1,481,344 research outputs found
Diabetes alone should not be a reason for withholding adjuvant chemotherapy for stage III colon cancer
No full textBackground: With increasing prevalence of diabetes mellitus and colon cancer, the number of patients suffering from both diseases is growing, and physicians are being faced with complicated treatment decisions. Objective: To investigate the association between diabetes and treatment/course of stage III colon cancer and the association between colon cancer and course of diabetes. Materials and Methods: Additional information was collected from the medical records of all patients with both stage III colon cancer and diabetes (n=201) and a random sample of stage III colon cancer patients without diabetes (n=206) in the area of the population-based Eindhoven Cancer Registry (1998–2007). Results: Colon cancer patients without diabetes were more likely to receive adjuvant chemotherapy compared with diabetic colon cancer patients (OR 1.8; 95% CI 1.2–2.7). After adjustment for age, this difference was borderline significant (OR 1.6; 95% CI 1.0–2.6). Diabetic patients did not have: significantly more side-effects from surgery or adjuvant chemotherapy; more recurrence from colon cancer; significantly shorter time interval until recurrence; or a poorer disease-free survival or overall survival. Age and withholding of adjuvant chemotherapy were most predictive of all-cause mortality. After colon cancer diagnosis, the dose of antiglycaemic medications was increased in 22% of diabetic patients, resulting in significantly lower glycaemic indexes than before colon cancer diagnosis. Conclusions: Since diabetic patients did not have more side-effects of adjuvant chemotherapy, and adjuvant chemotherapy had a positive effect on survival for both patients with and without diabetes, diabetes alone should not be a reason for withholding adjuvant chemotherapy.Journal of Comorbidity 2011;1(1):19–2
Comparison of Oncological Outcomes After Curative Resection for Right-side Colon Cancer and Left-side Colon Cancer: a Retrospective Observational Study
No full textAim: This study aims to compare clinicopathological findings and oncological outcomes after curative resection between right-side colorectal carcinoma (RCC) and left-side colorectal carcinoma (LCC).
Method: A retrospective review of 209 patients who underwent elective surgery for right and left colon cancer between January 2013 and October 2022 was conducted. After applying the exclusion criteria, 182 patients were included. The patients were grouped based on embryological development: right side (cecum, ascending colon, hepatic flexure, and proximal transverse colon) and left side (distal transverse colon, splenic flexure, descending colon, and sigmoid colon). Clinicopathological features, lymph node removal, and oncological outcomes were compared. Statistical analyses were performed using the chi-squared test, Fisher’s exact test, Mann-Whitney U test, the Kaplan-Meier method, and Cox regression analysis.
Results: Among the 182 patients, 108 (59.3%) had RCC, and 74 (40.7%) had LCC. No significant differences were found between the groups regarding age, gender, body mass index, carcinoembryonic antigen value, tumor size, T/N stage, lymphovascular/perineural invasion, positive lymph nodes, and hospital stay. However, more lymph nodes were removed in RCC cases (p<0.0001). Oncologically, 32.4% of the patients with RCC and 29.7% of the patients with LCC died during follow-up, with no difference in mean survival. Multivariate analysis identified age and tumor size as prognostic factors for 5-year survival.
Conclusion: Despite clinical and pathological differences between RCC and LCC, no significant difference was observed in 2- and 5-year survival. Early diagnosis and personalized treatment remain crucial for both cancer types. Further large-scale studies are recommended
Hyperspectral texture analysis for colon tissue biopsy classification
No full textDiagnosis and cure of colon cancer can be improved by performing automated histopathological analysis of colon biopsy samples. Due to significant observational variation between pathologists in several histological features, there is a need for the development of automated, quantitative analysis techniques. This paper presents a promising automative technique for the classification of hyperspectral colon tissue biopsy images. The application of hyperspectral imaging techniques in medical image analysis is a new domain for researchers. The main advantage of using hyperspectral imaging is the increased spectral resolution and detailed subpixel information. The proposed classification algorithm is based on the subspace projection techniques particularly Support Vector Machines (SVM) with Gaussian Kernel. Dimensionality reduction and tissue segmentation is achieved by Independent Component Analysis (ICA) and k-means clustering. Morphological features, which describe the shape, orientation and other geometrical attributes, are extracted in first set of experiments. Grey level cooccurrence matrices are computed for the second set of experiments. The SVM with appropriate choice of parameters for its Gaussian kernel efficiently exploits the non linear boundary between the benign and malignant classes of the colon tissue biopsies
Heme iron from meat and risk of colorectal cancer: a meta-analysis and a review of the mechanisms involved
No full textRed meat and processed meat intake is associated with a risk of colorectal cancer, a major cause of death in affluent countries. Epidemiological and experimental evidence supports the hypothesis that heme iron present in meat promotes colorectal cancer. This meta-analysis of prospective cohort studies of colon cancer reporting heme intake included 566,607 individuals and 4,734 cases of colon cancer. The summary relative risk of colon cancer was 1.18 [95%C.I.: 1.06-1.32] for subjects in the highest category of heme iron intake compared with those in the lowest category. Epidemiological data thus show a suggestive association between dietary heme and risk of colon cancer. The analysis of experimental studies in rats with chemically-induced colon cancer showed that dietary hemoglobin and red meat consistently promote aberrant crypt foci, a putative pre-cancer lesion. The mechanism is not known, but heme iron has a catalytic effect on (i) the endogenous formation of carcinogenic N-nitroso compounds and (ii) the formation of cytotoxic and genotoxic aldehydes by lipoperoxidation. A review of evidence supporting these hypotheses suggests that both pathways are involved in heme iron toxicit
Co-occurrence and morphological analysis for colon tissue biopsy classification
No full textDiagnosis and cure of colon cancer can be improved by efficiently classifying the colon tissue cells from biopsy slides into normal and malignant classes. This paper presents the classification of hyperspectral colon tissue cells using morphology of gland nuclei of cells. The application of hyperspectral imaging techniques in medical image analysis is a new domain for researchers. The main advantage of using hyperspectral imaging is the increased spectral resolution and detailed subpixel information. The proposed classification algorithm is based on the subspace projection techniques. Support vector machine, with 3rd degree polynomial kernel, is employed in final set of experiments. Dimensionality reduction and tissue segmentation is achieved by Independent Component Analysis (ICA) and k-means clustering. Morphological features, which describe the shape, orientation and other geometrical attributes, are extracted in one set of experiments. Grey level co-occurrence matrices are also computed for the second set of experiments. For classification, kernel discriminant analysis (LDA) with co-occurrence features gives comparable classification accuracy to SVM using a gaussian kernel. The algorithm is tested on a limited set of samples containing ten biopsy slides and its applicability is demonstrated with the help of measures such as classification accuracy rate and the area under the convex hull of ROC curves
Experts reviews of the multidisciplinary consensus conference colon and rectal cancer 2012: Science, opinions and experiences from the experts of surgery
No full textThe first multidisciplinary consensus conference on colon and rectal cancer was held in December 2012, achieving a majority of consensus for diagnostic and treatment decisions using the Delphi Method. This article will give a critical appraisal of the topics discussed during the meeting and in the consensus document by well-known leaders in surgery that were involved in this multidisciplinary consensus process. Scientific evidence, experience and opinions are collected to support multidisciplinary teams (MDT) with arguments for medical decision-making in diagnosis, staging and treatment strategies for patients with colon or rectal cancer. Surgery is the cornerstone curative treatment for colon and rectal cancer. Standardizing treatment is an effective instrument to improve outcome of multidisciplinary cancer care for patients with colon and rectal cancer. In this article, a review of the following focuses; Perioperative care, age and colorectal surgery, obstructive colorectal cancer, stenting, surgical anatomical considerations, total mesorectal excision (TME) surgery and training, surgical considerations for locally advanced rectal cancer (LARC) and local recurrent rectal cancer (LRRC), surgery in stage IV colorectal cancer, definitions of quality of surgery, transanal endoscopic microsurgery (TEM), laparoscopic colon and rectal surgery, preoperative radiotherapy and chemoradiotherapy, and how about functional outcome after surgery
Glycemic index, nutrient density, and promotion of aberrant crypt foci in rat colon
No full textWe speculated that a diet with a high glycemic index (GI), or a diet with a low nutrient density (nutrient-to-calorie ratio), would enhance colon carcinogenesis, presuma-bly via increased insulin resistance. Forty-eight female Sprague -Dawley rats (SD) received an azoxymethane injection (20mg /kg) and were randomized to 5 groups given an AIN76 diet containing (1) 65% starch by wt. (2) 65% glucose, GI=100, (3) 65% fructose, GI=23, (4) 82% starch, or (5) 39% oil and 39% sucrose. The nutrient density was halved in 45 diets compared to 13 diets. Promotion was assessed by the multi-plicity (number of crypts) of aberrant crypt foci (ACF), an early marker of colon carcinogenesis. Insulin resistance was estimated by (blood insulin x blood glucose), by plasma triglycerides, and by visceral fat. To confirm the results in another rat strain, the whole experiment was duplicated in 48 female Fischer F344 rats. Results show that: (i) ACF multiplicity was not different in glucose- and fructose-fed rats (p>0.7): diets with contrasting GI had the same effect on ACF growth. (ii) Diets of low nutrient density increased visceral fat (p<0.05), but reduced the ACF size in F344 (p<0.001, no reduction in SD). (iii) Indirect insulin resistance markers (FIRI index, blood triglycerides, visceral fat) did not correlate with ACF multiplicity. These results do not support the hypothesis that diets with a high glycemic index, or of low nutrient density, or diets that increase some indirect insulin resistance markers, can promote colon carcinogenesis in female rats
Dehydroalanine and Lysinoalanine in Thermolyzed Casein do not Promote Colon Cancer in the Rat
No full textThermolysis of proteins produces xenobiotic amino-acids such as the potentially toxic lysinoalanine, and the alkylating agent, dehydro¬alanine, which have been considered possible health hazards. We observed that thermolysed casein promoted aberrant crypt foci (ACF) and colon cancer growth in rats initiated with azoxymethane and speculated that promotion might be due to the formation of these compounds. To test this notion we first measured the concentration of the modified amino acids as a function of thermolysis time. The concentration of dehydroalanine in the casein paralleled the degree of promotion, that of lysinoalanine did not. We then tested diets containing foods with high levels of dehydroalanine (thermolysed sodium-caseinate, cooked Swiss cheese) for their effect on ACF promotion. They decreased the number and/or size of ACF significantly, indicating that dehydroalanine did not promote, but protected rats against colon carcinogenesis. These results do not support the notion that lysinoalanine or dehydroalanine are a hazard with respect to colon carcinogenicity
Classification of colon biopsy samples by spatial analysis of a single spectral band from its hyperspectral cube
No full textThe histopathological analysis of colon biopsy samples is a very important part of screening for colorectal cancer. There is, however, significant inter-observer and even intra-observer variability in the results of such analysis due to its very subjective nature. Therefore, quantitative methods are required for the analysis of histopathological images to aid the histopatholgists in their diagnosis. In this paper, we exploit the shape and structure of the gland nuclei cells for the classification of colon biopsy samples using two-dimensional principal component analysis (2DPCA) and Support Vector Machine (SVM). We conclude that the use of textural features extracted from non-overlapping blocks of the histopathological images results in a non-linear decision boundary which can be efficiently exploited using a SVM with appropriate choice of parameters for its Gaussian kernel. The SVM classifier outperforms all the remaining methods by a clear margin
Fruits, vegetables, and hMLH1 protein-deficient and -proficient colon cancer: The Netherlands cohort study.
No full textBACKGROUND: Clinical and pathologic differences exist between colon carcinomas deficient and proficient in the mismatch repair protein hMLH1. Animal and in vitro studies suggest that fruits, vegetables, folate, and antioxidants are associated with colonic expression of mismatch repair genes. METHODS: Associations between consumption of fruits and vegetables and hMLH1 protein-deficient and -proficient colon cancer were evaluated in the Netherlands Cohort Study on diet and cancer using a case-cohort approach. A self-administered food frequency questionnaire was completed, in 1986, by 120,852 individuals ages 55 to 69 years. Using immunohistochemistry, hMLH1 protein expression was assessed in colon cancer tissue obtained from 441 patients who were identified over 7.3 years of follow-up excluding the initial 2.3 years. Incidence rate ratios (RR) were estimated for hMLH1 protein-deficient and -proficient colon cancer. RESULTS: hMLH1 protein expression was absent in 54 tumors (12.2%) and present in 387 tumors. Fruit consumption was associated with hMLH1 protein-deficient colon cancer [highest versus lowest tertile, RR, 0.46; 95% confidence interval (95% CI), 0.23-0.90; P(trend) = 0.029] but not with hMLH1 protein-proficient tumors (highest versus lowest tertile, RR, 1.03; 95% CI, 0.78-1.35; P(trend) = 0.81). Total consumption of vegetables was not associated with either type of tumor (hMLH1 protein deficient: RR, 0.86; 95% CI, 0.45-1.65; P(trend) = 0.67; hMLH1 protein proficient: RR, 0.94; 95% CI, 0.72-1.23; P(trend) = 0.72). No associations were observed for folate, fiber, antioxidants, or subgroups of vegetables. CONCLUSION: These analyses indicate that an inverse association between consumption of fruits and colon cancer may be confined to the subgroup of tumors with a deficient mismatch repair system
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