ABSTRACT
BACKGROUND: Recent genome-wide studies identified a risk locus for colorectal cancer at 18q21, which maps to the SMAD7 gene. Our objective was to confirm the association between SMAD7 SNPs and colorectal cancer risk in the multi-center Colon Cancer Family Registry. MATERIALS AND METHODS: 23 tagging SNPs in the SMAD7 gene were genotyped among 1,592 population-based and 253 clinic-based families. The SNP-colorectal cancer associations were assessed in multivariable conditional logistic regression. RESULTS: Among the population-based families, both SNPs rs12953717 (odds ratio, 1.29; 95% confidence interval, 1.12-1.49), and rs11874392 (odds ratio, 0.80; 95% confidence interval, 0.70-0.92) were associated with risk of colorectal cancer. These associations were similar among the population- and the clinic-based families, though they were significant only among the former. Marginally significant differences in the SNP-colorectal cancer associations were observed by use of nonsteroidal anti-inflammatory drugs, cigarette smoking, body mass index, and history of polyps. CONCLUSIONS: SMAD7 SNPs were associated with colorectal cancer risk in the Colon Cancer Family Registry. There was evidence suggesting that the association between rs12953717 and colorectal cancer risk may be modified by factors such as smoking and use of nonsteroidal anti-inflammatory drugs.
Subject(s)
Colorectal Neoplasms/genetics , Genetic Predisposition to Disease , Polymorphism, Single Nucleotide , Registries , Smad7 Protein/genetics , Adult , Aged , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Body Mass Index , Case-Control Studies , Colonic Polyps/complications , Colonic Polyps/pathology , Colorectal Neoplasms/etiology , Colorectal Neoplasms/pathology , Female , Humans , Logistic Models , Middle Aged , Odds Ratio , Risk , Smoking/adverse effectsSubject(s)
Humans , Female , Middle Aged , Leiomyosarcoma/pathology , Renal Veins/pathology , Retroperitoneal Neoplasms/surgeryABSTRACT
BACKGROUND/AIMS: Laparoscopic cholecystectomy is now accepted as being safe for acute cholecystitis. However, it has not become routine, because the exact timing and approach to the surgical management remains ill defined. This study evaluated the effect of timing of LC in patients with acute cholecystitis. METHODOLOGY: Group 1, those patients who had LC for AC within 72 hours was compared with group 2, those who had LC for AC after 72 hours. Univariate logistic regression analysis and multivariate regression analysis were used to determine if any factors had a significant association with the complications, postoperative hospital stay, and conversion index. A value of p < 0.05 was considered statistically significant. RESULTS: Comparing the two groups, the conversion rate to an open procedure was significantly less (7.8% versus 18.4%, P_0.02) in the early treated patients. Furthermore, postoperative hospitalization (6.5 versus 9.5 days, P 0.01), and complications (8.8% versus 17.7%, P _0.02) were significantly reduced in patients undergoing early laparoscopic cholecystectomy. CONCLUSION: There is no advantage to delaying cholecystectomy for acute cholecystitis on the basis of outcomes in complications, rate of conversion to open surgery, and mean hospital stay. Thus, early cholecystectomy should be be the preferred surgical approach for patients with acute lithiasic cholecystitis.
