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The study population consisted of 140 consecutive colorectal cancer patients, inhabitants of the city of Szczecin, north-west Poland, who were histopathologically diagnosed in the period of 2 years - 1991-1992. Family history was obtained in 124 (88.6%) of patients. A definitive diagnosis of HNPCC was established if requirements of the International Collaborative Group on HNPCC (ICG- HNPCC) were met. Suspected HNPCC were recognised according to criteria described by Ponz de Leon or Mecklin or Kunitomo. HNPCC as defined by International Collaborative Group on HNPCC was identified in 2 (1.6%) families. Suspected HNPCC were recognised in 16.9%, 3.2% and 4.0% of patients if Ponz de Leon or Mecklin or Kunitomo criteria were applied, respectively. In our series in 19 of 124 cases, colorectal carcinomas were diagnosed in patients under 50 years of age. Only in one of these cases, features characteristic of HNPCC other than young age were found which suggests that in our region the frequency of somatic or germ line de novo mutations in genes predisposing to colorectal cancer may be high. Our results suggest that the frequency of HNPCC inherited from ancestors in Poland and other countries is approximately similar and this syndrome is common disease everywhere.
The aim of this study was to identify differences in Toll-like receptor (TLR) expression patterns in normal and diseased tissues of patients with polyps and colorectal cancer. Eight patients were included in the study group (aged 38 to 72 years). Sixteen HG-U133A oligonucleotide microarrays were analysed including four of colonic polyps, four of adenocarcinoma with different degree of histological differentiation (2 poorly and 2 highly differentiated), and eight of macroscopically normal tissue. The levels of selected TLR mRNA transcripts were analysed. An analysis of all per cent variability values with regard to malignancy stage increasing from polyp to stages I to III adenocarcinoma, and normal colon mucosa shows a statistically significant relationship for TLR2 (increasing) and TLR3 (decreasing). In polyps, copy numbers of TLR3, TLR4 and TLR5 mRNA were the highest and TLR7 mRNA the lowest. In normal colon mucosa of polyposis patients the highest mRNA copy numbers were observed for TLR3, and the lowest for TLR7. TLR3 may serve as a marker of colon tissue metaplasia and may indicate the tendency of normal tissue to form polyps transforming to colorectal cancer.
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Experimental studies as an inspiration for clinical investigation

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This study represents an attempt of showing own author's example of using basic research data as an inspiration for the clinical studies. The project evaluates the role of gastrin in colorectal carcinogenesis as well as the differences of its action in proximal and distal colon. Colonocytes were isolated from Fischer-344 rats and incubated for 2 minutes with gastrin (10-8M). This treatment resulted with 60-70% rise in tyrosine kinase (Tyr-k) and 150-200% - in phospholipase C activity as regards to basal levels. In vivo infusion of gastrin for 5 days to Fischer-344 rats resulted with 90-150% increase in distal but not proximal colonic mucosal proliferative activity as well as tyrosine phosphorylation of several colonic mucosal proteins. In clinical study, the mean fasting gastrin level in the control group was significantly lower (p<0.01) than in patients with colorectal cancer before surgery. Mean plasma gastrin level in patients with distal tumor yielded 105,31 ± 12,5 µ U/l and was significantly higher than in patients with the proximal tumor site (42, 2 ± 3,1 µU/l) (p<0,001). We conclude, that Tyr-k is involved in the mechanism of the trophic action of gastrin, particularly in distal colon. The differences in gastrin concentration in patients with distal and proximal tumors may probably contribute to the distinct pathogenesis and biological properties of those cancers.
It has been suggested that mutagen sensitivity is a constitutional factor which may be useful in identification of patients with an increased risk for the development of tumors. In this study, the chromosome sensitivity to bleomycin was measured according to Hsu in patients with hereditary non-polyposis colorectal cancer (HNPCC), sporadic colorectal cancer and in control persons with no tumor history in family. In vitro lymphocytes were exposed to bleomycin according to Hsu and chromosomal damage was quantified by scoring breaks of 100 cells. A significant difference (P < 0.01) in the mean number of breaks per cell (b/c) was found between HNPCC patients (0.59 ± 0.14; n = 12; mean age 55.4 yrs) and control individuals (0.35 ± 0.13: n = 12; mean age 55.8 yrs). In contrast, patients with sporadic colorectal cancer showed a mean b/c value of 0.43 ± 0.14 (n = 14; mean age 63.4 yrs) which was not significantly higher than that in control individuals for this group (0.42 ± 0.15; n = 14; mean age 63.1 yrs). Selenium protected lymphocytes of HNPCC patients against bleomycin activity in vitro.
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