Colorectal cancer in young adults: A difficult challenge

Campos, Fábio Guilherme

doi:10.3748/wjg.v23.i28.5041

Cited by 96 publications

(84 citation statements)

References 31 publications

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“…However, LSs represent 9.2% –21.3% of cases in this subgroup14–21 and this research like other current studies55–57 revealed it is a heterogeneous disease, which includes cases with a high familial component other than LS as well as a substantial proportion of sporadic cases with distal location.…”

Section: Discussionsupporting

confidence: 81%

Prevalence and clinicopathological characteristics of mismatch repair-deficient colorectal carcinoma in early onset cases as compared with late-onset cases: a retrospective cross-sectional study in Northeastern Iran

et al. 2018

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ObjectivesLynch syndrome (LS), a genetically inherited autosomal disorder, increases the incidence of colorectal carcinoma (CRC). We aimed to perform a universal strategy to assess the prevalence and clinicopathological characteristics of early onset CRCs at high risk of LS versus late-onset ones in the Iranian population.SettingA local population-based study from Northeastern Iran.Participants321 consecutive CRCs and pathology specimen screened between 2013 and 2016.Primary and secondary outcome measuresRetrospectively, information regarding the clinical criteria was obtained by interviewing the patients with CRC or, their families. Pathologists tested tumours with immunohistochemistry (IHC) staining of four mismatch repair (MMR) proteins (MLH1, MSH2, MSH6 and PMS2). Tumours with absent IHC staining of MLH1 were tested for BRAF mutations to exclude sporadic CRCs. Prevalence of early onset CRCs at high risk of LS and familial CRC type X were assessed as primary and secondary outcome measures, respectively.ResultsOf 321 CRCs (13/123 (10.57%), early onset vs 21/198 (10.6%) late-onset) were detected to be MMR-deficient (dMMR). Nine early onset cases and 14 late-onset ones with a loss of MLH1 underwent testing for the BRAF mutation, none of the early onset and four (2.02%) late-onset were recognised as sporadic. The difference in the outcome of IHC-analysis between early and late-onset CRCs at high risk of LS was not statistically significant (p=0.34). Majority of the suspected LS tumours from early onset patients had arisen in distal part (8/11 (72.72%) vs 8/14 (57.14%)), all of which were occurred in the rectum or sigmoid.ConclusionClinically, these findings suggest that in case of limitation for BRAF testing, the practitioner in Iran may consider managing early onset dMMR cases like LS until access to BRAF testing becomes available to them, before germline testing to accurately diagnose LS.

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Section: Discussionsupporting

confidence: 81%

Prevalence and clinicopathological characteristics of mismatch repair-deficient colorectal carcinoma in early onset cases as compared with late-onset cases: a retrospective cross-sectional study in Northeastern Iran

et al. 2018

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“…The distribution of incidence by age is important because it guides the screening strategy and particularly the lower limit of age to be targeted by this intervention. Indeed, it is clear that for ages with low specific incidence rates (young adult) with generally poor prognosis and sometimes familial or genetic characteristics are not suitable for mass screening (the cost-effectiveness of screening would be reduced) [13,[56][57][58][59].…”

Section: Discussionmentioning

confidence: 99%

Colorectal cancer incidence and clinicopathological features in northern Tunisia 2007–2009

Khiari

Hsaïri

2018

Colorect. Cancer

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Colorectal cancer (CRC) is the third most commonly diagnosed cancer worldwide. The aim of this study was to determine CRC incidence and to describe clinicopathological features in north Tunisia for the period 2007–2009. The North Tunisia Cancer Registry was the source of data for the identification of patients. The age-standardized incidence rates (ASRs) were respectively 13.6 cases (7.5/100,000 for colon cancer and 6.2 for rectal cancer) and 11.1 cases (6.5/100,000 for colon cancer and 4.4 for rectal cancer) per 100,000 among male and female. The ASR varied widely by regions in northern Tunisia. The most common site in colon cancer was the distal colon comparing to the proximal one (49.0 and 29.9% respectively). Adenocarcinoma was the most common histological type. CRC screening should be strengthened in Tunisia to achieve a reduction of CRC incidence and mortality.

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“…Colorectal cancer is the third most commonly diagnosed malignancy and the fourth leading cause of tumor-related death all over the world, accounting for ∼1.4 million newly diagnosed cases and almost 0.7 million deaths annually (1)(2)(3). Although colorectal cancer incidence and mortality rates have been stabilizing or declining in a number of high human development index countries, the rapid increases in incidence and mortality of colorectal cancer are observed in medium or low income countries (4) and in patients <40 years old (5,6). Moreover, most cases of colorectal cancer develop slowly over several years through adenocarcinoma sequence despite strong hereditary components (7).…”

Section: Introductionmentioning

confidence: 99%

Interleukin-24 Regulates T Cell Activity in Patients With Colorectal Adenocarcinoma

Zhang

Liu²,

2019

Front. Oncol.

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Interleukin (IL)-24 plays a potential anti-tumor activity in colorectal cancer in a dose-dependent manner. However, the immunoregulatory role of IL-24 to peripheral and tumor-infiltrating T cell function in colorectal cancer was not fully elucidated. In this study, twenty-nine colorectal adenocarcinoma patients and fifteen healthy individuals were enrolled. IL-24 expression and IL-24 receptor (IL-20R1, IL-20R2, and IL-22R1) mRNA relative level was measured by ELISA and real-time PCR, respectively. CD4 + and CD8 + T cells were purified from peripheral bloods and cancer specimens, and were stimulated with low (10 ng/ml) and high (100 ng/ml) concentration of recombinant IL-24. CD4 + T cells activity was assessed by measurement of Th cell percentage, transcriptional factors, and cytokine production. CD8 + T cells activity was evaluated by investigation of cytotoxic molecules, target cell death, and interferon-γ (IFN-γ) secretion. IL-24 was decreasingly expressed in both peripheral bloods and cancer tissues in colorectal adenocarcinoma patients. However, IL-20R1 and IL-20R2 was comparable between healthy controls and colorectal adenocarcinoma patients. Low concentration of IL-24 suppressed CD4 + T cell proliferation. In contrast, high concentration of IL-24 not only promoted CD4 + T cell proliferation, but also enhanced CD4 + T cell activity, which mainly presented as up-regulation of Th1/Th17 frequency, T-bet/RORγt mRNA, and IFN-γ/IL-17 production but down-regulation of Treg percentage, FoxP3 mRNA, and IL-10/IL-35 secretion. Moreover, high concentration of IL-24 also increased perforin and granzyme B expression in CD8 + T cells, and elevated cytolytic and non-cytolytic activity of CD8 + T cells, which presented as induction of target cell death and elevation of IFN-γ expression. However, low concentration of IL-24 did not affect bioactivity of CD8 + T cells. The current data indicated that IL-24 might regulate T cell function in a dose-dependent manner. High-concentration of IL-24 might promote anti-tumor immune responses in development novel therapeutic approaches to colorectal adenocarcinoma.

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Colorectal cancer in young adults: A difficult challenge

Cited by 96 publications

References 31 publications

Prevalence and clinicopathological characteristics of mismatch repair-deficient colorectal carcinoma in early onset cases as compared with late-onset cases: a retrospective cross-sectional study in Northeastern Iran

Prevalence and clinicopathological characteristics of mismatch repair-deficient colorectal carcinoma in early onset cases as compared with late-onset cases: a retrospective cross-sectional study in Northeastern Iran

Colorectal cancer incidence and clinicopathological features in northern Tunisia 2007–2009

Interleukin-24 Regulates T Cell Activity in Patients With Colorectal Adenocarcinoma

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