AIM: To compare the racial differences of anatomical distribution of colorectal cancer (CRC) and determine the association of age, gender and time with anatomical distribution between patients from America (white) and...AIM: To compare the racial differences of anatomical distribution of colorectal cancer (CRC) and determine the association of age, gender and time with anatomical distribution between patients from America (white) and China (oriental).METHODS: Data was collected from 690 consecutive patients in Cleveland Clinic Florida, U.S.A. and 870consecutive patients in Nan Fang Hospital affiliated to the First Military Medical University, China over the past 11years from 1990 to 2000. All patients had colorectal adenocarcinoma diagnosed by histology and underwent surgery.RESULTS: The anatomical subsite distribution of tumor,age and gender were significantly different between white and oriental patients. Lesions in the proximal colon (P＜0.001) were found in 36.3 % of white vs 26.0 % of oriental patients and cancers located in the distal colon and rectum in 63.7 % of white and 74 % of oriental patients (P＜0.001). There was a trend towards the redistribution from distal colon and rectum to proximal colon in white males over time, especially in older patients (＞80 years).No significant change of anatomical distribution occurred in white women and Oriental patients. The mean age at diagnosis was 69.0 years in white patients and 48.3 years in Oriental patients (P＜0.001).CONCLUSION: This is the first study comparing the anatomical distribution of colorectal cancers in whites and Chinese patients. White Americans have a higher risk of proximal CRC and this risk increased with time. The proportion of white males with CRC also increased with time.Chinese patients were more likely to have distal CRC and developed the disease at a significantly earlier age than white patients. These findings have enhanced our understanding of the disease process of colorectal cancer in these two races.展开更多
AIM:To explore the problems in the screening of colorecta carcinoma in the elderly. METHODS:Three models of colorectal cancer prevention were examined:standard screening,active check-up of suspected cases and summons ...AIM:To explore the problems in the screening of colorecta carcinoma in the elderly. METHODS:Three models of colorectal cancer prevention were examined:standard screening,active check-up of suspected cases and summons to have endoscopic check- up for previously diagnosed colorectal polyps.The study was performed among three groups of elderly individuals: Group 1 (167 cases),hospitalized asymptomatic individuals without symptoms in large intestines.Group 2 (612 cases): old individuals at home for the aged,out of which 32 showed symptoms of colon disorders;Group 3 (44 cases):elderly people with diagnosed polyps.As a result of 1788 rectosigmoidoscopies,we identified 61 individuals with polyps,out of which 44 patients were over 65 years old. However,only 9 of these 44 individuals agreed to have the endoscopy performed again. RESULTS:One cancer and 13 polyps were detected in Group 1,and two polyps in Group 2.However,it should be noted that only eleven individuals from Group 2 agreed to have the endoscopy.In Group 3,there were no relapses of the polyps among the nine individuals who came back for the endoscopy. CONCLUSION:Poor understanding of the screening procedures is one of the greatest problems in early detection of the cancer in the aged.Paradoxically,the cooperation is better with hospitalized patients,than with 'successfully old' persons.展开更多
AIM:To correlate cyclooxygenase-2(COX-2)expression profile with clinical and pathological variables to assess their prognostic/predictive value in colorectal carcinoma(CRC).METHODS:Archival tumor samples were analyzed...AIM:To correlate cyclooxygenase-2(COX-2)expression profile with clinical and pathological variables to assess their prognostic/predictive value in colorectal carcinoma(CRC).METHODS:Archival tumor samples were analyzed using immunohistochemistry for COX-2 expression in 94 patients with CRC.Patients were diagnosed and treatedat the Departments of Surgery and Oncology,King Abdulaziz University Hospital,Saudi Arabia.RESULTS:Fifty-six percent of the tumors showed positive cytoplasmic COX-2 expression,whereas 44%of cases were completely COX-2-negative.There were no significant correlations between COX-2 expression and sex,age,grade or tumor location.However,COX-2 expression revealed a significant correlation with tumor stage(P=0.01)and distant metastasis(P=0.02),and a borderline association with lymph node involvement(P =0.07).Tumors with high COX-2 expression showed a higher recurrence rate than tumors with no expression(P<0.009).In univariate Kaplan-Meier survival analysis,there was a significant(P=0.026)difference in disease-free survival between COX-2-positive and negative tumors in favor of the latter.COX-2 expression did not significantly predict disease-specific survival,which was much shorter for COX-2-positive tumors.In multivariate(COX)models,COX-2 did not appear among the independent predictors of disease-free survival or disease-specific survival.CONCLUSION:COX-2 expression seems to provide useful prognostic information in CRC,while predicting the patients at high risk for recurrent disease.展开更多
文摘AIM: To compare the racial differences of anatomical distribution of colorectal cancer (CRC) and determine the association of age, gender and time with anatomical distribution between patients from America (white) and China (oriental).METHODS: Data was collected from 690 consecutive patients in Cleveland Clinic Florida, U.S.A. and 870consecutive patients in Nan Fang Hospital affiliated to the First Military Medical University, China over the past 11years from 1990 to 2000. All patients had colorectal adenocarcinoma diagnosed by histology and underwent surgery.RESULTS: The anatomical subsite distribution of tumor,age and gender were significantly different between white and oriental patients. Lesions in the proximal colon (P＜0.001) were found in 36.3 % of white vs 26.0 % of oriental patients and cancers located in the distal colon and rectum in 63.7 % of white and 74 % of oriental patients (P＜0.001). There was a trend towards the redistribution from distal colon and rectum to proximal colon in white males over time, especially in older patients (＞80 years).No significant change of anatomical distribution occurred in white women and Oriental patients. The mean age at diagnosis was 69.0 years in white patients and 48.3 years in Oriental patients (P＜0.001).CONCLUSION: This is the first study comparing the anatomical distribution of colorectal cancers in whites and Chinese patients. White Americans have a higher risk of proximal CRC and this risk increased with time. The proportion of white males with CRC also increased with time.Chinese patients were more likely to have distal CRC and developed the disease at a significantly earlier age than white patients. These findings have enhanced our understanding of the disease process of colorectal cancer in these two races.
文摘AIM:To explore the problems in the screening of colorecta carcinoma in the elderly. METHODS:Three models of colorectal cancer prevention were examined:standard screening,active check-up of suspected cases and summons to have endoscopic check- up for previously diagnosed colorectal polyps.The study was performed among three groups of elderly individuals: Group 1 (167 cases),hospitalized asymptomatic individuals without symptoms in large intestines.Group 2 (612 cases): old individuals at home for the aged,out of which 32 showed symptoms of colon disorders;Group 3 (44 cases):elderly people with diagnosed polyps.As a result of 1788 rectosigmoidoscopies,we identified 61 individuals with polyps,out of which 44 patients were over 65 years old. However,only 9 of these 44 individuals agreed to have the endoscopy performed again. RESULTS:One cancer and 13 polyps were detected in Group 1,and two polyps in Group 2.However,it should be noted that only eleven individuals from Group 2 agreed to have the endoscopy.In Group 3,there were no relapses of the polyps among the nine individuals who came back for the endoscopy. CONCLUSION:Poor understanding of the screening procedures is one of the greatest problems in early detection of the cancer in the aged.Paradoxically,the cooperation is better with hospitalized patients,than with 'successfully old' persons.
基金Supported by Scientific Chair for Colorectal Cancer,King Abdul-Aziz University,Jeddah,Saudi Arabia
文摘AIM:To correlate cyclooxygenase-2(COX-2)expression profile with clinical and pathological variables to assess their prognostic/predictive value in colorectal carcinoma(CRC).METHODS:Archival tumor samples were analyzed using immunohistochemistry for COX-2 expression in 94 patients with CRC.Patients were diagnosed and treatedat the Departments of Surgery and Oncology,King Abdulaziz University Hospital,Saudi Arabia.RESULTS:Fifty-six percent of the tumors showed positive cytoplasmic COX-2 expression,whereas 44%of cases were completely COX-2-negative.There were no significant correlations between COX-2 expression and sex,age,grade or tumor location.However,COX-2 expression revealed a significant correlation with tumor stage(P=0.01)and distant metastasis(P=0.02),and a borderline association with lymph node involvement(P =0.07).Tumors with high COX-2 expression showed a higher recurrence rate than tumors with no expression(P<0.009).In univariate Kaplan-Meier survival analysis,there was a significant(P=0.026)difference in disease-free survival between COX-2-positive and negative tumors in favor of the latter.COX-2 expression did not significantly predict disease-specific survival,which was much shorter for COX-2-positive tumors.In multivariate(COX)models,COX-2 did not appear among the independent predictors of disease-free survival or disease-specific survival.CONCLUSION:COX-2 expression seems to provide useful prognostic information in CRC,while predicting the patients at high risk for recurrent disease.
