The increasing ratio of proximal to distal colorectal carcinomas was confirmed in this population-based study of 668 new cases diagnosed among Rochester, Minnesota residents between 1940 and 1979. The change was due to a rise in the incidence of proximal lesions (from 15.1 per 100,000 person-years in 1940-59 to 17.3 per 100,000 in 1960-79) and a simultaneous fall in the incidence of distal lesions (from 35.5 to 28.2 per 100,000 person-years). Changes in definitions or referral patterns played no role in these observations, although improved diagnostic capabilities may have had an impact on the incidence of proximal lesions. These discrepant changes in incidence strongly suggest that proximal and distal colonic cancers are different diseases or have a different pathogenesis. The changing incidence rates were not associated with consistent differences in clinical characteristics at the time of initial diagnosis.
BACKGROUND: Recently, it has been hypothesized that inflammation increases the risk of colorectal cancer. We investigated whether serum levels of C-reactive protein (CRP), a biomarker of inflammation, are associated with colorectal cancer, using serum samples collected in the Japan Collaborative Cohort Study (JACC Study).
METHODS: We conducted a nested case-control study in the JACC Study, investigating the relationship between the risk for colorectal cancer and serum levels of CRP determined by a high-sensitivity CRP enzyme immunoassay. The subjects recruited were 141 patients with colorectal cancer (63 males and 78 females) and 327 controls with no history of cancer (148 males and 179 females). Each case of colorectal cancer was matched for sex, age and participating institution to 2 or 3 controls. We used t-test to analyze mean differences in CRP levels between colorectal cancer cases and controls. Odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated using a conditional logistic regression model after adjusting for the potential confounding factors.
RESULTS: Serum CRP levels were not clearly associated with the risk of colorectal cancer. The OR of the highest serum CRP levels was 1.18 (95% CI: 0.68-2.06) for colorectal cancer and 1.42 (95% CI: 0.73-2.74) for colon cancer, compared to subjects with lowest serum levels. The OR for incidence of colorectal cancer showed a similar trend, but the difference was not significant. Thus, high serum CRP levels did not appear to increase the risk of colorectal cancer.
CONCLUSIONS: The present results suggest that high serum CRP levels are not associated with the risk of colorectal cancer in the JACC Study.
It is suggested that the consecutive administration of UFT at 400 mg/day was an effective and highly safe therapeutic method as postoperative adjuvant chemotherapy for rectal cancer.
The expression of aromatase (estrogen synthetase) is tissue specifically regulated through the alternative use of multiple exons 1 and promotors. We have determined the amounts of aromatase messenger ribonucleic acid (mRNA) and which type of multiple exons 1 of the human aromatase gene is used in breast tissues of 49 patients with breast cancer by reverse transcription-PCR analysis. The aromatase mRNA levels in these breast cancer tissues (4.53 +/- 0.66 x 10(-3) attomoles/micrograms RNA) were significantly (P < 0.01) higher than those in 16 nonmalignant breast tissues (1.73 +/- 0.40 x 10(-3) amol/micrograms RNA). Aromatase mRNA in all nonmalignant breast tissue were transcribed from skin fibroblast/fetal liver-specific exon 1 (exon 1b) of the gene. In 23 breast cancer tissues, the utilization of multiple exons 1 in the aromatase mRNA was the same as that in nonmalignant breast tissues, whereas in the other 26 cases, it changed from exon 1b to ovary-specific exon 1 (exon 1c). Such switching of tissue-specific exons 1 may affect strict regulation of the tissue-specific expression of aromatase, leading to abnormal expression of the aromatase. The consequent overproduction of local estrogen might promote carcinogenesis or the proliferation of breast cancers.
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