Role of macrophage colony stimulating factor and carcinoembryonic antigen in the diagnosis of colorectal cancer

Hematopoietic cytokines [HCs] induce proliferation of hematopoietic progenitor cells. Moreover, the HCs receptors have been found on non hematopoietic tumor cell lines including colorectal cancer [CRC]. Elevated concentrations of several circulating cytokines, among which macrophage colony stimulating factor [M-CSF], have been previously shown in patients with colorectal carcinoma. Elevated serum concentrations of M-CSF have been found in a variety of malignant diseases. The aim of our study was to study the significance of combined M-CSF and carcinoembryonic antigen [CEA] in the diagnosis of CRC and the association between of schistosomiasis endemicity and colorectal cancer

Patients and methods: The serum levels of M-CSF and CEA were assayed in 29 colorectal cancer, 29 colorectal adenoma patients and in 29 healthy subjects [control group]. We defined the diagnostic sensitivity, specificity and areas under ROC curves for the measurands. Complete colonoscopic examination and rectal snip for bilharzial ova were done

Results: Median values of MCSF and CEA were signiJicantIy higher in colorectal cancer patients than those in healthy subjects. The diagnostic specificities and positive predictive value were higher for M-CSF. The highest values of diagnostic parameters were observed when M-CSF and CEA were combined. The M-CSF area under the receiver operating characteristic [ROC] curve was larger than the area of CEA

Conclusions: M-CSF might be useful as a tumor marker, especially in combination with CEA, for diagnosis of colorectal cancer, but not in the differentiation between colorectal cancer and polyps

Bacterial nosocomial infections in chronic liver diseases

This study aimed to survey nosocomial infection in 90 patients with different stages of chronic liver disease in addition to 20 patients without liver diseases as a control group. 37.8% of the patients developed nosocomial infections during the course of their hospitalization compared with 20% of control subjects. A spontaneous bacterial peritonitis accounted for 44.1%, infection of respiratory tract accounted for 35.3%, followed by urinary tract infections [14.7%] and bacteremia [11.8%], intravenous cannula site infection [11.8%] and cellulitis [2.9%]. In conclusion, patients with liver cirrhosis are at an increased risk of developing nosocomial bacterial infections which add to poor prognosis and are associated with significantly high morbidity and mortality