Role of colonoscopy in colorectal cancer

Abstract

Colorectal cancer (CRC) represents the third most common malignancy throughout the world. Little or no improvement in survival has been effectively achieved in the last 50 years. Extensive epidemiological and genetic data are able to identify more precisely definite risk-groups so screening and early diagnosis can be more frequently accomplished. CRC is best detected by colonoscopy, which allows sampling for histologic diagnosis. Colonoscopy is the gold standard for detection of small and premalignant lesions, although it is not cost-effective for screening average-risk population. Colonoscopic polypectomy and mucosal resection constitute curative treatment for selective cases of invasive CRC. Similarly, alternative trans-colonoscopic treatment can be offered for adequate palliation, thus avoiding surgery. Colorectal cancer (CRC) represents the third most common malignancy worldwide 1 and the second leading cause of cancer-related death in the U.S., regardless of sex. In 1998, it is estimated that 20 000 cases were newly diagnosed, and 6000 Brazilians died of the disease 2 . Five-year associated mortality remains unchanged around 50% 3 ; advances in the operative technique and adjuvant therapy produced a modest impact on survival 4 . In this paper, a brief review of aspects of etiology, epidemiology, genetics, histology, and main determinants of prognosis of CRC will be followed by an in-depth evaluation of the role of colonoscopy in the screening, diagnosis, treatment, and surveillance of patients with CRC.

Metabolic changes in colorectal carcinomas are key factors for the early detection of neoplastic change

“…32 Increased fatty acid production usually leads to the accumulation of 3-hydroxybutyrate supporting the hypothesis of enhanced metabolic changes in tumor cells. 10,33,34 Metabolic alterations that occur during tumorigenesis in colorectal cells show an elevation in the amount and types of protein precursors (usually amino acids) and fats in malignant tissues, indicating that there is a higher energy requirement during high proliferation seen in these tissues. Glucose and inositol are reduced in neoplastic proliferation.…”

Three‐dimensional morphological characterization of colorectal pits from label‐free microscopy images

“…Advanced endoscopic imaging techniques as chromoendoscopy with dye-spraying, narrow-band imaging and autofluorescence imaging, improve upon the accuracy afforded by conventional white light imaging, providing a more detailed visualization of the mucosa by enhancing morphology and vascularization (Yoshioka et al, 2016). In particular, the surface pattern shows the colonic mucosa appearing granular due to numerous pits from the crypts of Lieberkühn, which are normally arranged regularly and are roundly shape (Alonso Araujo et al, 2001). Kudo et al (1994) first highlighted the feasibility of applying the "pit patterns" to distinguish neoplastic and nonneoplastic polyps, and described three main categories of pit patterns and five types of patterns: (1) non-neoplastic (type I and II), (2) neoplastic adenomatous (type III and IV), or (3) neoplastic cancer (type V) (Facciorusso et al, 2015;Kato et al, 2012;Li et al, 2014).…”

Kolorektal Kanserde Endoskopik Özelliklerler Tümör Patolojisini ve Tümör Evresini Predikte Edebilir mi?

“…Kolorektal kanserler (KRK) tüm dünyada en sık izlenen 3. kanser türü olup kansere bağlı ölümlerin ise 2. en sık nedenidir (1). Tarama programlarının yaygınlaşması ve tedavideki yeniliklere rağmen mortalite oranı bu grup hastalarda halen yüksektir.…”