ABSTRACT
Background: The colon has two different embryological origins, which is why it can be divided into right and left with different characteristics each one; therefore, neoplastic lesions have a different clinical picture and are also associated with different pathologies. Objective: To describe the clinical and histopathological characteristics of malignant colon tumors acording to their location. Material and methods: Descriptive, retrospective study with 94 patients diagnosed with colon cancer. Descriptive statistics were performed with the calculation of frequencies and percentages, and chi-squared tests were calculated. Results: Mean age was 61.3 years, 49 (52.1%) were women; 53 (56.4%) were left-sided and 41 (43.6%) right-sided. The main symptom was hematochezia in 32 (60.4%), in patients with left cancer; and diarrhea in 20 (48.8%), in patients with right-sided colon cancer. The presentation of stage I tumors and polyps, p = 0.044 and p = 0.043, respectively, was more frequent on the right side compared to the left side; in the left, hematochezia (p = 0.001), narrow stools(p = 0.05), and a history of type 2 diabetes mellitus (T2DM) (p= 0.036) were more frequent compared to the opposite site. Conclusions: Stage I and the presence of polyps were more frequent in right-sided cancer compared to left-sided cancer; T2DM, as well as hematochezia and narrow stools were more associated with the left side compared to the right side.
Introducción: el colon tiene dos orígenes embriológicos distintos, con lo que se puede dividir en derecho e izquierdo y cada uno tiene características diferentes; por tanto, las lesiones neoplásicas tienen un cuadro clínico diferente y se asocian también a diferentes patologías. Objetivo: describir las características clínicas e histopatológicas de los tumores malignos de colon según su localización. Material y métodos: estudio descriptivo, retrospectivo con 94 pacientes con diagnóstico de cáncer de colon. La estadística descriptiva se realizó con el cálculo de frecuencias y porcentajes, y se aplicaron pruebas de chi cuadrada. Resultados: la edad media fue 61.3 años, 49 (52.1%) fueron mujeres; 53 (56.4%) casos fueron izquierdos y 41 (43.6%) derechos. El síntoma principal fue hematoquecia en 32 (60.4%), en pacientes con cáncer izquierdo; y diarrea en 20 (48.8%), en pacientes con cáncer derecho. La presentación de tumores en estadio I y pólipos, p = 0.044 y p = 0.043, respectivamente, fue más frecuente en el lado derecho comparado con el lado izquierdo; en el izquierdo fueron más frecuentes la hematoquecia (p = 0.001), la disminución del grosor de las heces (p = 0.05) y el antecedente de diabetes mellitus 2 (p= 0.036) respecto al sitio contrario. Conclusiones: el estadio I y la presencia de pólipos fueron más frecuentes en el cáncer derecho comparado con el izquierdo; la diabetes mellitus 2, así como la hematoquecia y la disminución en el grosor de las heces se asociaron más al lado izquierdo en comparación con el derecho.
Subject(s)
Colonic Neoplasms , Diabetes Mellitus, Type 2 , Humans , Female , Middle Aged , Male , Retrospective Studies , Colonic Neoplasms/diagnosis , Gastrointestinal Hemorrhage , Neoplasm Staging , PrognosisABSTRACT
Objective To explore the expression of transcriptional regulation factor FHL 1 in pancreatic fibrosis of chronic pancreatitis (CP) and clinical significance.Methods Serum samples from 20 CP patients treated in the Department of Gastroenterology , Nanjing General Hospital and 20 healthy controls in the corresponding period were collected .The level of FHL1 in the serum was detected by ELISA .Twenty male Wistar rats were randomly divided into control group and CP group according to the body weight .The CP rat model was established by injecting dibutyltin dichloride ( DBTC) through tail vein .All the rats were killed at 28 days after injection and the pancreas was collected , which was observed using hematoxylin and eosin ( HE) staining to investigate pathological changes . The expression of FHL1 in pancreas was measured by immunohistochemistry (IHC) and Western blotting (WB).Results The average of serum FHL1 level in two groups were (0.86 ±0.22)g/L and (1.18 ±0.22)g/L, respectively.The level of FHL1 in serum of CP patients was significantly lower than that of healthy cases , and the difference was statistically significant (t=10.54, P=0.001).Damaged pancreatic lobular structure , acinar atrophy and the obvious fibrous hyperplasia were observed in CP rats .The pathological score of abnormal structure , acinar atrophy, fibrosis, and inflammatory cell infiltration in the pancreas of the CP group was (2.2 ±0.4),(2.0 ±0.7),(2.4 ±0.3) and (2.8 ±0.6), respectively, but was all 0 in control group.The difference between two group was statistically significant ( t value =17.24, 9.01, 25.22 and 14.75, respectively, all P<0.001).The expression of FHL1 in the pancreatic tissue of CP group were less than that of normal group , and the difference was statistically significant (IHC:15 798 ±3 247 vs 37 570 ±9 254, t=2.438,P=0.016;WB:0.44 ±0.11 vs 0.89 ±0.03, t=4.289, P=0.002).Conclusions The protein of FHL1 was in low expression in the pancreas of CPs , indicating that FHL1 may participate in the formation of pancreatic fibrosis .
ABSTRACT
Arteriovenous malformations (AVMs) comprising a feeding artery, nidus, and draining vein rarely develop in the gastrointestinal tract. Although almost all AVMs are asymptomatic, they cause massive painless rectal bleeding and subsequent chronic anemia. The definitive diagnosis of AVM is achieved by selective mesenteric angiography, and surgical resection is the treatment of choice. We detected an intestinal AVM involving the descending colon in a patient with severe hematochezia. The diagnosis was made by CT angiography performed using a 64-channel MDCT and the obtained 3D reconstruction images. The AVM showed an extensive vascular network on CT images, and it was treated by surgical resection. Here, we report this case of an intestinal AVM along with its imaging findings.
