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.

Special focus and aim of our research activities at AIT, the Austrian Institute of Technology, is to define reliable biomarkers suitable for early and non-invasive disease diagnosis from body fluids such as serum/plasma and saliva. Along a selection of research projects, which are described in more detail underneath, we will present and introduce the broad portfolio of high throughput technologies we successfully apply for diagnostic biomarker discovery and validation. As a first show case of successful non-invasive disease biomarker discovery we will present a study where we investigated and compared the genome wide methylation levels of lung cancer patients, patients suffering from lung fibrosis, patients with COPD (chronic obstructive pulmonary disease), and DNA samples derived from healthy lungs. Along this study we could identify specific methylation patterns for each of these lung diseases. After quantitative PCR validation of 240 disease specific methylation markers in the discovery sample set, the 90 top markers were picked and applied for serum testing (n=204). When we applied gradient boosting classification for differential diagnosis of tested lung diseases and healthy controls an AUC value of 0.95 was reached here to separate cancer from all other non-cancer samples whereas in differential diagnosis of healthy-, COPD and fibrosis patients AUC values of 0.71 and 0.49 were obtained for fibrosis, respectively COPD. Thus in case of COPD the presented method may be used to monitor cancer risk within COPD patients.