10 research outputs found
Increased MACC1 levels in tissues and blood identify colon adenoma patients at high risk
Background Colorectal cancer is a preventable disease if caught at early
stages. This disease is highly aggressive and has a higher incidence in
African Americans. Several biomarkers and mutations of aggressive tumor
behavior have been defined such as metastasis-associated in colon cancer 1
(MACC1) that was associated with metastasis in colorectal cancer patients.
Here, we aim to assess colon tissue MACC1 protein and circulating MACC1
transcripts in colon preneoplastic and neoplastic African American patients.
Methods Patients’ tissue samples (n = 143) have been arranged on three tissue
microarrays for normal (n = 26), adenoma (n = 68) and cancer (n = 49) samples.
Immunohistochemistry was used to detect MACC1 expression. Blood samples (n =
93) from normal (n = 45), hyperplastic (n = 15) and tubular adenoma (n = 33)
patients were used to assess MACC1 transcripts using qRT-PCR. Distribution of
continuous variables was tested between different diagnoses with
Kruskal–Wallis test. Categorical variables were tested by Chi square test. We
assessed the prognostic ability of IHC staining by calculating area under
receiver operating characteristics curve (ROC) for adenoma and cancer
separately. Differences between groups in terms of MACC1 transcript levels in
plasma were calculated by using non-parametric (exact) Wilcoxon-Mann–Whitney
tests. We performed all calculations with SPSS, version 21. Results In patient
tissues, there was a statistically significant difference in MACC1 expression
in normal vs. adenoma samples (p = 0.004) and normal vs. cancer samples (p <
0.001). There was however no major difference in MACC1 expression between
adenoma vs. cancer cases or tubular adenomas vs tubulovillous adenomas. The
area under the curve for both normal vs. adenoma and normal vs. cancer cases
were 70 and 67 %, respectively. MACC1 expression was not correlated to age,
gender or anatomical sample location. In patient plasma, MACC1 transcripts in
adenoma patients were significantly higher than in plasma from normal patients
(p = 0.014). However, the difference between normal and hyperplastic plasma
MACC1 transcripts was not statistically significant. Conclusion Metastasis-
associated in colon cancer 1 is expressed at early stages of colorectal
oncogenesis within the affected colonic tissue in this patient cohort. The
plasma transcripts can be used to stratify African American patients at risk
for potential malignant colonic lesions
3022 Metastatic Colon Adenocarcinoma Presenting as a Hilar Obstructing Lesion Diagnosed With EUS-FNB
Gastrointestinal Lesions in African American Patients With Iron Deficiency Anemia
Background: Iron deficiency anemia (IDA) is a frequent disorder that is associated with many serious diseases. However, the findings of an evaluation of IDA-associated gastrointestinal disorders are lacking among African American patients. Aim: To determine the most prevalent gastrointestinal lesions among African American patients with IDA especially in young men. Methods: We reviewed medical records (n = 422) of patients referred for evaluation of IDA from 2008 to 2012. Iron deficiency anemia was diagnosed using clinical laboratory tests. The results of esophagogastroduodenoscopy , colonoscopy, and pathology specimens along with demographic data were abstracted and analyzed using Stata. Results: The mean age was 61.9 years, and 50.5% were women. In total, 189 patients (45%) had gross gastrointestinal (GI) bleeding. The most frequent diagnoses were gastritis (40%), benign colonic lesions (13%), esophagitis (9%), gastric ulcer (6%), and duodenitis (6%). GI bleeding was significantly more frequent in men ( P  = 0.001). Benign and malignant colonic lesions were significantly more present among older patients: 16% vs 6% ( P  = .005) and 5% vs 0% ( P  = .008), respectively. Colitis was more prevalent in younger patients (⩽50): 11% vs 2% ( P  = .001). In patients with gross lower GI bleeding, the top diagnoses were gastritis (25%), benign colon tumors (10%), and duodenitis (6%). Colon cancer was diagnosed among 15 patients, and all these patients were older than 50 years of age. Conclusions: Gastritis and colonic lesions are most common associated lesions with IDA among African Americans. So bidirectional endoscopy is required for unrevealing of the cause of IDA in asymptomatic patients