Sporadic colorectal cancer (CRC) is a consequence of the accumulation of genetic and epigenetic alterations that result in the transformation of normal colonic epithelial cells to adenocarcinomas. Studies have indicated that a common event in the tumorigenesis of CRC is the association of global hypomethylation with discrete hypermethylation at the promoter regions of specific genes that are involved in cell cycle regulation, DNA repair, apoptosis, angiogenesis, adhesion and invasion. The present study aimed to investigate the epigenetic changes (DNA methylation) in 24 candidate genes in CRC. A total of 10 candidate hypermethylated (HM) and unmethylated (UM) genes were identified that may be useful epigenetic markers for non-invasive CRC screening. The five genes that had the highest average UM percentages in the control group were MLH1 (71.7%), DKK2 (69.6%), CDKN2A (68.4%), APC (67.5%) and hsa-mir-342 (67.4%). RUNX3 (58.9%), PCDH10 (55.5%), SFRP5 (52.1%), IGF2 (50.4%) and Hnf1b (50.0%) were the five genes with the highest average HM percentages in the test group. In summary, the present preliminary study identified the methylation profiles of normal and cancerous colonic epithelial tissues, and provided the groundwork for future large-scale methylation studies.

After surgical treatment of colorectal cancer, depression and indexes of anxiety were higher in the group of patients treated with chemotherapy when compared to the control group.

Although the tumor stage is today the most valuable prognostic variable in colorectal cancer, the preoperative CEA value can provide some additional information in the prognosis of the patient.

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Dietary habits, lifestyle, and polymorphisms in VDR (ApaI), CYP24A1 (rs6013897, rs158552, rs17217119) and CYP27B1 (rs10877012) were associated with a higher risk of CRC.

Among elderly patients with colorectal cancer, PA and PG-SGA were prognosis factors. PA >5° was associated with best survival and PG-SGA C with worst survival.

RESUMO -Racional -O câncer colorretal é a quarta causa de câncer no Brasil e o 5-fl uourouracil uma das principais drogas usadas no tratamento adjuvante e paliativo dessa doença. A toxicidade da quimioterapia e as alterações de qualidade de vida, causadas pela própria doença e pelo tratamento, são motivo de muitos estudos. INTRODUÇÃONo Brasil, o câncer colorretal é a quarta causa de câncer (14) , sendo a segunda causa de morte por câncer na Europa e nos Estados Unidos (21) Os avanços obtidos na compreensão dessa doença, sejam em termos de seu comportamento clínico, sejam quanto à patogênese molecular, traduziram-se em progressos importantes no âmbito do tratamento. Diversos estudos randomizados realizados nas últimas duas décadas ajudaram os especialistas em oncologia a elaborar uma estratégia multimodal de tratamento para o câncer colorretal. Esses estudos defi niram o papel da cirurgia no tratamento do tumor primário e das metástases, bem como da terapia adjuvante (15) e paliativa (33)

-Context -The body mass index (BMI) is the most common marker used on diagnoses of the nutritional status. The great advantage of this index is the easy way to measure, the low cost, the good correlation with the fat mass and the association to morbidity and mortality. Objective -To compare the BMI differences according to the WHO, OPAS and Lipschitz classification. Methods -A prospective study on 352 patients with esophageal, gastric or colorectal cancer was done. The BMI was calculated and analyzed by the classification of WHO, Lipschitz and OPAS. Results -The mean age was 62.1 ± 12.4 years and 59% of them had more than 59 years. The BMI had not difference between the genders in patients ≤59 years (P = 0.75), but over 59 years the BMI was higher in women (P<0.01). The percentage of undernourished was 7%, 18% and 21% (P≤0.01) by WHO, Lipschitz and OPAS, respectively. The overweight/obesity was also different among the various classifications (P≤0.01). Conclusions -Most of the patients with gastrointestinal cancer had more than 65 years. A different cut off must be used for this patients, because undernourished patients may be wrongly considered well nourished. HEADINGS -Body mass index. Nutritional status. Gastrointestinal neoplasms.