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

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

This study sought to replicate and expand findings reported by the National Surgical Adjuvant Breast and Bowel Project (NSABP) on prognostic factors in resectable colon cancer. Mantel-Haenszel tests and the Cox model were used to analyze prognostic significance and effect of primary disease symptoms and tumor location in 572 patients from the Gastrointestinal Tumor Study Group (GITSG), with resected Dukes' B2 and C colon cancer. Tumor location (left, right, and rectosigmoid/sigmoid) was of low prognostic importance (P greater than 0.10), and did not effect survival or disease-free survival (P greater than 0.10). Obstruction was an important indicator of prognosis, independent of Dukes' stage (P = 0.03). Bowel perforation is associated with poor prognosis in disease-free survival (P = 0.001). Rectal bleeding had a positive impact on survival (P = 0.08). Thus, obstruction, perforation, and rectal bleeding (but not location) are found to be prognostic factors in patients with Dukes' B2 or C colon cancer.
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PMID:Prognostic indicators of colon tumors. The Gastrointestinal Tumor Study Group experience. 348 70

Mononuclear cell (MNC) populations isolated from intestinal mucosa, mesenteric lymph nodes, and peripheral blood have been assessed for their natural killer (NK) (Leu-7+) cell proportions and NK cell activity against K-562 erythroleukemic target cells. In peripheral blood, normal proportions of Leu-7+ cells were found in patients with Crohn's disease or ulcerative colitis, whereas increased proportions in colorectal carcinoma may have been related to the higher mean age of these patients. Low proportions of Leu-7+ cells (less than 3%) were present in intestinal MNCs in Crohn's disease, ulcerative colitis, colon cancer, and miscellaneous intestinal diseases. All groups of patients had diminished NK activity of peripheral blood MNCs compared with a group of healthy controls. Intestinal NK cell activity from histologically normal mucosa correlated with autologous peripheral blood NK cell activity (p less than 0.001) but no such correlation was seen for patients with inflammatory bowel disease. Mucosal or nodal NK cell activity showed a wide range of activity but did not relate to the underlying disease, mucosal histopathology, drug therapy, or, in patients with cancer, Dukes' grading. Intestinal MNCs from all patient groups responded to stimulation with lymphoblastoid interferon, except in a small number of patients whose unstimulated activity was not detectable. In conclusion, the NK cell on intestinal mucosa behaves similarly in various intestinal diseases. However, the disparity between NK activity of autologous peripheral blood and intestinal MNCs in inflammatory bowel disease highlights the difficulty in extrapolating peripheral blood findings to mucosal immune events.
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PMID:Local immune mechanisms in inflammatory bowel disease and colorectal carcinoma. Natural killer cells and their activity. 350 98

This study was to assess the effect of stapled colorectal anastomoses on local recurrence, disease-free survival, and survival following curative resection for Dukes' B and C adenocarcinoma. Data were derived from two randomized prospective trials of the National Surgical Adjuvant Breast and Bowel Project designed to evaluate the efficacy of adjuvant therapy in colorectal cancer. Of 1111 patients with colonic anastomoses, 255 were stapled mechanically. There were no significant differences in disease-free survival, survival, or local tumor recurrence among patients subjected to stapled or handsewn anastomoses. Of the 181 patients undergoing anterior resection for rectal cancer, 82 anastomoses were fashioned with staples. No significant disadvantage in disease-free survival, survival, or local recurrence could be attributed to use of the mechanical stapling devices. Twelve percent of patients undergoing stapled rectal anastomoses developed a local recurrence as a first sign of treatment failure compared with 19 percent for the handsewn group. No significant differences in the length of distal margins were detectable. The average time on study was 41 months. The use of stapled anastomoses for carcinoma of the colon or rectum is not associated with an adverse effect on long-term outcome.
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PMID:A comparison of stapled and handsewn anastomoses in patients undergoing resection for Dukes' B and C colorectal cancer. An analysis of disease-free survival and survival from the NSABP prospective clinical trials. 351 1

To determine the frequency and clinical significance of oncogene abnormalities in colon cancer, deoxyribonucleic acids from 45 colon carcinomas and 15 benign adenomas were hybridized with 14 different protooncogene probes. Abnormalities of oncogenes were found in 22% of cancers at the time of resection. Amplification of c-myc or c-erbB-2 and allelic deletion of c-ras-Ha or c-myb were the most frequent abnormalities. The presence of altered oncogenes did not correlate with Dukes' stage, tumor progression, or patient survival after resection. One adenoma had an allelic deletion of the c-myb oncogene which was not seen in either the normal colon or an adjacent carcinoma. These data indicate that the spectrum of altered protooncogenes in colon carcinoma is similar to that of other adenocarcinomas, and that unstable oncogenes can be found before overt malignancy develops.
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PMID:Protooncogene abnormalities in colon cancers and adenomatous polyps. 355 13

The chemotactic migration in vitro of peripheral blood, intestinal mucosal, and mesenteric lymph node mononuclear cells has been assessed in patients with colorectal carcinoma. Peripheral blood mononuclear cells of patients exhibited normal chemotaxis. For control patients with non-malignant, non-inflammatory intestinal disease, the chemotaxis of mucosal mononuclear cells was similar to that of autologous peripheral blood mononuclear cells. The chemotactic migration of mucosal mononuclear cells, however, isolated distant from a colon cancer was less than that of autologous peripheral blood mononuclear cells. Chemotactic migration was progressively impaired with increasing closeness to the tumour itself. Chemotaxis of mucosal mononuclear cell was independent of the site of tumour and the Dukes' grading. Mononuclear cells from mesenteric lymph nodes, however, exhibited impaired migration only in patients with Dukes' C tumours. Supernatants of the collagenase digestion of either tumour or adjacent mucosa contained macrophage directed inhibitors of chemotaxis and these inhibitors were not produced by tumour mononuclear cells. The presence of such inhibitors in the digestion supernatants and the demonstration that proximity to the tumour was associated with impaired mononuclear cell motility suggest that the production of macrophage directed chemotactic inhibitors is by colon cancer cells and that this may be occurring in vivo.
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PMID:Tumour related inhibition of macrophage chemotaxis in patients with colon cancer. 358 69

In retrospective series, 17.0 to 25.5 per cent of those patients with carcinoma of the colon or rectum have been found to have concurrent inguinal herniation. This observation prompted the recommendation that patients with hernias be thoroughly screened for disease of the colon and rectum. That recommendation remains controversial in part because it has not previously been prospectively evaluated. In a one year period, 202 consecutive patients with inguinal hernias completed a preoperative protocol which included: 1, gastrointestinal history; 2, rectal examination; 3, testing of at least two stool specimens with the Hemoccult (Smith Kline Diagnostics) device; 4, sigmoidoscopy, and 5, barium enema. Malignant and premalignant diseases were discovered in five patients, only one of whom had gastrointestinal symptoms. Each malignant lesion was localized (Dukes' A or B) and, therefore, highly curable. Benign disease was found in 49 patients, including polyps in eight and one instance of tight sigmoid stricture. All of the malignant and 91 per cent of the benign lesions were in patients 50 years of age and older. The association between inguinal herniation and colorectal disease was previously attributed to luminal obstruction. In the present series, however, the sole obstructing lesion was a benign stricture. Another explanation for this association must, therefore, be sought. We conclude, on the basis of the results of this experience, however, that screening for pathologic factors of the colon and rectum is warranted in otherwise asymptomatic patients who are more than 50 years old and who present with inguinal hernias.
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PMID:Preoperative evaluation of patients with inguinal hernia for colorectal disease. 358 27

An adverse relationship between perioperative blood transfusions and the risk of subsequent recurrence of cancer was reported recently. We reviewed retrospectively the records of 171 patients who received initial therapy for colorectal adenocarcinoma from 1977 to 1979 at the Virginia Mason Medical Center. One hundred three patients (60%) received transfusions within 1 month of surgery and 37 patients (22%) developed recurrent cancer. No overall relationship between transfusion status (yes or no) and tumor recurrence or patient survival was found, although among subsets of patients (those with colon cancer or Dukes' Stage C2 disease), patients who had received transfusions were less likely to develop recurrent cancer than patients who had not (P = 0.01). No effect of transfusion on patient survival was found, even after consideration of potential confounding variables. The conflicting data regarding blood transfusion and cancer recurrence are reviewed, but it would appear to be premature to alter radically current blood transfusion practices based on the possibility that transfusion may adversely influence the risk of cancer recurrence.
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PMID:Perioperative blood transfusion does not increase the risk of colorectal cancer recurrence. 359 5

Modal DNA (ploidy) and sensitivity of DNA in situ to denaturation by acid have been analyzed by flow cytometry of 10 colorectal adenomas and 35 adenocarcinomas; 39 normal mucosa samples served as controls. A new method was developed to denature DNA in chromatin of the freshly isolated, intact, and unfixed individual cell nuclei from surgically resected material. The sensitivity of DNA denaturation (T alpha) was assayed by metachromatic staining with acridine orange and calculated as a ratio of the alpha t index of the tumor sample to the alpha t index of normal mucosa; the alpha t index is that fraction of DNA, following treatment at pH 1.4, that stains metachromatically with acridine orange at pH 2.6. All adenomas were diploid and in nine of 10 the T alpha value was close to 1.00, indicating no difference from control specimens in DNA sensitivity to denaturation. Forty-nine% of adenocarcinomas were aneuploid. Forty-six% of adenocarcinomas differed from normal in sensitivity of DNA to denaturation; the T alpha value was lower than 0.90 indicating that chromatin of the tumor cells was more resistant to denaturation than control cells. There was no correlation between sensitivity to denaturation of DNA and incidence of aneuploidy. However, there was a correlation between T alpha and the pathologically determined stage of disease. There was increased resistance to denaturation in 58% of tumors classified as Dukes' C/D stage, in 36% of tumors classified as Dukes' B, and in 20% classified as Dukes' A stage of the disease. Statistical analysis of these results revealed significant differences between distributions of T alpha in noninvasive (Adenomas and Dukes' A) versus invasive (Dukes' B and C/D) tumors with level of significance at P = 0.02. The data suggest that acid denaturation of DNA in situ may be a valuable adjunct in assessing the biology of colon cancer. The molecular basis for this phenomenon is discussed.
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PMID:DNA in situ sensitivity to denaturation: a new parameter for flow cytometry of normal human colonic epithelium and colon carcinoma. 360 42

Anticarcinoembryonic antigen (CEA) antisera which showed no reactions with normal adult feces were prepared in guinea pigs. Using these, levels of CEA in feces from patients with colorectal carcinoma were measured by gel diffusion and rocket immunoelectrophoresis. Sixteen of 22 (73 percent) patients with carcinoma of the colon or rectum (Dukes' A4/6, B6/8, C6/7, D0/1) had detectable CEA in their feces, while none was detected in the feces of four patients with gastric ulcers or in those of 22 normal volunteers. Five of the 16 fecal CEA-positive patients showed no elevation of plasma CEA levels. Measurements using a commercial CEA kit (Abbott Laboratories) could not detect the differences between fecal CEA values of patients with colorectal carcinoma and benign diseases, or those of normal volunteers. These results suggest that measurement of fecal CEA by specific anti-CEA antisera will be valuable in screening and diagnosis of colorectal carcinoma.
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PMID:Usefulness of carcinoembryonic antigen measurement in feces of patients with colorectal cancer. 362 64


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