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EN
Wstęp: Zakażenie miejsca operowanego występuje u 2,5–22,3% operowanych chorych. Jest ono wykładnikiem jakości leczenia na oddziałach zabiegowych i ma duży wpływ na jego koszt. Materiał i metodyka: Analizie poddano chorych, u których w obserwacji 30-dniowej wystąpiło zakażenie miejsca operowanego. Grupę wyjściową stanowiło 1581 chorych z rozpoznaniem raka jelita grubego poddanych zabiegowi operacyjnemu w jednym ośrodku. Kryteriami wyłączającymi z badania były: brak wiarygodnej dokumentacji leczenia (szpitalnego lub ambulatoryjnego) i zgon chorego przed 30. dniem po operacji bez rozpoznanego zakażenia miejsca operowanego. Analizę statystyczną wykonano przy użyciu programu Statistica 10. Wyniki: Powikłania pooperacyjne wystąpiły u 262 chorych (16,6%). Najczęściej występującym było zakażenie miejsca operowanego (198 pacjentów; 12,52%). Stwierdzono, że wystąpienie tego powikłania zależne było od zaawansowania klinicznego raka, wieku chorych, chorób współtowarzyszących (cukrzyca i choroby kardiologiczne). Ponadto zauważono, że powikłanie to występowało znamiennie częściej u chorych operowanych w trybie pilnym z powodu powikłań oraz u tych, u których wyłoniono stomię jelitową. Nie stwierdzono natomiast zależności wystąpienia tego powikłania od płci chorych i lokalizacji guza nowotworowego. Wniosek: U chorych po operacji raka jelita grubego największe zagrożenie wystąpienia zakażenia miejsca operowanego wystąpiło u chorych po 75. roku życia, obciążonych cukrzycą i chorobami kardiologicznymi, z dużym zaawansowaniem klinicznym raka, operowanych w trybie ostrego dyżuru, u których konieczne było wyłonienie stomii jelitowej (a szczególnie kolostomii).
2
Content available remote Prevalence ofCryptosporidiumsp. In Patients with Colorectal Cancer
100%
EN
Parasitic protozoans of the Cryptosporidium genus are intracellular intestinal parasites of mammals, causing cryptosporidiosis. Clinically, cryptosporidiosis manifests as chronic diarrhoea. Individuals with immune disorders, including those with neoplasms, are at risk of symptomatic invasion.The aim of the study was the evaluation of Cryptosporidium sp. prevalence in patients with diagnosed colorectal cancer.Material and methods. The studied group encompassed 87 patients with diagnosed colorectal cancer, undergoing surgery at the Department of General and Oncological Surgery, Pomeranian Medical University, in the years 2009-2010. Immunoenzymatic tests for Cryptosporidium sp. on faeces samples were performed with the use of commercial test kit, ProSpecT®Cryptosporidium Microplate Assay (Remel Inc).Results. The presence of Cryptosporidium sp. was found in 12.6% of studied patients with colorectal cancer. The performed statistical analysis did not reveal any correlation between Cryptosporidium sp. infection and gender, age, neoplasm advancement stage as per Astler-Coller scale, neoplasm differentiation grade, or neoplastic tumour localisation in relation to the splenic flexure.Conclusions. There was found high prevalence of Cryptosporidium sp. in patients with colorectal cancer. It was comparable to the prevalence reported for patients with immune deficiency.
EN
In Poland there there are about 15‑16 thousand cases of colon cancer per year. The health care system allows the treatment of patients with colorectal cancer in highly specialized hospitals, oncology centers and district hospitals. The results of treatment within different reference level differ. The aim of the study was to evaluate the results of surgical treatment of patients with colorectal cancer at a district hospitals compared with the results of highly specialized center. Material and methods. A retrospective study. The material consisted of 171 consecutively operated patients diagnosed with colorectal cancer treated in the Department of Surgery, District Hospital in Wołomin. The control group consisted of 200 patients treated surgically at the Department of General and Colorectal Surgery, University Hospital in Łódź. In both centers, the patients were operated on by surgeons with experience in operations on the large bowel. The demographic data, information on the type of indication (elective vs emergent), and the severity of the disease by AJCC / TNM scale were collected. In the district hospital there were patients with more advanced disease (p <0.001), older (p = 0.0001), and often operated under emergent indication (p = 0.0001). The telephone survey collected data on survival or the date of death of the patient and set the percentage of five-year survival. Results. The proportion of five-year survival in the study group and control group was respectively 46% and 71% (p <0.0001). The percentage of five-year survival among patients undergoing elective procedure in both centers were respectively for Wołomin and Łódź 58% and 73% (p = 0.008). The proportion of 5-year survival among “younger” patients (<70) was respectively in Wołomin and Łódź 64% and 81% (p = 0.004) for “older” patients with (> 70) 50% and 60% (p = 0.6747) Conclusions. Overall results of surgical treatment of patients with colorectal cancer in the district hospital are inferior to treatment results in a highly specialized center. The population treated in the district hospital is statistically significantly different in comparison to patients treated in highly specialized center. The following differences were captured: severity of the disease, age and type of indication (elective vs emergent). The diffrences has an influence on the outcomes. The five years survival for patients > 70 years undergoing elective procedure is not statistically different between the district hospital and highly specialized center.
EN
Due to increased colorectal cancer incidence there is a necessity of seeking new both prognostic and prediction factors that will allow to evolve new diagnostic tests. K-ras gene seems to be such a factor and its mutations are considered to be an early marker of progression of colorectal cancer. The aim of the study was to find a correlation between K-ras gene mutation in patients with diagnosed colorectal cancer and selected clinical parameters. Material and methods. A total of 104 patients (41 women and 63 men) with diagnosed colorectal cancer were included in this study. The average age of male group was 68.3 and in female group – 65.9. Samples were taken from paraffine blocks with tissue from diagnosed patients and K-ras gene mutation were identified. Afterwards the statistical analysis was made seeking the correlation betweenK-ras gene mutation incidence and clinical TNM staging system, tumour localisation, histological type, sex, age. Results. K-ras gene mutations were detected in 20.1% of all colorectal cancers. Significantly higher rate of K-ras gene mutations were diagnosed among patients classified at stage I (40%), stage IIC (50%) and stage IV (50%) according to the TNM classification. Conclusions. The results of our study are compatible with other studies and indicate the correlation between K-ras gene mutation and colorectal cancer incidence. Identification of K-ras gene mutation may complement other diagnostic methods at early stage of colorectal cancer.
EN
Introduction: Incidence, morbidity and 5-year survival rates illustrate the epidemiological situation of colorectal cancer and assess effectiveness of the treatment. In Poland, the National Health Fund is the payer of services. The data related to morbidity, incidence, and 5-year survival may be supplementary to the epidemiological data of the National Cancer Registry. Objective: Analysis of services granted by NHF in Bydgoszcz to persons with diagnosed colorectal cancer in 2006–2011 including the assessment of incidence, morbidity and 5-year survival of the population in the Kujawsko-Pomorskie province. Material and methods: The study analyzed the services recorded in the database of the National Health Fund in Bydgoszcz in 2006-2011 given to patients with colorectal cancer. The Kaplan-Meier method and the gambling rate were used to determine the probability of survival. Results: In 2006–2011, men were offered 10.1% more services than women. The most frequent services regarded colorectal cancer (48.9%), rectal cancer (43.8%) and esophageal cancer (7.2%). In total, 50410 services were provided. Despite increase in the number of women in the population, 388 more men died than women. The probability of survival was 46.8 % and 42.6% for men and women, respectively, furthermore 41.8%, 44.2% and 48.9% for colon cancer and esophageal and rectal folds cancer, respectively. Conclusions: In the Kujawsko-Pomorskie province during the period of 2006–2011, the number of diagnosed colorectal cancers increased as did the overall number of services provided. There was also a downward trend for the total number of services granted in relation to the increase in the number of new diagnosed cases. Incidence and morbidity rates were variable, gradually increasing in subsequent years and amounted to 59/100000 and 67/100000, 355/100000 and 408/100000 in 2010 and 2011, respectively. The probability of 5-year survival was 45.2%. Diagnosis of a disease in patients above 69 years of age increased the likelihood of death.
OncoReview
|
2020
|
tom 10
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nr 1
27-30
EN
Colorectal cancer is the second leading cause of cancer-related death worldwide. Trifluridine/tipiracil is a novel orally administered antineoplasmatic thymidine-based nucleoside analog which represents an approved option for the treatment of advanced metastatic colorectal cancer in patients who are refractory, or are not considered candidates for, currently available therapies. In this report, we present a case of chemotherapy using trifluridine/tipiracil confirming the effectiveness of this drug primarily in the term of prolongation of progression free survival.
7
Content available remote Unexpected domain composition of MACC1 links MET signaling and apoptosis
80%
EN
Colorectal cancer, one of the most challenging malignancies, still has a limited number of recognized prognostic and predictive markers indicating appropriate treatment. MACC1 (metastasis-associated in colon cancer-1), a novel regulator of tumor growth and metastasis has recently been identified as an important prognostic factor of metastatic disease in colorectal cancer. The mechanism of MACC1 activity remains undetermined. Here we apply a combination of fold recognition and homology modeling algorithms to draft MACC1 function. The applied methods revealed that the MACC1 protein consists of four domains: ZU5, SH3, and two C-terminal death domains (DD). Previously a similar domain architecture (ZU5-DD) was observed in other proteins, involved mainly in signal transduction and apoptosis regulation. Based on the specific aspects of the closest homologues' biology functional hypotheses on MACC1 are proposed. A broad range of bioinformatic analyzes indicates that MACC1, besides its involvement in signal transduction from the MET receptor, links MET signaling and apoptosis.
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Content available remote Tyrosine phosphatases as a superfamily of tumor suppressors in colorectal cancer
80%
EN
Phosphorylation and dephosphorylation processes catalyzed by numerous kinases and phosphorylases are essential for cell homeostasis and may lead to disturbances in a variety of vital cellular pathways, such as cell proliferation and differentiation, and thus to complex diseases including cancer. As over 80 % of all oncogenes encode protein tyrosine kinases (PTKs), protein tyrosine phosphatases (PTPs), which can reverse the effects of tyrosine kinases, are very important tumor suppressors. Alterations in tyrosine kinase and phosphatase genes including point mutations, changes in epigenetic regulation, as well as chromosomal aberrations involving regions critical to these genes, are frequently observed in a variety of cancers. Colorectal cancer (CRC) is one of the most common cancers in humans. CRCs occur in a familial (about 15 % of all cases), hereditary (about 5%) and sporadic (almost 75-80 %) form. As genetic-environmental interrelations play an important role in the susceptibility to sporadic forms of CRCs, many studies are focused on genetic alterations in such tumors. Mutational analysis of the tyrosine phosphatome in CRCs has identified somatic mutations in PTPRG, PTPRT, PTPN3, PTPN13 and PTPN14. The majority of these mutations result in a loss of protein function. Also, alterations in the expression of these genes, such as decreased expression of PTPRR, PTPRO, PTPRG and PTPRD, mediated by epigenetic mechanisms have been observed in a variety of tumors. Since cancer is a social and global problem, there will be a growing number of studies on alterations in the candidate cancer genes, including protein kinases and phosphatases, to determine the origin, biology and potential pathways for targeted anticancer therapy.
EN
Background: Colorectal cancer (CRC) is one of the most common malignancies in the world. The cancer stem cell (CSC) markers are associated with aggressive cancer types and poor prognosis. The objective of the study was to evaluate the CD133 expression and to correlate it with clinicopathological features in patients with CRC. Material and Methods: Our study included ninety patients with CRC who underwent curative surgical resection from 2012 to 2017 at the University Clinic for Digestive Surgery, Skopje, North Macedonia. Tumor samples were first analyzed with standard histopathological methods and then the CD133 expression was investigated immunohistochemically. The level of expression of CD133 was classified semiquantitatively. Low positivity was defined as positive immunoreactivity in <50% of tumor glands, and high positivity was defined as positive immunoreactivity in ≥50% of tumor glands. Furthermore, clinicopathological features of patients were retrospectively reviewed. Results: High expression of CD133 was found in 47.8% of patients’ CRC samples. In 69.6% of patients with metastatic lesions in visceral organs we found high expression of CD133. We found statistically significant differences in the expression of CD133 between patients with and without visceral metastatic lesions (P = 0.0153), between patients with a different T category (P = 0.0119), N status (P = 0.0066) and grade (G) (P = 0.0115). Our results showed that the stage of disease has the greatest impact on expression of CD133 (P < 0.00001). Conclusion: High expression of CD133 is a useful marker for prediction of the clinically aggressive type of CRC and can be routinely implemented in standard pathohistological diagnostics.
11
Content available PTEN – clinical significance in colorectal cancer
80%
EN
Phosphatase and tensin homolog deleted on chromosome ten (PTEN) is a human suppressor gene. Its protein product is a bispecific phosphatase playing the complex role in the cell cycle regulating processes and apoptosis by the mechanism of signal transduction into the cell via tyrosine kinase B signaling pathway (PI3K/Akt/mTOR). Reduction or loss of PTEN function is implicated in the pathogenesis of many malignancies, including colorectal cancer. A gradual decrease in the function of PTEN in the sequence of transformations: normal tissue–polyp–adenocarcinoma – disseminated cancer was indicated. The relation between the PTEN loss and the higher clinical severity of colorectal cancer was observed, i.a. higher TNM status and higher tendency to form metastases, leading in some of the studies to shortened patients survival during the observation period. The potential predictive value of the PTEN function loss for the EGFR-targeted therapy in patients with advanced colorectal cancer is the subject of controversy. The potential application of PTEN assessment in clinical practice as a prognostic and/or predictive factor requires further well-designed prospective studies on larger patient population, using the unified methodology. The aim of the study is to summarize the current knowledge on the role of PTEN gene and PTEN protein in the pathogenesis of colorectal cancer and the role of PTEN in clinical practice.
EN
Purpose: The aim of the study was to determine the significance of carcinoembryonic antigen and matrix metalloproteinase 2 peritoneal washes and serum concentration in patients suffering from colorectal cancer concerning tumor staging and 5-year survival rate in these patients. Methods: 80 patients who underwent curative surgery for colorectal cancer were included in the study. Preoperative serum and intraoperative peritoneal washes CEA and MMP-2 concentrations were measured. Results: Regarding tumor penetration, CEA-s and CEA-p concentrations were higher in subsequent stages from T2 to T4. Both CEA-s and CEA-p concentrations were lower in T2 compared to T3 and T4. Significant difference of CEA-s and CEA-p was noted between T2 and T4 stages. MMP-2-s concentration was higher in T3 compared to T2, the highest MMP-2-p concentration was in T4, with no statistical significance. Regarding nodular status, a significant difference of CEA-s was noted between N0 and N1. For CEA-p, significance was found between N0 and N2 as between N1 and N2. MMP-2-s concentration was the highest in N1, MMP-2-p concentration was the highest in T4, with no statistical significance. The 5-year survival rate for all patients was 63.53%. There were significant differences in CEA-s and CEA-p concentrations between patients with negative and positive 5-year survival. Conclusion: Intraoperative peritoneal washes concentration of CEA may potentially serve as an important factor for more precise colorectal cancer staging. CEA-p and CEA-s concentrations correlate with survival rate in patients suffering from colorectal cancer and can be useful as an additional prognostic factor. The usefulness of MMP-2 measurement still requires further studies.
EN
The aim of the study: We evaluated the connection between the presence of the -2518 A/G MCP-1 as well as 190 G/A CCR2 polymorphic variants and colorectal cancer (CRC) occurrence. Material and methods: Study group consisted of subjects with different stages of CRC as well as healthy controls. Genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Results: W observed an association between the colorectal cancer and the GG genotype of the -2518 A/G MCP-1 single nucleotide polymorphism. No statistically significant correlation was found between CRC and the 190 G/A CCR2 polymorphism. Conclusion: The results of this study support the hypothesis that polymorphism in the MCP-1 gene may contribute to the etiology of colorectal cancer.
14
80%
EN
Hereditary mixed polyposis syndrome (HMPS) is a rare condition of unknown genetic origin. The paper presents 25-year clinical follow up in a female patient with multiple gastrointestinal tract polyps of varied histology. They most likely served as sites of multiple colorectal cancers development. The clinical course is interesting in terms of diagnostics and therapy. The patient required extended genetic testing, intensive conservative treatment and numerous surgical procedures. This is the first case of HMPS presented in Polish publications.
OncoReview
|
2016
|
tom 6
|
nr 3
A134-142
EN
Introduction: Colorectal cancer is one of the most common cancers in both sexes and is one of the leading causes of death in Poland and the world. An effective method to prevent the development of colorectal cancer (CRC) is the detection of polyps during a screening colonoscopy and their removal. Objective: The aim of the study was to evaluate results of screening for early detection of colorectal cancer by colonoscopy. Material and methods: The study was based on analysis of medical records of 7965 patients who underwent colonoscopy as part of the National Screening Program (NSP) for Early Detection of Colorectal Cancer in the 2000–2014 period. Results: Polyps were removed in 2900 (36.4%) patients, among whom 1885 (23.6%) had adenomas, which were more frequent in men (32.9%). Tubular adenomas were observed in 1685 patients (21.1%), tubulo-villous adenomas were detected in 157 patients (2%) and villous adenomas – in 43 (0.5%) of them. Sixty-three (0.79%) colorectal cancers were detected in various clinical stages, including adenocarcinoma in situ in 3 patients. Probability of 5-year survival rate of colorectal cancer amounted to 74% while 10-years survival was reached in 63% of patients. Conclusions: The detection rate of polyps, adenomas and carcinomas thanks to screening colonoscopy was 36.4%, 23.6% and 0.79% respectively, while the probability of 5-year survival was 74%. An improvement in the quality of colonoscopy was observed in subsequent years of the NSP, which translated into better detection of adenomas.
EN
Introduction: Colorectal cancer is one of the most common cancers occurring in Poland. Unfortunately, this cancer is most often diagnosed at the time of great advancement. This is caused by the appearance of specific symptoms only in the late stages of cancer. Also, such low detection of early stages of adenocarcinoma may be caused by disregarding of slight symptoms. Purpose: To analyse symptoms in patients with colorectal cancer and correlate with chosen clinical-pathological parameters. Materials and methods: The study group consisted of 46 patients diagnosed with colorectal cancer. Information on symptoms associated with cancer (subjective and objective) have been selected from patients' medical history. The presence of these symptoms was correlated with the age and sex of patients, tumor location, histological type of cancer, grade of histological malignancy (G), stage of tumor (T stage), presence of lymph node metastases and distant metastases. Results: It has been shown that the presence of pain complaints described by the patient are associated with the occurrence of cancer in the colon. The painfulness and pathological resistance diagnosed by the physician are more often associated with cancer located in the colon. In the case of tumors located in the rectum, faecal admixtures appear more frequently. It has also been shown that the presence of admixtures of blood and mucus in the stool is associated with more advanced local tumors, infiltrating pericolorectal tissues (T3 + T4). Conclusions: Familiarity with clinical symptoms of colorectal cancer could make patients more sensitive to more often screening for cancer. Analysis of these symptoms could indicate to the physician the location or stage of the cancer.
EN
The 30-day mortality is one of the factors reflecting the quality of treatment. All these efforts focused on decreasing 30-day mortality will directly improve quality of care. The aim of the study was to identify risk factors of 30-day postoperative mortality in a cohort of patients operated on for colorectal cancer in one tertiary colorectal centre. Material and methods. Patients operated on due to colorectal cancer (CRC) between 2008 and 2014 were included in the study. 30-day mortality was assessed as an endpoint of the retrospective study. All records were collected from prospective database. Results. 1744 patients were operated on due to CRC. The 30-day mortality was noted in 65 patients (3.5%). In multivariable analyses we revealed that spread disease and poor general condition at admission were risk factors of 30-day mortality: OR 2.35; 2.01‑2.57 95%CI, p=0.03 and OR 2.18; 1.95‑2.41 95% CI; p=0.01, respectively. Emergency surgery significantly increased the risk of 30-day mortality: OR 2.64; 2.45‑2.87 95%CI; p=0.009. Low serum albumin concentration level and diabetes mellitus were additional risk factors for 30-day mortality, OR 1.65; 1.52‑1.78 95%CI; p=0.01 and OR 1.67; 1.41‑1.82 95%CI; p=0.03, respectively. Mortality was significantly higher after resection procedures than after only palliative operations: 4.21% vs 1.57%; p=0.002. Conclusions. Emergent patients, patients with advanced disease and in poor general state have to be assessed by multidisciplinary team to prepare them to operation. Additionally to reduce the risk of 30-day mortality decision of extend of surgery should be made by experienced surgeons.
EN
Participation of DNA repair systems in the pathogenesis of cancer has been a suspected phenomenon for a long time. Decreased efficiency in DNA repair translates to their ability to fix and consequently leads to mutations and the process of carcinogenesis. Linking individual polymorphisms of DNA repair systems with an increased risk of colorectal cancer will allow the classification of patients to high-risk groups and their placement under preventive program. The aim of the study was to determine the effect of XPF gene polymorphism Ser835Ser on increasing the risk of colorectal cancer in the Polish population. Material and methods. as the material blood collected from 146 patients diagnosed with colon cancer was used. The control group consisted of 149 healthy subjects. Genotyping was performed by Taq- Man method. Results. The results indicate that genotype TCC/TCT is associated with an decreased risk of colorectal cancer (OR 0.574; CI 95% 0.335-0.984; p=0.043). Conclusions. Based on these results, we conclude that the XPF gene polymorphism Ser835Ser may be associated with a decreased risk of colorectal cancer
EN
Colorectal cancer (CRC) is one of the deadliest cancers which lie in the incidence of morbidity in second place. Intensive research is to determine and confirm the genetic basis of this disease, which is believed may have a direct relationship with the reduced efficiency of DNA repair systems. The aim of this study was to determine the effect of APEX gene polymorphism Ile64Val on increasing the risk of colorectal cancer in the Polish population. Material and methods. The blood samples collected from 150 patients diagnosed with colon cancer was used. The control group consisted of 150 healthy subjects. Genotyping was performed by TaqMan method. Results. The results indicate that genotype Ile Val is associated with an increased risk of colorectal cancer (OR 2.069; 95% CI 1,205-3,552; p = 0.008). Conclusions. Based on these results, we conclude that the APEX gene polymorphism Ile64Val may be associated with an increased risk of colorectal cancer.
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80%
OncoReview
|
2016
|
tom 6
|
nr 2
A72-76
EN
Cancer causes huge problems, physical and mental nature mainly. In particular, we cannot forget about the functioning of these patients in the social and spiritual spheres. The increasing trend of incidence of rectal cancer makes the disease is becoming a priority for doctors, nurses and psycho-oncologists. Despite the increasing quality of medical services, patients face a number of problems associated with cancer treatment, which may result in formation of a colostomy. The procedure, which is necessary to save the patient’s life, is often perceived by them as “mutilation”. Acceptance of the disease and satisfaction of life in patients with a stoma after the operation for rectal cancer are dependent on many factors. Social support, living conditions and the time elapsed since creation of the stoma have great impact. “Stoma nurse” plays an extremely important role. Seeing the difficulties in adapting the stoma she should verify the patient’s pessimism as to his/her own self, develops a sense of responsibility from minor to major issues and strengthen a sense of independence.
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