Colon Rectal Cancer Research Articles

Clinicopathological and Molecular Features of Colorectal Cancer Patients With Mucinous and Non-Mucinous Adenocarcinoma.

BackgroundThe prognosis of mucinous adenocarcinoma (MAC) and non-mucinous adenocarcinoma (NMAC) in colorectal cancer (CRC) is controversial, and the molecular differences between them are unclear.MethodsBetween 2000 and 2010, a total of 1,483 CRC patients were included. Among them, 73 patients (4.9%) were diagnosed with MAC. The clinicopathological features and genetic alterations were compared between MAC and NMAC.ResultsAfter propensity score matching to balance age and sex between MAC and NMAC patients, 292 CRC patients (73 MAC and 219 NMAC) were enrolled in the analysis at a 1:3 ratio. In right-sided colon cancer, patients with MAC were more likely to have Borrmann types 3 and 4 tumors, poor differentiation, and advanced T category and tumor, node, metastasis (TNM) stage, chemotherapy, and a similar 5-year overall survival (OS) rate compared with patients with NMAC. In left-sided colon cancer and rectal cancer, patients with MAC were more likely to have Borrmann types 3 and 4 tumors, poor differentiation, lymphovascular invasion, advanced T and N categories and TNM stages, chemotherapy, and a worse 5-year OS rate than patients with NMAC. Regarding genetic alterations, for NMAC, right-sided colon cancer had more BRAF mutations than left-sided colon cancer and rectal cancer. For MAC, right-sided colon cancer was associated with more microsatellite instability-high tumors and more AKT1 mutations than left-sided colon cancer and rectal cancer.ConclusionThe genetic alterations are distinct between MAC and NMAC in CRC. Tumor location may have an impact on genetic alterations and patient prognosis in MAC and NMAC.

Differential Expression of miR-20a and miR-145 in Colorectal Tumors as Potential Location-specific miRNAs.

MicroRNAs (miRNAs), as tissue specific regulators of gene transcription, may be served as biomarkers for Colorectal Cancer (CRC). This study aimed to investigate the potential role of the cancer-related hsa-miRNAs as biomarkers in Colon Cancer (CC) and Rectal Cancer (RC). A total of 148 CRC samples (74 rectum and 74 colon) and 74 adjacent normal tissues were collected to examine the differential expression of selected ten hsa-miRNAs using quantitative Reverse Transcriptase PCR (qRT-PCR). The significantly elevated levels of miR-21, miR-133b, miR-18a, miR-20a, and miR-135b, and decreased levels of miR-34a, miR-200c, miR-145, and let-7g were detected in colorectal tumors compared to the healthy tissues (P<0.05). Hsa-miR-20a was significantly overexpressed in rectum compared to colon (p =0.028) from a cut-off value of 3.15 with a sensitivity of 66% and a specificity of 60% and an AUC value of 0.962. Also, hsa-miR-145 was significantly overexpressed in colon compared to the rectum (p =0.02) from a cut-off value of 3.9 with a sensitivity of 55% and a specificity of 61% and an AUC value of 0.91. In conclusion, hsa-miR-20a and hsa-miR-145, as potential tissue-specific biomarkers for distinguishing RC and CC, improve realizing the molecular differences between these local tumors.

Incidence of colorectal cancers in India

A number of studies on population-based cancer registries (PBCRs) data have been reported from India about various cancers. However, updated status of colorectal cancer is not available in literature. The objective is to provide an overview of age-specific and age-adjusted colorectal cancer incidence reported in 27 PBCRs in India. Secondary data on age-specific and age-adjusted rates of incidence rate, the lifetime risk of the disease was computed using cumulative risk and a number of cases for all ages (0–75 years), were collected from the report of the National Cancer Registry Program 2012-2014 in 27 population-based control registries. The annual incidence rates (AARs) for colon cancer and rectal cancer in men are 5.36 and 5.17/100,000, respectively. The AAR for colon cancer in women is 4.3/100,000. Males were comparably at higher risk than females. The maximum lifetime risk of developing colon cancer ranged from 167 to 500 females and lifetime risk of developing rectum cancer ranged from 100 to 353 in males. The risk of colorectal cancers was high amongst the Northeast population followed by South regions of India. The management of colon and rectal cancer cases and screening could serve to control the disease.

Abstract PR-10: Identifying new risk factors for early-onset CRC in population under 50 years old using EHR-based machine learning

Abstract Objective: Colorectal cancer (CRC) is the 3rd most common cancer in the United States. Despite declining incidence in patients older than 50, there has been an increasing trend of CRC in patients under the age of 50. Some risk factors such as inflammatory bowel disease and inherited genetic syndromes can lead to early onset of CRC; yet incidence of these disorders is not concomitant with the increase of CRC under 50 years old. This study utilizes machine learning models with electronic health records (EHR) data from the OneFlorida network—a clinical research network contributing to the national PCORnet to demonstrate a potential avenue for investigation of the rise in incidence. Methods: This study applied four machine learning algorithms on a cohort of 1,227 CRC cases and matched 34,157 controls, all under the age of 50 extracted from the OneFlorida network. Colon cancer (CC) and rectal cancer (RC) were modeled separately. For each case patient, we created a prediction window starting from the first recorded encounter in their EHR to end dates of 0, 1, 3, and 5 years prior to the case CC/RC index date. For each control patient we matched them to cases based on age at an encounter date to close to the case index date. The data was split into a training set (80%) for training the models, and a testing set (20%) used to measure model performance. SHapley Additive exPlanations (SHAP) was used to analyze significant features. Results: Notable trends in model prediction results were decreased sensitivity across prediction windows as data per patient decreased, in both RC and CC cohorts. Zero-year and 1-year prediction area under the curve (AUC) was significant at 0.64 to 0.75 for all algorithms across RC and CC. As the prediction window widened, the prediction performance dropped to as low as 0.35 (i.e., 5-year prediction). The best performing algorithm across all experiments was the support vector machine (SVM). Top predictors identified in the CC cohort include hypertension, cough/asthma, chronic sinusitis, anxiety d/o, and atopic dermatitis, while top predictors in the RC cohort include obesity, female gender, HIV, anxiety d/o and asthma. Conclusions: Disorders with chronic immunosuppression (e.g., HIV) or inflammation (e.g., obesity, asthma, sinusitis, dermatitis) may represent immune-axis derangements contributing to a favorable state for CRC. This preliminary study provides early insight into the capacity of artificial intelligence to uncover new risk factors in the population of patients with onset of young-onset CRC with more algorithm refinement and risk factor exploration underway. Citation Format: Michael B. Quillen, Taylor M. Parker, Jiang Bian, Thomas George. Identifying new risk factors for early-onset CRC in population under 50 years old using EHR-based machine learning [abstract]. In: Proceedings of the AACR Virtual Special Conference on Artificial Intelligence, Diagnosis, and Imaging; 2021 Jan 13-14. Philadelphia (PA): AACR; Clin Cancer Res 2021;27(5_Suppl):Abstract nr PR-10.

Post-transcriptional suppression of G protein-coupled receptor 15 (GPR15) by microRNA-1225 inhibits proliferation, migration, and invasion of human colorectal cancer cells

The G protein-coupled receptors (GPRs) have been shown to regulate several cancer related processes. The aberrant expression of GPRs has been linked to the development of several cancers. The present study was designed to examine the expression and decipher the role of GPR15 in the development of human colorectal cancer. The results revealed GPR15 to be significantly (P < 0.05) upregulated in colorectal cancer cells. The silencing of GPR15 inhibited the growth of the colorectal cancer cells via induction of apoptosis. Induction of apoptosis in colorectal cancer cells was associated increase in Bax and decrease in Bcl-2 expression. The silencing of GPR-15 also caused a significant (P < 0.05) decline in the migration and invasion of the colorectal cancer cells. Bioinformatic analysis and luciferase assay revealed that the expression of GPR15 to be post-transcriptionally regulated by microRNA-1225 (miR-1225). The expression of miR-1225 was found to significantly (P < 0.05) downregulated in colorectal cancer cells and its overexpression caused suppression of GPR15 and inhibited the proliferation of the colorectal cancer cells. Nonetheless, overexpression of GPR15 could avoid the growth inhibitory effects of miR-1225. The results suggest that the GPR15/miR-1225 axis play an important role in the development of colon rectal cancer and exhibit therapeutic implications for its treatment.

Artificial Intelligence in Decision-Making for Colorectal Cancer Treatment Strategy: An Observational Study of Implementing Watson for Oncology in a 250-Case Cohort.

BackgroundPersonalized and novel evidence-based clinical treatment strategy consulting for colorectal cancer has been available through various artificial intelligence (AI) supporting systems such as Watson for Oncology (WFO) from IBM. However, the potential effects of this supporting tool in cancer care have not been thoroughly explored in real-world studies. This research aims to investigate the concordance between treatment recommendations for colorectal cancer patients made by WFO and a multidisciplinary team (MDT) at a major comprehensive gastrointestinal cancer center.MethodsIn this prospective study, both WFO and the blinded MDT’s treatment recommendations were provided concurrently for enrolled colorectal cancers of stages II to IV between March 2017 and January 2018 at Shanghai Minimally Invasive Surgery Center. Concordance was achieved if the cancer team’s decisions were listed in the “recommended” or “for consideration” classification in WFO. A review was carried out after 100 cases for all non-concordant patients to explain the inconsistency, and corresponding feedback was given to WFO’s database. The concordance of the subsequent cases was analyzed to evaluate both the performance and learning ability of WFO.ResultsOverall, 250 patients met the inclusion criteria and were recruited in the study. Eighty-one were diagnosed with colon cancer and 189 with rectal cancer. The concordances for colon cancer, rectal cancer, or overall were all 91%. The overall rates were 83, 94, and 88% in subgroups of stages II, III, and IV. When categorized by treatment strategy, concordances were 97, 93, 89, 87, and 100% for neoadjuvant, surgery, adjuvant, first line, and second line treatment groups, respectively. After analyzing the main factors causing discordance, relative updates were made in the database accordingly, which led to the concordance curve rising in most groups compared with the initial rates.ConclusionClinical recommendations made by WFO and the cancer team were highly matched for colorectal cancer. Patient age, cancer stage, and the consideration of previous therapy details had a significant influence on concordance. Addressing these perspectives will facilitate the use of the cancer decision-support systems to help oncologists achieve the promise of precision medicine.

Treatment patterns and primary reasons for adjusted treatment in older and younger patients with stage II or III colorectal cancer

ObjectiveThis study aims to assess age-related treatment patterns and primary reasons for adjusted treatment in patients with colorectal cancer. MethodsPatients with colorectal cancer stage II or III diagnosed between 2015 and 2018 in the Netherlands were eligible for this study. Data were provided by the Netherlands Cancer Registry and included socio-demographics, clinical characteristics, treatment patterns and primary reasons for adjusted treatment. Treatment patterns and reasons for adjusted treatment were analysed according to age groups. ResultsOf all 29,620 patients, 30% were aged <65 years (n = 8994), 34% between 65 and 75 years (n = 10,173), 27% between 75 and 85 years (n = 8102) and 8% were ≥85 years (n = 2349). Irrespective of cancer location or stage, older patients received less frequently a combination of surgery and (neo)adjuvant therapy compared to younger patients (decreasing from 55% to 1% in colon cancer patients, and from 71% to 23% in rectal cancer patients aged <65 years and ≥85 years respectively). Omission of surgical treatment increased with age in both patients with colon cancer (ranging from 1% in patients aged <65 years to 16% in those ≥85 years) and rectal cancer (ranging from 12% in patients aged <65 years to 56% in those ≥85 years). The most common reasons for adjusted treatment were patient preference (27%) and functional status (20%), both reasons increased with advancing age. ConclusionsGuideline non-adherence increased with advancing age and omission of standard treatment was mainly based on patient preference and functional status. These findings provides insight in the treatment decision-making process in patients with colorectal cancer. Future research is necessary to further assess patient’s role in the treatment decision-making process.

Are colorectal cancer patients at risk for COVID-19 infection during the postoperative period? The Covid-GRECCAR study.

IntroductionDuring the COVID-19 pandemic, cancer patients have been regarded as having a high risk of severe events if they are infected with SARS-CoV-2, particularly those under medical or surgical treatment. The aim of this study was to assess the posttreatment risk of infection by SARS-CoV-2 in a population of patients operated on for colorectal cancer 3 months before the COVID-19 outbreak and who after hospitalization returned to an environment where the virus was circulating.Materials and methodsThis French, multicenter cohort study included consecutive patients undergoing elective surgery for colorectal cancer between January 1 and March 31, 2020, at 19 GRECCAR hospitals. The outcome was the rate of COVID-19 infection in this group of patients who were followed until June 15, 2020.ResultsThis study included 448 patients, 262 male (58.5%) and 186 female (41.5%), who underwent surgery for colon cancer (n = 290, 64.7%), rectal cancer (n = 155, 34.6%), or anal cancer (n = 3, 0.7%). The median age was 68 years (19–95). Comorbidities were present in nearly half of the patients, 52% were at least overweight, and the median BMI was 25 (12–42). At the end of the study, 448 were alive. Six patients (1.3%) developed COVID-19 infection; among them, 3 were hospitalized in the conventional ward, and none of them died.ConclusionThe results are reassuring, with only a 1.3% infection rate and no deaths related to COVID-19. We believe that we can operate on colorectal cancer patients without additional mortality from COVID-19, applying all measures aimed at reducing the risk of infection.

Review on Colonrectal Cancer

The aim of the study of colon cancer is to introduce the basic information of cancer cell and the basic information of colon cancer. The research on colon cancer gave the information about hallmarks of cancer cell. exaggerated continuous proliferation, resistance to cell death as well as tumor suppressors, angiogenesis, spreading and metastasis and replicative immortality, the symptoms of colon cancer: Frequent bowel dysfunction (Diarrhea-constipation), Abdominal pain, nausea &amp; vomiting, Pain during defecation, and Bloating, the types of colon cancer: Familial Adenomatous Polyposis (FAP) and Lynch syndrome, nonpolyposis Colorectal Cancer, and the treatment of colon cancer: Treatment strategies differ according to the stage and development of the tumor. Surgery and adjuvant chemo are the two common methods in stages 2 and 3 of the disease. Palliative care is most common in patients at stage 4 to improve quality of life. The information which extracted from papers from other researchers formed the research of colon cancer.

Design and implementation of cancer patient survival prediction model based on ensemble learning method

To study the impact of genomics on cancer diseases, bioinformatics and integrated learning methods are used to conduct survival analysis on colon cancer and rectal cancer data in the cancer gene map database. Firstly, according to the significant expression and stability test, the long-chain non-coding RNA in the transcriptome that has a significant impact on clinical prognosis survival analysis was initially screened. Then use a random forest ensemble learning algorithm to train it to get a preliminary model. Finally, based on the optimized random survival forest model, the Cox regression model was once again integrated, and the risk values of the two were integrated. The RCCT (Random-Cox Combined to Survival) method was proposed to provide clinical decision-makers certain reference values.

The Role of Interleukin-22 Receptor1 in the Proliferation and Apoptosis of Colonrectal Cancer

Background: To study the relationship between interleukin-22 receptor1 (IL-22R1) and the proliferation and apoptosis of colon cancer cells. Methods: SW480, SW620 (Human Colorectal Cancer Cell Lines) that express positive to IL-22R1 were exposed in the environment of IL-22. The proliferation trial included 5 groups: IL-22, 5-FU, 5-FU + IL-22, medium and control. The apoptosis trial included 4 groups: IL-22, 5-FU, 5-FU + IL-22 and control. The result of apoptosis was detected by Apoptosis Kit (AnnxinVPE and 7-AAD), and proliferation was detected by Ki67 antibody (Cell proliferation-associated nuclear antigens). The rates of proliferation and apoptosis were detected by flow cytometry. Changes of the rate of proliferation and apoptosis before and after silencing were compared and analyzed statistically after silencing the gene of IL-22R1. Result: The combination of IL-22R1 and IL-22 could significantly inhibit the apoptosis of colon cancer cells and promote the proliferation of colon cancer cells (P &lt; 0.05). The effect was significantly weakened when IL-22R1 was silenced (P &lt; 0.05). Conclusion: IL-22R1 combined with IL-22 could promote the proliferation and inhibit apoptosis of colorectal cancer cells. In addition, blocking IL-22R1 could eliminate the influence of IL-22 on the proliferation and apoptosis of colorectal cancer cells.

Polyaniline-based field effect transistor for DNA/RNA biomarker sensing: Comparison to electrochemical impedance and inorganic layer

One relevant aspect of the research in materials science focus on studying materials properties for applications in the field of sensing and biosensing devices aiming to obtain portable, stable, sensitive, and low-cost detection systems for a broad range of diseases, traumas, and infections. We report a polyaniline (PANI)-based extended-gate field effect transistor DNA/RNA (DNA-EGFET) biosensor. The biosensor is based on a functionalized Au reference electrode with thiolated bio-receptor single-strand DNA (ssDNA) corresponding to the μDNA-224, an overexpressed DNA biomarker sample for rectal colon cancer, and the transduction system is based on an electrodeposited PANI thin film as sensing stage. Variations on net surface charge of the hybridized single strand DNA led to changes of the output voltage from the FET system, which could be correlated to the concentration of the detected complementary DNA. Comparison between the potentiometric EGFET biosensor and the electrochemical impedance spectroscopy (EIS) biosensor used for DNA/RNA measurements and the use of organic and inorganic (metal oxide) semiconducting sensing materials were performed. This DNA-EGFET biosensor offered fast response, sensitivity of 3.3 ± 0.3 mV/log[tDNA], linearity of 96 % in a detection range from 1 pmol/L to 1 μmol/L and LoD of 9.77 pmol/L in buffer solution. The application and comparison of the PANI based DNA-EGFET for measurements of DNA biomarkers was demonstrated as a proof-of-concept of the advantages and easy fabrication of the device.

Circulating liver function markers and colorectal cancer risk: A prospective cohort study in the UK Biobank.

Evidence links the liver to development of colorectal cancer (CRC). However, it remains unknown how liver function may influence CRC risk in the general population. We conducted a prospective cohort study in the UK Biobank of 375 693 participants who provided blood samples in 2006 to 2010. Circulating levels of liver function markers (alanine transaminase [ALT], aspartate transaminase [AST], total bilirubin [TBIL], gamma glutamyltransferase [GGT], alkaline phosphatase [ALP], total protein [TP] and albumin [ALB]) were measured. Incident cancer cases were identified through linkage to the national cancer registry up to 2019. Repeated biomarker measurements were available from a subset of 11 320 participants who were re-assessed in 2012 to 2013. After a median follow-up of 10.0 years, we documented 2662 cases of CRC. Circulating levels of ALT, AST, TBIL, GGT, TP and ALB at baseline were inversely associated with CRC risk (P < .01), with multivariable hazard ratio (95% confidence interval) comparing decile 10 vs 1 of 0.62 (0.51-0.75), 0.63 (0.53-0.75), 0.85 (0.72-1.02), 0.74 (0.61-0.89), 0.70 (0.59-0.84) and 0.66 (0.55-0.79), respectively. Strengthened associations were found after recalibration for repeated measurements. The associations appeared stronger for proximal colon cancer than distal colon cancer and rectal cancer, but consistent for early-, mid- and late-onset CRC. In a large cohort of general population, the UK Biobank, higher circulating levels of ALT, AST, TBIL, GGT, TP and ALB, largely within the normal range, were associated with a lower risk of CRC. The findings support a link between liver function and CRC, and may spur future research on the gut-microbiota-liver axis.

Anti-Proliferative Activity of A Hydrophilic Extract of Manna from Fraxinus angustifolia Vahl through Mitochondrial Pathway-Mediated Apoptosis and Cell Cycle Arrest in Human Colon Cancer Cells.

Manna is produced from the spontaneous solidification of the sap of some Fraxinus species, and, owing its content in mannitol, is used in medicine as a mild laxative. Manna is also a rich source of characteristic bio-phenols with reducing, antioxidant and anti-inflammatory properties. This study assesses the activity of a hydrophilic extract of manna (HME) on cellular and molecular events in human colon-rectal cancer cells. HME showed a time- and concentration-dependent anti-proliferative activity, measured by MTT assay, in all the cell lines examined, namely Caco-2, HCT-116 and HT-29. The amounts of HME that caused 50% of cell death after a 24 h treatment were 8.51 ± 0.77, 10.73 ± 1.22 and 28.92 ± 1.99 mg manna equivalents/mL, respectively; no toxicity was observed in normally differentiated Caco-2 intestinal cells. Hydroxytyrosol, a component of HME known for its cytotoxic effects on colon cancer cells, was ineffective, at least at the concentration occurring in the extract. Through flow-cytometric techniques and Western blot analysis, we show that HME treatment causes apoptosis, assessed by phosphatidylserine exposure, as well as a loss of mitochondrial membrane potential, an intracellular formation of reactive oxygen species (ROS), increases in the levels of cleaved PARP-1, caspase 3 and Bax, and a decrease in Bcl-2 expression. Moreover, HME interferes with cell cycle progression, with a block at the G1/S transition. In conclusion, the phytocomplex extracted from manna exerts an anti-proliferative activity on human colon cancer cells through the activation of mitochondrial pathway-mediated apoptosis and cell cycle arrest. Our data may suggest that manna could have the potential to exert chemo-preventive effects for the intestine.

Stroma Amount in Human Cancer

Background: The development of a reactive tumor stroma is a hallmark of tumor progression. Based on a large number of smaller studies, using different methods, desmoplasia is generally considered associated with poor prognosis. The variability between tumor types regarding stroma fraction, and its prognosis associations, have not been systematically analyzed. Methods: We quantified the tumor stroma in 16 solid cancer types from 2732 patients. The tissue segmentation into stromal and epithelial compartment was performed using objective machine-learning method, driven by a combination of pan-cytokeratin staining, tissue autofluorescence patterns and nuclei characteristics. Findings: Stroma fraction was highly variable within and across the tumor types. Survival analysis in individual tumor types revealed both positive and negative associations of the tumor stroma fraction with survival. A meta-analysis across all cancer types indicated an association of higher stroma fraction with longer survival. Interpretation: Findings strongly argue against the commonly promoted simplistic view of a general associations between high stroma abundance and poor prognosis. Findings also suggest that full exploitation of the prognostic potential of tumor stroma requires analyses that go beyond determination of stroma abundance. Funding Statement: This study was partly supported by The Swedish Cancer Society, The Lions Cancer Foundation Uppsala, Sweden, The Swedish Government Grant for Clinical Research, The Mrs Berta Kamprad Foundation, Sweden, Sellanders foundation, P. O. Zetterling Foundation, and The Sjoberg Foundation, Sweden. Image annotation was provided by HistoOne AB, Uppsala, Sweden (https://histo.one). Declaration of Interests: The authors declare no potential conflicts of interest. Ethics Approval Statements: Colon Cancer (CC) and Rectal Cancer (RC) patient cohort - (Ethical approval Uppsala, 116/07; 419/15). Pariampullary Cancer of intestinal (PACi) and pancreatobiliary (PACpb) type patient cohort - (Ethical approval Lund, 445/07). Ovarian Cancer (OVC) patient cohort - (Ethical approval Lund, 445/07). High Grade Serous Ovarian Cancer (HGSC) patient cohort - (Ethical approval Stockholm, 2016/551–32). Renal Clear Cell (RCC) patient cohort - (Ethical approval Malmo, 282/07). Urine Bladder Cancer (UBC) patient cohort - (Ethical approval Uppsala, 2005/143). Endometrial Cancer (ENC) patient cohort - (Ethical approval Helsinki, 2016/010). Non Small Cell Lung Cancer presented as Lung Squamous Cell Carcinoma (LUSC) and Lung Adenocarcinoma (LUAD) patient cohort - (Ethical approval Uppsala, 532/12). Gastroesophageal Junction Adenocarcinoma (GECA) and Stomach Cancer (SC) patient cohort - (Ethical approval Lund, 445/07). Prostate Cancer (PC) patient cohort - (Ethical approval Lund, 494/05). Breast Cancer (BRC ER- and ER+) patient cohort - (Ethical approval Uppsala, Umea, 2005/118/2).

Analysis of the specific common competences of the Degree Courses in Speech Therapy and on the ability to apply in the didactic systems

This article, taken from the ending research thesis of the studies in Business Administration in Pegaso University,derives from the lack of detailed data on colon-rectal cancer in Apulia, in 2019. The clinical, economic and statisticalstudy introduced has given the possibility to examine the neoplasia incidence in Apulia reality, to estimate forthe first time the Lars major phenomenon (Low Anterior Resection Syndrome) after a rectum surgical treatment. These goals have been achieved starting from the national data analysis provided by Airtum and Aiom; andoperating through benchmarking, among the most virtuous Italian realities, it has been possible to estimate theforecast of refundability of health services generated by the treatment of colon cancers, rectal cancers and of theLars phenomenon management. We can see the incidence of 2,802 total cases of colon-rectal cancer so divided:1,920 colon cancer cases and 882 rectal cancer cases. The Lars phenomenon, according to the most recent medicalliterature, presents 444 cases, considering that 90 % of the 882 rectum tumors will have a surgery; 56% of thesedevelops Lars major. Assuming to treat all cases of Lars major, it would potentially be possible a refundability of63,492 Euros. While, as regards the refundability obtained from the treatment of the 2,802 colon-rectal cancer totalcases, it could be hypothesized a total refundability of 18,897,408 Euros.

The Incidence Rate of Colorectal Cancer in Saudi Arabia: An Observational Descriptive Epidemiological Analysis.

IntroductionColorectal cancer (CRC) is the third most commonly diagnosed malignancy and its incidence, as well as mortality rate, is increasing globally. In this paper, the epidemiological analysis of CRC which includes colon cancer (CC) and rectum cancer (RC) is done among the Saudi Arabian population based on the registered cases in the Saudi cancer registry between 2006 and 2016. The study describes the crude incidence rates (CIRs) and age-standardized incidence rates (ASIRs) of colorectal cancer by year of diagnosis, age group, and administrative regions to explore the spread, distribution, trend, and factual state of the disease in Saudi Arabia.MethodologyFor statistical analysis of data, t-test, sex ratio, descriptive statistics, and Kruskal–Wallis were done using IBM Statistical Package for the Social Sciences version 20.0 (SPSS). A total of 7849 and 5164 of colorectal cancer and rectum cancer cases were reported from January 2006 to December 2016, respectively.ResultsResults displayed that CRC is more frequent in males than females and have a high mean number and percentage in the old age group (60–75 and above). Riyadh (for CC and RC), Makkah (CC), and Eastern Province (RC) showed the highest mean CIR and ASIR for males. The highest CIR sex ratio was calculated in Jouf and Madinah for CC whereas Qassim, Jazan, and Tabuk were calculated highest for RC. Highest ASIR sex ratio reported in Jouf (CC) and Tabuk (RC). Lowest CIR and ASIR among males were reported in Baha (CC) and northern region (RC). In females, the highest mean CIR and ASIR were reported in Riyadh (CC and RC) and Makkah (CC). Lowest CIR and ASIR among females were reported in Jazan in both CC and RC.ConclusionRegions of Eastern Province, Northern Region, and Jouf showed the most significant changes of CIRs and ASIRs for both cancers, whereas the least significant change was reported in Jazan from 2006 to 2016.

Colon-rectal Cancer and Lars Management

This article, taken from the ending research thesis of the studies in Business Administration in Pegaso University,derives from the lack of detailed data on colon-rectal cancer in Apulia, in 2019. The clinical, economic and statisticalstudy introduced has given the possibility to examine the neoplasia incidence in Apulia reality, to estimate forthe first time the Lars major phenomenon (Low Anterior Resection Syndrome) after a rectum surgical treatment. These goals have been achieved starting from the national data analysis provided by Airtum and Aiom; andoperating through benchmarking, among the most virtuous Italian realities, it has been possible to estimate theforecast of refundability of health services generated by the treatment of colon cancers, rectal cancers and of theLars phenomenon management. We can see the incidence of 2,802 total cases of colon-rectal cancer so divided:1,920 colon cancer cases and 882 rectal cancer cases. The Lars phenomenon, according to the most recent medicalliterature, presents 444 cases, considering that 90 % of the 882 rectum tumors will have a surgery; 56% of thesedevelops Lars major. Assuming to treat all cases of Lars major, it would potentially be possible a refundability of63,492 Euros. While, as regards the refundability obtained from the treatment of the 2,802 colon-rectal cancer totalcases, it could be hypothesized a total refundability of 18,897,408 Euros.

Colon-rectal Cancer and Lars Management - Forecast of refundability of health services in Apulia in 2019

This article, taken from the ending research thesis of the studies in Business Administration in Pegaso University, derives from the lack of detailed data on colon-rectal cancer in Apulia, in 2019. The clinical, economic and statistical study introduced has given the possibility to examine the neoplasia incidence in Apulia reality, to estimate for the first time the Lars major phenomenon (Low Anterior Resection Syndrome) after a rectum surgical treatment. These goals have been achieved starting from the national data analysis provided by Airtum and Aiom; and operating through benchmarking, among the most virtuous Italian realities, it has been possible to estimate the forecast of refundability of health services generated by the treatment of colon cancers, rectal cancers and of the Lars phenomenon management. We can see the incidence of 2,802 total cases of colon-rectal cancer so divided: 1,920 colon cancer cases and 882 rectal cancer cases. The Lars phenomenon, according to the most recent medical literature, presents 444 cases, considering that 90 % of the 882 rectum tumors will have a surgery; 56% of these develops Lars major. Assuming to treat all cases of Lars major, it would potentially be possible a refundability of 63,492 Euros. While, as regards the refundability obtained from the treatment of the 2,802 colon-rectal cancer total cases, it could be hypothesized a total refundability of 18,897,408 Euros.

Comprehensive Analysis of Prognostic Value and Immune Infiltration of Chromobox Family Members in Colorectal Cancer.

Objective: Colorectal cancer (CRC) is one of the common malignant tumors worldwide. Chromobox (CBX) family proteins are important components of epigenetic regulation complexes and are implicated in the development of multiple cancers by blocking differentiation and promoting proliferation. However, little is known about the function of distinct CBX proteins in colorectal cancer.Methods: Oncomine, Gene Expression Profiling Interactive Analysis (GEPIA), Kaplan-Meier plotter, cBioPortal, GeneMANIA, and TIMER were utilized to analyze differential expression, prognostic value, genetic alteration and immune cell infiltration of CBXs in colorectal cancer patients.Results: The expression levels of CBX1/2/3/4/5 and CBX8 were significantly elevated in CRC tissues, whereas the expression levels of CBX6/7 were reduced. CBX3 was significantly associated with the clinical cancer stage and short disease-free survival (DFS) in CRC patients. High mRNA expression of CBX5/6 was associated with short overall survival (OS) in rectal cancer patients. CBX3/5/6 could be potential prognostic biomarkers for the survival of CRC patients. Moreover, the functions of the differentially expressed CBXs were primarily related to the SUMOylation of DNA methylation proteins and chromatin organization and may regulate the pluripotency of stem cells. The expression of CBXs were significantly correlated with the infiltration of diverse immune cells, including six types of CD4+ T cells, macrophages, neutrophils, B cells, CD8+ T cells, and dendritic cells in colon cancers and rectal cancers.Conclusions: Our study may provide novel insights for the selection of prognostic biomarkers of CBX family in colorectal cancer.