Abstract

ABSTRACTBackground: Colorectal cancer is the most common gastrointestinal tract cancer worldwide. InIraq, colorectal cancer was the seventh top cancers, whereas in Kurdistan, it was the fourth mostcommon cancer for both males and females. Although the methods of the diagnosis and therapyhave been improved, only about 50% of the patients who resected the tumor died from diseasewithin 5 years, due to distant metastasis. The study was carried out to determine the frequency ofhistopathological types of colorectal cancer, and to evaluate the correlation between colorectalcancer regarding the grade, stage, with different histological finding which include desmoplasticreaction, lymphocytic infiltration, foamy macrophages, necrosis, intraglandular necrosis, andcalcification.Subject and Methods: This study includes (108) patients diagnosed with colorectal cancer.Cases were collected during the period January 2015 - December 2017 from the histopathologicaldepartment at Central Public Health Laboratory and other private labs in Duhok city. Clinicalinformation were obtained from the available histopathological reports. Paraffin embedded blockswere sectioned and stained with immunohistochemistry markers; Ki67 and VEGF then processedautomatically according to protocols supplied by the antibody manufacturer.Results: Patients age ranged from18-83 years with a mean of 54.42 years. The peak ages of thepatients were between 60-69 years. Male: female ratio was 1.5:1. The commonest tumor locationwas (recto-sigmoidal region); rectum was (42.6 %) and sigmoid colon was(22.2%).Conventionaladenocarcinoma was the predominant type 86(79.6%), majority of cases were moderatelydifferentiated adenocarcinoma constituting85.2%. Stage III was the highest stage constituting56(51.9%), followed by stage II which constitute 37(34.3%).The local invasion of the mucosaand other layers of colonic wall were associated with desmoplasia and collagen fiber remodeling.Infiltration of foamy macrophages decreased in number in relation to higher grade. Intraglandularnecrosis showed significant correlation with tumor invasiveness, lymph node metastasis andgrade. The frequency of both markers Ki67 and VEGF were 77 and 75 respectively. Ki67immunoreactivity revealed significant relationship with tumor grade (P=0.014), whereas VEGFhad significant relationship with TNM stage (P = 0.019), as well as the local invasion to thecolorectal wall (P 0.009).Conclusions: Moderate differentiated adenocarcinoma (85.2%) and stage III (51.9%) were themost frequent diagnosed cases with colorectal cancer. Macrophages infiltration was converselyrelated with grading of colorectal cancer. Histopathological changes like desmoplastic reactionand intraglandular necrosis were common findings in colorectal cancer and they were inconcordance correlation with stage and grade.Ki67 had relationship with tumor grade, whereasVEGF correlate with tumor invasion.

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The article was added to IASJ on 2019-05-12

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