Colorectal cancer (CRC) is the 3rd common cancer in the world. Because the five-year survival rate is below 60 % in the patients with CRC, two important respects in CRC researches are early diagnosis and more effective chemotherapeutic drugs. In fact, the studies on molecular pathology of CRC can resolve these two problems. Insulin has a role in the carcinogenesis and developments of CRC, and 5-FU is a standard chemotherapeutic drug for the patients with stage III CRC. As a human securin, PTTG has a major role in many functions. In our studies of 2-D proteomics, PTTG correlates with the invasiveness of CRC. Besides, it is found to be highly expressed in many types of cancer, but the expression of PTTG is, however, low or undetectable in normal tissues. This character of tumor-specific expression is suitable for drug and target therapy. Therefore, we use cell line HT-29 to study the effects of 5-FU and insulin on the expression of PTTG. We have found that insulin in the physiologic level up-regulates PTTG. In normal physiologic level, insulin up-regulates PTTG, in a dose-dependent manner. On the other hand, the induction of PTTG by insulin more than normal physiologic level is decreased. In the studies with 5-FU, PTTG has a higher level after treatment, but not in dose-dependent manner. The up-regulation of PTTG by 5-FU is decreased in a higher dose. In cancer cells, insulin regulated pathways may contribute to the growth, proliferation, and apoptosis of tumors by activating oncogenic molecular targets such as PTTG. We have showed that insulin of bio-physiologic level can up-regulate PTTG in colon cancer HT-29 cell lines. Induction of PTTG by insulin suggests a mechanism by which insulin may contribute to the development and/or progression of colon cancers. To tumor- specific expression of PTTG, induction of PTTG by insulin, consequently, may be a target of colon cancer treatment. In the studies of 5-FU and PTTG, we have found that 5-FU in HT-29 cells can induce PTTG, with a peak effect in a dose around IC50. Interestingly, the induction of PTTG is decreased in a higher dose of 5-FU. This is a new finding in the effect of 5-FU on PTTG. Accordingly, we can realize why PTTG in some studies is suppressed; the others have a higher level. More importantly, the connection of PTTG expression between sister chromatic separation and DNA repair after DNA damage is more reasonable. Based on this finding, we propose that PTTG connects DNA damage response pathways, sister chromatic separation and apoptosis after DNA damage. Therefore, PTTG has a key role after DNA damage, deciding cells to have DNA repair/cell cycle arrest or to progress to apoptosis.

Polyalthia longifolia is a lofty evergreen tree found in India and Sri Lanka. Today, P. longifolia var. pendula is in large-scale cultivation in south Taiwan as a landscape plant. A new compound, clerodane diterpenoid 16-hydroxycleroda-3,13-dien-15, 16 -olide¡]CD¡^, was isolated from the bark of Polyalthia longifolia var. pendula. The compound was shown with cell growth inhibitory property at first screen in KMU¡]Kaohsiung Medical University¡^. In our study, antiproliferative activity of CD on human colorectal adenocarcinoma cells¡]HT29 and HCT116¡^were tested and the inhibitory concertration of 50¢Mcell viability¡]IC50¡^is 5 £gg/ml¡]HCT116¡^ and 10 £gg/ml¡]HT29¡^determined by MTT(3-[4, 5-dimethylthiazol-2-yl]-2, 5-diphenyltetrazolium bromide) assay. The caspase 3 and PARP cleavage experiment results indicated that CD induced apoptosis is dose dependent manner. We found that CD induced sub-G1 accumulation and reactive oxygen species(ROS) release by flow cytometry analysis. Pretreatment of N-Acetyl-L-cystine(NAC), an antioxidant agent, can reverse the anti-proliferation effect by CD. We found that CD induced loss of mitochondria membrane potentiol¡]£G£Zm¡^. We also analysis differentially expressed proteins by 2-D electrophoresis and find drug response proteins, e.g. HSP10, Profilin-1, Peroxindoxin-1. RT-PCR and western blot was performed to confirm the protein expression changes. It is interesting to reveal the role of these proteins in the colorectal cancinogenesis and anti-tumor drug response.

In Taiwan, colorectal cancer incidence rate and mortality rate had been increased remarkably. Colorectal cancer was the third leading cause of death in all cancers in Taiwan, which had cause serious threaten on the health condition of people. The CRC screening rate is relatively low in Taiwan, from the statistic information in Bureau of Health Promotion shows that less than 20 % of colorectal cancer cases were detected on stage 0 and stage £L in Taiwan. The early detection rate was relatively low as comparing with colorectal cancer in the United States. However, if colorectal cancer is vital for the optimal treatment to obtain a correct diagnosis promptly, the long-term survival rate can reach as high as 90% for the early staged CRC. As we know, regular screening examination for colorectal cancer was the first step to treat colorectal cancer. The key point for promoting the colorectal cancer screening rate was to realize the factors which affecting the willingness of receiving the screening examination among older adults. Due to that, this study is aimed to identify the attitude toward screening and health-belief recognition among older adults above 40 years old within the community screening program, in order to realize factors influence the older adults¡¦ willingness of the colorectal cancer screening and Colonoscopy. The study design was a cross-sectional co-relational community-based survey. The data collection period was from August 2007 to May 2008. Data were collected from older adults which above 40 years old in Taipei and Kaohsiung. There were 462 samples which included 279 samples were having an experience of CRC screening before, and 183 samples were never had such screening before. The data was analyzed with descriptive statistics and inferred statistics such as Chi-square, Independent T-Test, Logistic regression analysis, Path analysis. The Logistic regression analysis was used to determine the related factors which might affecting the willingness of CRC screening among the older adults in community, including the factors applying from Health Belief Model such as Perceived threat, Perceived benefits of taking actions, Perceived barriers of taking actions, Cues to actions, Self-Efficacy, Health Motivation. Also addressed the factors related to attitudes such as fear about cancer, worry about accurate or safety of screening method, optimistic. The results of the study were as following. (1)In health belief related sectors, Perceived threat, Barriers, Cues to actions were significant with both the willingness of receiving Colonoscopy and FOBT screening. Except for those three factors that mentioned above, Health motivation would influence the willingness of FOBT screening, instead of Colonoscopy. (2) In attitude related sectors, fear about cancer, worry about accurate or safety of screening method were significant with both the willingness of receiving Colonoscopy and FOBT screening. (3) In health status sectors,bowel symptoms were significant with the willingness of receiving FOBT screening. Health behavior would only significant with the willingness of receiving Colonoscopy. (4) Age, social activity, screening experience would affect the willingness of receiving FOBT screening. On the other hand, the willingness of receiving Colonoscopy was no significant with demographic characteristic. Besides, the results of the path analysis were shown as below. (1)Optimistic would affect Cues to actions factor, and health behavior may affect Health motivation factor, under such relation, optimistic and health behavior would indirect affect the willingness of receiving FOBT.(2)Bowel symptoms would affect Perceived threat which may indirect affect the willingness of receiving Colonoscopy. (3)The knowledge of CRC and CRC screening would also indirect affect the willingness of receiving FOBT and Colonoscopy. The major attribution of this study was to realize the factors influence the willingness of accepting CRC screening, which could provide for health promotion policy makers to develop suitable policy for CRC health protect planning. The study may be implicated in the following aspects¡G(1) Not only settle the goals of screening, and also suggest policy makers to promote the awareness and health belief toward colon cancer to target groups which the study result had shown. (2)With the union of the community and medical, physician counseling may enhance the CRC screening rate, especially Colonoscopy. (3)Fulfill the knowledge of detect colon cancer and CRC screening among older adults, make themselves know how to decrease the threat of the disease, in order to achieve the goal of improving their health and saving the expense of the injure.

Background: Colorectal cancer is the third most commonly diagnosed cancer and the second leading cause of cancer death in Arizona. Given that by the year 2030 Arizona is expected to be the second most populated state in the U.S., it is imperative to evaluate whether this state has the colorectal screening capacity to accommodate the growing population.Methods: 338 members of the American College of Gastroenterology were invited to participate. Information for the total number of colonoscopies and sigmoidoscopies performed during an average week was ascertained by analyzing 105 surveys. We estimated the current and potential volume of screening procedures.Results: Physicians reported performing 8,717 endoscopic procedures weekly (7,990 colonoscopies and 727 sigmoidoscopies). They reported being able to increase their capacity by an additional 3,183 (36.5%) procedures a week (2,347 colonoscopies and 836 flexible sigmoidoscopies).Conclusions: Our findings suggest that Arizona has the ability to significantly expand its endoscopic capacity.

DKK1, SFRP1, WIF-1, and Wnt5a encode Wnt pathway genes that are frequently silenced by promoter hypermethylation in colorectal cancer. Despite attractive biological consequences of these events, it is unclear whether they contribute to patient prognostication or may influence tumour cell biology within distinct patient subsets. I sought to determine the prognostic roles of these methylation events in a large cohort of colorectal carcinomas from Ontario and Newfoundland. Methylation was quantified and associated with patient clinicopathlogical features. Methylation was present in cancer tissue. DKK1, Wnt5a, and SFRP1 were strongly and independently associated with tumour subtype in a manner that suggested subtype-specific activity of Wnt signaling. Methylation of DKK1 was a borderline prognosticator of favourable outcome. These results offer intriguing insight into subtype-specific biology and lead to a proposed model whereby methylation-induced Wnt bias may contribute to patient outcome.

Introduction: This study evaluated long-term outcomes of young survivors of colorectal cancer including survival, development of acute illnesses, and childbirth. Methods: Persons aged 20-44 diagnosed with colorectal cancer and surviving at least five years were identified using the Ontario Cancer Registry and compared to randomly selected controls. Outcomes included death, admission to hospital for acute illness, and childbirth in women, determined by linkage to provincial administrative data. Results: There were 917 cancer survivors in this study. Survivors were more likely to die (HR 8.2, 95%CI [5.8, 11.6]), and require admission to hospital for acute illness (rate ratio 3.4, 95%CI [2.9, 4.1]) than controls. There was no difference in admissions for childbirth in women (HR 0.6, 95%CI [0.3, 1.4]). Conclusions: Five-year survivors of colorectal cancer remain at high risk of long-term death and illness. Aggressive surveillance for recurrent malignant disease is necessary to mitigate risk of death.

Introduction: This study evaluated long-term outcomes of young survivors of colorectal cancer including survival, development of acute illnesses, and childbirth. Methods: Persons aged 20-44 diagnosed with colorectal cancer and surviving at least five years were identified using the Ontario Cancer Registry and compared to randomly selected controls. Outcomes included death, admission to hospital for acute illness, and childbirth in women, determined by linkage to provincial administrative data. Results: There were 917 cancer survivors in this study. Survivors were more likely to die (HR 8.2, 95%CI [5.8, 11.6]), and require admission to hospital for acute illness (rate ratio 3.4, 95%CI [2.9, 4.1]) than controls. There was no difference in admissions for childbirth in women (HR 0.6, 95%CI [0.3, 1.4]). Conclusions: Five-year survivors of colorectal cancer remain at high risk of long-term death and illness. Aggressive surveillance for recurrent malignant disease is necessary to mitigate risk of death.

No description available.

Human papillomavirus (HPV) infections play a crucial role in human carcinogenesis. Greater than 96% of all cervical carcinomas are positive for high-risk HPV infections; especially types 16 and 18. High-risk HPV onco-proteins, E6 and E7, are consistently expressed in such cancers and function by inactivating p53 and pRb tumor suppressors, respectively. The presence of high-risk HPVs is also correlated with anogenital cancers. In this study, we examined the effect of high-risk HPV type 16 E6 and E7 oncoproteins in two normal human colorectal epithelial cell lines, NCE1 and NCE5. We report that the expression of E6/E7 proteins, alone, induced cellular transformation of both cell lines; consequently, NCE1-E6/E7 and NCE5-E6/E7 form colonies in soft agar with respect to their wild type cells. This is accompanied by cell cycle deregulation, as is demonstrated by the over-expression of cyclin dependant kinases (cdks) and their respective cyclins. Furthermore, we demonstrate that E6/E7 oncoprotein transduction induces migration of colorectal epithelial cells. More still, well analyzed Id gene expression, a family member of the helix-loop-helix (HLH) transcription factors involved in the regulation of cell invasion and metastasis of human cancer cells. In parallel, using tissue microarray analysis we found that the four members of the Id protein family are correlated with the presence of HPV type 16 and 18 in human colon cancer tissues. Our data suggests that high-risk HPV infections are sufficient to induce cellular transformation of normal human colorectal cells, in vitro. Furthermore, the correlation with the Id family of proteins may present a novel set of markers associated with HPV induced colorectal carcinogenesis. Our results may suggest a new approach to detect and prevent colorectal cancer.

In der vorliegenden Arbeit werden mit den Jahren 2005/2006 und 2007 qualitätsrelevante Parameter von Patienten mit einem kolorektalen Karzinom vor und unmittelbar nach Gründung des Darmzentrums an der Universitätsklinik Leipzig analysiert. Ziel dieser Arbeit war es zu untersuchen, welchen Einfluss die Gründung eines zertifizierten Darmzentrums kurzfristig auf die Behandlungsqualität von Patienten mit einem kolorektalen Karzinom hat. Die durch die Deutsche Krebsgesellschaft festgelegten Struktur- bzw. Ergebnisparameter wurden für die Jahre 2005 und 2006 retrospektiv - ab 2007 kontinuierlich erfasst. Die meisten, aber nicht alle Anforderungen der Deutschen Krebsgesellschaft wurden erreicht, bzw. umgesetzt. So zeigte sich eine bessere Dokumentation der Behandlung, insbesondere in der Pathologie. Ausserdem konnte eine Zunahme der Fallzahlen verzeichnet werden. Die Ergebnisse der Arbeit zeigen, dass durch eine Zertifizierung als Darmzentrum zunächst eine Verbesserung der Dokumentation und Standardisierung der Therapie bewirkt werden kann. Kurzfristig kann in einigen, aber nicht allen Behandlungsparametern, eine Qualitätsverbesserung, insbesondere in der Chirurgie, erreicht werden.