scholarly journals The implication of BRAF mutation in advanced colorectal cancer

2021 ◽  
Author(s):  
Emma O’Riordan ◽  
Michael William Bennett ◽  
Louise Daly ◽  
Derek G Power
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Natural History ◽  
Advanced Colorectal Cancer ◽  
Molecular Subtype ◽  
Standard Of Care ◽  
University Hospital ◽  
Control Group ◽  
Increased Risk ◽  
History Of

Abstract Background Advanced colorectal cancer (CRC) is frequently a lethal disease. Mutations in the BRAF gene is a key driver in CRC pathogenesis and confers a poor prognosis. To date, Irish data on this molecular subtype of CRC is lacking. Aims Our aim was to compare the natural history of Irish patients with BRAF (BRAFMUT) metastatic CRC with a control group of metastatic CRC patients without BRAF mutation (BRAFWT wild- type). Method A retrospective observational analysis of advanced CRC patients with known BRAFMUT was conducted by chart review. BRAFMUT patients were identified from the Cork University Hospital (CUH) histopathology database. Controls with known BRAFWT were randomly selected from the database. Demographic characteristics and clinicopathological data were recorded. Survival was assessed with Kaplan–Meier curve/Cox proportional hazard models. Results Twenty patients with BRAFMUT and 36 with BRAFWT were studied. BRAFMUT were more likely female (75% vs 33%, p = 0.007) and right-sided (65% vs 31.4%, p = 0.033). Median overall survival was lower in BRAFMUT group (17.3 months (95% CI 0–40.8)) compared to patients with BRAFWT (median survival not reached, log rank p = 0.001). On multivariate analysis, BRAFMUT was independently associated with an increased risk of mortality (HR 12.76 (95% CI 3.15–51.7), p < 0.001). Conclusion BRAFMUT advanced colorectal cancer was associated with significantly reduced overall survival in this Irish CRC population. Knowledge of mutation status should now be considered standard of care and should dictate management. Surgeons should be aware of this genetic signature as the natural history of the disease may mitigate against an aggressive surgical strategy. A prospective study should be conducted to further corroborate these findings.

Risk of colonic adenoma in patients with non–colorectal cancers.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e13070-e13070
Author(s):  
Hamzah Abu-Sbeih ◽  
Faisal Ali ◽  
Wei Qiao ◽  
Phillip Lum ◽  
Mehnaz Shafi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
The United States ◽  
Personal History ◽  
Control Group ◽  
Colonic Adenoma ◽  
Crc Screening ◽  
Adenoma Detection ◽  
Increased Risk ◽  
History Of

e13070 Background: In the last two decades, the incidence of colorectal cancer (CRC) has decreased dramatically after the implementation of CRC screening in the United States. Several risk factors for colonic adenoma (CA), the main precursor for CRC, have been found. Whether personal history of non-colorectal cancer (NCRC) is a risk factor for CA has not been studied. Here, we assess the risk of CA in patients with NCRCs. Methods: We conducted a retrospective study of cancer patients who underwent colonoscopy after cancer diagnosis between 2009 and 2018. We included patients without history of NCRC as a control group. Multivariate logistic regression was used to assess independent risk factors for CA (Table 1). Results: Total of 9408 patients with NCRC were included; CA was detected in 4503 (48%). Histology revealed tubulovillous features in 611 (14%) patients and villous in 51 (1%). High grade dysplasia was detected in 1,317 (29%) patients and adenocarcinoma in 388 (9%). The rate of adenocarcinoma was the highest in patients with multiple myeloma (14%). Adenoma detection rate (ADR) was 30% in patients younger than 40 years ( n= 1621), 32% in patients between 40 and 50 years ( n= 812), 47% in patients between 50 and 60 years ( n= 2892), and 55% in patients older than 60 years ( n= 4493). Multivariate analysis revealed an increased risk of CA with old age, male sex, family history of CRC, and high body mass index ( P< 0.05). The median time from NCRC diagnosis to CA detection was 3 years (IQR 1-8). Conclusions: ADR in patients with a personal history of NCRC is higher than the ADR of patients without NCRC. CRC screening should be performed after the diagnosis of NCRC is made, even if it was before the standard threshold of CRC screening age of 50 years.[Table: see text]

scholarly journals Perspectives and controversies in the treatment of advanced colorectal cancer: From paliation to cure

2002 ◽  
Vol 49 (2) ◽  
pp. 37-39
Author(s):  
Ivan Popov
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Advanced Colorectal Cancer ◽  
Clinical Status ◽  
Objective Response ◽  
Tumor Burden ◽  
New Drugs ◽  
Time To Progression ◽  
History Of

Advanced colorectal cancer (ACRC) has been traditionally considered resistant to chemotherapy, with no clear benefit in relation to time to progression and overall survival. Nevertheless, nowadays first and second line therapeutic approaches have dramatically changed the natural history of ACRC, and that means that at present the most important decision in a patient is not to treat or no to treat with chemotherapy, but to choose the best chemotherapy schedule at any time. Following this purpose it has been necessary, not only the emergence of new drugs and schedules, but also the understanding of the clinical efficacy. Actually, to the classic parameters such as, objective response, time to progression, and overall survival, new parameters studying clinical benefit have been added. Among these new parameters we can find the weight loss, symptom-free period, quality of life, pain-free interval, etc. Therefore, the really important aim in these situations is the patient clinical status, being less important the survival or the tumor burden reduction.

scholarly journals Colorectal cancer and Blastocystis sp. infection

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Violetta Sulżyc-Bielicka ◽  
Lidia Kołodziejczyk ◽  
Małgorzata Adamska ◽  
Bogumiła Skotarczak ◽  
Sylwia Jaczewska ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Light Microscopy ◽  
Control Group ◽  
Intestinal Protozoan ◽  
Oncological Treatment ◽  
Increased Risk ◽  
Blastocystis Sp ◽  
Clinical Consequences ◽  
History Of ◽  
Stool Samples

Abstract Background Blastocystis sp. is a common intestinal protozoan found worldwide. Based on gene analysis, 17 subtypes (STs, ST1–ST17) have been identified, 9 of which have been isolated from humans. Differences in clinical consequences may depend on differences among the STs. Here, we evaluated the prevalence of Blastocystis sp. in patients with colorectal cancer (CRC) compared to a control group and assessed the relationships between Blastocystis sp. infection and sex; age; and CRC grade, stage, and location. Methods The study included 107 CRC patients (41 women and 66 men, median age 65 years); 124 subjects without colorectal cancer or a history of oncological disease comprised the control group (55 women and 69 men, median age 63). Stool samples were collected from patients before oncological treatment and examined using light microscopy (iodine-stained smear). Additionally, PCR-based identification of Blastocystis sp. was performed in 95 stool samples from CRC patients and 76 stool samples from the control group. Results Light microscopy showed that the prevalence of Blastocystis sp. was significantly higher in CRC patients than in the control group (12.15% and 2.42%, respectively; p = 0.0041). Multivariate analysis showed that the odds of Blastocystis sp. infection were fivefold higher in the CRC group than in the control group. PCR-based molecular examinations demonstrated that the proportion of patients infected with Blastocystis sp. was significantly higher in the CRC group than in the control group (12.63% and 2.63%, respectively; p = 0.023). The predominant ST in the CRC group was ST3, detected in nine patients (75%), followed by ST1 (2 patients, 16.7%) and ST2 (1 patient, 8.3%). No association was found between Blastocystis sp. infection and age, sex, or CRC stage, grade, or location. Conclusions The results showed that CRC was associated with an increased risk of opportunistic Blastocystis sp. infection, even before oncological treatment. To the best of our knowledge, this is the first report estimating the prevalence of Blastocystis sp. infection in CRC patients before oncological treatment in Europe.

scholarly journals Patients with infective endocarditis and history of injection drug use in a Swedish referral hospital during 10 years

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anna Damlin ◽  
Katarina Westling
Keyword(s):  
Infective Endocarditis ◽  
Drug Use ◽  
Injection Drug Use ◽  
Clinical Characteristics ◽  
National Registry ◽  
Injection Drug ◽  
University Hospital ◽  
Prosthetic Heart Valves ◽  
Increased Risk ◽  
History Of

Abstract Background Patients with injection drug use (IDU) have increased risk of developing infective endocarditis (IE). Previous studies have reported recurrent IE, increased duration of hospital stay, poor adherence and compliance as well as higher mortality and worse outcomes after surgery in the IDU-IE patient group. Further studies are needed to provide a basis for optimized care and prevention of readmissions in this population. This study aims to describe the clinical characteristics and outcomes among patients with IDU-IE. Methods Data of adults with IDU-IE and non-IDU-IE, treated between 2008 and 2017 at the Karolinska University Hospital in Stockholm were obtained from the Swedish National Registry of Infective Endocarditis. Clinical characteristics, microbiological results, treatment durations, results from echocardiography and in-hospital mortality were compared between the groups. Results Of the total 522 patients, 165 (32%) had IDU-IE. Patients with IDU-IE were younger than the patients with non-IDU-IE (mean age IDU-IE: 41.6 years, SD 11.9 years; non-IDU-IE: 64.3 years, SD 16.4 years; P <  0.01). No difference in distribution of gender was observed, 33% were females in both the IDU-IE and the non-IDU-IE group. History of previous IE (IDU-IE: n = 49, 30%; non-IDU-IE: n = 34, 10%; P <  0.01) and vascular phenomena (IDU-IE: n = 101, 61%; non-IDU-IE: n = 120, 34%; P <  0.01) were more common among patients with IDU-IE while prosthetic heart valves (IDU-IE: n = 12, 7%; non-IDU-IE: n = 83, 23%; P <  0.01) and known valvular disease (IDU-IE: n = 3, 2%; non-IDU-IE: n = 78, 22%; P <  0.01) were more common among patients with non-IDU-IE. Aetiology of Staphylococcus aureus (IDU-IE: n = 123, 75%; non-IDU-IE: n = 118, 33%; P <  0.01) as well as tricuspid (IDU-IE: n = 91, 55%; non-IDU-IE: n = 23, 6%; P <  0.01) or pulmonary valve vegetations (IDU-IE: n = 7, 4%; non-IDU-IE: n = 2, 1%; P <  0.01) were more common in the IDU-IE group. The overall incidence of IDU-IE decreased during the study period, while the incidence of definite IE increased (P <  0.01). Conclusions This study presents that patients with IDU-IE were younger, less frequently treated with surgery and had higher prevalence of vascular phenomena and history of previous IE, aspects that are important for improved management of this population.

scholarly journals Insulin Resistance and Inflammation in Black Women with and without Breast Cancer: Cause for Concern

2016 ◽  
Vol 26 (4) ◽  
pp. 513 ◽  
Author(s):  
Kathleen A. Griffith ◽  
Seon Yoon Chung ◽  
Shijun Zhu ◽  
Alice S. Ryan
Keyword(s):  
Breast Cancer ◽  
Insulin Resistance ◽  
Black Women ◽  
White Women ◽  
Cancer Recurrence ◽  
Control Group ◽  
Study Objective ◽  
Increased Risk ◽  
Tnf Α ◽  
History Of

<p class="Pa7"><strong>Objective: </strong>After chemotherapy for breast cancer, Black women gain more weight and have an increased mortality rate compared with White women. Our study objective was to compare biomarkers associated with obesity in Black women with and without a history of breast cancer.</p><p class="Pa7"><strong>Design: </strong>Case-control</p><p class="Pa7"><strong>Setting: </strong>Academic/federal institution</p><p class="Pa7"><strong>Participants: </strong>Black women with a history of breast cancer (cases) and age-matched controls.</p><p class="Pa7"><strong>Methods: </strong>We compared insulin resistance, inflammation, and lipids in overweight and obese Black women with a history of breast cancer (n=19), age similar controls (n=25), and older controls (n=32). Groups did not differ on mean body mass index (BMI), which was 35.4 kg/m2, 36.0 kg/m2, and 33.0 kg/m2, respectively.</p><p class="Default"><strong>Main Outcome Measures: </strong>Insulin resis­tance (HOMA-IR); inflammation (TNF-α, IL-1b, IL-6, IL-8, CRP); lipids (cholesterol, triglycerides).</p><p class="Pa7"><strong>Results: </strong>Cases had 1.6 and 1.38 times higher HOMA-IR values compared with age similar and older controls, respectively (P≤.001 for both). TNF-α and IL-1b were significantly higher in cases compared with both control groups (P&lt;.001 for both). IL-6 was also higher in cases compared with age-similar controls (P=.007), and IL-8 was lower in cases compared with older controls (P&lt;.05). Lipids did not differ between cases and either control group.</p><p class="Default"><strong>Conclusions: </strong>Black women with breast cancer were significantly more insulin resis­tant with increased inflammation compared not only with age similar controls but with women who were, on average, a decade older. These biomarkers of insulin resistance and inflammation may be associated with increased risk of breast cancer recurrence and require ongoing evaluation, especially given the relatively abnormal findings com­pared with the controls in this underserved group. <em></em></p><p class="Default"><em>Ethn Dis. </em>2016;26(4):513-520; doi:10.18865/ed.26.4.513</p>

scholarly journals Impact of polymorphisms in DNA repair genes XPD, hOGG1 and XRCC4 on colorectal cancer risk in a Chinese Han Population

2019 ◽  
Vol 39 (1) ◽  
Author(s):  
Dexi Jin ◽  
Min Zhang ◽  
Hongjun Hua
Keyword(s):  
Colorectal Cancer ◽  
Gene Polymorphisms ◽  
Colorectal Carcinogenesis ◽  
Chinese Han Population ◽  
Control Group ◽  
Chinese Han ◽  
Han Population ◽  
Increased Risk ◽  
Hogg1 Gene ◽  
Repair Genes

Abstract Background: This research aimed to study the associations between XPD (G751A, rs13181), hOGG1 (C326G, rs1052133) and XRCC4 (G1394T, rs6869366) gene polymorphisms and the risk of colorectal cancer (CRC) in a Chinese Han population. Method: A total of 225 Chinese Han patients with CRC were selected as the study group, and 200 healthy subjects were recruited as the control group. The polymorphisms of XPD G751A, hOGG1 C326G and XRCC4 G1394T loci were detected by the RFLP-PCR technique in the peripheral blood of all subjects. Results: Compared with individuals carrying the XPD751 GG allele, the A allele carriers (GA/AA) had a significantly increased risk of CRC (adjusted OR = 2.109, 95%CI = 1.352–3.287, P=0.003). Similarly, the G allele (CG/GG) of hOGG1 C326G locus conferred increased susceptibility to CRC (adjusted OR = 2.654, 95%CI = 1.915–3.685, P<0.001). In addition, the T allele carriers (GT/TT) of the XRCC4 G1394T locus have an increased risk of developing CRC (adjusted OR = 4.512, 95%CI = 2.785–7.402, P<0.001). The risk of CRC was significantly increased in individuals with both the XPD locus A allele and the hOGG1 locus G allele (adjusted OR = 1.543, 95%CI = 1.302–2.542, P=0.002). Furthermore, individuals with both the hOGG1 locus G allele and the XRCC4 locus T allele were predisposed to CRC development (adjusted OR = 3.854, 95%CI = 1.924–7.123, P<0.001). The risks of CRC in XPD gene A allele carriers (GA/AA) (adjusted OR = 1.570, 95%CI = 1.201–1.976, P=0.001), hOGG1 gene G allele carriers (CG/GG) (adjusted OR = 3.031, 95%CI = 2.184–4.225, P<0.001) and XRCC4 gene T allele carriers (GT/TT) (adjusted OR = 2.793, 95%CI = 2.235–3.222, P<0.001) were significantly higher in patients who smoked ≥16 packs/year. Conclusion: Our results suggest that XPD G751A, hOGG1 C326G and XRCC4 G1394T gene polymorphisms might play an important role in colorectal carcinogenesis and increase the risk of developing CRC in the Chinese Han population. The interaction between smoking and these gene polymorphisms would increase the risk of CRC.

scholarly journals Recurrent Miscarriage and Consanguinity among Omani Women– A Cross Sectional Study

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Fatma Al Hoqani ◽  
Wadha Al Ghafri ◽  
Saneya El tayeb ◽  
Yahya Al Farsi ◽  
Vaidyanathan Gowri
Keyword(s):  
Recurrent Miscarriage ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Control Group ◽  
P Value ◽  
Cross Sectional ◽  
Recurrent Miscarriages ◽  
Sultan Qaboos University ◽  
Chi Squared ◽  
History Of

Objective: to determine the prevalence of explained and unexplained recurrent miscarriages (RM) and to find out if there is a significant relationship between recurrent miscarriages and consanguinity. Methods: A cross sectional in which the cases group included all women with RM attending the outpatient clinic at Sultan Qaboos University Hospital from July 2006 to April 2012 and the controls group included women with no history of RM after matching them with cases for age (case to control ratio was 1:1). The main outcome measures were the prevalence of consanguinity in women with or without recurrent miscarriages. Results: During study period a total of 290 women with RM were seen. Of which, 150 (51.7%) women had unexplained RM. Control group with no history of RM were 300 women. Consanguinity rate among cases (49.5%) %) was less than the controls (52.7 %%). Both first cousin and second cousin marriages were more common in the controls than the cases and it was not statistically significant (p value 0.476, chi squared test). Conclusion: In this study we found that more than half of RM cases were unexplained and there was no significant association between RM and consanguinity.

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