Background: Identifying the local foci and clusters of diseases can help reduce incidence and mortality by making necessary interventions. This study aimed to detect possible COLORECTAL cancer incidence clusters using spatial analyses at point-level data at small census units in Arak, Iran, from 2009 to 2014. Methods: In this ecologic study, recorded data on COLORECTAL cancer in Arak were collected from the Arak Cancer Registry. All records were evaluated using various methods to detect and resolve probable error events or duplicated records. Then, SaTScan software was used to explore spatial clusters. The Discrete Poisson-based Probability Model was utilized to analyze the clusters. Results: A total of 398 incident cases of COLORECTAL cancer were identified. The mean age at diagnosis was 62. 8 ±,14. 6 years. Among COLORECTAL cancer cases, 179 (45%) and 219 (55%) were females and males, respectively. Most cases were categorized with colon topography codes (n = 119, 66. 5%). Three spatial clusters of COLORECTAL cancer using individual geocodes were detected. The most high-risk cluster was located near the southern highway in Arak, a highway with transit routes for heavy and light vehicles (p=0. 0004). The second significant high-risk cluster was a district located in the vast part of the center of Arak (p=0. 003). The third high-risk cluster was an area in the suburb of Arak, between Farmahin-Arak Road and Northern highway (p=0. 06). Conclusion: This study identified three essential clusters for the high incidence of COLORECTAL cancer in Arak. The data would be useful for further evaluation of the environmental and lifestyle factors. Furthermore, the obtained pattern might be related to confounding impacts of environmental and lifestyle factors.

On encountering an eyelid or orbital mass, apart from common skin lesions, the diagnosis requires systemic evaluation, radiological and eventually histological confirmation. The majority are uncommon conditions for ophthalmologists.1 The presenting signs in all soft tissue NEOPLASMs and carcinomas are rather similar with lid swelling and proptosis. In this edition Langerhans cell histiocytosis (LCH), granular cell tumor (GCT) and eyelid conjunctival amyloidosis have been reported. In all the diagnosis is based on confirmation of an adnexal mass and by imaging followed by a histopathological report along with systemic investigation.

Background: Non-polypoid COLORECTAL NEOPLASMs and related malignancies are difficult to be detected using traditional colonoscopy. In this study, we attempted to evaluate frequency of flat and depressed COLORECTAL NEOPLASMs using high-magnifying colonoscopy.Materials and methods: Patients with medical indication of colonoscopy who referred to Talaghani hospital in 1385 were evaluated. After preparation, total colonoscopy (Olympus, CF-Q240TL, Japan) was performed up to cecum. Lesions were classified according to macroscopic presentation and Paris classification, and then they were evaluated regarding pit patterns after 100-fold magnification. Pathologic findings of lesions were studied by two expert pathologists.Results: One hundred patients with mean age of 44.3 ±16.1 were studied. In total 27 lesions (17 polypoid, 10 non-polypoid) were found in 18 patients. Peduculated polyps (9 polyps) were the most common lesions. We found 8 flat and 2 slightly elevated polyps. There was no depressed lesion. In pathologic examination, there were 21(77.8%) adenomas, mostly tubular (12, 66.6%). One adenocarcinoma was also detected. Pit pattern II was the most common pattern found.Conclusion: As non-polypoid NEOPLASMs are frequent lesions in Iran, we recommend performing high-magnifying colonoscopy in patients with suspected presentations in traditional colonoscopy. 

Background: COLORECTAL cancer is a highly prevalent cancer around the world and Iran. There are different criteria that can affect the survival rate of this disease. Surgical margin status is one of these criteria; there are still challenges about how it can change the surveillance of the disease. Objectives: In this study, we assessed the relativity between surgical margin status and the stage of disease in Iranian patients suffering from COLORECTAL cancer. Methods: This is an observational cross-sectional study. A total of 797 patients with COLORECTAL cancer were included and a checklist of demographic, clinical, and pathological data was filled for each one. Based on the pathology result of the biopsy, the patients were divided into different histological groups. Surgical margin status was defined individually. To declare the relativity between surgical margin status and independent variables, we used Spearman's rho test. Results: The stage of the disease and its histological type and grade were significantly correlated. There was also a significant correlation between histological grade and type of the disease. Conclusions: Surgical margin status and stage of the disease are challenging prognostic factors in disease recurrence and survival. The patients who participated in this study had meanly higher age and stage of diagnosis than earlier studies either global or local. It can be due to a lack of a systematic program for early detection of CR cancer in Iran that emphasizes the necessity of GI screening systems.

Background: This report analyses an experience with 42 liver resections for metastatic COLORECTAL carcinoma.Methods: Forty-two patients underwent curative resection for liver metastasis from COLORECTAL cancer between January 2004 and December 2007, with a follow up period that ranged from 3 to 66 months. In this retrospective study, early postoperative 30 day mortality and morbidity in addition to the effects of Dukes’ stage, type of resection, number and size of the tumor, synchronous or metachronous metastases, resection margin, sex, age and chemotherapy protocol on three year survival were analyzed retrospectively.Univariate analyses of survival were estimated using the Kaplan-Meier method. Multivariate analysis was evaluated using Cox regression method. The value of P<0.05 was accepted as signicant.Results: Early postoperative morbidity and mortality rates were 7.14% and 0%, respectively. Fourteen patients died during the follow-up period of 3 to 66 months (mean, 40.40±12.87) . Median survival was 56 months and three year survival rate was 71.30%. Recurrence occurred in 11 patients (26.00%) after liver resection and additional surgery was performed for two of them.At univariate analysis, the number of tumors (<4), tumor size (<4 cm), type of resection and negative resection margins were signicantly correlated with three year survival. Sex, age, Dukes’ stage, synchronous or metachronous metastasis, recurrence and chemotherapy protocol were not predictive of long-term prognosis. Multivariate analysis revealed that tumor size > 4 cm and presence of more than four tumors before surgery were associated with a 5.89 and 2.18-fold increased risk of death, respectively.Conclusion: Curative resection is one of the most important treatment options that can demonstrate long-term survival for patients.

Context: Gut microbiota fulfill a vital role in COLORECTAL cancer. The aim of this study was to systematically review all the existing literature on the association of mucosa-associated and fecal microbiota with the incidence, location, and stage of both COLORECTAL adenoma and carcinoma. Acquisition Evidence: The scientific search was conducted up to July 2018. Among a total of 616 articles, 54 fulfilled the inclusion and exclusion criteria and were reviewed. The Newcastle-Ottawa Scale (NOS) for surveying the standard was utilized for quality control. Results: A total of 54 articles were incorporated in the study. Fusobacteria 39 (72%), Firmicutes 22 (40%), Bacteroidetes 19 (35%), Proteobacteria 15 (27%), and Actinobacteria 10 (18%) were the most prevailing phylum that were found in COLORECTAL cancer patients. Among these taxa, some of them grew more in COLORECTAL cancer patients in contrast with the control,conversely, some taxa such as Collinsella, Pedobacter, Bifidobacterium, Megamonas, Brevundimonas, Burkholderia were less prevalent in COLORECTAL cancer patients. Moreover, in some taxa like Prevotella, Alistipes, Lachnospiraceae, Subdoligranulum, Roseburia, Ruminococcus, Eubacterium, Dorea, Bacillus, Parvimonas, Faecalibacterium, Dialister, Staphylococcus, Lactobacillus, Enterococcus, Blautia, Escherichia coli, and Pseudomonas, there have been controversies among specialists. Conclusion: Until now, several studies have incontestably reported the potential role of gut microbiota to be used for the detection of COLORECTAL cancer,however, there are no predefined protocols. In this article, we attempted to summarize and organize articles that have investigated the microbiota as a type of strategy for screening COLORECTAL cancer.

Background: The Peucedanum species have many pharmacological effects due to the presence of coumarins, flavonoids, phenolic compounds, and essential fatty acids in these species. In this study, for the first time, the anticancer activity of Peucedanum chenur methanolic extract via the induction of apoptosis and inhibition of invasion in HCT-116 human colon cancer cells was investigated. Methods: P. chenur methanolic extract effect on HCT-116 cells viability and antioxidant activity were evaluated using MTT assay, DPPH, and iron chelating tests, respectively. Changes in mRNA expression level in a panel of relevant genes were assessed by the quantitative real-time PCR. Also, apoptosis was assessed by cell cycle analysis and Annexin V/PI method, and the effect on cell migration was tested using scratch test. Results: P. chenur methanolic extract increased significantly the expression of BAX while decreased the expression of BCL-2, AKT1, FAK, RhoA, and MMP genes compared to the control group. BAX/BCL-2 ratio and apoptosis elevated, whereas cell migration reduced significantly. Besides, our extract showed an appropriate antioxidant activity. Conclusion: P. chenur may be introduced as a new chemopreventive agent in medicine due to its notable power in terms of induction of apoptosis and inhibition of invasion.

Background: The risk of local recurrence in COLORECTAL cancer has been associated with the length of clear distal margin in the specimen taken during original resection. It has been reported that there is significant specimen shrinkage. This study aimed to quantify the degree of shrinkage after fixation in formalin and to investigate the factors affecting specimen shrinkage. Methods: This research was a single-center prospective study. All adult patients who underwent COLORECTAL surgery for cancer had demographics, surgical details, and cancer staging and pathology recorded. Colonic specimens were measured immediately post resection including the total length, the mesenteric length and the distal length from the palpable tumor. Multiple logistic linear regression was applied to identify factors associated with distal margin shrinkage. Results: Right-sided colectomy specimens had an inconsistent degree of shrinkage. Left-sided colectomy specimens showed an average shrinkage of 20% (CI 4% –,36%). The only other factor observed that had statistically significant association on the shrinkage of distal margins in specimens was increasing tumor size. Conclusion: Specimens resected during anterior resection for COLORECTAL cancer have a consistent level of shrinkage. Locally advanced tumors were observed to have an association with specimen distal margin shrinkage,however, the mechanism is unclear. This new evidence can assist intra-operative decision making to allow adequate distal margin resection.

Although COLORECTAL cancer (CRC) is one of the most common cancers, the exact molecular mechanism of this cancer is not yet known. Circular RNAs (circRNAs), a class of non-coding RNAs, are newly identified and their role in the pathogenesis of various cancers has been shown. In this research, we studied the expression pattern and clinical importance of hsa_circ_000425 in CRC patients. After evaluation of hsa_circ_000425 expression rate in 4 CRC cell lines and 100 paired CRC tissues, the potential correlation between hsa_circ_000425 expression rate and clinicopathological parameters of CRC patients was analyzed. Additionally, receiver operating characteristic (ROC) curve was drawn to study the diagnostic value of hsa_circ_000425. A significant downregulation of hsa_circ_000425 was observed in both CRC tissues and cell lines. In addition, this downregulation was significantly associated with differentiation and lymphatic metastasis. The area under the ROC curve of hsa_circ_000425 was 0. 839 (P < 0. 001). hsa_circ_000425 may have a role in the pathogenesis of CRC and might act as a potential biomarker for the diagnosis and treatment of CRC; although further molecular studies must be performed in this regard.