Colorectal Cancer in South Africa: a Heritable Cause Suspected in many Young Black Patients
S. Afr. med. j. (Online)
; 99(2): 103-106, 2009.
Article
in En
| AIM
| ID: biblio-1271284
Responsible library:
CG1.1
ABSTRACT
Background. Colorectal carcinoma (CRC) has a low incidence among the black African population. Largely unrecognised in the scientific literature is the fact that a disproportionately large number of young black patients (50 years old) present with CRC. Objectives. To analyse those tumours; which we propose may link them to morphological features associated with known genetic pathways. Methods. A retrospective review of South African patients histologically diagnosed as having CRC by the Division of Anatomical Pathology; National Health Laboratory Service (NHLS) and the University of the Witwatersrand (1 732 patients from 1990 to 2003). The histology was fully reviewed in 609 patients (1997 - 2002); and all specimens from patients 50 years of age were subjected to immunohistochemistry tests for mismatch repair proteins; as well as APC and p53 proteins. Results. Most young patients (50 years) were black (41v. 10white; p=0.001). Blacks had predominantly proximal tumours and significantly more poorly differentiated and/or mucinous tumours (p=0.006); and loss of mismatch repair protein expression was more evident than in whites. Conclusions. It seems likely that CRC in young blacks develops through the accumulation of mutations; most probably via mis- match repair deficiency or promoter methylation; which in turn is linked to poor differentia- tion and a mucinous architecture
Full text:
1
Index:
AIM
Main subject:
Colorectal Neoplasms
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Black People
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Young Adult
Language:
En
Journal:
S Afr Med J
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S. Afr. med. j. (Online)
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SAMJ. South African medical journal
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South African medical journal
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South African medical journal (Online)
Year:
2009
Type:
Article