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1.
Rev. Méd. Inst. Mex. Seguro Soc ; 59(6): 579-584, 01-dic-2021. ilus
Article in Spanish | LILACS | ID: biblio-1357673

ABSTRACT

Introducción: el sarcoma fibromixoide de bajo grado (LGFMS) se considera un tumor de tejidos blandos raro, que tiene tendencia a surgir del tronco y de las extremidades inferiores, su localización en el área intraabdominal se considera poco común. Objetivo: describir un caso de LGFMS primario de colon transverso perforado con metástasis hepática. Caso clínico: describimos el caso de un paciente masculino de 57 años con dolor abdominal de inicio súbito; en la cirugía se encontró un tumor con absceso y perforación en el colon transverso que infiltraba hasta la raíz del mesenterio. Se realizó hemicolectomía izquierda extendida con colostomía de colon ascendente. Más tarde, en una exploración posoperatoria, se encontró que tenía enfermedad hepática metastásica. Conclusiones: este caso es único en términos de ubicación y presentación. Es un recordatorio del diagnóstico diferencial del dolor abdominal agudo. Hasta donde sabemos, es el primer caso de LGFMS del colon con metástasis hepática sincrónica.


Background: Low grade fibromyxoid sarcoma (LGFMS) is considered a rare soft tissue tumor and has a tendency to arise from deep soft tissue of the trunk and lower extremities, the intraabdominal area is considered a rare location. Objective: To describe the first case of a LGFMS arising from the transverse colon with liver metastasis Clinical case: We describe a 57-years-old male patient with abdominal pain of sudden onset; at surgery he was found to have an abscessed tumor in the transverse colon that infiltrated to mesentery root. An extended left hemicolectomy was performed with ascending colon colostomy. Later on, a postoperative scan he was found to have metastatic liver disease Conclusions: This case is unique in terms of the location and presentation. It's a reminder of differential diagnosis of acute abdominal pain. To our knowledge is the first case of a LGFMS of the colon with synchronous liver metastasis.


Subject(s)
Humans , Male , Female , Colonic Neoplasms , Intestinal Perforation , Neoplasm Metastasis , Sarcoma , Tertiary Healthcare , Colostomy , Abdominal Pain , Colectomy , Colon , Colon, Ascending , Liver Diseases
2.
Oncología (Ecuador) ; 31(3): 201-212, 30-diciembre-2021.
Article in Spanish | LILACS | ID: biblio-1352465

ABSTRACT

Introducción: La supervivencia relativa a los cinco años para pacientes con cáncer colorrectal (CCR) se presenta entre el 60% en América del Norte y de 40% o menos en Argelia y Estonia. Es objetivo del presente estudio establecer la supervivencia a nivel local y determinar los factores asociados en un estudio de un centro nacional de referencia en Quito, Ecuador. Metodología: El presente estudio observacional se realizó en el Hospital de Especialidades Eugenio Espejo de la ciudad de Quito-Ecuador, en el período de enero del 2010 a diciembre del 2016. Se incluyeron pacientes con cáncer colorrectal. Las variables fueron descriptivas demográficas, variables clínicas y mortalidad. La muestra fue no probabilística, tipo censo. La variable mortalidad, fue estudiada con las variables Independientes clínicas, epidemiológicas con análisis actuarial de supervivencia. Resultados: Se incluyeron 395 casos, el 62.3% mujeres, con una edad 60 años (16 a 94). El 7.1% de casos refirieron algún tipo de exposición de riesgo relacionado a CCR. La supervivencia global fue del 56%, con una tasa de mortalidad del 7%. Casos con CCR estadio I sobrevida a los 6 años de 100%, con estadio II 96.5%, en el estadio III el 84%, estadio IV de 63% (P=0.001). Pacientes con instrucción secundaria o superior con supervivencia del 95% versus 88% en pacientes con instrucción primaria/analfabetos (P=0.048). La supervivencia es mayor en pacientes con diagnóstico temprano esta-dios (I y II) (P=0.007). Conclusión: La supervivencia en el presente estudio se asoció al nivel de instrucción de los pacientes, al estadiaje del cáncer, y al diagnóstico temprano sobre todo en pacientes con comorbilidades. No se evidenció relación con factores de riesgo como tabaco, alcohol, presencia de pólipos, etc.


Introduction: The five-year relative survival for patients with colorectal cancer (CRC) is between 60% in North America and 40% or less in Algeria and Estonia. The objective of this study is to estab-lish survival at the local level and determine the associated factors in a study of a national referral center in Quito, Ecuador. Methodology: The present observational study was carried out at the Eugenio Espejo Specialty Hospital in the city of Quito-Ecuador, in the period from January 2010 to December 2016. Patients with colorectal cancer were included. The variables were descriptive demographic, clinical variables and mortality. The sample was non-probabilistic, census type. The mortality variable was studied with the independent clinical and epidemiological variables with actuarial survival analysis. Results: A total of 395 patients were analyzed, 62.3% women, aged 60 years (16 to 94). 7.1% of cases referred to some type of risk exposure related to CRC. Overall survival was 56%, with a mortality rate of 7%. Cases with stage I CRC survival at 6 years of 100%, with stage II 96.5%, in stage III 84%, stage IV of 63% (P = 0.001). Patients with secondary education or higher with survival of 95% versus 88% in patients with primary education / illiterate (P= 0.048). Survival is higher in patients with early diagnosis stages (I and II) (P = 0.007). Conclusion: Survival in the present study was associated with the level of education of the patients, the staging of the cancer, and early diagnosis, especially in patients with comorbidities. There was no evidence of a relationship with risk factors such as tobacco, alcohol, presence of polyps, etc.


Subject(s)
Humans , Male , Female , Adult , Survival Analysis , Risk Factors , Colonic Neoplasms , Colorectal Neoplasms , Early Detection of Cancer , Life Style
3.
Arq. gastroenterol ; 58(3): 359-363, July-Sept. 2021. tab, graf
Article in English | LILACS | ID: biblio-1345304

ABSTRACT

ABSTRACT BACKGROUND: The gold standard test for colorectal cancer screening the colonoscopy. Although this is the test of choice, colonoscopy misses a significant number of lesions, mainly in the proximal colon. With the purpose of reducing the number of lesions missed, new techniques have been studied, amongst them, retroflexed view in the right side of the colon and the second direct forward view. OBJECTIVE: Assessing the safety of the retroview in the proximal colon (cecum and ascending colon), its impact on the detection of lesions in the proximal colon and its advantage over the double right forward view using adenoma detection rate and adenoma miss rate. METHODS: Three hundred and ninety-three patients who came to Hospital Mater Dei to undergo colonoscopy from March to July 2017, prospectively. Out of these, 372 were included in the study based on the following exclusion criteria: being under 18 years of age, inadequate bowel preparations (Boston scale <7), history of colectomy, inflammatory bowel disease or polypoid diseases. First, an endoscopist inserted the colonoscope into the cecum and examine the cecum and the ascending colon with a forward view twice. In the third insertion into the cecum, retroflexed view was performed, cecal mucosa was examined until the hepatic flexure in search of polyps missed on forward view. All lesions found were resected and sent for histological analysis. RESULTS: In 334 (89.8%) patients, retroflexed view was performed successfully, 65.8% of failures were attributed to the loops of the device which prevented the maneuver. The direct view identified 175 polyps in the proximal colon in 102 people. Retroflexed view detected 26 polyps missed by the direct view in 24 (6.5%) people, with a missing rate of 12.9% in the test with only the forward view. Out of the 26 polyps found in retroview, 21 (80.76%) were adenomas, one of them with a high-grade dysplasia. Eleven patients had polyps seen only in retroflexed view. Retroview has increased the polyp detection rate from 27.41% to 31.72% and the adenoma detection rate from 21.77% to 25%. The adenoma miss rate by the double direct view was 12.8%. Without the retroview, one polyp in every 13.91 colonoscopies would be missed (number needed to treat - NNT=13.91). There was no adverse event. CONCLUSION: The retroflexed view technique in the proximal colon was shown to be safe, fast and feasible in most cases. It increased the adenoma detection rate and was shown to be advantageous in this study wit benefit beyond the double direct view.


RESUMO CONTEXTO: O exame padrão ouro para rastreamento de câncer colorretal é a colonoscopia. Apesar de ser o exame de escolha, a colonoscopia perde um número não desprezível de lesões, principalmente no cólon proximal. Com a intenção de reduzir a perda de lesões, novas técnicas são estudadas, dentre elas, a retroflexão em cólon direito e a segunda visão frontal direta. OBJETIVO: Avaliar a segurança da retrovisão no cólon proximal (ceco e cólon ascendente), o seu impacto na detecção de lesões em cólon proximal e sua superioridade sobre a dupla visão frontal direta usando taxa de detecção de adenoma e taxa de adenoma perdido. MÉTODOS: Foram avaliados 393 pacientes de forma prospectiva que procuraram o Hospital Mater Dei para realizar colonoscopia entre março e julho de 2017. Desses, 372 foram incluídos baseados nos critérios de exclusão: menores de 18 anos, preparos intestinais inadequados (escala de Boston <7), com antecedente de colectomia, doença inflamatória intestinal ou síndromes polipoides. Primeiramente um endoscopista realizou a inserção do colonoscópio até o ceco e examinou o ceco e o cólon ascendente em visão frontal por duas vezes. Na terceira reinserção até o ceco era realizada a retroflexão e inspeção da mucosa do ceco até a flexura hepática em busca de pólipos perdidos à visão frontal. Todas lesões encontradas foram ressecadas e enviadas para análise histológica. RESULTADOS: Em 334 (89,8%) pacientes a retroflexão foi realizada com sucesso, 65,8% dos insucessos foram atribuídos a alças no aparelho que impediram a manobra. A visão direta identificou 175 pólipos no cólon proximal em 102 pessoas. A retroflexão detectou 26 pólipos perdidos pela visão direta em 24 (6,5%) pessoas, com uma taxa de perda de 12,9% no exame apenas em visão frontal. Dos 26 pólipos encontrados em retrovisão, 21 (80,76%) eram adenomas, um deles com displasia de alto grau. Onze pacientes tinham pólipos vistos apenas em retroflexão. A realização da retrovisão aumentou a taxa de detecção de pólipo de 27,41% para 31,72% e a taxa de detecção e adenomas de 21,77% para 25%. A taxa de adenoma perdido pela dupla visão direta foi de 12,8%. Se a retrovisão não fosse realizada, um pólipo a cada 13,91 colonoscopias seria perdido (NNT=13,91). Não houve nenhum evento adverso. CONCLUSÃO: A técnica de retroflexão em cólon proximal mostrou-se segura, rápida e factível na maioria dos casos. Ela aumentou a taxa de detecção de adenomas e mostrou-se soberana neste estudo com benfeitorias além da dupla visão direta.


Subject(s)
Humans , Adolescent , Colonic Polyps/diagnostic imaging , Colonic Neoplasms/diagnostic imaging , Colonoscopy , Tertiary Care Centers
4.
Rev. cuba. cir ; 60(3): e1150, 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1347387

ABSTRACT

Introducción: La metástasis hepática del cáncer de colon es una entidad frecuente. Objetivo: Identificar los factores asociados a la supervivencia en pacientes intervenidos de cáncer de colon con metástasis hepática sincrónica. Métodos: Se realizó un estudio observacional, descriptivo y transversal a 34 pacientes operados con este diagnóstico, en el servicio de Cirugía General del Hospital Provincial Docente "Saturnino Lora" de Santiago de Cuba, desde 2010 hasta 2019. Fue estimada la supervivencia global y por diferentes periodos de tiempo en la cohorte, según el método de Kaplan-Meier. La comparación de las curvas de supervivencia para las covariables seleccionadas se realizó mediante la prueba de igualdad de distribuciones (Log-Rank de Mantel y Cox). Resultados: La supervivencia global a los seis meses y al año del diagnóstico fue de 66,5 por ciento y 66,2 por ciento, respectivamente, con mediana de dos años (IC 95 por ciento: 0,97-3,02). La supervivencia fue superior si el paciente presentó una metástasis versus dos o más, así como la de ambos lóbulos marca la menor probabilidad de supervivencia. Los tumores bien y moderadamente diferenciados mostraron mayor probabilidad de supervivencia al año que los pocos diferenciados, sin diferencias significativas. Conclusiones: La cirugía permite mejorar la sobrevida global y libre de enfermedad, aunque el uso de las distintas opciones terapéuticas para el cáncer colónico con metástasis hepática sincrónica continúa controvertido. La supervivencia de estos enfermos está condicionada por la estadificación, diferenciación histológica del tumor, localización y número de metástasis, entre otros factores(AU)


Introduction: Liver metastasis from colon cancer is a frequent entity. Objective: To identify the factors associated with survival in patients operated on for colon cancer with synchronic liver metastasis. Methods: An observational, descriptive and cross-sectional study was carried out, from 2010 to 2019, with 34 patients with this diagnosis operated on in the general surgery service of Saturnino Lora Provincial Teaching Hospital of Santiago de Cuba. Overall survival was estimated, as well as by different time periods in the cohort, using the Kaplan-Meier method. The comparison of the survival curves for the selected covariates was carried out using the test of equality of distributions (log-rank or Mantel-Cox test). Results: Overall survival six months and one year after diagnosis was 66.5 percent and 66.2 percent, respectively, with a median of two years (95 percent CI: 0.97-3.02). Survival was higher if the patient had one metastasis versus two or more, while metastasis in both lobules represents the lowest probability of survival. Well and moderately differentiated tumors showed higher probability of survival at one year than the little differentiated ones, without significant differences. Conclusions: Surgery improves overall and disease-free survival, although the use of different therapeutic options for colon cancer with synchronic liver metastases remains controversial. The survival of these patients is conditioned by staging, histological differentiation of the tumor, location and number of metastases, among other factors(AU)


Subject(s)
Humans , Male , Female , Adult , Colonic Neoplasms/surgery , Survivorship , Neoplasm Metastasis/diagnostic imaging , Epidemiology, Descriptive , Cross-Sectional Studies , Observational Studies as Topic
6.
Electron. j. biotechnol ; 52: 76-84, July. 2021. graf, ilus
Article in English | LILACS | ID: biblio-1283597

ABSTRACT

BACKGROUND: Butyrate is a histone deacetylase inhibitor that induces apoptosis and inhibits cell proliferation of colorectal cancer cells. To improve its anticancer activity, butyrate has been evaluated mixed with drugs and different molecules. Plant antimicrobial peptides are attractive anticancer alternative molecules because they show selective cytotoxic activity against different cancer cell lines. In this work, we explore if the plant defensin c-thionin (Capsicum chinense) can improve butyrate activity on Caco-2 cell line and we also determined the mechanism of death activated. RESULTS: The combined treatment of c-thionin (3.5 mM) and butyrate (50 mM) showed higher cytotoxicity on Caco-2 cells with respect to single treatments. Also, the combined treatment reduced cell proliferation and exhibited a higher rate of apoptosis than single treatments. Combined treatment induced caspases 8 and 9 activation to an extent comparable with that of butyrate while c-thionin did not activate caspases. Additionally, reactive oxygen species generation preceded the onset of apoptosis, and superoxide anion production was higher in cells treated with the combined treatment. CONCLUSIONS: The c-thionin from Habanero chili pepper improved the butyrate cytotoxicity on Caco-2 cells. This effect occurred through apoptosis induction associated with reactive oxygen species production. Therefore, the combination of butyrate with cytotoxic antimicrobial peptides could be an attractive strategy for cancer therapy.


Subject(s)
Humans , Butyrates , Capsicum/chemistry , Adenocarcinoma , Colonic Neoplasms , Cell Cycle , Reactive Oxygen Species , Apoptosis , Caco-2 Cells , Defensins , Thionins
7.
Rev. cuba. cir ; 60(2): e1049, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1280215

ABSTRACT

Introducción: El cáncer de colon mantiene un importante impacto social y una alta morbilidad a pesar de programas de detección precoz existentes. Ocupa el cuarto lugar entre los tumores malignos y un número importante de pacientes son operados de urgencia por las complicaciones de esta enfermedad, muchas veces desconocida hasta el momento de la cirugía. Objetivo: Caracterizar la cirugía de urgencia realizada a los pacientes con diagnóstico de cáncer de colon complicado. Método: Se realizó un estudio observacional, descriptivo, de corte transversal entre enero de 2014 y diciembre de 2016, en el Servicio de Cirugía General. La muestra fue de 96 pacientes portadores de esta entidad en el Hospital Universitario "General Calixto García". Resultados: Se analizó la incidencia según sexo, relación sexo/localización, relación localización/complicación, estadificación y mortalidad. Prevalecieron los tumores de colon en el sexo femenino y por ende fueron más frecuente las pacientes con complicaciones quirúrgicas por esta entidad en nuestro centro. Predominó la localización derecha globalmente, con predominio femenino. La oclusión intestinal fue la complicación más frecuente. Sobresalió el estadio II según TNM con un 37,5 por ciento y una mortalidad postoperatoria del 31 por ciento. Conclusiones: Nuestros datos coinciden con la tendencia nacional sobre la mayor incidencia del cáncer de colon en pacientes femeninas, son estas las que mayor tasa de morbilidad y mortalidad reportan. Seguir perfeccionando el programa de prevención y detección temprana de la entidad y su tratamiento oportuno causará la reducción de los índices que hoy se exhiben(AU)


Introduction: Colon cancer still has an important social impact and high morbidity despite existing early detection programs. It ranks fourth among malignant tumors, while a significant number of patients undergo emergency surgery for complications of this disease, many times unknown until the time of surgery. Objective: To characterize the emergency surgery performed to patients with a diagnosis of complicated colon cancer. Method: An observational, descriptive, cross-sectional study was carried out, between January 2014 and December 2016, in the general surgery service. The sample consisted of 96 patients with this entity and from General Calixto García University Hospital. Results: The incidence was analyzed according to sex, sex/location relationship, location/complication relationship, staging and mortality. Colon tumors prevailed in the female sex and, therefore, patients with surgical complications from this entity were more frequent in our center. There right location predominated globally, with a predominance in the female sex. Intestinal obstruction was the most frequent complication. Stage two, according to the TNM classification, stood out, accounting for 37.5 percent, together with a postoperative mortality of 31 percent. Conclusions: Our data coincide with the national trend on the highest incidence of colon cancer in female patients, who account for the highest morbidity and mortality rates. Continuing to improve the entity's prevention and early detection program, as well as its timely treatment, will bring about a reduction in the rates nowadays reported(AU)


Subject(s)
Humans , Male , Female , Colonic Neoplasms/diagnosis , Emergencies , Intestinal Obstruction/complications , Neoplasm Staging/methods , Epidemiology, Descriptive , Cross-Sectional Studies , Colonic Neoplasms/epidemiology , Observational Studies as Topic
8.
Rev. cuba. cir ; 60(2): e989,
Article in Spanish | LILACS, CUMED | ID: biblio-1280220

ABSTRACT

Introducción: El cáncer de colon constituye un grave problema sanitario debido a su alta incidencia y mortalidad. Objetivo: Describir algunos aspectos epidemiológicos, etiopatogénicos, diagnósticos, terapéuticos y evolutivos del cáncer de colon con metástasis hepáticas. Métodos: Revisión documental en bases de datos bibliográficos biomédicas sobre el tema durante el período 2015-2020. Se seleccionaron 31 artículos relacionados con el objetivo propuesto. Desarrollo: Los pacientes con cáncer de colon con metástasis hepáticas sincrónicas son tratados mediante tres estrategias: la tradicional o clásica consiste en la resección quirúrgica del tumor primario y posteriormente, quimioterapia, radioterapia o ambas, para proceder a la resección de las lesiones hepáticas tres a seis meses después; la simultánea, consistente en la resección de la lesión tumoral primaria y de las metástasis hepáticas en un mismo acto quirúrgico, seguida de quimioterapia, radioterapia o ambas y la inversa, que administra de tres a seis ciclos de quimioterapia sistémica, seguidos por la resección de las metástasis hepáticas y en un segundo tiempo resecar el tumor primario, todo esto con quimioterapia durante el intervalo entre ambas cirugías. Conclusiones: El único tratamiento con potencial curativo en los pacientes con metástasis hepáticas debe ser la resección de todo el volumen tumoral hepático con márgenes adecuados y la suficiente preservación del parénquima sano (25 - 30 por ciento), según criterios oncológicos y anatómicos establecidos, lo que incide en la calidad de vida y la supervivencia de estos enfermos(AU)


Introduction: Colon cancer is a serious health concern due to its high incidence and mortality. Objective: To describe some epidemiological, etiopathogenic, diagnostic, therapeutic and evolutionary aspects of colon cancer with hepatic metastases. Methods: Documentary review about the subject carried out in biomedical bibliographic databases, during the period 2015-2020. Thirty-one articles related to the proposed objective were selected. Development: Colon cancer patients with synchronous hepatic metastases are treated using three strategies: the traditional, or classic, strategy consists in surgical resection of primary tumor and, subsequently, chemotherapy, radiotherapy or both, before proceeding then to resection of liver lesions three to three six months later; the simultaneous strategy consists in resection of primary tumor lesion and hepatic metastases in the same surgical procedure, followed by chemotherapy, radiotherapy or both; and the reverse strategy, in which three to six cycles of systemic chemotherapy are administered, followed by resection of hepatic metastases and, in a second stage, resection of primary tumor, all this with chemotherapy during the interval between both surgeries. Conclusions: The only treatment with curative potential in patients with hepatic metastases should be the resection of the entire hepatic tumor volume with adequate margins and sufficient preservation of the healthy parenchyma (25-30 percent), according to established oncological and anatomical criteria, which has an incidence on the quality of life and survival of these patients(AU)


Subject(s)
Humans , Quality of Life , Databases, Bibliographic , Colonic Neoplasms/surgery , Colonic Neoplasms/epidemiology , Neoplasm Metastasis/therapy , Survivorship , Liver/injuries
9.
Medicina (B.Aires) ; 81(1): 99-102, mar. 2021. graf
Article in Spanish | LILACS | ID: biblio-1287247

ABSTRACT

Resumen La resección transmural endoscópica es una técnica que permite la resección en bloque de lesiones colónicas en pacientes en los cuales han fracasado los métodos endoscópicos convencionales como la resección mucosa endoscópica o la disección submucosa endoscópica. Presentamos el caso de un hombre de 75 años con antecedentes de adenoma de colon con fibrosis debido a dos intentos previos fallidos de resección endoscópica en otra institución. Realizamos con éxito el procedimiento de resección transmural endoscópica evitando así una cirugía.


Abstract Endoscopic full-thickness resection is a technique that allows in block resection of colonic lesions in patients in whom conventional endoscopic methods such as endoscopic mucosal resection or endoscopic submucosal dissection have failed. We present a case of a 75-year-old man with history of a difficult-to-resect colon adenoma. He had undergone two previous failed attempts of endoscopic mucosal resection due to non-lifting sign in another center. We successfully performed an endoscopic full-thickness resection procedure, avoiding unnecessary surgery.


Subject(s)
Humans , Male , Aged , Adenoma/surgery , Adenoma/diagnostic imaging , Colonic Neoplasms/surgery , Endoscopic Mucosal Resection , Fibrosis , Treatment Outcome
10.
Rev. cuba. cir ; 60(1): e1020, ene.-mar. 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1289371

ABSTRACT

Introducción: El cáncer de colon se erige como la neoplasia del tubo digestivo más frecuente en la presente centuria. Objetivo: Identificar algunos factores clínicos, epidemiológicos y diagnósticos en pacientes operados de cáncer de colon con metástasis hepática sincrónica. Métodos: Se realizó un estudio observacional, descriptivo y transversal de una muestra de 31 pacientes operados con diagnóstico definitivo de cáncer de colon con metástasis hepática sincrónica, en el servicio de Cirugía General del Hospital Provincial Docente "Saturnino Lora" de Santiago de Cuba durante el periodo comprendido entre 2010 y 2019. Resultados: La edad promedio fue de 63,2 años. Existió predominio de la enfermedad inflamatoria intestinal como antecedente patológico personal, y del alcoholismo como factor de riesgo. La sintomatología predominante fue dolor abdominal y cambios del hábito intestinal, así como el tumor palpable al examen físico del abdomen. La ecografía abdominal y el colon por enema fueron los procederes de diagnóstico más utilizados. Prevalecieron los tumores en el colon izquierdo a nivel del descendente. Todos los tumores malignos fueron adenocarcinomas a predominio de los moderadamente diferenciados. Conclusiones: Las edades avanzadas de la vida, así como la presencia de tabaquismo y alcoholismo son factores epidemiológicos característicos de la población de enfermos aquejados de cáncer de colon con metástasis hepática. Los elementos clínicos identificados constituyeron los habitualmente descritos en la literatura médica, aunque los estudios imaginológicos utilizados preoperatoriamente resultaron limitados para el diagnóstico del cáncer de colon con metástasis hepática sincrónica, precisándose el hallazgo de las lesiones metastásicas durante la intervención quirúrgica(AU)


Introduction: Colon cancer is the most frequent digestive-tract neoplasm in the present century. Objective: To identify some clinical, epidemiological and diagnostic factors in patients operated on for colon cancer and synchronic hepatic metastasis. Methods: An observational, descriptive and cross-sectional study was carried out in a sample of 31 patients operated on with a definitive diagnosis of colon cancer and synchronic hepatic metastasis, in the general surgery service of Saturnino Provincial Teaching Hospital in Santiago de Cuba, during the period between 2010 and 2019. Results: The average age was 63.2 years. There was a predominance of inflammatory intestinal disease as a personal pathological antecedent, as well as alcoholism as a risk factor. The predominant symptoms were abdominal pain and changes in intestinal habits, as well as a tumor palpable on physical abdominal examination. Abdominal ultrasound and lower barium enema were the most used diagnostic procedures. Tumors prevailed at the level of the left descending colon. All malignant tumors were adenocarcinomas, predominantly moderately differentiated ones. Conclusions: Advanced ages of life, as well as smoking and alcoholism are characteristic epidemiological factors among the population of patients suffering from colon cancer with hepatic metastases. The clinical elements identified were those usually described in the medical literature, although the imaging studies used preoperatively were limited for the diagnosis of colon cancer with synchronic hepatic metastasis, a fact that required finding metastatic lesions during surgery(AU)


Subject(s)
Humans , Male , Female , Middle Aged , Surgical Procedures, Operative/methods , Abdominal Pain/etiology , Colonic Neoplasms/diagnosis , Neoplasm Metastasis/diagnostic imaging , Epidemiologic Factors , Epidemiology, Descriptive , Cross-Sectional Studies , Observational Studies as Topic
11.
Rev. colomb. cir ; 36(2): 358-365, 20210000. fig
Article in Spanish | LILACS | ID: biblio-1247573

ABSTRACT

El adenocarcinoma colorrectal es la tercera causa de muerte por cáncer en mujeres y la cuarta en hombres a nivel mundial. Se diagnostica en su mayoría en pacientes mayores a los 50 años, siendo la edad media al momento del diagnóstico los 72 años. A pesar eso, se estima que en los próximos años aumentará la incidencia en personas jóvenes y de mediana edad. Debido a esta proyección y considerando que la ausencia de signos y síntomas específicos no permite un diagnóstico oportuno, se hacen necesarias la sensibilización clínica y un alto índice de sospecha en las presentaciones atípicas. Se presenta el caso de una paciente joven que consulta por un cuadro de un mes de síntomas respiratorios quien, después de tratamiento antibiótico, antiviral e inmunomodulador sistémico, presenta sepsis de origen abdominal por peritonitis de cuatro cuadrantes secundaria a perforación de colon sigmoide debida a adenocarcinoma bien diferenciado, metastásico a pulmón, que la llevó a la muerte


Colorectal adenocarcinoma is the third leading cause of cancer death in women and the fourth in men worldwide. It is diagnosed mostly in patients older than 50 years, being 72 years the mean age at diagnosis. Despite this, it is estimated that the incidence in young and middle-aged people will increase in the coming years. Due to this projection and considering that the absence of specific signs and symptoms does not allow a timely diagnosis, clinical sensitization and a high index of suspicion are necessary in atypical presentations. We present the case of a young female patient who consulted for a one-month history of respiratory symptoms who, after treatment with antibio-tic, antiviral and systemic immunomodulatory agents, presented sepsis of abdominal origin due to four-quadrant peritonitis secondary to perforation of the sigmoid colon due to adenocarcinoma well differentiated, metastatic to the lung, which led to her death


Subject(s)
Humans , Colorectal Neoplasms , Neoplasm Metastasis , Peritonitis , Colonic Neoplasms , Young Adult , Intestinal Perforation
12.
An. bras. dermatol ; 96(1): 103-105, Jan.-Feb. 2021. graf
Article in English | LILACS | ID: biblio-1152796

ABSTRACT

Abstract Muir-Torre syndrome is a rare, autosomal dominant genodermatosis, characterized by sebaceous neoplasms and visceral carcinomas. The authors describe the case of a patient who, 16 years after the diagnosis of colon carcinoma, presented a verrucous plaque on the pubic region, histopathologically compatible with sebaceous adenoma. The need to investigate this syndrome is emphasized, especially in cases of sebaceous neoplasms located outside the head, face, and neck. Screening for neoplasms in these patients and their families is mandatory.


Subject(s)
Humans , Sebaceous Gland Neoplasms , Carcinoma , Adenoma , Colonic Neoplasms , Muir-Torre Syndrome
13.
Rev. Col. Bras. Cir ; 48: e20202644, 2021. graf
Article in English | LILACS | ID: biblio-1155365

ABSTRACT

ABSTRACT Objective: to establish the epidemiological profile of ostomized patients treated at the Health Care Service for Ostomy Patients in Juiz de Fora and region (SASPO/JF) and to quantify the pathologies that led to the stoma as well as the ostomy-related complications. Method: a retrospective study was carried out with the analysis of 496 medical records of patients registered at HCSOP/JF over 30 years and who remained in at the service in June 2018. The following variables were considered: age, sex, pathology that led to the stoma, type, time, location and complications of stomas. Results: 53.43% were male patients and 46.57% female. The average age was 56.24 years among men and 58.40 years among women. Eight patients had two types of ostomies simultaneously and a total of 504 ostomies were as follows: 340 colostomies (67.46%), 117 ileostomies (23.21%) and 47 urostomies (9.33%). Additionally, 47.65% of the colostomies and 76.92% of the ileostomies were temporary, while all urostomies were permanent. In 70.24% of cases, the reason for making the stoma was malignancy. There were 277 stomas with one or more complications (54.96%). Conclusions: most of the ostomized patients were over 50 years old and the main diagnosis that led to the stoma was malignancy. Ileostomies had a higher percentage of complications than colostomies and urostomies and, for all types of stomas, the most frequent complication was dermatitis.


RESUMO Objetivo: elaborar o perfil epidemiológico dos pacientes estomizados atendidos no Serviço de Atenção à Saúde da Pessoa Ostomizada de Juiz de Fora e região (SASPO/JF) e quantificar tanto as patologias que levaram à confecção, quanto as complicações presentes nas estomias. Método: realizado estudo retrospectivo com análise de 496 prontuários de pacientes cadastrados no SASPO/JF ao longo de 30 anos e que permaneciam em atendimento no serviço em junho de 2018. Foram consideradas as seguintes variáveis: idade, sexo, patologia que levou à confecção do estoma, tipo, caráter temporal, localização e complicações das estomias. Resultados: 53,43% dos pacientes eram do sexo masculino e 46,57% do sexo feminino. A média de idade entre os homens foi de 56,24 anos e entre as mulheres foi de 58,40 anos. Oito pacientes apresentaram dois tipos de estomias simultaneamente e o total de 504 estomias foi distribuído da seguinte forma: 340 colostomias (67,46%), 117 ileostomias (23,21%) e 47 urostomias (9,33%). Além disso, 47,65% das colostomias e 76,92% das ileostomias foram temporárias, enquanto todas as urostomias foram permanentes. Em 70,24% dos casos, o motivo para confecção do estoma foi a neoplasia maligna. Foram encontrados 277 estomas com uma ou mais complicações (54,96%). Conclusão: as estomias predominaram em pacientes com mais de 50 anos e o principal diagnóstico que levou à confecção dos estomas foi a neoplasia maligna. As ileostomias apresentaram maior percentual de complicações do que as colostomias e urostomias e, para todos os tipos de estomas, a complicação mais frequente foi a dermatite.


Subject(s)
Humans , Male , Female , Adult , Aged , Ostomy/methods , Ostomy/statistics & numerical data , Colorectal Neoplasms/surgery , Colonic Neoplasms/surgery , Delivery of Health Care/statistics & numerical data , Colostomy/methods , Colostomy/statistics & numerical data , Ileostomy/methods , Ileostomy/statistics & numerical data , Retrospective Studies , Colorectal Surgery , Middle Aged
14.
Braz. j. med. biol. res ; 54(2): e10394, 2021. tab, graf
Article in English | LILACS | ID: biblio-1153512

ABSTRACT

MicroRNAs (miRNAs) have been indicated to be frequently dysregulated in various cancers and promising biomarkers for colon cancer. The present study aimed to assess the prognostic significance and biological function of miR-1273a in colon cancer. The expression levels of miR-1273a was estimated using quantitative real-time polymerase chain reaction. Kaplan-Meier survival curves and Cox regression analysis were used to evaluate the prognostic value of miR-1273a in patients of colon cancer. The effects of miR-1273a on cell proliferation, migration, and invasion were investigated by cell experiments. The expression of miR-1273a was downregulated in colon cancer tissues and tumor cell lines compared with the normal controls (all P<0.001). The aberrant expression of miR-1273a was associated with vascular invasion (P=0.005), differentiation (P=0.023), lymph node metastasis (P=0.021), and TNM stage (P=0.004). The patients with low miR-1273a expression had low overall survival compared with the patients with high miR-1273a expression (log-rank P=0.002). miR-1273a was detected to be an independent prognostic biomarker for patients. Furthermore, the results of cell experiments revealed that miR-1273a downregulation promoted, while miR-1273a upregulation suppressed the cell proliferation, migration, and invasion. In conclusion, all data indicated that a downregulated expression of miR-1273a predicted poor prognosis for colon cancer and enhanced tumor cell proliferation, migration, and invasion. Thus, we suggest that methods to promote miR-1273a expression may serve as novel therapeutic strategies in colon cancer.


Subject(s)
Humans , Male , Female , Middle Aged , Colonic Neoplasms/diagnosis , MicroRNAs/genetics , Biomarkers, Tumor/genetics , Cell Movement/genetics , Colonic Neoplasms/genetics , Cell Proliferation/genetics , Neoplasm Invasiveness
15.
Autops. Case Rep ; 11: e2020224, 2021. graf
Article in English | LILACS | ID: biblio-1142411

ABSTRACT

Retroperitoneal liposarcomas are rare tumors arising from the soft tissue of the retroperitoneum and are of mesenchymal cell origin. They can reach a large size prior to causing symptoms and generally have a poor prognosis. We present the case of a 93-year-old lady presenting with a large retroperitoneal liposarcoma at the site of a previous colonic anastomosis for the adenocarcinoma treatment. It caused minimal symptoms initially, but surgical resection was undertaken when the tumor was found to be growing significantly in size. However, due to the tumor's location and its invasion into surrounding structures, the resection was not feasible and subsequently abandoned. A retroperitoneal liposarcoma arising from the site of a previous colonic resection has not been previously described. A review of the diagnosis and current management of these lesions is also given.


Subject(s)
Humans , Female , Aged, 80 and over , Retroperitoneal Neoplasms/pathology , Colonic Neoplasms , Liposarcoma/pathology , Colorectal Surgery
16.
Evid. actual. práct. ambul ; 24(1): e002102, 2021. tab
Article in Spanish | LILACS | ID: biblio-1222362

ABSTRACT

El cáncer colorrectal presenta un problema para la salud pública a nivel mundial. En Argentina, se diagnostican aproximadamente 13.500 casos cada año. El tamizaje como medida de prevención secundaria es una medida beneficiosa para lograr un abordaje temprano con mejores resultados. Los dos métodos más utilizados para el tamizaje son la videocolonoscopía y la prueba de sangre oculta en materia fecal, sobre todo la de tipo inmunoquímico que con el paso de los años fue reemplazando a la prueba de guayaco por su mayor practicidad. El primero es un método invasivo y que requiere anestesia, mientras que el segundo no tiene un efecto adverso directo pero debe realizarse con una cadencia mayor. El objetivo de los autores de este artículo fue evaluar la evidencia sobre la sensibilidad y especificidad de ambos métodos, como también sus beneficios y daños a partir de la consulta de un paciente a su médico de familia. Ninguna prueba parecería ser inferior para el tamizaje de cáncer colorrectal en una población de riesgo promedio, y ambas pueden usarse en programas de rastreo. Sin embargo, no existen estudios que comparen ambos métodos de manera directa, y toda prueba inmunoquímica fecal positiva debe ser seguida de una colonoscopía. La elección de la prueba puede depender de los valores y preferencias de los pacientes. (AU)


Colorectal cancer presents a public health problem worldwide. In Argentina, approximately 13,500 cases appear each year. Screening as a secondary prevention measure is a beneficial measure to achieve an early approach with better results. The two most used methods for screening are video colonoscopy and faecal immunochemical test, the former being invasiveand requiring anaesthesia, while the latter does not have a direct adverse effect but must be performed at a higher rate. The objective of this article was to evaluate the evidence for the sensitivity and specificity of both methods, as well as their benefits and harms. No test would appear to be inferior for colorectal cancer screening in an average-risk population, and both can be used in screening programs. However, there are no studies comparing both methods directly, and any positive faecal immunochemical test should be evaluated with a colonoscopy. The choice of the test may depend on the values and preferences of the patients. (AU)


Subject(s)
Humans , Male , Middle Aged , Colonic Neoplasms/prevention & control , Early Detection of Cancer/methods , Patient Participation , Mass Screening/methods , Meta-Analysis as Topic , Public Health , Sensitivity and Specificity , Colonoscopy/statistics & numerical data , Early Detection of Cancer/adverse effects , Secondary Prevention/methods , Patient Preference , Systematic Reviews as Topic , Occult Blood
17.
Article in English | WPRIM | ID: wpr-922123

ABSTRACT

BACKGROUND@#The side effects of chemotherapy-induced nausea and vomiting (CINV) and myelosuppression reduce the cancer patients' adherence to chemotherapy. Many Chinese patients choose Chinese medicine (CM) during chemotherapy to reduce side effects; however, the evidence is lacking. The efficacy of a CM herbal treatment protocol, Jianpi Bushen Sequential Formula (, JBSF) will be evaluated on chemotherapy completion rate among patients with colon cancer.@*METHODS@#A multi-center double-blind randomized controlled trial (RCT) will be conducted on 400 patients with colon cancer who will receive 8 cycles of adjuvant chemotherapy with oxaliplatin and capecitabine (CAPEOX). Patients will be randomized 1:1 to receive the JBSF or placebo formula. The primary outcome is the overall chemotherapy completion rate. The secondary outcomes include individual chemotherapy completion rate, 4-cycle completion rate of chemotherapy, time to treatment failure, relative dose intensity and treatment toxicity. Follow-up visits will be scheduled before every and after last chemotherapy.@*DISCUSSION@#This study will provide evidence on whether JBSF can improve the chemotherapy completion rate and reduce side effects among patients with colon cancer. (Trial registration: ClinicalTrials.gov, No. NCT03716518).


Subject(s)
Chemotherapy, Adjuvant , Colonic Neoplasms/drug therapy , Double-Blind Method , Humans , Multicenter Studies as Topic , Nausea , Quality of Life , Randomized Controlled Trials as Topic , Treatment Outcome , Vomiting
18.
Article in Chinese | WPRIM | ID: wpr-921529

ABSTRACT

Objective To establish a human colon cancer cell line HCT-116/5-FU resistant to 5-fluorouracil(5-FU)and explore the relationship between runt-related transcription factor 3(RUNX3)and drug resistance of colorectal cancer.Methods The human colon cancer cell line HCT-116/5-FU with resistance to 5-FU was established by low concentration gradient increment combined with high-dose intermittent shock.CCK-8 method was used to determine the half maximal inhibitory concentration(IC


Subject(s)
Cell Line, Tumor , Colonic Neoplasms/genetics , Core Binding Factor Alpha 3 Subunit , Drug Resistance, Neoplasm , Fluorouracil/pharmacology , Humans , Transcription Factor 3
19.
Article in Chinese | WPRIM | ID: wpr-878893

ABSTRACT

This study aims to investigate the potential mechanism of curcumin in mediating interleukin-6(IL-6)/signal transducer and activator of transcription 3(STAT3) signaling pathway to repair intestinal mucosal injury induced by 5-fluorouracil(5-FU) chemotherapy for colon cancer. SD rats were intraperitoneally injected with 60 mg·kg~(-1)·d~(-1) 5-FU for 4 days to establish a model of intestinal mucosal injury. Then the rats were randomly divided into model group(equal volume of normal saline), curcumin low, medium and high dose groups(50, 100, 200 mg·kg~(-1)), and normal SD rats were used as control group(equal volume of normal saline). Each group received gavage administration for 4 consecutive days, and the changes of body weight and feces were recorded every day. After administration, blood was collected from the heart, and jejunum tissues were collected. The levels of serum interleukin-1β(IL-1β) and tumor necrosis factor-α(TNF-α) were detected by ELISA, and at the same time, the concentration of Evans blue(EB) in jejunum was measured. Hematoxylin-eosin(HE) staining was used to observe the pathological state of jejunum, and the length of jejunum villi and the depth of crypt were measured. The positive expression levels of claudin, occludin and ZO-1 were detected by immunohistochemistry. Western blot was used to detect the protein expression of IL-6, p-STAT3, E-cadherin, vimentin and N-cadherin in jejunum tissues. The results showed that, curcumin significantly increased body weight and fecal weight(P<0.05 or P<0.01), decreased fecal score, EB concentration, IL-1β and TNF-α levels(P<0.05 or P<0.01) in rats. In addition, curcumin maintained the integrity of mucosal surface and villi structure of jejunum to a large extent, and reduced pathological changes in a dose-dependent manner. Meanwhile, curcumin could increase the positive expression of occludin, claudin and ZO-1(P<0.05 or P<0.01), repair intestinal barrier function, downregulate the protein expression of IL-6, p-STAT3, vimentin and N-cadherin in jejunum tissues(P<0.05 or P<0.01), and upregulate the protein expression of E-cadherin(P<0.05). Therefore, curcumin could repair the intestinal mucosal injury induced by 5-FU chemotherapy for colon cancer, and the mechanism may be related to the inhibition of IL-6/STAT3 signal and the inhibition of epithelial-mesenchymal transition(EMT) process.


Subject(s)
Animals , Colonic Neoplasms/drug therapy , Curcumin , Fluorouracil/toxicity , Interleukin-6/genetics , Intestinal Mucosa/metabolism , Rats , Rats, Sprague-Dawley , STAT3 Transcription Factor/metabolism , Signal Transduction
20.
Article in Chinese | WPRIM | ID: wpr-879187

ABSTRACT

Astragali Radix-Curcumae Rhizoma is a classic drug pair mainly used for the treatment of digestive tract-related inflammation and tumors, but the ratio is not fixed in clinical practice. In order to study whether the anti-tumor effect of the drug pair is diffe-rent under different ratios, orthotopic transplantation model of colon cancer was established in mice. Then the principal component analysis(PCA) and cluster analysis(CA) were used to explore the effect of different ratios of the drug pair on the tumor growth and metastasis, and select the optimal ratio of Astragali Radix-Curcumae Rhizoma for anti-colon cancer effect. After administration for 15 days, the body weight of colon cancer mice with the tumor removed, the tumor volume and the number of liver metastases were mea-sured; the pathological changes of tumor tissue and liver tissue were observed by HE staining. At the same time, Western blot method was used to detect the protein expression level of tumor growth-related indicators in tumor tissue(Ki67, HBP1, AFP) and tumor metastasis-related indicators in liver tissue(β-catenin, E-cadherin, vimentin, p53) of the tumor-bearing mice. Subsequently, PCA and CA were used to select the optimal ratio of Astragali Radix-Curcumae Rhizoma for anti-colon cancer effect. The experimental results showed that different ratios of Astragali Radix-Curcumae Rhizoma inhibited tumor growth and metastasis to varying degrees. The ratio at 1∶1 of Astragali Radix-Curcumae Rhizoma had the best inhibitory effect on tumor growth, and the 2∶1 ratio group had the best effect on inhibiting liver metastasis and improving weighed loss. Astragali Radix-Curcumae Rhizoma significantly up-regulated the protein expression of HBP1 in tumor tissue of colon cancer mice, and significantly down-regulated the protein expression of Ki67 and AFP in tumor tissue; meanwhile, Astragali Radix-Curcumae Rhizoma significantly up-regulated the protein expression of E-cadherin in liver tissue of colon cancer mice, and significantly reduced the protein expression of β-catenin, vimentin and p53 in liver tissue. PCA results showed that the first three groups in the Astragali Radix-Curcumae Rhizoma compatibility group that were closer to the sham operation group were in the order of 2∶1, 1∶1 and 3∶2, among which the center distance of the 2∶1 group was the shortest from the sham operation group, indicating that the ratio 2∶1 of Astragali Radix-Curcumae Rhizoma had the best intervention effect on colon cancer in mice, consistent with the commonly used clinical proportion. CA results showed that 11 groups of colon cancer mice were classified into 3 categories: Astragali Radix-Curcumae Rhizoma compatibility group, sham operation group and model group, which was consistent with the theory. The results of this study provide a basis for more effective clinical application of Astragali Radix-Curcumae Rhizoma in the treatment of colon cancer, and provide new ideas for the development of classic drug pairs.


Subject(s)
Animals , Astragalus Plant , Colonic Neoplasms/drug therapy , Drugs, Chinese Herbal , Mice , Plant Roots , Rhizome
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