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Article
Colorectal Carcinoma Presentation and Management

Authors: Talib A.Majid --- Wasem Muhamed Shakir --- Aqeel Shakir Mahmmod
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2009 Volume: 8 Issue: 3 Pages: 204-211
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACTBACKGROUND:Colorectal carcinoma is the most common gastrointestinal tract cancer worldwide. In men, it is the third cancer after lung and prostate cancer, while in women; it is the third common cancer after lung and breast cancer. Despite the clear relationship with aging, colorectal carcinoma is not strictly a disease of elderly and 6-8 % of cases occur in patients below 40 years of age. Colorectal cancers are of favorable prognosis provided they are diagnosed and treated in early stage.OBJECTIVE:This study aims to assess the patterns of presentation, distribution, and management of colorectal carcinoma in Gastroenterology and Hepatology Teaching Hospital.METHODS:From November 2005 to November 2007, 80 patients with colorectal carcinoma 50 males and 30 females were admitted to the Gastroenterology and hepatology center. The age, sex, presentation, modes of investigation, stage of the cancer, treatments as well as complications have been described.RESULTS:Male: female ratio about 1.6:1 with peak age of incidence is 60-69 year age group, 17.5% of cases are below age of 40 most of them were with worse histopathological types and advanced stage. The main presenting symptom was bleeding per rectum 63%.The mean period between onset of presenting symptoms and final diagnosis was 7 months .The most common sites were rectum 35% . Fiftythree percent were moderately differentiated ,47.5% were Duke's-C.CONCLUSION:The study highlights the distribution of colorectal carcinoma, presenting symptoms, modalities of treatment, keeping in mind the increasing incidence of colorectal carcinoma in younger age groups.


Article
TP53 Over expression In Colorectal Carcinoma By Immunohistochemistry

Author: Maather Baqer Hussein. M.B.Ch.B, MSC pathology, Faculty of medicine, Al-Qadysia university
Journal: KUFA MEDICAL JOURNAL مجلة الكوفة الطبية ISSN: 1993517X Year: 2012 Volume: 15 Issue: 1 Pages: 25-36
Publisher: University of Kufa جامعة الكوفة

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Abstract:-Fifty paraffin blocks of colorectal carcinomas cases included in this study were randomly selected from January 2007 to Juan 2007 from the histopathological department in AL-Sadr Teaching Hospital.Of the fifty paraffin blocks of the studied colorectal carcinomas' cases; 29 cases (58%) were males and 21 cases (42%) were females. Their ages range was (16-80) years with an overall mean age (56.44±13.558) years , (58%) cases in distal colon (26%) cases were rectal , well differentiated carcinoma in (40%) cases , their stages by Dukes they were (36%) Dukes C followed by (30%) Dukes B then (18%) Dukes D and (16%) Dukes A. Fifty cases were submitted for immunohistochemical stain for P53 antibody, 39 cases (78%) were positive , and positive cases classified as weak positive in 18 cases (36%) and strong positive in 21cases (42%) ,also as faint staining pattern in 15 cases (38.4%) and dense staining pattern in 24 cases (61.6%).TP53 expression was more in distal colon cases (82.7%) , higher stages Dukes C (83.3) and D ( 88.8%) and poorly differentiated cancer (94.7%) , With no significant correlation of TP53 expression and site and stage of tumor but with significant relationship with grade of tumor

اهدف الدراسة هو البحث عن التعبير المناعي النسيجي الكيميائي لجين أل P53 كمؤشر للتغيرات الجينية الطارئة في ألخلايا السرطانية لأورام القولون ومقارنته في النسيج الحميد ولمعرفة ترابط هذا التغير مع ثوابت أخرى مثل درجة تمايز الورم، موقع الورم في الأمعاء الغليضه وأخيرا درجة انتشاره. منذ بداية كانون الثاني 2007 وحتى حزيران 2007 تم جمع 50 عينة من مرضى مصابين بسرطان القولون (21أنثى و 29 ذكور) تراوحت أعمارهم بين 16 و80 سنه مع معدل عمر 56,44 سنه ،وقد قورنت هذه المجموعة مع مجموعه أخرى (عشرون حاله) مصابين بأمراض القولون الحميدة. أظهرت الدراسة المناعية النسيجية أن تعبير أل-TP53 كان موجبا في 78% من سرطان القولون, بينما لم يلاحظ أي تعبير لهذا ألجين في النسيج الطبيعي (قيمة ألفا < 0,05). كان تعبير أل-TP53 أكثر في المرضى في القولون البعيد أكثر منه في القولون المستقيم والقولون القريب ، وفي أعلى مراحل الانتشار[Dukes C&D] و في الأورام ذات التمايز الضعيف (الدرجة الثالثة ) عنه في الأورام ذات التمايز القوي والمتوسط (الدرجة الأولى والثانية). مع عدم وجود ترابط بين ألتعبير المناعي النسيجي ل TP53 مع موقعه ودرجة انتشاره (قيمة ألفا > 0.05) كما انه توجد علاقة واضحة لتعبير أل-TP53 مع درجة التمايز (قيمة ألفا < 0.05).


Article
13- IMMUNOHISTOCHEMICAL ANALYSIS OF P53 PROTEIN IN COLORECTAL CARCINOMA AND ITS RELATIONSHIP TO CLINICOPATHOLOGIC FEATURES

Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2011 Volume: 17 Issue: 1 Pages: 85
Publisher: Basrah University جامعة البصرة

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Abstract

Hassanain H Khudier* & Daria Ismail Ameen@*MB,ChB, FIBMS Path., Department of Pathology, College of Medicine, University ofSulaimania. @MB,ChB, Pathology lab., gynecological and obstetric SulaimaniaTeaching Hospital.Correspondence to: Dr. Hassanain H. Khudair, Sulaimania teaching hospital, E-mail: hhk1970@gmail.comAbstractColorectal cancer regarded as one of the most widespread malignant tumor in the world.It is considered the second leading death factor among people in some developedcountries. Colorectal cancer comprises several distinct histological types includingadenocarcinoma which forms 85%-95% of all colorectal cancer cases. Pathogenesis ofcolorectal cancer is a multistep process characterized by involvement of many geneticalterations, including p53.The aim of this study is to detect the expression of p53 protein in colorectal carcinomaand to show its relationship with some clinicopathological features including age,gender, histological types, histological grades and staging.Forty paraffin-embedded tissue blocks of colectomy specimens were used in thisretrospective study. They were collected from the Department of Pathology in SulaimaniaTeaching Hospital, Shorsh Hospital and Shehid Saifeddin Private Clinic from January2007 to July 2008.Two sections of 4 micrometer thickness were taken from each paraffin embedded tissueblock. First section was taken for hematoxylin and eosin stain and the other one forimmunohistochemistry [anti-p53 monoclonal antibody] by using DakoCytomationEnvision + Dual Link System-HRP (DAB+). The relationship between p53 over expressionand the dependent variable (age, gender, histological types, histological grades, andstaging) were evaluated statistically using an analysis of variance (ANOVA) with STATA 8soft ware (College station, Tx). A positive reaction for p53 was scored on a semiquantitativebase as score 0 (no staining), score 1+ (weak staining), score 2+ (moderatestaining), and score 3+ (strong staining).Staining was negative for p53 (score 0) in 16 cases (40%). Positive cases were scored as(1+) in 4 cases (10.0%); (2+) in 8 cases (20.0%); and (3+), in 12 cases (30.0%). There wereno significant relationships between p53 over expression and age (p=0.682), gender(p=0.924), histological types (p=0.30), histological grades (p=0.516), and the stage of thedisease (p=0.281). Conclusions: Considering the p53 protein over expression in arelatively high percentage of patients, it seems that p53 mutation may play an importantrole in the development of colorectal carcinoma. There were no significant relationshipsbetween p53 protein expression and some clinicopathologic variables such as age,gender, histological types, histological grades, and the stage of the disease.


Article
BCL2 and P53 immunoexpression in colorectal carcinoma
BCL2 و P53 الدالة المناعية في سرطان القولون والمستقيم

Authors: Salah Abubakir Ali --- Tenya Tariq Abdulhameed
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2014 Volume: 18 Issue: 2 Pages: 751-755
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: The products of BCL2 and P53 genes are involved in the regulation of proliferation and apoptosis and have been associated with prognosis in several malignancies, including colorectal carcinoma. This study aimed to investigate the expression of antiapoptotic BCL2 protein in colorectal carcinoma and to examine its association with one of the important mediators of apoptosis (P53 protein) and with clinicopathological factors, and to assess the prognostic value of the combined BCL2 /P53 phenotypes by studying their relation with the two most important prognostic factors of grading and staging.Methods: A retrospective and prospective study was carried out from the period of August 2010 to June 2011. Sixty eight formalin-fixed, paraffin-embedded blocks of colorectal carcinoma cases were evaluated regarding BCL2 expression, P53 nuclear accumulation and their concomitant expression using immunohistochemistry by Dako Cytomation.LSAB + System-HRP.Results: The study shows that 29.41% of the colorectal tumors were positive for BCL2 protein expression and associated with earlier stage tumors (P = 0.021), while 72.06% were positive for P53 protein expression and associated with later stage tumors (P = 0.006) and male gender (P = 0.005). There was a trend toward an inverse correlation between BCL2 and P53 expression (P = 0.0013). Tumors that did not express detectable levels of BCL2 but exhibited nuclear accumulation of P53 were most common and associated with later stage tumors (P = 0.003).Conclusion: Concomitant assessment of both BCL2 and P53 status may be valuable in predicting the aggressiveness of tumors in patients with colorectal carcinomas.

Keywords

Colorectal carcinoma --- BCL2 --- P53


Article
Correlation between BCL2 protein expression and clinicopathological parameters of colorectal carcinoma

Author: Dr.Shoroq Mohamed Abas Al-Temimi
Journal: KUFA MEDICAL JOURNAL مجلة الكوفة الطبية ISSN: 1993517X Year: 2011 Volume: 14 Issue: 2 Pages: 206-213
Publisher: University of Kufa جامعة الكوفة

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This study was conducted to estimate the expression of BCL2 oncoprotein in human colorectal carcinoma and to show its possible correlation to the clinic-pathological parameters. 50 patients of colorectal carcinoma studied in Diwania teaching hospital , out of 50 cases there were only 14 cases positive for bcl2 expression, (10%) of them with strong positive staining pattern, (12%) of them with moderate positive and (6%) with weak positive. Grade I showed (66.7) strong positive staining pattern, while Grade III showed (100%) weak positive staining pattern, also this study showed high expression of BCL2 in stage A,B than stage C,D which were with negative result. Aim of the studyThe aim of our study was to estimate possible correlations between the Bcl-2 expression and some clinicopathological parameters in colorectal carcinoma

البحث عن التعبير المناعي النسيجي الكيميائي لجين أل bcl-2 كمؤشر للتغييرات الطارئة في الخلايا السرطانية لأورام القولون والمستقيم. تمت دراسة50عينة من سرطان القولون في مختبرات مستشفى الديوانية التعليمي. أظهرت الدراسة وجود ترابط في التعبير النسيجي لجين أل- bcl-2 مع مجموعات تمايز المرض ودرجة انتشاره وكان التعبير أكثر في العينات ذات التمايز القوي (الدرجة الأولى) والمجموعة غير المنتشرة ضمن جدار القولون والمستقيم عنه في العينات ذات التمايز الضعيف (الدرجة الثالثة) والمنتشرة خارج جدار القولون والمستقيم مما يدل على أن لهذا ألجين دورا اساسيآ في تقيم سرطان القولون والمستقيم المستقبلية وانتشاره وتحديد أهمية استجابته للعلاج.


Article
Association of Streptococcus bovis with colorectal carcinoma

Author: Nooria R. S. Mohammed نورية رزاق
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2010 Volume: 52 Issue: 1 Pages: 71-73
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: - This study was carried out to investigate the ability of Streptococcus bovis to colonise colorectal cancer.Patients and Methods: - A total of 106 outpatients were subjected for colonscopy. Carcinoma biopsies from patients with colorectal cancer tissue from patient with polyps and normal mucosa stool and blood from all patient and controls were cultured and identified for S.bovis.Results: - The histopatholgical findings confirmed that 38 patients had colorectal carninoma, 27 patients with benign polyps and 41 with normal colonic mucosa. The faecal carriage rate of S.bovis was 15(39.5%) in patient with colorected cancer, 5(18.5%) in patients with polyp and 7(17.1%) in control.Conclusion: - Faecal colonization by Streptococcus bovis in colorectal cancer patient was higher than in control healthy people and patients with polyp.Keywords: - Streptococcus bovis. Colorectal Carcinoma (CRC).


Article
Matrix Metalloproteinase – 9 Expressions Associated With Malignant Colorectal Carcinoma
تعبير Matrix Metalloproteinase – 9 المقترنه بسرطان القولون المستقيمي

Author: Zainab Fadhel Ashoor زينب فاضل عاشور
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2017 Volume: 16 Issue: 2 Pages: 74-78
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Cancer metastatic is dependent on capability of tumor cells to enter "blood and lymphatic system" and there after form tumors in "lymph nodes and distant organs". Matrix metalloproteinase-9(MMP-9) is considered to as important for degradation of the basement membrane and extracellular matrix through cancer invasion and other tissue-remodelling events. This study evaluate the value of Matrix metalloproteinase-9, by Immunohistochemical technique in a series of50 colorectal carcinoma tissues. There was a significant difference betweenMMP-9protein and tumor differentiation, as well as tumor stage.There was highly significant difference in mean percentage of (MMP-9) proteins expression in tissue of colorectal carcinoma (CRC) and colorectal normal tissue (CRN).Conclusion: This study shows that (MMP-9)expression in colorectal cancer is related with better prognosis.

يعتمد انتشارالسرطان على قدرة الخلايا الخبيثة لدخول الدم والجهاز اللمفاوي وبالتالي تشكيل أورام في الغدد الليمفاوية والأعضاء البعيدة. وتعتبر مصفوفة الفلزي-9 (MMP-9) بأنها مهمة لتدهور الغشاء القاعدي والمواد خارج الخلية خلال غزو السرطان وغيرها من احداث إعادة تشكيل الأنسجة.في هذه الدراسة تم تحديدقيمةMMP-9بواسطة تقنية التحليل المناعى الكيميائيفي سلسلة من50نسيج من سرطانالقولون المستقيمي هناكفرق معنوي بين بروتينMMP-9وتمايز الورم ،فضلا عن مرحلةالورم.كما ان هناكاختلاف معنوي كبيرفينسبةمتوسطتعبير بروتينMMP-9فيأنسجةسرطانالقولون المستقيميوالأنسجة الطبيعية القولون والمستقيم. تبين هذه الدراسه ان تعبير MMP-9 في سرطانالقولون المستقيمي ترتبط مع تقدم الورم.


Article
CEA, CA19-9 & A-FP as tumor markers for colorectal carcinoma

Authors: Ansam A. AL-Bayatti --- khdier AL-Rawak --- ragad I.AL-Masral
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2006 Volume: 48 Issue: 1 Pages: 36-40
Publisher: Baghdad University جامعة بغداد

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Article
BCL-2 OVEREXPRESSION IN COLORECTAL CARCINOMA
فرط التعبير المناعي للـ Bcl-2 في سرطان القولون والمستقيم

Author: Alaa Ghani Hussain علاء غني حسين
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2008 Volume: 6 Issue: 2 Pages: 66-76
Publisher: Al-Nahrain University جامعة النهرين

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Background: Colorectal cancer is a major cause of morbidity and mortality worldwide. Prognostic assessment influences the treatment of patients with colorectal cancer, including decisions about adjuvant therapy. Bcl2 over-expression is a genetic event associated with tumor progression and is a prognostic marker of this disease.Objective: Colorectal carcinoma is a major cause of morbidity and mortality worldwide. Bcl2 overexpression is a genetic event associated with tumor progression and is a prognostic marker for this disease. The aim of this study is to assess the expression of bcl2 in colorectal carcinoma and its correlation with other clinicopathological parameters.Methods: From January 2004- January 2005, thirty –five formalin fixed paraffin embedded tissue samples from patients with colorectal carcinoma were included in this study. Four-micrometer tissue sections were obtained for each case, two of them were stained by H&E and the diagnosis had been revised, and the other two were stained immunohistochemically by using avidin biotin alkaline phosphatase method for evaluating bcl2 expression. The presence of red cytoplasmic staining in less than 25% of tumor cells was considered a positive expression of bcl2.Statistical analysis of all the results were performed using Chi square test at level of significance alpha = 0.05 (P<0.05) regarded as statistically significant.Results: Bcl2 expression was significantly higher in low grade and early stage colorectal carcinoma .Non mucinous colorectal cancer showed more bcl2 expression than the mucinous type. An inverse correlation was found between bcl2 expression with the greatest diameter of the tumor and the lymph node status. Bcl2 expression was correlated neither with the age nor with the sex of the patient and the tumor location.Conclusion: Bcl2 over-expression correlates with many variables as low grade colorectal tumor, early stage, non mucinous type, small tumor size and negative lymph node status.

خلفية الدراسة: يعد سرطان القولون والمستقيم سبب رئيسي للفنائية والمرضية في جميع انحاء العالم . ان التقييم التكهني يؤثر على علاج سرطان القولون والمستقيم بضمنها القرارات حول العلاج المساعد .يعد التعبير المناعي للـ bcl2 هو حدث جيني مرتبط بتقدم الورم وهو مؤشر تكهني للمرض.هدف الدراسة: دراسة التعبير المناعي للـ bcl2 في سرطان القولون والمستقيم وبيان مدى علاقته بالعوامل المرضية والسريرية للورم.المواد وطرق العمل: للفترة من كانون الثاني 2004 – كانون الثاني 2005 تم اختيار 35 مقطع شمعي لمرضى مصابين بسرطان القولون استعاديا تغطي الفترة من كانون الثاني 2004 الى كانون الثاني 2005 وتم تحضير اربعة شرائح نسيجية بسمك 4 مايكروميتر, اثنان منها صبغت بصبغة الهيماتوكسيلين والايوسين وتم اعادة فحصها لغرض تشخيصها وتصنيفها نسيجيا والاثنان الاخران صبغت بطريقة التصبيغ الكيميائي النسيجي المناعي للكشف عن الـ bcl2 . ان وجود التفاعل السايتوبلازمي الاحمر في المقطع اعتبر تفاعلا ايجابيا . بدمج الشدة والكمية للصبغة المناعية فان الصبغة السايتوبلازمية الضعيفة مع كمية من الخلايا الورمية اقل من 25 % اعتبر ايجابيا للتعبير المناعي للـ bcl2 .تم التحليل الاحصائي لكل النتائج بأستعمال Chi square واعتبر ت قيمة P اقل من (0,05) كقيمة ذات مغزى او دلالة احصائيا.النتائــج: ان التعبير المناعي للـ bcl2 في الدرجة الدنيا كان ذا مغزى احصائيا . وجد ان تعبير ال bcl2 كان اكثر في الاورام عالية التمايز النسيجي (او ذات الدرجة الدنيا لتصنيف المرض ) وفي المراحل المبكرة للورم . اظهر سرطان القولون والمستقيم غير المخاطي الـ bcl2 اكثر من النوع المخاطي وكان هذا ذو قيمة او دلالة احصائيا. هناك علاقة معكوسة وجدت بين التعبير المناعي للـ bcl2 مع اكبر قطر للورم وحالة العقد اللمفاوية . ان التعبير المناعي للـbcl2 غيرمرتبط بعمر وجنس المريض وموقع الورم.الاستنتاج: ان ظهور بروتين bcl2 في سرطان القولون والمستقيم يترافق مع بعض عوامل المرض كالدرجة الدنيا لتصنيف المرض , المراحل المبكرة للمرض , النوع غير المخاطي لسرطان القولون والمستقيم , صغر حجم الورم والحالة السلبية للعقد اللمفاوية .


Article
Expression of D20-40 and CD in patients with colorectal carcinoma
زيادة هيئة التعبير CD34, 40-D2 في المرضى المصابيين بسرطان القولون والمستقيم

Author: Basim M. Kashman باسم محمد خشمان
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2011 Volume: 53 Issue: 4 Pages: 419-423
Publisher: Baghdad University جامعة بغداد

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