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PubMed1992

[Endoscopic treatment of early colorectal cancer].

Early cancer of the colon and rectum is currently treated by endoscopic or surgical resection. We studied the indications for endoscopic treatment of early colorectal cancers (80 lesions) in relation to the size and macroscopic findings. The endoscopic treatment consists of polypectomy for a pedunculated or a sessile polyp and strip biopsy for a plaque-like or a depressive lesion. Microscopic or most small cancers were completely treated endoscopically. From macroscopic findings of the early cancers, type Ip (less than 2cm and 2cm in diameter) was completely treated by polypectomy, type I s and type II a (less than 1cm and 1cm in diameter) by polypectomy or strip biopsy, and type II c (less than 0.5cm and 0.5cm in diameter) by strip biopsy.

Colonic Neoplasms↗
PubMed1991

[Multiple primary colo-rectal carcinoma--an analysis of 28 cases].

Of 226 cases with colo-rectal carcinoma treated, 21 (7.89%) had synchronous and 7 (2.63%) had metachronous multiple primary lesions. In these 28 cases, 13 (46.43%) were complicated by adenomatous polyp, in which 7 cases (53.85%) became malignant. The tumor in 9 cases (18.75%) of synchronous carcinoma was less than 1 cm in diameter and could not be palpated during operation. The early metachronous carcinoma could be detected by fiberendoscopy during follow-up. Its diagnostic accuracy can be improved by fiberendoscopy before operation and during follow-up.

Adenocarcinoma↗
PubMed1989

Generalized juvenile polyposis with carcinoma.

Generalized juvenile polyposis usually is not associated with an increased risk for gastrointestinal carcinoma. A subgroup of patients, however, have juvenile polyps with adenomatous features. A case report of juvenile polyposis, together with adenocarcinoma of the colon and review of the literature, are presented to emphasize the potential for malignancy in this subgroup of patients and to guide appropriate evaluation.

Adenocarcinoma↗
PubMed1988

[A case of signet-ring cell type cancer of the colon].

A rare case of a primary signet-ring cell carcinoma of the sigmoid colon in a 66-year-old man is reported. Endoscopically, a sessile polyp, 2 cm in diameter, was found in sigmoid colon, consisting mainly of a well differentiated adenocarcinoma and, partially of a signet-ring cell carcinoma. A residual polyp was found at the same site in the sigmoid colon, sixth months after surgery. The resected polyp was histologically confirmed as being a signet-ring cell carcinoma, which had infiltrated into submucosal space by scirrhous invasion. After a polypectomy, a partial colectomy was performed and no carcinoma cells have been identified in the resected colon. We have speculated that this signet-ring cell polyp could develop into Borrmann type 4 advanced colon cancer.

Adenocarcinoma↗
PubMed1989

Apparent synergism between radiation and the carcinogen 1,2-dimethylhydrazine in the induction of colonic tumors in rats.

We have evaluated the interaction of radiation and 1,2-dimethylhydrazine (DMH) with respect to colon carcinogenesis in the Fischer 344 rat and have demonstrated the utility of this model for future more detailed mechanistic studies. In initial experiments, single doses of abdomen-only radiation (9 Gy) or DMH (150 mg/kg) were employed alone or in combination. Radiation was administered 3.5 days prior to the DMH. At 8 months post-treatment, the incidence of DMH-induced colon tumors was doubled by prior radiation exposure. When the protocol was repeated employing a DMH dose of 135 mg/kg with a 6-month observation period, the incidence of tumors induced by DMH alone was reduced, but the combination of radiation plus DMH still resulted in an augmentation of tumor incidence. When the protocol of radiation plus DMH was repeated three times at monthly intervals, a 15-fold increase in tumor incidence (from 5 to 74%) was observed at 6 months post-treatment. This finding demonstrates an apparent synergy between the radiation and the chemical carcinogen. Throughout these studies, the appearance of carcinomas was associated with preexisting colonic lymphoid nodules. The reproducibility of tumor induction as well as range of tumor incidence generated by variations in this system may be adequately sensitive to examine the combination of much lower doses of radiation and/or chemical carcinogen. The relationship between existing lymphoid aggregates which alter local epithelial cell kinetics and which are associated with fenestrations in the basement membrane, and the development of colon cancer in congruent sites may assist in defining dose-response curves for combined agents as well as providing a system for evaluating the mechanisms underlying their interactions.

Adenoma↗
PubMed1987

DNA in situ sensitivity to denaturation: a new parameter for flow cytometry of normal human colonic epithelium and colon carcinoma.

Modal DNA (ploidy) and sensitivity of DNA in situ to denaturation by acid have been analyzed by flow cytometry of 10 colorectal adenomas and 35 adenocarcinomas; 39 normal mucosa samples served as controls. A new method was developed to denature DNA in chromatin of the freshly isolated, intact, and unfixed individual cell nuclei from surgically resected material. The sensitivity of DNA denaturation (T alpha) was assayed by metachromatic staining with acridine orange and calculated as a ratio of the alpha t index of the tumor sample to the alpha t index of normal mucosa; the alpha t index is that fraction of DNA, following treatment at pH 1.4, that stains metachromatically with acridine orange at pH 2.6. All adenomas were diploid and in nine of 10 the T alpha value was close to 1.00, indicating no difference from control specimens in DNA sensitivity to denaturation. Forty-nine% of adenocarcinomas were aneuploid. Forty-six% of adenocarcinomas differed from normal in sensitivity of DNA to denaturation; the T alpha value was lower than 0.90 indicating that chromatin of the tumor cells was more resistant to denaturation than control cells. There was no correlation between sensitivity to denaturation of DNA and incidence of aneuploidy. However, there was a correlation between T alpha and the pathologically determined stage of disease. There was increased resistance to denaturation in 58% of tumors classified as Dukes' C/D stage, in 36% of tumors classified as Dukes' B, and in 20% classified as Dukes' A stage of the disease. Statistical analysis of these results revealed significant differences between distributions of T alpha in noninvasive (Adenomas and Dukes' A) versus invasive (Dukes' B and C/D) tumors with level of significance at P = 0.02. The data suggest that acid denaturation of DNA in situ may be a valuable adjunct in assessing the biology of colon cancer. The molecular basis for this phenomenon is discussed.

Acridine Orange↗
PubMed1987

[A case of multiple colorectal cancers repeatedly resected 5 times].

A case of successive metachronous colorectal cancers repeatedly resected 5 times during an 8-year period is reported. The 1st cancer was found in the sigmoid colon when the patient (male) was 32 years old. The 2nd was a mucosal carcinoma of the rectum which was locally excised. The 3rd was found in the ascending colon, and there was detected yet another small cancer in the adenoma in the resected specimen. The 4th and 5th cancers were found in the transverse colon and rectum, respectively. This case is considered to be highly associated with genetic factors. Long-term and careful surveillance is mandatory for early detection of recurrent or additional tumors.

Adenocarcinoma↗
PubMed1987

[Progress in the treatment of colonic cancers: early detection].

A parallelism was found to exist in cases of colon carcinoma between the number of affected lymph nodes and the chance of survival. Prognostication is possible by means of Dukes classification and the TNM system. Prospects of therapy can be improved by early detection of the tumour proper and of precancerous lesions. Colonoscopy is recommended as the optional diagnostic method, which applies equally to postoperative follow-up.

Colon↗