Expression of NF-kB and COX2 in colorectal cancer among native Indonesians: the role of inflammation in colorectal carcinogenesis.

AIM: to evaluate the expression of NF-kB and COX2 in native Indonesians with sporadic colorectal cancer (CRC). METHODS: we conducted a matched-pair case-control study by acquiring both CRC and tumor-adjacent normal tissues from the same subjects. CRC patients who underwent surgery at Cipto Mangunkusumo Hospital, Jakarta, or Hasan Sadikin Hospital, Bandung, were enrolled in the study. The specimens were immunohistologically stained with antibody directed against p65 (RelA) to assess NF-kB expression and against human COX2 protein to assess COX2 expression. RESULTS: sixty-seven specimens consisting of both CRC and tumor-adjacent normal tissues were analyzed. COX2 expression was positive in 39 CRC tissues (58.2%), but in only 19 tumor-adjacent normal tissues (28.4%; p=0.0002). NF-kB expression was positive in 47 CRC tissues (70.1%), but in only 27 tumor-adjacent normal tissues (40.3%; p<0.0001). CONCLUSION: inflammation plays a role in the carcinogenesis of sporadic CRC in native Indonesians. This support potential use of nonsteroidal anti-inflammatory drugs as chemopreventive agents for CRC.

A randomized, controlled, double-blind trial of the adjunct use of Clebopride in polyethylene glycol electrolyte (PEG) solution for colonoscopy preparation.

AIM: To study the benefit of Clebopride as an adjuvant in polyethylene glycol electrolyte (PEG) solution for colonoscopy preparation. METHODS: Eighty one adult patients who underwent colonoscopy examination were recruited in this randomized double blind controlled study. First group received PEG and placebo, whereas second group received PEG and Clebopride. Two litres of PEG was taken at night before colonoscopy. The acceptability and tolerability of bowel preparation were assessed through interview method. The efficacy of bowel preparation was assessed using Aronchick's Criteria. RESULTS: In terms of acceptability, 64 patients (31 patients from placebo group vs 33 patients from Clebopride group) were able to drink two litres of PEG solution. Sixty patients (29 patients from placebo group and 31 patients from Clebopride group) were willing to accept PEG solution for their next bowel preparation. On the term of tolerability, nausea, abdominal distension, and borborygmus were more frequent in the placebo group (34.2% vs 27.9%; 44.7% vs 32.6%; 26.3% vs 4.6% respectively). However, only the difference at the incidence of borborygmus that was statistically significant (p<0.05). On the terms of efficacy, both groups showed a comparable bowel preparation quality with 88.4% of bowel preparation in Clebopride group and 81.6% of bowel preparation in placebo group were optimal (p = 0.585). CONCLUSION: The adjunct use of Clebopride in PEG solution for colonoscopy preparations tends to increase the acceptability, tolerability, and efficacy. The presence of borborygmus was significantly lower in the Clebopride group.

Expression of NF-kappaB and COX-2 in young versus older patients with sporadic colorectal cancer.

AIM: To distinguish the expression of NF-kappaB and COX-2 between young and older group of sporadic colorectal cancer patients. METHODS: This was a comparative study between sporadic CRC patients aged 40 years or younger and patients aged 60 years or more. Expression of NF-kappaB and COX-2 were assessed by immunohistochemical method using rabbit polyclonal antibodies against human p65 NF-kappaB and COX-2 proteins. RESULTS: There were 98 cases of sporadic colorectal cancers between 1999 and 2007 obtained from the Department of Anatomical Pathology, Faculty of Medicine University of Indonesia, Jakarta and Department of Anatomical Pathology, Faculty of Medicine Padjajaran University, Bandung. There were 60 patients aged 60 years or more and 38 patients aged 40 years or less. Most tumors were located in the distal colon. Positive expression of NF-kappaB was found in 72 (73.5%) cases, whereas COX-2 expression was found in 48 (49.0%) cases. No significant difference of NF-kappaB and COX-2 expression between young and older patients. CONCLUSION: The expression of nuclear factor kappaB (NF-kappaB) in Indonesian patients with sporadic colorectal cancer was high. However, cyclooxygenase-2 (COX-2) was only expressed in half of patients. There was no significant difference of NF-kappaB and COX-2 expressions between patients aged 40 years or less and patients aged 60 years or more. Further studies are needed to elaborate the role of inflammation in sporadic colorectal carcinogenesis.