results: A statistically significant difference in the benefit of using probiotics was found during postoperative hospitalization and the occurrence of fatal outcome in the first six months. All complications were more present in the group of patients untreated with probiotic, with statistical significance shown only in the case of ileus. Probiotic has a statistically significant reduction in postoperative complications in the localization of tumours on the rectum -33.3% and the ascending colon -16.7%. Conclusion: There is a significant benefit of administering probiotics in surgically treated patients for colorectal adenocarcinoma.


Assuntos
Abscesso Abdominal/epidemiologia , Adenocarcinoma/terapia , Fístula Anastomótica/epidemiologia , Colectomia , Neoplasias Colorretais/terapia , Íleus/epidemiologia , Probióticos/uso terapêutico , Infecção da Ferida Cirúrgica/epidemiologia , Adenocarcinoma/patologia , Bifidobacterium , Colo Ascendente/patologia , Neoplasias Colorretais/patologia , Humanos , Lactobacillus , Estadiamento de Neoplasias , Cuidados Pós-Operatórios , Complicações Pós-Operatórias/epidemiologia , Neoplasias Retais/patologia , Neoplasias Retais/terapia , Streptococcus thermophilus
14.
BMC Cancer ; 19(1): 1196, 2019 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-31805970

RESUMO

BACKGROUND: NF1(Neurofibromatosis type 1) is an autosomal dominant genetic disorder. Patients with NF1 have an increased risk of developing benign or malignant tumours, such as gastrointestinal stromal tumours (GISTs). However, the coexistence of NF1, GIST and colon cancer is very rare, and few cases have been reported in the literature. CASE PRESENTATION: We admitted a case of a 64-year-old man with type 1 neurofibromatosis, GISTs, and ascending colon cancer. This case was characterized by café-au-lait macules, discrete cutaneous neurofibromas, nodular neurofibromas, multiple jejunal tumours, and ascending colon cancer. Laparoscopic exploration revealed ascending colon cancer and multiple jejunal tumours. Laparoscopic right hemicolectomy and local excision of the jejunal tumours were performed successfully. The pathological results confirmed moderate differentiated adenocarcinoma of the ascending colon with multiple jejunal GISTs (low risk, very low risk). Moreover, the immunohistochemistry results of multiple jejunal GISTs suggest that NF1 is positive. Whole-exome sequencing (WES) of colon cancer revealed mutations in more than 20 genes, including KRAS, PIK3CA, APC, SMAD4, etc. The results of whole-exome sequencing (WES) of jejunal GISTs revealed an NF1 mutation and no KIT or PDGFR gene mutation. CONCLUSION: We report a rare case of simultaneous NF1, GIST and colon adenocarcinoma. For patients with NF1, benign and/or malignant tumours are often combined. Therefore, these patients should undergo regular physical examinations so that early detection and early treatment can be achieved.


Assuntos
Colo Ascendente/cirurgia , Neoplasias do Colo/cirurgia , Tumores do Estroma Gastrointestinal/cirurgia , Neurofibromatose 1/cirurgia , Colectomia , Colo Ascendente/patologia , Neoplasias do Colo/genética , Neoplasias do Colo/patologia , Comorbidade , Tumores do Estroma Gastrointestinal/genética , Tumores do Estroma Gastrointestinal/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Neurofibromatose 1/genética , Neurofibromatose 1/patologia , Neurofibromina 1/genética , Sequenciamento Completo do Exoma
15.
Cancer Sci ; 110(12): 3708-3717, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31648389

RESUMO

The incidence of rare neuroendocrine tumors (NET) is rapidly increasing. Neuroendocrine carcinoma (NEC) is a NET with poorly differentiated histological features, high proliferative properties and associated poor prognoses. As these carcinomas are so rare and, thus, affect only a small number of patients allowing for few cell lines to be derived from patient biopsies, the histological, immunohistochemical, and clinical characteristics associated with colorectal NEC and NEC in other organs have yet to be clearly defined. Herein, we describe the establishment of a novel NEC cell line (SS-2) derived from a tumor resection of the ascending colon from a 59-year-old Japanese woman. The histological, electron microscopic and immunohistochemical features of chromogranin A (CgA) as well as confirmation of synaptophysin positivity in this tumor were typical of those commonly observed in surgically resected colorectal NEC. Further, the Ki-67 labeling index of the resected tumor was >20% and, thus, the tumor was diagnosed as an NEC of the ascending colon. The SS-2 cell line maintained characteristic features to those of the resected tumor, which were further retained following implantation into subcutaneous tissues of nude mice. Additionally, when SS-2 cells were seeded into ultra-low attachment plates, they formed spheres that expressed higher levels of the cancer stem cell (CSC) marker CD133 compared to SS-2 cells cultured under adherent conditions. SS-2 cells may, therefore, contribute to the current knowledge on midgut NEC biological function while providing a novel platform for examining the effects of colorectal NEC drugs, including CSC.


Assuntos
Carcinoma Neuroendócrino/patologia , Colo Ascendente/patologia , Neoplasias do Colo/patologia , Antígeno AC133/análise , Animais , Carcinoma Neuroendócrino/tratamento farmacológico , Linhagem Celular Tumoral , Neoplasias do Colo/tratamento farmacológico , Feminino , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Pessoa de Meia-Idade , Transplante de Neoplasias
16.
Medicine (Baltimore) ; 98(35): e16742, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31464903

RESUMO

RATIONALE: Cases of coexistence of 2 cancers, such as colorectal cancer and diffuse large B-cell lymphoma (DLBCL), colorectal cancer and myelodysplastic syndrome (MDS), and DLBCL with MDS, have been reported, whereas the coexistence of 3 different cancers in a patient is extremely rare. Here we report a case of co-occurrence of colon adenocarcinoma, DLBCL, and MDS in a 78-year-old Chinese man. PATIENT CONCERNS: He presented to our hospital with palpable lumps in the abdomen without any of the following symptoms including abdominal pain, fever, contact pain, tenesmus, changes in bowel habits and shape, nausea, and vomiting. DIAGNOSES: The patient was first diagnosed with sigmoid colon adenocarcinoma and DLBCL in the right ascending colon using enhanced computed tomography, colonoscopy, and immunohistochemistry. After resection of the sigmoid adenocarcinoma and DLBCL, MDS was diagnosed according to the results of routine blood tests, bone marrow aspiration smear, and flow cytometry. INTERVENTIONS: Overall, the patient was treated with surgical resection of the sigmoid adenocarcinoma and DLBCL of the colon, combined with 4 cycles of chemotherapies targeting MDS. OUTCOMES: Blood test results and follow-up indicated that the treatment regimen showed promising outcomes. LESSONS: In conclusion, a case of synchronous existence of colon cancer, DLBCL, and MDS is reported, which suggests that careful attention should be paid clinically to checking the state of bone marrow for elderly cancer patients. Efforts are also needed to establish an effective system for distinguishing the origin of multi-existent cancers and to develop effective therapeutic regimens for multi-existent cancers with fewer side effects.


Assuntos
Adenocarcinoma/diagnóstico por imagem , Colo Ascendente/diagnóstico por imagem , Linfoma Difuso de Grandes Células B/diagnóstico por imagem , Síndromes Mielodisplásicas/diagnóstico , Neoplasias do Colo Sigmoide/diagnóstico por imagem , Adenocarcinoma/cirurgia , Idoso , Biópsia , Medula Óssea , China , Colo Ascendente/patologia , Colonoscopia , Tratamento Farmacológico , Humanos , Linfoma Difuso de Grandes Células B/cirurgia , Masculino , Síndromes Mielodisplásicas/tratamento farmacológico , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias Primárias Múltiplas/terapia , Neoplasias do Colo Sigmoide/cirurgia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
17.
Mol Pharm ; 16(9): 4059-4064, 2019 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-31393129

RESUMO

Cytochrome P450 (CYP) 3A4 and P-glycoprotein (P-gp) have broad substrate overlap and are involved in the metabolism and transport of nearly 50% of currently prescribed medications. In the intestine, CYP3A4 and P-gp are coexpressed in the enterocytes at the intestinal villous tip and act in a coordinated manner to limit drug and xenobiotic oral bioavailability prior to further metabolism and disposition in the liver. Crohn's disease (CD), a form of inflammatory bowel disease, introduces a transmural intestinal insult that disrupts the intestinal barrier function; it therefore has the potential to affect intestinal drug metabolism and transport. We hypothesized that individuals with CD have reduced intestinal expression of CYP3A4 and P-gp. We obtained intestinal biopsy samples from individuals with and without CD and quantified the expression of CYP3A4 and P-gp. When we carried out Western analysis for protein expression, we observed a significant reduction in ileal (45% decrease) and colonic (78% decrease) CYP3A4 protein expression in subjects with CD compared with those without. Similarly, an 85% reduction in colonic P-gp protein expression was seen in the CD patients. Our data highlight important and novel findings pertaining to CD-associated changes to the intestinal expression of CYP3A4 and P-gp that are of relevance to better predict substrate drug dosing for patients with CD.


Assuntos
Membro 1 da Subfamília B de Cassetes de Ligação de ATP/metabolismo , Doença de Crohn/metabolismo , Citocromo P-450 CYP3A/metabolismo , Mucosa Intestinal/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Células CACO-2 , Colo Ascendente/metabolismo , Colo Ascendente/patologia , Doença de Crohn/patologia , Enterócitos/metabolismo , Feminino , Humanos , Íleo/metabolismo , Íleo/patologia , Masculino , Proteínas dos Microfilamentos/metabolismo , Pessoa de Meia-Idade , Adulto Jovem
18.
BMJ Case Rep ; 12(7)2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31337625

RESUMO

We present the case of a 34-year-old woman who was diagnosed to have adenocarcinoma of the caecum based on the clinical, radiological, histopathological and intraoperative findings. However, postoperative histopathology showed only features of xanthogranulomatous inflammation without any evidence of malignancy. This benign chronic inflammatory condition could present as a histological surprise. It is important for both surgeons and pathologists alike to be aware of this.


Assuntos
Adenocarcinoma/patologia , Colo Ascendente/patologia , Doenças do Colo/patologia , Neoplasias do Colo/patologia , Erros de Diagnóstico , Granuloma/patologia , Inflamação/patologia , Xantomatose/patologia , Adenocarcinoma/diagnóstico , Adenocarcinoma/cirurgia , Adulto , Biópsia , Colectomia , Doenças do Colo/diagnóstico , Neoplasias do Colo/diagnóstico , Neoplasias do Colo/cirurgia , Feminino , Granuloma/diagnóstico , Humanos , Inflamação/diagnóstico , Xantomatose/diagnóstico
19.
Korean J Gastroenterol ; 74(1): 46-50, 2019 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-31344772

RESUMO

Actinomycosis can mask malignant diseases. This paper reports a case of colonic diffuse large B-cell lymphoma (DLBCL), which was misdiagnosed as abdominal actinomycosis. A 76-year-old woman presented with right flank pain and weight loss. Abdominal CT and colonoscopy revealed a huge ascending colon mass. Despite the initial impression of a malignancy, a colonoscopic biopsy revealed no malignant cells, but sulfur granules and a filamentous organism suggesting actinomycosis. Intravenous penicillin G was administered under the impression of abdominal actinomycosis but her condition deteriorated rapidly. Follow up CT showed markedly increased colon mass and new multiple nodular lesions around the ascending colon. Sono-guided percutaneous biopsy of the nodular lesion was performed. The pathological result was DLBCL. The patient was scheduled to undergo chemotherapy but the patient expired due to cancer progression. The diagnosis of gastrointestinal infiltrating tumors is often difficult because a superficial biopsy usually does not provide a confirmative diagnosis. This case highlights the difficulty in making a correct diagnosis of lymphoma due to the concomitant actinomycosis. Malignant conditions must be considered in cases of actinomycosis with no response to antimicrobial therapy.


Assuntos
Actinomicose/diagnóstico , Linfoma Difuso de Grandes Células B/diagnóstico , Abdome/diagnóstico por imagem , Actinomicose/complicações , Actinomicose/tratamento farmacológico , Idoso , Antibacterianos/uso terapêutico , Colo Ascendente/patologia , Colonoscopia , Feminino , Humanos , Linfoma Difuso de Grandes Células B/complicações , Penicilinas/uso terapêutico , Tomografia Computadorizada por Raios X
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