Questionnaire assessment based on signs, symptoms and history in the prevention of colorectal cancer

INTRODUCTION: Colorectal cancer (CRC) is an important pathology characterized by tumors in colorectal segments. Colonoscopy is the gold standard of CRC detection, but it is very expensive. Then, new methods are required for CRC screening to reduce mortality and improve the cost-benefit ratio. Objective: Evaluate the efficacy of a questionnaire (QSSA) based on signs and symptoms of CRC. METHODS: The QSSA was answered by 40 patients, before the colonoscopy procedure. The patients were divided into two groups: group I, with 20 patients showing positive result in the questionnaire, and group II, with 20 people showing negative result in the questionnaire. Colonoscopy was considered positive when presenting neoplasm or its precursor. The result was statistically analyzed by Fischer's exact test and sensitivity calculation. RESULTS: The results showed 14 positive and 26 negative colonoscopies. Group I had 9 positive and 11 negative colonoscopies and Group II, 5 positive and 15 negative (p=0.20) colonoscopies. The questionnaire presented sensitivity of 64.2%. CONCLUSION: The use of this questionnaire based on signs and symptoms of CCR alone was not effective in CCR screening

Immunohistochemical evaluation of p53 and Ki-67 proteins in colorectal adenomas

CONTEXT: The appearance of adenomas and their progression to adenocarcinomas is the result of an accumulation of genetic changes in cells of the intestinal mucosa inherited or acquired during life. Several proteins have been studied in relation to the development and progression of colorectal cancer, including tumor protein p53 (p53) and antigen identified by monoclonal antibody Ki-67 (Ki-67). OBJECTIVE: To evaluate the expression of p53 and Ki-67 in colorectal adenomas and correlate the observed levels with clinical and pathologic findings. METHOD: The sample consisted of 50 adenomatous polyps from patients undergoing colonoscopy. After performing polypectomy, polyps were preserved in a formalin solution with 10% (vol./vol.) phosphate buffer, submitted for routine preparation of sections and slides and stained with hematoxylin and eosin. For each adenoma we then performed immunohistochemistry to detect specific p53 and Ki-67 proteins using a streptavidin-biotin-peroxidase enzyme immunoassay. RESULTS: p53 was detected in 18% of the adenomas. The average Ki-67 protein index (i.Ki-67) was 0.49. A statistically significant difference was observed in p53 (P = 0.0003) and Ki-67 (P = 0.02) expression between adenomas with low- and high-grade dysplasia, particularly for p53. The expression of Ki-67 was greater in rectal adenomas than in colic adenomas (P = 0.02). No relationship was found between the expression of the two proteins in the sample. CONCLUSION: The p53 protein is expressed in a proportion of adenomas, while the Ki-67 protein was expressed in all adenomas. The expression of p53 was higher in adenomas with high-grade dysplasia. The expression of Ki-67 was higher in rectal adenomas and in adenomas with high-grade dysplasia