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• W2805000949 abstract "Colorectal Cancer Is The Third Most Common Cancer Worldwide, With An Estimated130,000 New Patients Diagnosed Each Year. It Is The Second Leading Cause Of Death BecauseOf Cancer (Approximately 55,000 People Annually)[1]. In India The Incidence Of ColorectalCancer Is 3.9 Per One Lakh Population And The Mortality Rate Is 2.8 Per One LakhPopulation[2]. About 60% Of All Patients Diagnosed With Colorectal Carcinoma Will PresentWith Locally Advanced Disease[3]. Appropriate Therapeutic Decision Making For TheseIndividuals Depends Primarily On The Depth Of Penetration Of The Primary Tumor AndMetastatic Disease In The Regional Lymph Nodes[3].NORMAL LARGE BOWELThe Large Bowel Comprises The Terminal 1 To 1.5 Meters Of The Gastrointestinal TractAnd Is Divided Into Caecum, Ascending Colon, Transverse Colon, Descending Colon, SigmoidColon & Rectum.HISTOLOGYThe Large Bowel Wall Is Composed Of Four Layers1. MucosaEpitheliumLamina PropriaMuscularis Mucosa2. Sub Mucosa3. Muscularis Propria4. SerosaThe Mucosa Is Lined By Columnar Epithelium Into Which The Crypts Open. TheSurface Epithelium Is Composed Of Absorptive Cells And Goblet Cells. In Addition TheSurface Epithelium Contains Immature And Undifferentiated Cells, Endocrine Cells AndPaneth Cells. The Epithelium Overlying The Lymphoid Follicles Of Lamina Propria ContainsFollicle Associated Epithelial Cells Or ‘M’ Cells (M For Microfold Or Membrane Cells).The Absorptive Cells Have Basally Located Nuclei, Mucin Negative AcidophilicCytoplasm And Luminally Directed Apical Striated Borders. They Absorb Excess Water AndElectrolytes From The Intestinal Contents. The Goblet Cells Synthesize, Store And SecreteMucin Granules. The Paneth Cells Are Seen Only In Caecum And Proximal Right Colon AndThey Secrete Lysozyme And Epidermal Growth Factor. Lymphocytes And OccasionalEosinophils May Be Present Between The Surface Epithelial Cells. The Crypts Are TubularAnd Are Arranged Parallel To Each Other.The Lamina Propria Contains Few Lymphocytes (Both T And B Cells), Plasma Cells,Histiocytes And Mast Cells Scattered In A Network Of Collagen Fibers, Smooth MuscleBundles, Vessels And Nerves. Lymphoglandular Complexes Are Normal Structures FormedBy Deep Crypt Epithelium Surrounded By Lymphoid Follicles Which Extend From Mucosa ToSubmucosa. Pericryptal Fibroblast Sheath Is A Collection Of Fibroblasts And MyofibroblastsLocated Around The Crypts In Superficial Lamina Propria.The Muscularis Mucosa Is Composed Of Thin Layer Of Smooth Muscles. TheSubmucosa Is Composed Of Loose Connective Tissue Similar To That Of Lamina Propria. ItAlso Contains Submucosal Plexus Of Meissner And Often Contains Fat Cells. The MuscularisPropria Is Composed Of Inner Circular And Outer Longitudinal Layers Of Smooth MusclesWith The Myenteric Plexus Of Auerbach Between Them. The Outer Layer Is Collected ToForm Three Thick Bands Known As Taenia Coli. The Taenia Is Shorter In Length Than The OtherLayers Of The Colonic Wall. This Results In The Production Of Sacculations Or Haustrations OnThe Wall Of The Colon.The Serosa Is Composed Of A Single Layer Of Flattened To Cuboidal Mesothelial CellsAnd The Subjacent Fibroelastic Tissue. It Forms Small Pouches Filled With Fat Known AsAppendices Epiploicae. The Serosa Is Missing Over The Posterior Aspect Of Ascending AndDescending Colon.THE VERMIFORM APPENDIXThe Appendix Is The Narrowest Part Of The Gut. The Crypts Are Poorly Formed. TheLongitudinal Muscle Coat Is Complete And Thick All Around. Taenia Coli Are Absent. TheSubmucosa Contains Abundant Lymphoid Tissue That May Completely Fill It. The LymphoidTissue Is Not Present At Birth, It Gradually Increases And It Is Best Seen In Children Above 10Years Of Age. Subsequently There Is Progressive Reduction In Quantity Of Lymphoid Tissue.THE RECTUMThe Rectum Has A Continuous Coat Of Longitudinal Muscle And There Is No TaeniaColi. The Peritoneum Covers The Front And Sides Of The Upper One-Third And Only The FrontOf The Middle Third. The Rest Of The Rectum Is Devoid Of A Serous Covering.WHO CLASSIFICATION OF PRIMARY TUMOURS OF COLON ANDRECTUM [4]Tumours Of The Colorectal Region Are Classified Pathologically Into Different TypesWhich Are Based On The Microscopic Features.Epithelial TumoursNon-Epithelial TumoursI. AdenomaA. TubularB. VillousC. TubulovillousD. SerratedII. Intraepithelial NeoplasiaA. Low GradeB. High GradeIII. CarcinomaA. AdenocarcinomaB. Mucinous CarcinomaI. LipomaII. LeiomyomaIII. Gastrointestinal Stromal TumourIV. LeiomyosarcomaV. AngiosarcomaVI. Kaposi SarcomaVII. Malignant MelanomaVIII. Malignant LymphomaIX. Marginal Zone LymphomaX. Mantle Cell LymphomaXI. Diffuse Large B Cell LymphomaXII. Burkitt LymphomaC. Signet Ring Cell CarcinomaD. Small Cell CarcinomaE. Squamous Cell CarcinomaF. Adenosquamous CarcinomaG. Medullary CarcinomaH. Undifferentiated CarcinomaIV. CarcinoidA. Enterochromaffin CellB. L CellC. OthersV. Mixed Carcinoid - AdenocarcinomaADENOCARCINOMAAdenocarcinoma Is The Most Common Tumour Type. Most Are Well To ModeratelyDifferentiated And Lack Specific Histological Features, Although Colorectal Tumours Tend ToShow Cribriform Patterns With Central Necrosis, A Feature That Is Useful If A MetastaticTumour Is Encountered With An Occult Colorectal Primary. Dysplasia In Adjacent MucosaMay Be Seen, But Frequently The Invasive Tumour Obliterates Any Pre-Existing Polyp FromWhich It May Have Arisen[5].MUCINOUS ADENOCARCINOMAThis Is One Of The Subtypes Of Adenocarcinoma That Secretes Extracellular Mucin.At Least 50% Of The Tumour Must Be Mucinous In Order To Make This Diagnosis. MucinousAdenocarcinomas Are Associated With Microsatellite Instability. Whether MucinousTumours Have A Better Prognosis Is Uncertain. Mucinous Change May Also Be Seen InConventional Adenocarcinomas Treated With Neoadjuvant Chemoradiotherapy[6].SIGNET RING CELL CARCINOMASignet Ring Cell Carcinoma Is Composed Of At Least 50% Cells With IntracytoplasmicMucin And Eccentrically Placed Nuclei, Resembling Gastric Signet Ring Cell Tumours. TheTumour Grows In A Diffuse Fashion[7].SMALL CELL CARCINOMASmall Cell Carcinoma May Have Areas Of Glandular Or Squamous Differentiation.The Prognosis Is Extremely Poor[8].SQUAMOUS AND ADENOSQUAMOUS CARCINOMASThese Are Extremely Rare Tumours. They Have Been Associated With Ulcerative Colitis,Schistosomiasis And Pelvic Irradiation. The Survival Rates Are Similar To Adenocarcinomas.The Following Criteria Is Essential For Making The Diagnosis Of Squamous OrAdenosquamous Carcinomas§ There Must Be No Other Sites Of Squamous Cell Carcinoma In The Body§ There Must Be No Involvement Of Cloacogenic Or Squamous Lined Mucosa[9].MEDULLARY CARCINOMAThis Is An Important Subtype Of Colorectal Cancer, Added To The WHOClassification In 2000. It Has A Characteristic Phenotype With Sheets Of Cells And NumerousTumour Infiltrating Lymphocytes On Microscopy. This Phenotype Is Associated With TheLynch Cancer Family Syndrome (Hereditary Non-Polyposis Colorectal Cancer). PatientsWith This Syndrome May Also Have Ovarian, Endometrial, Skin And Other GastrointestinalTumours. The Colorectal Tumours Show A Loss Of Mismatch Repair Proteins Such As MSH(Muts, Escherichia Coli, Homolog In 60% Of Cases) Or MLH (Mutl, Escherichia Coli,Homolog In 30% Of Cases), Which Can Be Demonstrated With Immunohistochemistry[10].UNDIFFERENTIATED CARCINOMAThey Represent Less Than 1% Of Colorectal Cancers. They Are Malignant EpithelialTumours That Have No Glandular Or Other Features To Indicate Definite Differentiation. TheAbsence Of Intracytoplasmic Mucin Helps To Differentiate These Tumours From PoorlyDifferentiated Adenocarcinomas[11].CARCINOIDS AND NEUROENDOCRINE CARCINOMAThey Are Rare In The Colon But Focal Neuroendocrine Differentiation Can Occur InConventional Adenocarcinomas. These Are Commonly Seen In Caecum And Rectum[12].MIXED CARCINOID - ADENOCARCINOMAThey Originate From The Endodermally Derived Multipotential Cells Located At TheBase Of The Crypts Which During The Neoplastic Transformation Undergo DifferentiationAlong Several Different Pathways[13].MESENCHYMAL TUMOURSMesenchymal Tumors In The Colorectum Are Rare. Histologically They ResembleTheir Counterparts In Soft Tissues. Leiomyoma Is The Commonest Mesenchymal Tumour[14].LYMPHOMALymphomas Are Less Frequent In Large Bowel. They Are Nearly Always Of Non-Hodgkin’s Type. Most Of Them Belong To MALT-Type (Mucosa Associated LymphoidTissue) Category[15].METASTATIC TUMOURSMetastases Form Disc Like Areas With Central Ulceration. They Originate FromMalignant Melanoma, Lung Tumours, Renal Cell Carcinoma Or Mesothelioma.[16]Colorectal Adenocarcinomas Affect Males Slightly More Than Females And The MeanAge Of Incidence Is 62 Years. Both Environmental And Genetic Factors Are Involved In TheCause And Pathogenesis.There Are A Number Of Genetic Mutations Involved In Colorectal Carcinogenesis.These Can Be Assessed By Immunohistochemistry. Mutations In P53 Have Been Found ToOccur In 70% To 80% Of Patients With Colon Cancer[1]. This P53 Mutation Was Proposed AsA Late Event In The Transition From Adenoma To Carcinoma.Preclinical Investigations Have Demonstrated That Mutant P53 Renders MalignantCells Less Sensitive To Most Chemotherapeutic Agents, With The Exception Of The Taxanes,Which Seem To Be Indifferent To P53 Status. The Purpose Of This Study Is To Analyse The Age,Sex And Site Distribution In Colorectal Adenocarcinomas In Our Institution And ToInvestigate The Level Of Expression Of P53 In Colorectal Adenocarcinomas And CorrelateThis With The Histological Grade And Stage." @default.
• W2805000949 created "2018-06-01" @default.
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• W2805000949 date "2012-04-01" @default.
• W2805000949 modified "2023-09-27" @default.
• W2805000949 title "Immunohistochemical Evaluation of ColorectalMalignancies – A Study of 100 Cases." @default.
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