Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0699790 (colon cancer)
 28,837 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Caudal type homeobox gene-1 and -2 (CDX-1 and CDX-2), homologues of the Drosophila homeobox gene caudal, encode transcription factors in endoderm derived tissues of the intestine. CDX genes control proliferation and differentiation of intestinal mucosal cells and colon cancer cells. Hirschsprung's Disease (HD) or congenital intestinal aganglionosis, a major developmental anomaly of intestine, which causes functional intestinal obstruction, is frequently associated with enterocolitis. Aetiology of HD-associated enterocolitis (HDEC) remains obscure. Reduction of gut mucosal enteroendocrine cells, and inefficient transfer of the secretory immunoglobulin A across the gut mucosal cell were shown to be associated with enterocolitis in HD patients suggesting that mucosa may directly involve in the pathophysiology of HDEC. This study aims to ascertain whether the CDX-1 and CDX-2 genes, that control the proliferation and differentiation of mucosal cells, play a role in HDEC. Using semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) and in situ hybridisation, we analysed the expression of CDX-1 and CDX-2 genes in colon specimens of normal controls, necrotising enterocolitis (NEC) infants, and HD patients with and without enterocolitis. We showed for the first time that CDX-1 and CDX-2 genes were expressed in the colonic mucosal epithelium in normal, NEC and in HD infants. However, the expressions of both genes were reduced in patients with HDEC. Our findings suggest that reduced expression of CDX-1 and CDX-2 genes in mucosa may be associated with the development of HDEC.
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PMID:CDX-1 and CDX-2 are expressed in human colonic mucosa and are down-regulated in patients with Hirschsprung's disease associated enterocolitis. 1156 52

By 1996, the median survival of patients with cystic fibrosis (CF) in North America had increased to 31 years. With the markedly improved life expectancy, many CF patients are now adults. There is an associated increased risk of certain colonic disorders, and the emergence of other previously unrecognized disorders, in adult CF patients. The distal intestinal obstruction syndrome (DIOS), which is more common in older patients, is a frequent cause of abdominal pain. Intussusception may complicate DIOS; other differential diagnoses include appendiceal disease, volvolus, Crohn's disease, fibrosing colonopathy and colonic carcinoma. The diagnosis of acute appendicitis, although uncommon in patients with CF, is often delayed, and appendiceal abscess is a frequent complication. The prevalence of Crohn's disease in CF has been shown to be 17 times that of the general population. Right-sided microscopic colitis is a recently recognized entity in CF of uncertain clinical significance. Fibrosing colonopathy has been confined mostly to children with CF, attributed to the use of high strength pancreatic enzyme supplements, but it has been reported in three adults. Nine cases of carcinoma of the large intestine have been reported worldwide, associated with an apparent excess risk of digestive tract cancers in CF. Despite high carrier rates of Clostridium difficile in patients with CF, pseudomembranous colitis is distinctly rare, but severe cases complicated by toxic megacolon have been reported. In these patients, watery diarrhea is often absent. Adult CF patients with refractory or unexplained intestinal symptoms merit thorough investigations.
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PMID:Colonic disorders in adult cystic fibrosis. 1157 1

Laparoscopic bowel surgery has developed slowly over the last decade, with virtually all procedures having been attempted with these laparoscopic techniques. The benefits of this approach to colorectal surgery have resulted in decreased lengths of stay, smaller incisions, and a potentially lower risk of small bowel obstruction. Resection of benign inflammatory disease presents particular challenges and may be expected to result in higher conversion rates. However, with increasing experience, even complicated diverticular disease and Crohn's disease can be managed laparoscopically. There is a growing body of data that suggests the early concerns regarding colon cancer resection, specifically port site recurrences, may have been exaggerated. Even more importantly, the early results of a number of prospective randomized trials are suggesting that survival and cure rates are not jeopardized by laparoscopic colectomy. The surgical techniques are demanding and require a level of standardization to achieve success. Laparoscopic colorectal surgery will have a definite role in the future.
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PMID:Laparoscopic techniques in intestinal surgery. 1158 68

We report herein an unusual case of primary mesosigmoidal hydatid cyst that presented as acute left colonic obstruction mimicking sigmoid colon cancer. A 61-year-old man with a 3-day history of abdominal pain, distention, obstipation, vomiting, and fever was admitted to the emergency department of our hospital. Surgery was performed under a presumptive diagnosis of acute left colonic obstruction. The intraoperative findings were highly suggestive of sigmoid colonic carcinoma and Hartmann's procedure was performed. Histopathological examination of the pathological specimen revealed an isolated hydatid cyst embedded in mesosigmoid which had caused mechanical sigmoidal obstruction. Primary extrahepatic, intra-abdominal localization of a hydatid cyst is not unusual. Therefore, as a hydatid cyst may cause a wide variety of clinical syndromes, it should be kept in mind in the differential diagnosis of mechanical bowel obstruction, especially in endemic regions.
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PMID:Isolated mesosigmoidal hydatid cyst as an unusual cause of colonic obstruction: report of a case. 1175 91

Hereditary nonpolyposis colorectal cancer (HNPCC) is associated with highly penetrant germline mutations in mismatch repair genes. Due to a high lifetime risk in gene carriers for synchronous and for metachronous colorectal cancer and endometrial cancer in women, prophylactic and extended surgery are considered as options for gene carriers. A 54-year-old patient with a history of metachronous rectal cancer and a family history fulfilling the Amsterdam criteria presented with carcinoma of the cecum and highly dysplastic adenomas of the splenic flexure and descending colon. As a result of these findings, medical history and molecular diagnosis, the decision was made to perform colectomy and prophylactic hysterectomy with oophorectomy; histological examination of the specimen showed three synchronous colon carcinomas. The 31-year-old son carrying the pathogenic mutation refused to be included in the HNPCC surveillance program. One year later he presented with symptoms of bowel obstruction, and a carcinoma of the descending colon was diagnosed. Intraoperatively, in addition to the colon cancer, a small bowel cancer and peritoneal carcinomatosis were found. In another family fulfilling the Amsterdam criteria without known germline mutation a woman presented with synchronous cancer of the ascending colon and the lower rectum at the age of 49 years. Proctocolectomy and prophylactic hysterectomy were performed, which revealed an additional colon cancer and endometrial cancer. We discuss approaches for individual decision making for surgery in HNPCC patients. Is a subtotal colectomy indicated in the case of first colon cancer in HNPCC patients, or if the first tumor occurs in the lower rectum, should a proctocolectomy or a restorative proctocolectomy be considered? The aim of prospective clinical studies should be to assess acceptability, survival rates, mortality, and the quality of life in HNPCC patients who have undergone surveillance and standard oncological resections versus extended or prophylactic surgery.
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PMID:Combined molecular and clinical approach for decision making for surgery in HNPCC patients: a report on three cases in two families. 1176 Sep 4

Anemia is common in cancer patients and is associated with reduced survival. Recent studies document that treatment of anemia with blood transfusion in cancer patients is associated with increased infection risk, tumor recurrence, and mortality. We therefore investigated the incidence of preoperative anemia in colorectal cancer and assessed risk factors for anemia. Prospective data were collected on 311 patients diagnosed with colorectal cancer over a 6-year period from 1994 through 1999. Patients were stratified by age, gender, presenting complaint, preoperative hematocrit, American Joint Committee on Cancer (AJCC) stage, and TNM classification. Discrete variables were compared using Pearson's Chi-square analysis. Continuous variables were compared using Student's t test. Differences were considered significant when P < 0.05. The mean age of the study cohort was 67 +/- 9.2 with 98 per cent of the study population being male. The mean AJCC stage was 2.2 +/- 1.2 and the mean preoperative hematocrit was 35 +/- 7.9 with an incidence of 46.1 per cent. The most common presenting complaints were hematochezia (n = 59), anemia (n = 51), heme-occult-positive stool (n = 33), bowel obstruction (n = 26), abdominal pain (n = 21), and palpable mass (n = 13). Preoperative anemia was most common in patients with right colon cancer with an incidence of 57.6 per cent followed by left colon cancer (42.2%) and rectal cancer (29.8%). Patients with right colon cancer had significantly lower preoperative hematocrits compared with left colon cancer (33 +/- 8.5 vs 36 +/- 7.4; P < 0.01) and rectal cancer (33 +/- 8.5 vs 38 +/- 6.0; P < 0.0001). Patients with right colon cancer also had significantly increased stage at presentation compared with left colon cancer (2.3 +/- 1.3 vs 2.1 +/- 1.2; P < 0.02). Age was not a significant risk factor for preoperative anemia in colorectal cancer. We conclude that there is a high incidence of anemia in patients with colon cancer. Patients with right colon cancer had significantly lower preoperative hematocrits and higher stage of cancer at diagnosis. Complete colon evaluation with colonoscopy is warranted in patients with anemia to improve earlier diagnosis of right colon cancer. A clinical trial of preoperative treatment of anemic colorectal cancer patients with recombinant human erythropoietin is warranted.
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PMID:Preoperative anemia in colon cancer: assessment of risk factors. 1207 43

This study evaluated 115 patients with complicated primary gastrointestinal cancers which underwent surgical resection at Belen Hospital, Trujillo, Per , since 1966 to 1996, with the aim to determine their clinical-pathological features and to identify some prognostic factors that influenced five-year survival rate in those complicated with obstruction. Median age was 55 19 years (range, 4 to 91 years) and the male: femaleratio was of 1.5: 1. Abdominal pain was the most common symptom (100%). The most frequent complication was obstruction (72%), followed by perforation (17%) and massive haemorrage (11%). The gastric adenocarci noma was most frequently associated w th obstruction and massive haemorrage; whilst perforation ocurred meanly in small bowei neoplasms, especially in lymphomas. Five year survival rate in the total series was of 13%, and this was greater in those cases with obstruction. In patients with gastric outlet obstructive syndrome the tumor size (p<0.05) and macroscopic type (p<0.05) were factors related with the 5 - year - survival rate and in those with intestinal obstruction by colon cancer prognostic factors were the tumor size (p<0.05) and the clinical stage (p<0.05). We concluded that an early diagnosis in these patients is very important to define an opportune surgical treatment.
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PMID:[CLINICAL PATHOLOGICAL FEATURES AND SURVIVAL RATE FACTORS IN COMPLICATED PRIMARY GASTROINTESTINAL CANCERS] 1219 10

Laparoscopic bowel surgery has demonstrated patient care benefits of decreased duration of hospital stay, smaller incisions, lower risk of cardiopulmonary complications, and reduced risk of small-bowel obstruction. Resection of complicated diverticular disease and inflammatory bowel disease can be technically challenging and may be associated with higher conversion rates. The applicability of these techniques to colon cancer is supported by a growing body of evidence that demonstrates similar survival and recurrence rates obtained by open resection and the exaggeration of the risk of port site recurrences. Laparoscopic colorectal surgery has also challenged much of the standard postoperative care plans used for colectomy. Optimal postoperative care of the laparoscopic colectomy patient requires an appreciation of the faster recovery enjoyed by these patients and the fact that ambulation and dietary advancement need to be accelerated. Coordination between the surgical team and the postoperative care team is essential to obtain all the benefits associated with this new approach to the management of colorectal disease.
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PMID:Care of the laparoscopic colectomy patient. 1247 80

Ultrasonography (US) is often the first imaging study performed in patients with abdominal pain or vague symptoms related to the gastrointestinal tract. An awareness of the US appearances of diseases of the intestine is essential to achieve the proper diagnosis and to enable appropriate triage of cases. Pathologic processes that affect the intestine generally result in decreased peristalsis and bowel wall thickening, both of which tend to decrease the luminal gas content. These changes permit evaluation of the intestine and surrounding structures with transabdominal and transvaginal US. US is useful in diagnosis of infectious and inflammatory conditions, such as appendicitis, Crohn disease, diverticulitis, epiploic appendagitis, pseudomembranous colitis, small bowel obstruction, small bowel vasculitis, and celiac disease. US is also helpful in diagnosis of tumors, such as gastric cancer, bowel lymphoma, and colon cancer. Familiarity with the US appearances of diseases that affect the intestine may allow specific diagnosis based on the degree and distribution of bowel wall thickening and associated changes of the perienteric tissues.
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PMID:US of gastrointestinal tract abnormalities with CT correlation. 1253 41

A 55-year-old man was referred to us after transverse colostomy for intestinal obstruction caused by descending colon cancer with peritoneal dissemination. The colon lesion was palpated as a well-defined hard mass in the left lower abdomen and the disseminated lesion as a hard mass with an unclear border in the right lower abdomen. CEA level was 917 ng/ml at admission. Left hemicolectomy was performed for tumor reduction and TS-1 of 120 mg/day was started 6 days after surgery (4 weeks administration followed by a 2-week rest period). Administration discontinued due to nausea 4 weeks after commencement of the therapy, and restarted as a 2-week administration followed by a 2-week rest period. There has been no adverse reaction since then. Twenty-seven weeks after surgery, CEA level was reduced to 47 ng/ml and peritoneal dissemination was found to have disappeared upon physical examination and computed tomograph. TS-1 is expected to be an effective agent for the treatment of colon cancer with peritoneal dissemination.
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PMID:[A case of advanced colon cancer with peritoneal dissemination completely responding to TS-1]. 1499 64


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