Chronic inflammation plays a pivotal role in the development of COLORECTAL CANCER (CRC) in patients with inflammatory bowel disease (IBD).An orchestrated interplay of immune cells with numerous inflammatory mediators including reactive oxygen and nitrogen species, cyclooxygenase 2, and several cytokines promotes colitis-associated CANCER (CAC). Recent findings have shown that inflammatory pathways not only are important in the development of CAC but are also involved in the pathogenesis of SPORADIC CRC. Hereby, we review the existing experimental and clinical evidence that suggest a link between inflammation and tumorigenesis in SPORADIC CRC.

Background: Today, CANCER is one of the major health problems worldwide, and the importance of this disease in our country is growing. This CANCER is the third cause of death and accounts for the second largest group of non-transmissible chronic diseases. COLORECTAL CANCER is the most common gastrointestinal CANCER and includes 10% of deaths from CANCER around the world. Different genetic and environmental factors play a role in causing of this CANCER and in this study we investigated the environmental factors associated with COLORECTAL CANCER in Isfahan, Iran.Methods: In this case - control study, 125 patients with COLORECTAL CANCER, who had positive results by colonoscopy, were selected as case group from COLORECTAL CANCER center in Isfahan (Seyed Al Shohada Hospital) and 135 people, had a negative colonoscopy results, were selected as control group, from the same center. Cases and controls were matched by age, sex and place of residence. According to the aim of the study to investigate the cause factors of the SPORADIC COLORECTAL CANCER, patients who had a positive family history were excluded. Extracted data included age, sex, activity, diet, consumption of NSAIDs, smoking and BMI. Data were analyzed using a logistic regression model after entry into the SPSS software.Findings: From the total patients studied, 9.51% were male, 1.48% female, mean age of patients was 58.32±11.002. Through multiple analysis, an inverse relationship was found between physical activity (OR=0.49, CI 95%: 0.34-0.7) and non-steroidal drugs (OR=0.07, CI95%: 0.02-0.2) with COLORECTAL CANCER.Moreover, a positive association was found between dietary fat intake and COLORECTAL CANCER (OR=4.86, CI 95%: 2.96-5.45). In this study, no correlation was found between smoking and BMI with COLORECTAL CANCER.Conclusion: Due to the fact that COLORECTAL CANCER is preventable and its increased incidence, educational interventions, disease screening and identifying the role of diet and physical activities in the disease appears to be necessary.

Background: Records from the CANCER registry system of Iran indicate thatCOLORECTAL CANCER is the third most common CANCER in Iranian men and fourth mostcommon among Iranian women. In this study we have investigated the environmentalfactors associated with COLORECTAL CANCER in Isfahan, Iran. Methods: In this case-control study, we randomly selected 187 patients withCOLORECTAL CANCER who had positive results by colonoscopy and pathology (case group)and 250 persons who had negative colonoscopy results (control group) from theColonoscopy Unit of Al Zahra Hospital and COLORECTAL CANCER Center of Seyed AlShohada Hospital from 2014 to mid-2015. This study aimed to find the risk factors forSPORADIC COLORECTAL CANCER; therefore, we excluded patients with positive family history. Participants completed a self-administered questionnaire that asked about sex, age, bodymass index, smoking status, job-related physical activity, and nonsteroidal antiinflammatorydrug consumption. Results: This study enrolled 187 COLORECTAL CANCER patients (98 males and 89females) and 250 individuals without COLORECTAL CANCER (107 males and 143 females). Multiple analysis demonstrated a significant association of age (odds ratio: 1. 04; 95%confidence interval: 1. 02, 1. 06) and body mass index (odds ratio: 1. 09; 95% confidenceinterval: 1. 03, 1. 15) with COLORECTAL CANCER risk. Men had an almost two-fold riskcompared with women (odds ratio: 1. 85; 95% confidence interval: 1. 14, 2. 99). Subjectswho did not use nonsteroidal anti-inflammatory drugs had an almost three-fold riskcompared with nonsteroidal anti-inflammatory drug consumers (odds ratio: 0. 34; 95%confidence interval: 0. 19, 0. 62). Analysis for job-related physical activity, also indicatedan association between the no/low active group with COLORECTAL CANCER (odds ratio noactivity: 36. 09; 95% confidence interval: 10. 94, 119 and odds ratio low activity: 2. 96; 95% confidence interval: 1. 43, 6. 13). Conclusion: Knowledge of the risk factors involved in COLORECTAL CANCER incidencemakes it possible to identify people at risk and begin risk reduction strategies as wellas screening programs.

Objective: The polymorphic variants at codon 72 of the p53 gene, encoding proline or arginine at residue 72, produce marked changes in the p53 structure. From the evidence that the DNA mismatch repair system and p53 interact to maintain genomic integrity, we hypothesized that codon 72 variations may influence the prevalence of microsatellite instability (MSI), a feature of malignancies associated with mismatch repair deficiency in SPORADIC COLORECTAL CANCER.Materials and Methods: We investigated the frequency of MSI in three P53 codon 72 genotypes using genomic DNAs from 144 paraffin blocks of SPORADIC COLORECTAL adenocarcinomas by testing the BAT-26 poly(A) marker. We used PCR-SSCP analysis to detect tumor sample MSI for the nonisotopic detection of deletions in the BAT-26 poly (A) mononucleotide repeat. Associations between qualitative variables were evaluated using the X2-test. Statistical significance level was set to p≤0.05.Results: MSI analysis revealed that 24.3% of the tumors (n=35) were MSI-positive and 75.7% (n=109) were MSI-negative. The frequency of microsatellite instability in the arginine/arginine, arginine/proline and proline/proline genotypes were 11 (16.9%), 22 (36.1%) and 2 (11.1%) respectively. A significant difference in distribution of MSI was found for the arginine/proline genotype compared with the grouped arginine/arginine and proline/proline genotypes (p=0.05).Conclusion: Our findings suggested that COLORECTAL adenocarcinomas arising in individuals with the p53 codon 72 arginine/proline heterozygosity are more prone to microsatellite instability than those with other p53 genotypes. In our study, MSI was important in the carcinogenesis of SPORADIC COLORECTAL CANCER arising in pro/arg heterozygotes.

Background: The DNA mismatch repair (MMR) system is one of the molecular pathways involved in COLORECTAL CANCER (CRC) carcinogenesis that consists of several genes, including MLH1 (MutL homolog 1), MSH6 (MutS homolog 6), MSH2 (MutS homolog 2), and MSH3 (MutS homolog 3). The protein encoded by PMS2 (post-meiotic segregation 2) is also essential for MMR. Here, we address the correlation between immunohistochemical and transcriptional expression of PMS2 with the tumor grade and clinical stage of non-hereditary/SPORADIC CRC disease. Methods: This study retrospectively analyzed 67 COLORECTAL resections performed for 38 male and 29 female patients. Random biopsies were taken by a gastroenterologist from patients referring to three hospitals in the cities of Zanjan, Urmia and Qazvin (Iran) during 2017-2019. All specimens were examined and classified for localization of tumor, pathological stage and grade. The PMS2 protein expression was studied immunohistochemically and analysis of mRNA expression was performed in the same tissue sections. Results: Immunohistochemistry and quantitative real-time polymerase chain reaction (PCR) analysis showed a decrease in PMS2 expression compared with paraCANCERous tissue (P < 0. 001), which correlated with tumor stage. In addition, reduced PMS2 expression was correlated with the tumor differentiation grade, underlining a connection between downregulation of PMS2 and progression of CRC. Comparing the PMS2 mRNA levels in different groups showed the following results: 0. 92 ± 0. 18 in patients with Stage I CRC tumor, 0. 86 ± 0. 38 in Stage Ⅱ , 0. 50 ± 0. 29 in Stage Ⅲ , and 0. 47 ± 0. 23 in Stage Ⅳ . Conclusion: These findings suggest that PMS2 may provide a potential reliable biomarker for CRC classification by combined immunohistochemical and mRNA analysis.

Background: High-fat diets have been considered a risk factor for SPORADIC COLORECTAL CANCER (CRC) in West-ern countries. However, data for this phenomenon are lacking in China. The purpose of this study was to com-prehensively evaluate the association between diet and the risk for SPORADIC CRC in Shandong Province, China. Methods: In this case-control study, 317 patients with SPORADIC CRC and 317 controls were collected in Shan-dong Province, China. All the samples were collected on the basis of rigorous screening criteria. The data were analyzed using a χ 2 test, univariate or multivariate conditional logistic regression, and stratified analysis. Results: Multivariate logistic regression showed that the following are risk factors for SPORADIC CRC (all P<0. 05): consumption of pork, fried food or barbecued meat; high Body Mass Index (BMI); alcohol abuse; psychosis; and the presence of a factory causing pollution near the home. Moreover, univariate analysis revealed the following qualities were also positively associated with CRC (all P<0. 05): intake of animal oil, consuming brawn and kipper, smoking, exhibiting frequent anger, and poor sleep quality. Eating fresh fruit was inversely correlated with the incidence of CRC (P=0. 012). Further stratified analysis demonstrated that BMI and the con-sumption of fried food, barbecued meat, or garlic were correlated with colon CANCER. However, alcohol abuse and psychosis were related to an increased risk for rectal CANCER. Conclusion: Dietary factors are related to SPORADIC CRC in Shandong Province. Future interventions should focus on reducing the related risk factors while advocating for practice of the protective factors.

Background and Aim: COLORECTAL CANCERs often arise from benign polyps. Adenomatous polyps and serrated polyps progress step by step to adenocarcinoma and change to malignant CANCERs. Genetic and epigenetic changes have relationship with specific stages in polyp-adenocarcinoma progression and COLORECTAL CANCER histopathological changes. In this study we applied immunohistochemistry (IHC) staining in SPORADIC COLORECTAL polyps to assay functional status of MLH1, MSH2, MSH6, and PMS2 proteins. Materials and Methods: In this cross-sectional study we assessed all patients with SPORADIC COLORECTAL polyps admitted and performed polypectomy in gastrointestinal department of Taleghani Hospital from 2004 to 2008. Results: IHC was abnormal in 6.8%, 4.5%, 3%, and 4.8% for MLH1, MSH2, MSH6, and PMS2, respectively. In all cases with abnormal PMS2, MLH1 was abnormal, while the same story happened with abnormal MSH2 and MSH6 (p<0.001). IHC staining results showed significant differences according to polyp location, and mean age of the patient (p<0.05). Meanwhile, adenomatous polyps and serrated adenoma polyps showed significant differences when MLH1 and PMS2 were considered (p<0.05). Conclusion: IHC staining is suggested for serrated adenoma specially those in left colon. However, IHC staining for right-sided polyps may not have increased benefits for patients' management.