EVOLUTION OF COLORECTAL CANCER IN SCHISTOSOMIASIS

Farid, Mohamed; El- Awady, Saleh; Abdel-Moneim, Hesham; Sakr, Hanem; Abd El-Ghafar, Adel; El- Desouky, Ebrahim

doi:10.21608/ejsur.2006.372983

EVOLUTION OF COLORECTAL CANCER IN SCHISTOSOMIASIS

Document Type : Original Article

Authors

¹ Colorectal Surgery Unit, Mansoura Faculty of Medicine, Egypt.

² Radiotherapy and nuclear medicine department, Mansoura Faculty of Medicine, Egypt.

³ Community medicine department, Mansoura Faculty of Medicine, Egypt

⁴ Pathology department, Mansoura Faculty of Medicine, Egypt.

10.21608/ejsur.2006.372983

Abstract

Aim: To define the clinico-pathologic character of schistosomiasis mansoni associated colorectal cancer (S.CRC) and the
possible carcinogenic relation of Schistosoma mansoni (S.M).
Methods: This study included 176 patients with colorectal cancer associated with S.M. Their clinical database and surgical pathology sheets were documented with the detection of S.M on stool analysis, serologic tests, pathologic associated lesions and tumor P53 protein expression using immuno-cytochemical assay.
Results: Sixty eight patients (40%) with S.CRC were below 40 years with male predominance (1.8 – 1), distal CRC
predominance in 109 patients (62%), mucinous type in 58 patients (33%), higher grades II, III in 136 patients (79%), with
significant angio-invasion in 50 patients (30%), lymph vessels invasion in 50 patients (35%) and perineural invasion in 17
patients (10%), associates with poor immune response in 8 patients (5%), preceded with schistosomal lesions especially in patients with schistosomal colitis ≥ 10 years, associates with TP53 in 114 cases (65%) and presented at advanced stages in 99 cases (56%) with only hepatic metastasis in 28 cases (90%).
Conclusion: S.CRC is a special clinical entity that has an aggressive pathologic pattern, bad biologic behavior and the SM is implicated in SCRC progression.

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