Current Prognostic Factors In Colorectal Cancer

Research Article
Giorgio Maria Paolo Graziano., Antonio Di Cataldo and Antonino Graziano
DOI: 
http://dx.doi.org/10.24327/ijrsr.2018.0903.1847
Subject: 
science
KeyWords: 
Biomolecular markers surgery
Abstract: 

Introduction: Colorectal carcinoma is one of the main causes of mortality due to neoplasia in all Western countries and with high technological development. There are 150,000 in Europe and 30,000 in Italy 5-year survival is on average 40-50%, reaching 80-90% in the early forms Approximately 80% of patients with colon cancer are diagnosed with radically resectable disease. 35% of these develop a disease recovery that in most cases (80%) occurs within the first 2 or 3 years after surgery and the prognosis varies depending on the stage of the disease at diagnosis: Stage I 90%, Stage II 70-80%, Stage III 40-65% survival at 5 years. It is important to define the prognosis of the relationship between the positive lymph nodes and the analyzed lymph nodes. .. the aim of the present study is aimed at the evaluation of histopathological parameters and biological indices with prognostic indication in the colon of the colon in relation to our experience, in order to identify stable and independent prognostic factors Materials and methods: From January 2010 to December 2017 consulted the database of the AOU "G Rodolico" University of Catania Department of medical sciences and specialists II were treated 93 cases of colon neoplasia with headquarters: in the blind 3 n cases (3.5%), colon ds n 39 cases (41.5%), transverse colon n 4 cases (4.2%), colon sn n 41cases (44.6%), sigma n 6 cases (6.2%)). . The histopathological parameters and the biological indexes examined were the histological examination of the lymph nodes, tumor markers and biological expression of tumor aggressiveness, the label index, (anti-EGF and PTEN PIC3A predictive) and (BRAF VEGF prognostic) Results: Some mutations in candidate genes such as BRAF, PIK3CA and PTEN, whose effectiveness as a predictive marker remains uncertain. they have been used as potential predictive biomarkers for both somatic (tumor) and germ (patient) DNA. The results obtained indicate that mutation rates of 35% for KRAS, 7% for NRAS, 10% for BRAF, 10% for PIK3CA, 8% for PTEN, 68% for TP53, 2% for EGFR, <2% Alterations of Germinal DNA directly affects the patient's cells and can influence factors such as bioavailability, kinetics and drug metabolism, as well as interaction with the immune system and local tissue responses. Discussion It is important to underline the centrality of the neoplastic tissue for the correct histopathological diagnosis the first aid comes from the evaluation of the tumor grading. The definition of the parameter that implies the following aspects: the type of neoplasia (papiparous muciparous, ring with castone) the degree of differentiation (formation of glands loss of polarity, invasiveness) atypical cytological mitotic activity such parameter contributes in a determined manner to perfecting the diagnostic evaluation. ) Microsatellite instability status is a prognostic and predictive factor for rectal tumors. Patients with high microsatellite instability (MSI-H) have a better prognosis than those with stable microsatellites (MSS) this new parameter is still under study. (57.58) .Conclusions To improve risk stratification, it is necessary to explore prognostic factors related to tumor biology that are independent of clinical and pathological variables. finally, the new markers assume a predictive meaning in terms of survival after resection