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Volume 59, Issue 4 (8-2001)
Tumor angiogenesis shown by Microvessel Count (MVC) or Microvessel Density (MVD), is assessed by several studies as prognostic factor in some types of tumors, and also in colorectal carcinoma. This article is payed to correlation between clincopathologic factors and tumor angiogenesis. In this study, immunohistochemical techniques are used for vascular evaluation in specimens from twenty-nine colorectal carcinoma, and stained for Factor VIII-Related Antigen (F8RA) by using monoclonal antibody. Uni and multivariate analysis disclosed that total MVC was higher in tumor [76.3±33 (×100=2.5 mm²/field) and 29.8±11 (×200=0.785 mm²/field)] than in normal tissue [37.7±15.8 (×100) and 17.6±7.8 (×200)], (P=0.022, P=0.000009). Microvessel quantification was significantly higher in stage D (115±36.6, ×100 and 26.7±6.4, ×200, P=0.002 and P=0.04). In this study MVD has correlation with vascular invasion (P=0.024, ×100 and P=0.007, ×200), the mean tumor vessel count although was increased with clinicophatologic findings such as age<60 years, male, right colon involvement, infiltrating type, mucinous carcinoma, transmural penetration, grade III, lymphatic and perineural invasion, but was not statistically significant. Lymph node and hematogenous metastasis and size of tumor also, was not important. As a conclusion, MVD was increased in tumor and has shown correlation with metastasis, and vascular invasion. Resulting angiogenesis increase risk of metastasis.
Volume 67, Issue 9 (12-2009)
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Background: Routine oophorectomy in women with colorectal
cancer is under debate, the aim of this study is to determine
incidence, clinicopathologic features and prognostic factors of ovarian
involvement in primary colorectal cancer (CRC) and
to clear the role of prophylactic oophorectomy.
Methods: Data
from primary CRC women treated between years 1990 and 2004 were
retrieved and clinical and pathologic features of those who had undergone
oophorectomy during CRC surgery were reviewed.
Results: One
hundred eighty cases (mean age 47.5 years) were included. In 120(66.6%),
ovaries were preserved and 60(33.3%) cases underwent bilateral
oophorectomy in addition to primary CRC
resection. Reasons for oophorectomy were prophylactic in 22(36.6%),
abnormal morphology in 35(58.3%), and undetermined in 3(5%)
cases. There were five metastatic carcinomas, eight primary ovarian tumors and 47
normal ovaries in pathologic evaluation. No complication directly related to
oophorectomy was noted. Patients with ovarian metastases had higher stages of
tumor. Ovarian metastases were not related to menstrual status, CRC
location, size, differentiation, and mucin production, as well as abnormal
morphology of ovary. The global prevalence of ovarian metastasis in CRC was 2.7%, and
isolated ovarian metastases occurred in less than half of them. Of 120 women
that underwent colectomy alone, eight (6.6%)
developed ovarian metastasis during two years of follow-up. Only three cased
had isolated ovarian metastases. No patient with synchronous or metachronous
ovarian metastases from CRC survived five years.
Conclusion: Isolated ovarian metastases
from primary CRC occur with a low frequency
and this may partially explain the debate regarding prophylactic oophorectomy
at the time of curative resection for primary CRC.
Volume 70, Issue 2 (5-2012)
Background: Patients with endometrial or ovarian cancer have an increased risk for breast or colon cancer. The aim of this study was to assess the individual and age-related characteristics of patients with a combination of these malignancies.
Methods: In this retrospective descriptive study, we reviewed the medical records of 100 patients admitted for endometrial or ovarian cancer in Rasol Akram, Akbarabadi and Firozgar educational Hospitals in Tehran, Iran, during 2010- 2011. Colon polyps were evaluated by immunohistochemistry assay.
Results: The mean age, weight and BMI of the patients were 50.21, 65.9 and 26.07, respectively. Among 100 cases participating in this study, five (5%) patients had colon polyps. All the five cases with colon polyp had positive familial histories of ovarian cancer.
Conclusion: With considering the low prevalence of colorectal polyps among women with ovarian and endometrial cancers, patient's follow-up for screening test is not recommended.
Volume 70, Issue 4 (7-2012)
Background: Probiotic microorganisms are living normal flora of human body that have nutritional value and health benefits when administered in adequate amounts. The health benefits include prevention of bacterial diarrhea, skin eczema and recently understood, prevention and control of various cancers, as well. Different mechanisms such as stimulating the immune system, modifying the composition of gastrointestinal and genitourinary tract normal flora and prevention of the carcinogenic activity of fecal enzymes have been identified for their probiotic activity. Due to the high density of the normal flora in the gut and also preferentially sporadic nature of colorectal cancers, these cancers are among the main candidates of treatment trials with probiotics. In this study, direct effects of probiotic lactobacilli on colon cancer tumor cells were studied.
Methods: Supernatant fluid and bacterial extracts were prepared and CaCo-2 cells were treated by these materials. Subsequently, the effects of the aforesaid elements were evaluated on cell proliferation, cell necrosis and cell apoptosis by MTT assay, LDH assay and caspase-3 activity.
Results: The supernatants of lactobacilli decreased cell proliferation and increased cell apoptosis but they did not have any effect on cell necrosis. In contrast, when cancerous cells were treated by lactobacilli extract, it lead to cell necrosis in addition to reduction in cell proliferation and increase in cell apoptosis.
Conclusion: The use of lactobacillus probiotics may reduce proliferation of tumor cells in the early stages of colorectal cancers.
Volume 71, Issue 10 (1-2014)
Background: Colorectal carcinoma is considering as a curable disease. Treatment of recurrent cases is hard and sometimes impossible. Evaluation of the rate and affecting factors of recurrence in each hospital would help to decreasing recurrent cases. The aim of this study is evaluation of the rate, clinical and pathologic features, and outcome of recurrent colorectal carcinoma in a referral teaching hospital in Tehran. Methods: Clinical data of 166 curative resections of colorectal carcinoma who were operated between Mehr 1384 and Mehr 1388 (between 23 September 2005 and 23 September 2009) in Imam Khomeini Hospital and were accessible for follow up was collected. Follow up data was collected prospectively up to Farvardin 1391 (19 April 2012). Forty nine recurrences were happened in this period. We compared recurrent and non-recurrent cases for different variables Results: Average age of the patients was 53.5 years, and 47% of them were female. The median time to the diagnosis of recurrent disease was 12 months (range 1 months to 54 months). There were no significant differences between recurrent and non-recurrent patients about age, sex, sub-site of the tumor and sub-type of primary operation. Rate of overall recurrence, local recurrence and distant metastasis were 29.5%, 15.7% and 12.1% respectively. Local recurrence rate was higher in colon cancer (16.44% vs. 15.05%) but distant metastasis rate was higher in rectal cancer (12.9% vs. 10/96%). Rate of curative re-resection was about 25%. Overall survival of the recurrent patients who underwent surgery was better than who underwent chemo or radiotherapy (66.7% vs. 56.8%). Median survival time of recurrent patients after primary surgery was 28 months, and after diagnosis was 12 months (9.28- 14.72,95% CI). Conclusion: In this study the rate of overall recurrence was 29.5%. Local recurrence rate was higher in colon cancer (16.44% vs. 15.05%) but distant metastasis rate was higher in rectal cancer (12.9% vs. 10/96%).
Volume 71, Issue 12 (3-2014)
Background: Colorectal Cancer (CRC) is the third common cancer in the world. One of the pathways in colorectal tumor genesis is Microsatellite Instability (MSI+). MSI is detected in about 15% of all colorectal cancers. Colorectal tumors with MSI have dis-tinctive features compared with Microsatellite Stable (MSS) tumors. Due to the high percentage of MSI+ in patients with CRC in Iran, screening of this type of CRC is im-perative. In current study, two markers (BAT-26 and BAT-25) were used to determine an appropriate screening technique with high sensitivity and specificity to diagnose MSI status in patients with CRC. Methods: Allelic variation in two markers (BAT-26 and BAT-25) was analyzed in tis-sues and sera of 44 normal volunteers and tumor and matched normal mucosal tissues as well as sera of 44 patients with sporadic colorectal cancer by Real Time PCR (Hy-bridization probe) and High-Performance Liquid Chromatography (HPLC) techniques. The sensitivity and specificity of Real Time PCR and HPLC compared with sequencing as gold standard. The data were statistically analyzed using Student’s t-test and 2 or fisher exact test, where applicable with (P<0.05). Receiver-operating-characteristic (ROC) curves were used to evaluate the sensitivity and specificity. Results: The sensitivity and specificity of BAT-26 with Real Time PCR method (Hy-bridization probe) were 100% in comparison with gold standard method. Whereas the sensitivity and specificity of BAT-26 and BAT-25 with HPLC were 83%, 100% and 50%, 97%, respectively. Neither HPLC nor Real time PCR could detect circulating DNA with MSI property in sera. Conclusion: The sensitivity and specificity of real time PCR in MSI detection is the same as sequencing method and more than HPLC. BAT-26 marker is more sensitive than BAT-25 and MSI detection with Real time PCR could be considered as an accu-rate method to diagnose MSI in CRC tissues not sera.
Volume 71, Issue 12 (3-2014)
Background: In advanced stages, Colorectal cancer remains often refractory to classic therapies. In consequence, search for new therapeutic modalities with minimal toxicity is of particular interest in colon cancer management. In this regard, powerful growth-inhibitory effect has been shown for fish-oil derived Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid (DHA) against cancer cells. In the present study, we evaluated the anti-cancer effect of EPA and DHA (n3-polyunsaturated fatty acids, n3-PUFAs) on the human colorectal cancer cell line (LS174T) on a dose-response and time-course ba-sis. Methods: LS174T cells were cultured in RPMI-1640 medium supplemented with 10% fetal bovine serum at 37 ºC in a humidified incubator. Cancer cells were treated to vari-ous concentrations of EPA and DHA (50, 100, 150 µM/L) and incubated for 24-72 hours. Following treatments, dose-response and time-course cytotoxicity using viability and MTT assays were performed. Results: Viability analysis showed that 150 µM/L PUFAs decreased significantly the proliferation of treated cells, as compared to untreated cells. In this regard, cell viabil-ities were found to be %31±%5.1 and %30±%2.6 for DHA and EPA respectively. Moreover, treatment of cells with increasing concentrations of EPA and DHA signifi-cantly decreased growth rates in a dose-and time-dependent manner. Following 72 hours treatments with 150 µM/L PUFAs, growth rates were found to be %19±%5.5 and %20±%5 for DHA and EPA relative to untreated cells respectively. Conclusion: The results of this study indicate that n3-PUFAs decrease cell proliferation and could provide new approaches in malignant tumor therapeutic strategies.
Volume 72, Issue 3 (6-2014)
Background: Radiotherapy has been used to treat many types of cancers over the past years. Radiotherapy generates side effects on normal tissues. Radiosensitizer products provide decrease in tumor proliferation and reduce radiation dose in radiotherapy. Docosahexaenoic Acid (DHA) as an omega-3 polyunsaturated fatty acid has anti-proliferative effects on malignant cells. In this study, the effects of DHA accompanied by ionizing radiation on growth rate and survival fraction of HT29 colorectal cancer cells were evaluated. Methods: The present study was performed at the Institute of Biotechnology, affiliated to Urmia University, Urmia, Iran in the year 2013. In this laboratory experiment, ma-lignant cells were cultured in RPMI-1640 supplemented with 10% fetal bovine serum. HT-29 cells were cultured at 5105 cells/well into 6-well culture plates for overnight. Thereafter, the cells were pretreated with either 50 or 100 µM DHA for 4 hours and malignant cells were irradiated with either dose of 2 or 10 Gy. Cell viability was evalu-ated by trypan blue staining after 48 hours. Moreover, malignant cells were pretreated with either 50 or 100 µM DHA for 48 hours and irradiated with dose of 2 to 10 Gy. Thereafter, survival rate was evaluated by 3-(4,5-Dimethylthiazol-2-Yl)-2,5-Diphenyltetrazolium Bromide (MTT) assay after 6 days. Results: Cell viabilities were found to be 59.8% and 17.5% for 50 µM DHA in combi-nation with doses of 2 and 10 Gy respectively. Using 100 µM DHA diminished cell vi-ability up to 47% and 13.9% following doses of 2 and 10 Gy respectively. Treatment of cells with DHA accompanied by increasing doses of γ-rays significantly diminished survival rate. In treated cells with 50 and 100 µM DHA, survival rate were measured to be 79.1%, 57.6%, 42.8%, 40.5%, 34% and 55.8%, 43.7%, 33.6%, 27.9%, 23.5% for doses of 2, 4, 6, 8 and 10 Gy respectively. Conclusion: Our study indicates that DHA decreases colorectal cancer cells prolifera-tion and could provide a new radiosensitizer drug to enhance the efficacy of colorectal cancer radiotherapy.
Volume 72, Issue 5 (8-2014)
Background: Colorectal cancer is the third most common cancer in the world. Non-coding RNA especially miRNAs have important regulatory roles in cancer. miRNAs are small non coding RNA 21-23 nucleotides long which have different levels of expression between tumors and normal tissues. This study was designed to compare expression level of miRNA-21 between Iranian population colorectal cancer tissues and normal tissue. Methods: This case-control study has performed in medical genetics department of Tehran University of Medical Sciences from January to November 2013. We used 35 samples. The samples were isolated from tumor and adjacent normal tissues of colon. Thirty-five samples were divided into different groups according to cliniopathologic features including tumor size (>4 and <4 cm), metastasis (+ and -) and stage. After small RNA extraction from tissues by small RNA purification kit the quality and quan-tity of extracted RNA was determined using spectrophotometry. cDNAs were synthe-sized and real-time polymerase chain reaction carried out. Finally expression levels were statistically analyzed by LinRegPCR and REST software. Results: miRNA-21 expression ratio in stages I, II and III were 1/804 and 4/574, re-spectively, the increase from stage III was statistically significant (P= 0.037). The ex-pression were also studied according to different clinicopathologic status of colon can-cer, tumor size (>4 and <4 cm) and metastatic (+ and -), miRNA-21 over expressed in both groups, however the increase was not statistically significant. Conclusion: In this study, we found miR-21 over-expression in advanced stage in tu-moral tissue comparing with normal adjacent tissue. This means perhaps in the future it would be possible to use miRNA-21 as an informative prognostic biomarker to guide for better treatment strategies for colorectal cancer patients. Our findings also indicate that miRNA-21 is a promising new molecular target for designing novel therapeutic strategies to control colorectal cancer.
Volume 72, Issue 7 (10-2014)
Background: Colorectal cancer is a major cause of morbidity and mortality throughout the world, and its treatments include surgery, chemo-radiotherapy. Despite improvements in clinical outcomes of patients with this tumor over the past decades, prognosis remains poor with a 5-year survival rate of <10%. Angiogenesis inhibitor agents have been recently added to the treatment regimen of this disease. In the past two decades, it has been recognized that selective inhibitors of the cyclooxygenase -2 (Cox-2) enzyme result in the regression in the size of colorectal tumor, and one of its reasons is attributed to angiogenesis inhibition. The present study aimed at identifying the molecular pathways of angiogenesis inhibition by celecoxib. Methods: HCT-116, which is one of the cell lines of Colorectal cancer (separated from human colorectal adenocarcinoma) was provided by the National Cell bank of Iran (NCBI) affiliated to Pasteur Institute. It was then cultured in DMEM (high glucose) culture medium containing 10% FBS, and then treated in the active substance of celecoxib at pharmacological concentrations of 50 mM (C50) and 100 mM (C100). Afterwards, RNA was extracted and cDNA was prepared. The oligonucleotide of HIF-1 Alpha gene (angiogenesis initiator) was prepared and the level of HIF-1 alpha gene expression was assessed with a real-time PCR device in three control, C50 and C100 groups. Results: HIF-1 alpha gene expression significantly decreased in the celecoxib treatment group (compared with control group) with the concentration of C100 (P< 0.001), but no change was observed in the concentration of C50. Conclusion: Angiogenesis is a key factor in the carcinogenesis process and FDA today approved bevacizumab as a first-line treatment for patients with metastatic colorectal cancer. The results of this study showed one of the causes of angiogenesis reduction in celecoxib-treated colorectal cancer. According to clinical findings and basic studies, celecoxib will be hopefully used as a first-line therapy along with chemotherapy in the near future in colorectal cancer. The advantages of this treatment method include its low cost and low side effects.
Volume 72, Issue 8 (11-2014)
Background: Red Blood Cell's (RBC)’s folate may be related to decreased risk of colorectal adenoma. Methylenetetrahydrofolate reductase (MTHFR) is a key regulatory enzyme in folate metabolism. The MTHFR C677T polymorphism is located in the Exon 4 region and is associated with the change of folate level. This study evaluated the associations between RBC’s Folate levels and colorectal adenoma risk, taking into account whether this associations is modified by MTHFR Polymorphism. Methods: In a case-control study conducted from January to October 2007 in Endoscopy-Colonoscopy ward of Shahid Faghihi Hospital, Shiraz. Participants were 177 case of colorectal adenoma who had pathologic-confirmed adenomatous polyps in full colonoscopy examination and 366 controls without polyps in full colonoscopy. Fasting venous blood were drawn from patients in order to determine RBC’s folate and to identify the MTHFR polymorphism by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Results: Gender Distribution in the patient group were 57.6% male and 42.3% female and control group consisted of 55.1% male and 43.9% female. 50.2% of cases and 49.2% of controls were in the age group “45 years and above”. The T allele frequency was 56.6% in control group and 34.4% in colorectal adenoma patients. There was a significant association between T allele in -677 position of MTHFR gene and colorectal adenoma susceptibility (OR: 1.85, 95% CI: 0.76-4.24, P<0.001). Mean concentration of RBC’s folate was not statistically significant among three groups with TT genotype (mutation homozygote), CT genotype (heterozygote), and CC genotype (wild-type homozygote) (P>0.05) but mean concentration of RBC’s folate was the lowest in TT genotype compare with two other genotype. Odd's Ratio for low (<140ng/ml) versus high level of RBC’s folate in participants with TT genotype was (OR: 2.08, 95% CI: 0.10-2.19, P<0.05) as compare with the CC ones. Conclusion: The result of this study suggested an inverse association between RBC's folate concentration and colorectal adenomas risk, which may be more relevant for those with the MTHFR TT genotype.
Volume 73, Issue 1 (4-2015)
Background: The molecular studies indicate some of the genes in the promoter region itself, will undergo methylation. Methylation of CpG islands in the promoter region of that cause silence or reduced expression of genes involved in cell growth pathways, which are colorectal cancer causing agents. Detection of methylation status can be used as a marker for cancer diagnosis and prediction of disease. CDKN2A tumor suppressor gene encodes a protein, which inhibit CDK 4/6 and loss of retinoblastoma protein phosphorylation (pRb) is involved. The purpose of this study was to investigate the molecular hypermethylation in exon 1 of CDKN2A gene in patients with colorectal cancer and normal subjects. Methods: In this case-control study, the study population consisted of 20 patients with colorectal cancer and 10 healthy persons. Samples in paraffin blocks were prepared in pathology department of Mehr Hospital, Tehran, Iran, from December 2010 to June 2012. Then, specific primers were designed for the methylation and Non-methylation of CDKN2A gene. To determine the level of exon 1 methylation of CDKN2A gene, methylation-specific polymerase chain reaction (MSP) method was performed. Results: In this study, hypermethylation in exon 1 of CDKN2A gene were observed in 80% of tumor tissues (16 cases) and 20% of normal tissues (2 cases). The patients aged older than 50 years, had a higher CDKN2A gene methylation and frequency than patients younger than 50 years old (66% vs 34%) (P<0/001). Conclusion: The result of this study has been confirmed the role of CDKN2A gene promoter methylation of CpG sites of colorectal cancer as the leading cause of colorectal cancer. These data suggest that epigenetic silencing via aberrant methylation of the CDKN2A promoter plays a critical role in the inactivation of this tumor suppressor gene in colorectal cancer and can be used as a marker for early detection and identification of potential applications.
Volume 74, Issue 6 (9-2016)
Background: Kirsten rat sarcoma (KRAS) gene is a target of genetic alterations which are diagnostic and prognostic biomarkers in patients with metastatic colorectal cancer who are treated with monoclonal anti-EGFR antibodies such as cetuximab and panitumumab. KRAS mutations are seen in 35-42% of patients with colorectal cancer. The high frequency of these mutations in colorectal cancer represents their high potential as a biomarker in early diagnosis of cancer. This study was done to evaluate the frequency of KRAS gene mutations in a small population of Iranian patients suffering from colorectal cancer.
Methods: 50 formalin-fixed paraffin-embedded tissue blocks with colorectal cancer (CRC), already confirmed by histopathology and immunohistochemistry testing, were received to Payvand Clinical and Specialty Laboratory, Tehran, from across the country in 2015. DNA was extracted from the tissue blocks and its quality was then evaluated. The reverse dot blotting method was used to evaluate KRAS gene mutations.
Results: KRAS mutations were found in 42% of the study patients. 30% and 12% of the mutations were found in codon 12 and codon 13, respectively. Moreover, no mutation was found in codon 61. Results also showed that the most frequency of samples examined belonged to male with 68% (average age of 56 years old) and then to female with 32% (median age of 54.8 years old).
Conclusion: This study was performed to evaluate the frequency of KRAS gene mutations in Iranian colorectal cancer patients. According to the study results, the frequency of KRAS mutations was consistent with that of other countries, reported in previous studies. The high prevalence of these mutations in patients with colorectal cancer indicates the important role of these genes in this group of patients. Thus, the presence of these mutations can be used as a suitable biomarker for evaluation of response to targeted therapies in patients suffering from colorectal cancer.
Volume 74, Issue 10 (1-2017)
Background: There is no need to explain the importance of collection, recording and analyzing the information of disease in any health organization. In this regard, systematic design of standard data sets can be helpful to record uniform and consistent information. It can create interoperability between health care systems. The main purpose of this study was design the core dataset to record colorectal cancer information in Iran.
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Methods: For the design of the colorectal cancer core data set, a combination of literature review and expert consensus were used. In the first phase, the draft of the data set was designed based on colorectal cancer literature review and comparative studies. Then, in the second phase, this data set was evaluated by experts from different discipline such as medical informatics, oncology and surgery. Their comments and opinion were taken. In the third phase refined data set, was evaluated again by experts and eventually data set was proposed. Results: In first phase, based on the literature review, a draft set of 85 data elements was designed. In the second phase this data set was evaluated by experts and supplementary information was offered by professionals in subgroups especially in treatment part. In this phase the number of elements totally were arrived to 93 numbers. In the third phase, evaluation was conducted by experts and finally this dataset was designed in five main parts including: demographic information, diagnostic information, treatment information, clinical status assessment information, and clinical trial information. Conclusion: In this study the comprehensive core data set of colorectal cancer was designed. This dataset in the field of collecting colorectal cancer information can be useful through facilitating exchange of health information. Designing such data set for similar disease can help providers to collect standard data from patients and can accelerate retrieval from storage systems. |
Volume 75, Issue 5 (8-2017)
Methods: In the present analytical-descriptive study, the investigated population was chosen from the cases with colonic polyps that referred to the Gastroenterology and Liver Diseases Research Center, Taleghani Hospital, Tehran, Iran, from October 2014 to April 2015. Forty four biopsy polyp samples and 10 normal tissue samples were collected, as well as the demographic and clinical properties of the patients and the expression level of AXIN2 gene was quantified by Real-time PCR. The outcomes were analyzed by the ABI Prism 7500 Sequence Detection System (SDS) software, version 2.1.0 (Applied Biosystems Inc., Foster City, CA, USA) and GraphPad Prism, version 3 (GraphPad Software Inc., La Jolla, CA, USA) Also, the expression changes of the intended gene in target groups were compared with the normal tissues using the 2-ΔΔCt equation.
| Results: The data showed enhanced level of the expression of AXIN2 gene in the colonic polyps in comparison to the normal tissues (RQ>2), which was significantly upper in adenoma polyps compared to the hyperplastic group (P=0.015). Also, unlike the rectum, the AXIN2 gene activity in colon area was higher than normal tissue. |
Volume 76, Issue 2 (5-2018)
Methods: The investigated population was chosen from the cases with colonic polyps that referred to the Taleghani Hospital, Tehran, Iran, from April 2014 to May 2016. 22 biopsy samples from patients with adenomatous polyps and 10 samples from healthy individuals as control group were selected. Demographic and clinical properties were collected from patients' files. The Bid gene expression was evaluated using Real-time PCR by ABI 7500 (Applied Biosystems Inc., Foster City, CA, USA). Results were analyzed by the ABI 7500 system SDS version 2.3 and GraphPad Prism, version 5 (GraphPad Software Inc., La Jolla, CA, USA). the expression changes of the intended gene in target groups were compared with the normal tissues using the 2-∆∆CT equation.
Results: Based on the quantitative real-time PCR, the gene expression of Bid gene significantly increased in adenomatous polyps in comparison with the control group (healthy individuals) (RQ>2). Also, polyps were seen in ascending colon, transverse colon, descending colon and rectum showed increased expression compared to control group, but in the sigmoid section of the intestine, there was no change in expression of Bid gene compared to control group.
Conclusion: According to the present study, the expression of Bid gene increased in adenomatous polyps, compared with the normal tissue (healthy group). It suggests that Bid gene by increasing the expression in response to the onset of dysplasia and disruption of the apoptotic cycle, it tries to compensate for the apoptosis.
Volume 76, Issue 6 (9-2018)
Methods: This experimental study was performed in cell culture lab, Institute of Biotechnology, affiliated to the Urmia University, Urmia, Iran from April to September 2017. LS174T colorectal cancer cells at a density of 5×105 cells per well were cultured in RPMI-1640 medium supplemented with 10% fetal bovine serum (FBS) and kept at 37 °C in a humidified incubator with 5% CO2 for 24 hours. Thereafter, the cells were treated with 50, 100, 150 and 200 μmol EPA for 48 hours and cell numbers were counted using neobauer chamber and caspase-3 activities were measured by performing the caspase-3 colorimetric assay (Abcam, Cambridge, MA, USA). Furthermore, 5×103 LS174T colorectal cancer cells were cultured and treated with the above-mentioned EPA concentrations for 24, 48 and 72 hours, after which cell proliferation rate was evaluated by WST-1 proliferation assay (Roche Diagnostics, Mannheim, Germany).
Results: Treatment of LS174T colorectal cancer cells with 50, 100, 150 and 200 μmol EPA decreased the number of cells in a dose-dependent manner. We also found that treatment of malignant cells with increasing EPA concentrations (50 to 200 μmol) significantly decreased cell proliferation in a dose and time dependent manner. After a 72 hours treatment of LS174T cells with 200 μmol EPA, cell proliferation was calculated to be 30.3% compared to untreated control cells. Following 48 hours treatment, caspase-3 activity increased with increasing EPA concentrations in which at 200 μmol EPA, caspase-3 activity increased by 3.4 fold compared to untreated control cells.
Conclusion: Fish-oil derived eicosapentaenoic acid as a safe compound decreases the number of colorectal cancer cells and their proliferation rate and activates caspase-3 enzyme, as an executor protein in apoptosis.
Volume 78, Issue 3 (6-2020)
Methods: The current research was a case-control study. Fecal samples were provided from 31 healthy individuals, 42 adenomatous polyposis patients and 20 colorectal cancer cases that were referred to Taleghani Hospital, Tehran, Iran, from August 2016 to August 2017 for colorectal cancer screening tests. Fecal samples were collected to analyze intestinal bacteria including, Lactobacillus, Escherichia coli, and Prevotella by absolute quantitative real-time polymerase chain reaction (PCR). The number of these gut bacteria was precisely determined by this method of real-time PCR.
Results: Higher number of Prevotella with 24.6 CT number (P<0.005) and E.coli with 20.4 CT number (P<0.015) were achieved in colorectal cancer cases and adenomatous polyposis patients in contrast to samples from normal individuals. On the contrary, the opposite range was observed for the quantification of Lactobacillus and greater numbers of bacteria (CT=28.6) were detected in normal, compared to the colorectal cancer cases and adenomatous polyposis (P<0.001).
Conclusion: The gut microbiota composition of individuals with colorectal cancer and adenomatous polyposis differs from that of healthy individuals, and the higher numbers of pathogenic microbiota versus beneficial microbiota present in those with colorectal cancer and adenomatous polyposis. In contrast, healthy individuals have higher numbers of beneficial gut microbiota than pathogenic microbes. These findings need more experimental analysis and investigation to better clarify.
Volume 81, Issue 2 (5-2023)
Methods: In this study, we evaluated the detection rate of VI, PI and SI in 180 patients of CRC who underwent surgical resection based on basic pathology reports, review of hematoxylin and eosin (H&E) slides with considering morphologic clues such as “protruding tongue” and “orphan artery” signs, and elastin stain for detection of VI. In addition, the stage of the disease, pT stage, tumor location, tumor type and grade were categorized, separately. We used the Fisher’s exact test for comparing variables between the two groups. P<0.05 was considered significant. All data analyzed using SPSS version 26.
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Results: Overall, the detection rate of VI was significantly increased in review of H&E slides with considering morphologic clues (P=0.019) and also using elastin stain (P<0.05) than basic pathology reports, but no significant differences observed in PI (P=0.118) and SI (P=1.00) between the first basic pathology reports and review of H&E slides. Also, significant differences observed in VI, PI and SI based on AJCC stage, pT stage and grade of tumor (P<0.05).
Conclusion: Considering the prognostic importance of VI detection in the treatment of patients of CRC, Slide review with attention to the morphologic clues such as “protruding tongue” and “orphan artery” signs and elastin staining could be used for better detection of VI in patients of CRC in routine surgical specimens. |
Volume 81, Issue 9 (12-2023)
Methods: This economic evaluation study was conducted using the cost-effectiveness method between July 2016 and February 2017. Evaluation of the effectiveness of screening methods was done using a systematic review. Cost evaluation was also done using the costs obtained from the tariff approved by the Iranian Ministry of Health in 2015 for colonoscopy and sigmoidoscopy. Finally, the combined model of decision tree and Markov was used to evaluate the cost effectiveness. Incremental Cost Effectiveness Ratio (ICER) formula was used for cost effectiveness analysis considering the final outcome of 5-year survival of high-risk individuals. Excel and TreeAge software were used for data analysis.
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Results: The effectiveness of sigmoidoscopy and colonoscopy in increasing 5-year survival is 11 and 15.7%, respectively, and colonoscopy screening is 4.7% more than sigmoidoscopy. The cost of colonoscopy and sigmoidoscopy screening was calculated as 1000 and 19920 billion Rials, respectively. Based on cost-effectiveness analysis, the cost of treating patients in the case of screening with colonoscopy and sigmoidoscopy is lower than without screening. The ICER ratio of colonoscopy and sigmoidoscopy compared to no screening was -4/441/389/160 and -4/757/954/940 Rials respectively, and colonoscopy compared to sigmoidoscopy was -3/699/785/880 Rials, respectively. Finally, the use of colonoscopy leads to spending 3/699/785/880 Rials less in exchange for obtaining 4722 additional survivals with the prevention of colorectal cancer compared to sigmoidoscopy.
Conclusion: Screening by colonoscopy and sigmoidoscopy methods are effective in reducing the incidence and death of colorectal cancer compared to no screening. Screening by colonoscopy is a dominant option for the high-risk population in Iran. Colonoscopy screening is more cost effective compared to sigmoidoscopy. However, decisions about colorectal cancer screening and screening methods depend on local resources and personal preferences. |
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