European Journal of Molecular & Clinical Medicine

Aim: The aim of this study was to evaluate the clinico-pathological profile of colorectal cancer patients in our tertiary care hospital.
Material and methods: This prospective as well as retrospective study was conducted in Gastroenterology division of Department of General Medicine at Ananta Institute of Medical Sciences & Research Center, Udaipur, Rajasthan, India. Total 174 patients presenting with colorectal cancer (CRC) from August 2019 to July 2022 were included in the study. Study tools were Study-questionnaire, investigations [routine blood tests, CEA, Colonoscopy, USG, CECT and MRI] and histopathological reports. Parameters studied were age, sex, site of lesion, clinical presentations and histopathology of the lesion.
Results: We observed that overall proliferative type was the most common type of tumor in our patients (n=75; 43.10%) with p value of <0.0001, followed by infiltrative (n=59; 33.91%), ulcerative (n=36; 20.69%) and ulcero-infiltrative (n=4; 2.29%). History of colorectal cancer in family was present in 45 (25.86%) of patients; with statistically significant p value of <0.0001. Out of 174 patients, 81 (46.55%) were smokers (p value 0.544). The most common clinical presentation of the patients in our study was change in bowel habits (n=136; 78.16%) followed by bleeding per rectum (PR) (n=117; 67.24%), abdominal pain (n=102; 58.20%) and generalized weakness (n=78; 44.83%). Most common site of involvement was rectum (n=78; 44.83%) followed by right colon (ascending colon and ceacum) (n=5531;61%), descending colon (n=18; 10.34%), sigmoid (n=16; 9.19%) and transverse colon (n=7;(4.02%). Together rectosigmoid comprise about 54.02% of total CRC. In our study we found elevated preoperative CEA levels (≥ 5.1 ng/ ml) in 80 (45.98%) patients, not elevated (≤ 5.0 ng/ml) in 36(20.69%) patients and not taken/unknown in 58 (33.33%) patients.
Conclusion: The incidence of CRC is increasing in younger age group and younger patients present at advanced stage. Lack of awareness about CRC in general population and lack of screening programs are responsible for advanced stage of CRC at presentation. Public awareness through mass-media, screening of high-risk populations, early diagnosis, cost-effective multi-modality treatment and regular follow-up is the call of the time for limiting the morbidity and mortality associated with colorectal cancer.

Background: Epstein-Barr virus (EBV) has been classified among group 1 listof infectious agentsthat is carcinogenic to humans. Some primary colonic cancers are often overexpressing the p16 protein while in contrast; others showed the high incidence of p16 repression by methylation. Objective: The present study was conducted to explore and compare the demo-pathological relation of EBV infection along with p16 expression in normal colonic mucosa, benign colon tumors, and colonic denocarcinoma. Patients and Methods: Seventy (70) colonic mucosal biopsies were enrolled and examined for EBERs and P16 gene expression which were done by chromogenic in situ hybridization (CISH) and immunohistochemical technique (IHC), respectively. These samples were belonged to (30) patients diagnosed with colorectal cancer mass, (25) from benign colon tumors (15) control tissues, which were proved by colonoscopy and histopathological examinations as apparently normal colorectal tissues. Results: Malignant colonic tumors showed positive results of EBERs -CISH detection in 56.7% (17 out of 30 tissues) while in benign colonic tumors were 24 % (6 out of 25 tissues), followed by the apparently healthy colonic control tissues were 20% (3 out of 15 tissues). The present positive p16-IHC results in malignant colonic tumors were 60% (18 out of 30 tissues) while in the benign colonic tumor and apparently healthy colon control tissues were 68% (17 out of 25 tissues) and 20% (3 out of 15 tissues), respectively. Conclusion: it was concluded from this study that the high rates ofEBV- EBERs expression could point to a their possible roles incolonic carcinogenesis, meanwhile, the p16- proteinexpression in colonic adenocarcinoma as compared to benign colon tumors and normal colonic mucosae could played roles in struggling against both EBV infection as well as colonic carcinogenesis.