| 1. |
- Dafnis, George
(författare)
-
Colonoscopy : Introduction and development, completion rates, complications and cancer detection
- 2001
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In a population-based study in the county of Södermanland, 6066 colonoscopies performed in 4304 patients from 1979 to 1995 inclusive were evaluated. As indications, bleeding increased and polyps and unclear x-ray findings decreased. Surveillance (cancer, polyps, colitis) was fairly stable. Both the rate of complete colonoscopies (overall 75%), and the proportion of colonoscopies performed by experienced endoscopists increased over time. The annual number of barium enemas was relatively constant up to 1992, but then decreased. Completion rates decreased by female sex and by age, and increased by previous colonic surgery or long-standing colitis, but remained unchanged by time period or presence of diverticulosis. Completion rates were influenced by endoscopist's experience and to some extent by intensity of colonoscopy. There was a large inter-endoscopist variation, at each level of experience, in the ability to perform complete colonoscopy, implying substantial differences in individual learning curves. The overall morbidity was 0.4%, diagnostic morbidity 0.2% and therapeutic morbidity 1.2%. Most frequent complications were bleeding (0.2%) and perforation (0. 1 %), with no colonoscopy-related mortality. Bleeding was confined to therapeutic colonoscopy and occurred immediately, mostly after removal of large thick-stalk polyps. Perforations at diagnostic colonoscopy occurred in the left colon; they were diagnosed sooner than at therapeutic colonoscopy, at which the caecum was the most frequent perforation site. Bleeding complication rate was correlated to experience of the endoscopists. Colorectal cancers were diagnosed in 174 patients and in 6 patients were not detected at colonoscopy. Comparing these, there were no significant differences in gender, age, indications, presence of polyps or diverticulosis, time period, or experience of endoscopist. The mean completion rate for the endoscopists was lower in patients with undetected cancers. Coexisting inflammatory bowel disease was more common in patients with late diagnosis. The sensitivity was 96.7%, higher when the indication was bleeding, canoer or unclear x-ray, and lower when the colonoscopy was performed on other indications.
|
|
| 2. |
- Kindler, Csaba, et al.
(författare)
-
Detection of Free Cancer Cells in Pelvic Lavage with Double Immunocytochemistry at Rectal Cancer Surgery
- 2017
-
Ingår i: Anticancer Research. - : International Institute of Anticancer Research. - 0250-7005 .- 1791-7530. ; 37:4, s. 1563-1568
-
Tidskriftsartikel (refereegranskat)abstract
- Background/Aim: The aim of the present study was to describe a double immunocytochemical staining method for detecting free cancer cells after rectal cancer surgery and to evaluate their extent and prognostic role. Materials and Methods: Immunocytochemistry was performed using antibodies against cytokeratin 20/caudal-typehomeobox transcription factor 2 (CDX2) and mucin glycoprotein-2 (MUC2)/p53 protein. The study included 29 patients with infraperitoneal rectal cancer who underwent bowel resection and four controls. The pelvic lavage was retrieved at the start of laparotomy, after total mesorectal excision and after abdominal lavage with sterile water. Results: Free cancer cells were detected with the double immunocytochemical method in the two controls with carcinomatosis and one control with sigmoidal cancer. None of the patients with rectal tumours had presence of free cancer cells. Conclusion: Immunocytochemical analysis of peritoneal lavage was feasible and negative in patients with infraperitoneal rectal cancer. Further studies are encouraged to investigate the clinical relevance in cases with free cancer cells after incomplete total mesorectal excision.
|
|
| 3. |
- Lindmark, Gudrun, et al.
(författare)
-
qRT-PCR analysis of CEACAM5, KLK6, SLC35D3, MUC2 and POSTN in colon cancer lymph nodes : An improved method for assessment of tumor stage and prognosis
- 2024
-
Ingår i: International Journal of Cancer. - : John Wiley & Sons. - 0020-7136 .- 1097-0215. ; 154:3, s. 573-584
-
Tidskriftsartikel (refereegranskat)abstract
- One fourth of colorectal cancer patients having curative surgery will relapse of which the majority will die. Lymph node (LN) metastasis is the single most important prognostic factor and a key factor when deciding on postoperative treatment. Presently, LN metastases are identified by histopathological examination, a subjective method analyzing only a small LN volume and giving no information on tumor aggressiveness. To better identify patients at risk of relapse we constructed a qRT-PCR test, ColoNode, that determines levels of CEACAM5, KLK6, SLC35D3, MUC2 and POSTN mRNAs. Combined these biomarkers estimate the tumor cell load and aggressiveness allocating patients to risk categories with low (0, −1), medium (1), high (2) and very high (3) risk of recurrence. Here we present result of a prospective, national multicenter study including 196 colon cancer patients from 8 hospitals. On average, 21 LNs/patient, totally 4698 LNs, were examined by both histopathology and ColoNode. At 3-year follow-up, 36 patients had died from colon cancer or lived with recurrence. ColoNode identified all patients that were identified by histopathology and in addition 9 patients who were undetected by histopathology. Thus, 25% of the patients who recurred were identified by ColoNode only. Multivariate Cox regression analysis proved ColoNode (1, 2, 3 vs 0, −1) as a highly significant risk factor with HR 4.24 [95% confidence interval, 1.42-12.69, P =.01], while pTN-stage (III vs I/II) lost its univariate significance. In conclusion, ColoNode surpassed histopathology by identifying a significantly larger number of patients with future relapse and will be a valuable tool for decisions on postoperative treatment.
|
|
