Is Seum Homocysteine Level Elevated in Colorectal Tumor? / 대한소화기학회지

BACKGROUND/AIMS: Although it has been known that folate will participate in colorectal carcinogenesis, the relationship between blood folate level and colorectal cancer is less consistent. The blood folate level does not reflect the systemic folate status. By contrast, serum homocysteine has become a sensitive marker for the folate deficiency. We attempted to explain the correlation between folate and colorectal cancer according to the serum homocysteine level. METHODS: We reviewed the clinical records, including alcohol history of 184 patients taking the colonoscopy and measurement of the serum homocysteine level at Health Promotion Center from 2001 to 2002. One hundred fifty-one of 184 were included, excluding 33 patients with previous history of colonic polyp, cerebrovascular, cardiovascular attack and thromboembolism. They were divided into the normal control (n=111) and the adenomatous polyp group (n=40). We had selected the colorectal cancer group (n=50) from the collection list of the tissue and blood bank less than 3 months storage interval. RESULTS: There was no significant difference in the mean serum homocysteine level among three groups. However, in the subjects with high alcohol consumption, there was a significant difference in the mean serum homocysteine between the normal control (n=7) and the adenomatous polyp group (n=9) (10.2 vs 15.1 micromol/L, p<0.05). CONCLUSIONS: There was no correlation of serum homocysteine and colorectal tumor. However, in the subjects with high alcohol consumption, high serum homocysteine might be related to the development of adenomatous polyp.

Research Advance of Muir-Torre Syndrome / 中国普外基础与临床杂志

Objective To review recent studies on Muir Torre syndrome (MTS) and to improve the knowledge about MTS.Methods The literatures in recent years on clinic and gene research of MTS were reviewed.Results MTS was is a rare autosomal dominant disorder characterized by the predisposition to both sebaceous tumors (or multiple keratoacanthomas) and internal malignancies. Gastrointestinal cancers were the most common kind of internal malignancies in MTS patients(61%),followed by genitourinary cancers(22%). In most cases(56%),sebaceous tumors appeared after the emergence of internal maliganancy. Both hereditary nonpolyposis colorectal cancer(HNPCC) and MTS were caused by germline mutations in the DNA mismatch repair genes. MTS patients exhibit significantly more mutations in the hMSH2 than in the hMLH1. In these cases , both internal and skin tumors showed the characteristic of high microsatellite instability(MSI).Conclusion The presence of sebaceous tumors(or multiple keratoacanthomas) necessitates the search for internal malignancies. It is mandatory that patients with MTS, as patients with HNPCC, should be regularly followed up to search new malignancies. Evaluation and monitoring of the family members of patients are also necessary. The patients and their families should be counseled for genetic test. Sequencing the hMSH2 gene should be the prior selection of further examinations when clinical manifestations, history and laboratory tests suggest MTS.