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Query: UMLS:C0699790 (colon cancer)
 28,837 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purpose of this presentation is to point out the importance of this new diagnosis and treatment method, recently incorporated. The studies were done with the Fibroscope F9-A with doble channel, equipped with an desection smear for polipectomies and an extracting forceps. The patients arrive with their intestine perfectly cleaned with classical methods. This detail is most important for the polipectomies. If the local conditions aren't the desired, presence of bowels or barium of an previous enema, we postpone both, examination and polipectomy, because those are causes of false diagnosis in the first case or eventual accidents in the second condition. Regarding this, we had an performing doing a biopsy in an stenosing neoplasm of the sigmoid colon. We believe it convenient to prevent this complication, to reduce the air pressure before performing the biopsy. Of the 160 patients examinated, 54 had no patology, 32 had polips and of this group 4 had multiple poliposis, 4 had association with diverticulosis and 3 associated with neoplasm. (4 were neoplasm, 10 stenosis without mucous lesions, 1 villous adenoma, 1 megacolon and 1 rectitis). We made 12 polipectomies, 10 with the conventional technique and 2 associated with surgery. We had no accidents and one of them was an early stage of colon cancer.
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PMID:[Personal experience in colonoscopy and polypectomy]. 74 24

Between 1968 and 1972, 33 patients with carcinoma of the colon or the rectum underwent a radical surgical procedure followed by adjuvant irradiation therapy. One month after surgery, 6,000 rads were delivered in 6 to 7 weeks. Five of these patients presented later a radiotherapy ileitis, colitis or rectitis. One of them developed a rectitis of the anastomotic area with important diarrheas treated by drugs only; a second presented bowel subobstructions induced by a radiotherapy ileitis and died in cachexy a few months later. The 3 other patients underwent surgery again; one of them for adhesions in the anastomotic area: a definite left colostomy was realized for a stenosic rectitis in the second patient; the last patient underwent surgery 4 times again and died from a rupture of the iliaca artery. Discussion on the observations made at surgery and on the surgical pathology data could explain the high rate of these iatrogenic lesions induced by radiotherapy.
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PMID:[Digestive lesions caused by radiotherapy after surgery (author's transl)]. 89 56

Selenium deficiency may be implicated in the pathogenesis of some human diseases, including colon cancer. The incidence of carcinoma of the colon is increased in patients with ulcerative colitis. We measured the serum concentration of selenium in 22 patients with ulcerative colitis and 22 sex-, age-, height and weight-matched controls. Although no significant difference was found in mean serum selenium between patients and controls (patients: 0.92 mumol/l, controls: 0.79 mumol/l), the serum selenium level decreased with increasing extension of the disease. The differences between serum selenium concentrations in patients with proctitis-sigmoiditis, left-sided colitis and pan-colitis were statistically significant. No correlation was found between serum selenium concentrations and the sex, age, height, or weight of the patients. The inverse correlation between serum selenium concentration and the extension of the disease may be caused by a decreased absorption of selenium from the diseased colon in ulcerative colitis.
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PMID:[Concentration of selenium in serum of patients with ulcerative colitis]. 948 Apr 57

The 114 patients with ulcerative colitis diagnosed in Greater Cape Town between 1970 and 1979 were followed up 11 years later. Ninety per cent of those contacted were in remission or had mild symptoms only. Eleven patients had died; 3 deaths (in total colitis patients) were disease-related but the overall mortality rate in ulcerative colitis was not increased. There was only 1 case of carcinoma of the colon. The 5-year surgical rate was 5% increasing to 23% 10 years after diagnosis. Six patients (35%) had had a Park's pouch, 3 (18%) ileorectal anastomosis, and 8 (47%) panproctocolectomy or colectomy with an ileostomy. The incidence of surgery was higher in those with total colitis. In those patients who did not have the rectum removed, there was a 100% recurrence of proctitis. Park's pouch patients remained well and incontinence was not a problem. Thirty-one per cent of patients with proctitis at diagnosis had evidence of extension of disease to the colon at follow-up. Ulcerative colitis may be a more benign disease than often believed, with mortality from the disease and need for surgery being associated almost exclusively with extensive disease.
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PMID:Medium-term follow-up of ulcerative colitis in Cape Town. 238 84

The epidemiology of ulcerative colitis (UC) in Stockholm County 1955-79 was investigated. There were 1274 cases. The proportion of patients with proctitis, left-sided and total extent of disease remained constant over the study period. The incidence increased over the first 20 years followed by a plateau. The peak incidence in relation to age increased slightly but remained in the third and fourth decade through the study period. The incidence in men over 40 years of age increased markedly towards the end of the study. There were 109 deaths at follow-up (Dec. 1981) among those having the UC diagnosis between 1955-1979. Twentysix out of 41 patients who died due to UC did so postoperatively. The mortality pattern among those 68 patients who had causes of death unrelated to UC was similar to the expected. There was a decrease in cumulative survival probability compared with the expected, in particular in those with total colitis. This was also seen when only deaths unrelated to UC were included suggesting an increased sensitivity to the ordinary disease spectrum in UC patients. Between 1945-1979 there were 1339 patients who had UC diagnosed. Twentyfive of those had developed colon cancer (24 with total colitis) at follow-up (Dec. 1981). Eighteen were dead at follow-up, the survival time being in direct relation to the Dukes' grading at cancer diagnosis irrespective of age. The cumulative cancer risk at 25 years duration (total colitis patients only) was 13% (SD 4%) compared to the expected 1,9%. In a selected group of 71 patients followed for cancer surveillance during the period 1974-82 nine patients developed at least low grade dysplasia including one Dukes' A carcinoma. The dysplasia or cancer leading to operation was found above the rectum in four of five operated patients, all having total colitis with a duration ranging between 25-44 years.
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PMID:Ulcerative colitis in Stockholm County--a study of epidemiology, prognosis, mortality and cancer risk with special reference to a surveillance program. 347 21

Utilising the population based data resources of the Rochester Epidemiology Project, we estimated survival and risk of subsequent colon cancer in the 182 residents of Rochester, Minnesota, initially diagnosed with chronic ulcerative colitis (CUC) between 1985 and 1979. Twenty five (13.7%) had a proctocolectomy during the course of follow up. Three patients developed colorectal adenocarcinoma after the initial diagnosis of CUC (relative risk = 1.9, 95% CI 0.4-5.4). Excluding proctitis cases, the relative risk of cancer was 2.4 (95% CI 0.3-8.7). At last follow up, 37 (20.3%) were dead; only 10 patients had chronic ulcerative colitis mentioned on the death certificate. Overall survival was similar to that expected for the general population of like age and sex. Our results suggest that chronic ulcerative colitis in the community is typically a milder disease than would appear from hospital or referral centre series.
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PMID:Prognosis of chronic ulcerative colitis in a community. 367 56

Short chain fatty acids (SCFAs) have been the subject of much research over the past few decades. They play a vital role in maintenance of colonic integrity and metabolism. They are produced when dietary fibre is fermented by colonic bacteria. SCFAs are avidly absorbed in the colon, at the same time as sodium and water absorption and bicarbonate secretion. Once absorbed, SCFAs are used preferentially as fuel for colonic epithelial cells and have trophic effects on the epithelium. Clinically, SCFAs have been studied as possible therapeutic agents in diversion colitis, ulcerative colitis, radiation proctitis, pouchitis and antibiotic-associated diarrhoea. Although some promising effects have been observed in uncontrolled studies, a specific therapeutic role for SCFAs remains to be defined. SCFAs may be the effector of the beneficial role of fibre in prevention of colon cancer.
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PMID:Review article: short chain fatty acids in health and disease. 967 8

Radiotherapy for malignant pelvic disease is commonly accompanied by treatment-induced proctitis, and rarely by colorectal cancer. Translocation of the beta-catenin protein, which is a key downstream effector of the Wnt signal transduction pathway, is frequently found in colorectal cancer. Nuclear beta-catenin enhances transcriptional activity of the cyclin D1 gene in cancer cells. Here, we evaluate the involvement of the Wnt pathway in radiation-induced colon carcinogenesis with rats (n = 36). Beta-catenin, APC, and cyclin D1 expression profiles were analyzed by immunohistochemistry in radiation-induced chronic colon injury including cancers and ulcerative lesions in rats (n = 12 in treated group, n = 12 in control group). In total, 3 cases of invasive adenocarcinomas were developed in the irradiated portion 50 weeks after a single dose of 36 Gy irradiation. Nuclear translocation of beta-catenin was observed in all radiation-induced colon cancers, whereas this protein was also found in the cytoplasm and/or nucleus of 9 cases of non-neoplastic irradiated colonocytes. Nuclear translocation of beta-catenin correlated with loss of APC and gain of cyclin D1 expression, suggesting activation of the Wnt pathway during radiation-induced colorectal carcinogenesis. A single dose of 10 Gy was also given for acute injury (n = 12: 3 each in days 0, 3, 5, and 7, respectively). Beta-catenin expression was distributed in the cytoplasm of degenerating glands at day 3 and 5, and was observed in the cell membrane of those glands with histological normalization at day 7 after irradiation. Because translocation of beta-catenin was found in irradiated-colonic mucosa as well as colon cancer, disruption of beta-catenin expression might be one of the early events in radiation-induced colonic carcinogenesis.
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PMID:Altered expression of beta-catenin during radiation-induced colonic carcinogenesis. 1253 May 73

Ulcerative colitis is a chronic disease with recurrent symptoms and significant morbidity. The precise etiology is still unknown. As many as 25 percent of patients with ulcerative colitis have extraintestinal manifestations. The diagnosis is made endoscopically. Tests such as perinuclear antineutrophilic cytoplasmic antibodies and anti-Saccharomyces cerevisiae antibodies are promising, but not yet recommended for routine use. Treatment is based on the extent and severity of the disease. Rectal therapy with 5-aminosalicylic acid compounds is used for proctitis. More extensive disease requires treatment with oral 5-aminosalicylic acid compounds and oral corticosteroids. The side effects of steroids limit their usefulness for chronic therapy. Patients who do not respond to treatment with oral corticosteroids require hospitalization and intravenous steroids. Refractory symptoms may be treated with azathioprine or infliximab. Surgical treatment of ulcerative colitis is reserved for patients who fail medical therapy or who develop severe hemorrhage, perforation, or cancer. Longstanding ulcerative colitis is associated with an increased risk of colon cancer. Patients should receive an initial screening colonoscopy eight years after the onset of pancolitis and 12 to 15 years after the onset of left-sided disease; follow-up colonoscopy should be repeated every two to three years.
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PMID:Ulcerative colitis: diagnosis and treatment. 1801 75

Inflammatory bowel diseases (IBD) are classically divided in Crohn's disease (CD) and ulcerative colitis (UC). However, these two entities are still heterogeneous and a further classification in subphenotypes is necessary. Clinical subphenotypes are easy to use, do not necessitate complicated tests and can already give very important information for the management of the patients. In CD, clinical subphenotypes are based on age at diagnosis, disease location and disease behaviour. Age at diagnosis allows to differentiating paediatric CD, classical young adult onset and more seldom CD of the elderly. These categories are associated with a different risk of development of complications and disabling disease and may have partly different pathophysiology. The classification on disease behaviour, including stricturin, penetrating or uncomplicated disease may have an impact on reponse to medical treatment and need for surgery. Finally the classification based on location is particularly relevant since it has been associated with different types of complications. Particularly ileal disease has been associated with the risk of surgery and colonic (particularly rectal) disease, with the risk of perianal disease. In UC, the classification in subphenotypes is essentially based on disease location, distinguishing proctitis, left-sided colitis and extensive colitis. This subclassification also has a very significant clinical relevance since extensive colitis has been associated with and increased risk of colon cancer, colectomy and even in some studies, mortality.
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PMID:Necessity of phenotypic classification of inflammatory bowel disease. 2164 Sep 27


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