Mucins in neoplastic spectrum of colorectal polyps: can they provide predictions?

BACKGROUND: The significance of expression of different mucins in succession of malignant transformation of colorectal polyps is not determined yet. The aim of the present study was to determine the pattern of expression of MUC1, MUC2, MUC5AC and MUC6 in colorectal polyps and to evaluate the applicability of using mucin expression in predicting the extent of malignant transformation in colorectal polyps. METHODS: A total of 454 polyp specimens comprising 36 hyperplastic polyps, 15 serrated adenomas, 258 tubular adenomas, 114 tubulovillous adenomas, and 31 villous adenomas were included in this study, and were immunostained for MUC1, MUC2, MUC5AC and MUC6 by using mucin specific antibodies. RESULTS: MUC1 and MUC6 were absent in all hyperplastic polyps and their expression was higher in serrated and traditional adenomas. Only 5 cases including 2 serrated adenomas, 1 tubulovillous adenoma, and 2 villous adenomas stained negative for MUC2. The highest expression of MUC5AC was observed in serrated adenomas followed by tubular adenomas. Binary logistic regression analysis indicated that positive staining for MUC1, and MUC6, and negative staining for MUC2 would increase the risk of invasion to mucosa or the muscularis mucosae in colorectal polyps. Ordinal regression analysis demonstrated a positive association between the level of staining for MUC1 and risk of being of high configuration/grade in colorectal polyps. CONCLUSIONS: MUC1, MUC2, MUC5AC, and MUC6 have the potential to be used as predictors of malignant transformation and invasion to mucosa or the muscularis mucosae in colorectal polyps. The most reliable predictions can be achieved by determining the level of expression of MUC1.

Colorectal cancer in Iran: immunohistochemical profiles of four mismatch repair proteins.

PURPOSE: The aim of the present study was to determine the profile of mismatch repair (MMR) defects in Iranian colorectal cancer patients by using immunohistochemical staining for products of four MMR genes: MLH1, MSH2, PMS2, and MSH6. METHODS: Tissue samples of 343 patients were immunostained for MLH1, MSH2, PMS2, and MSH6. Clinical and family history and survival data were compared between normal and abnormal staining patterns. RESULTS: Fourteen percent of the patients had abnormal nuclear staining for MMR proteins. MLH1 was absent in four, MLH1/PMS2 in 15, PMS2 in five, MSH2 in 12, and MSH2/MSH6 in 12 patients. These tumors were more proximal, had a nonsignificant better survival, and were more associated with positive family history. Estimation of this study of prevalence of hereditary nonpolyposis colorectal cancer in Iran was 5.5% of the total colorectal cancers. CONCLUSIONS: Along with the recommendations of the National Institute of Cancer, we recommend immunohistochemistry staining for MLH1, MSH2, PMS2, and MSH6 for determining the eligibility of patients for mutation analysis of MMR genes.

Obesity and functional constipation; a community-based study in Iran.

BACKGROUND: Many factors have been linked to the occurrence of constipation, but few studies exist regarding the link between obesity and constipation. The aim of this study was to assess the association between body mass index (BMI) and functional constipation in the Iranian community. METHODS: From May 2006 to December 2007, a cross sectional study was conducted in the Tehran province and a total of 18,180 adult persons were drawn up randomly. One questionnaire was filled in two stages through interviews. In the first part, personal characteristics and 11 gastrointestinal symptoms were listed. Those who reported at least one of these 11 symptoms were referred for the second interview. The second part of the questionnaire consisted of questions about different gastrointestinal disorders based on the Rome III criteria including functional constipation. RESULTS: 459 adult persons were found to have functional constipation. The mean +/- SD of BMI was 26.5 +/- 4.7 and 60% of the patients had a BMI more than 25. Age and education were significantly associated factors with obesity, showing that older patients and less educated patients were more overweight and obese. Smoking, marital status and sex were not significantly associated with obesity but, up to 60% of low educated women who had functional constipation, had a BMI more than 25. CONCLUSIONS: Our study showed that about 60% of patients with functional constipation were overweight, which was more than the mean of our community. In addition there may be an association between higher BMI level and the low education level with constipation in Iranian women.

Burden of hospitalization for gastrointestinal tract cancer patients - Results from a cross-sectional study in Tehran.

BACKGROUND: Cancer is the third most common cause of death in Iran. The gastrointestinal cancers are the most frequent neoplasms among Iranian males and second to breast cancer among females. The objective of this study was to provide accurate up-to-date epidemiological information of hospitalized patients with GI tract cancer in Iran. METHODS: This study was designed as a retrospective cross-sectional survey included all consecutive GI cancer patients admitted over a one year period in a randomly selected hospital group located in metropolitan Tehran in 2006. Residence, age, sex, type of cancer and length of hospitalization were analyzed. RESULTS: A total of 2,674 GI tract cancer patients were included in the study, There were 1,616 men (60.4%) and 1,058 women (39.6%). The majority of cancers were in the colorectum (40.0%), followed by the stomach (34.5%) and the esophagus (17.1%). The mean hospitalized durations were 7.5-/+6.5 days for men and 7.2-/+8.1 days for women. Male patients were significantly older than the women. CONCLUSION: By considering the hospitalized GI tract cancers and majority cases of colorectal cancer, prevention programs like as CRC screening should be going on in order to reducing morbidity and incidence rates in a high-risk population for GI tract cancers.