Colorectal cancer (CRC) is a complicated disease in which both genetic pre-desposition and environmental factors are important. Patients with inflammatory bowel disease (IBD) have an increased risk... Show moreColorectal cancer (CRC) is a complicated disease in which both genetic pre-desposition and environmental factors are important. Patients with inflammatory bowel disease (IBD) have an increased risk of developing CRC, and it is believed that treatment of IBD patients with 5-Aminosalicylic acid (5-ASA) reduces the CRC risk. The general purpose of the studies described in this thesis was to evaluate the effect of 5-ASA on the development of CRC, as well as determining the feasibility of introducing 5-ASA as an adjuvant therapy for CRC patients. Animal research showed that chronic 5-ASA medication has the ability to prevent colitis-associated CRC, confirming results from 5-ASA medication in IBD patients. Although 5-ASA was not able to prevent the development of sporadic CRC, 5-ASA treatment was found to hold a great promise for the treatment of CRC, by exerting CRC growth inhibiting, anti-progression and cell death inducing effects, and should be considered to be implemented in a future treatment strategy to CRC. Besides this, the determination of cell death products in the circulation of CRC patients and within the tumour, holds a great promise for selection of CRC patient treatment and patient folluw-up. Show less
The current thesis discusses the use of molecular and biological tumor markers to predict clinical outcome. By studying several key processes in the develepment of cancer as regulation of cell... Show moreThe current thesis discusses the use of molecular and biological tumor markers to predict clinical outcome. By studying several key processes in the develepment of cancer as regulation of cell motility (non-receptor protein tyrosin adesion kinases, FAK, Src and paxillin, Apoptosis (caspase-3 activity and M30 expression) and regulation of cell growth (COX-2 expression). In addition the use of selective COX-2 inhibitors for the treatment of colorectal cancer liver metastases is investigated and discussed. The main outcomes of the thesis are that combined FAK/Src immunohistochemical expression is predictive of tumor recurrence in colorectal cancer, but is not overexpressed in liver metastases. Increased tumor cell apoptosis can have a positive or a negative impact on survival and local recurrence, depending on the location of the tumor in the large bowel . In rectal cancer caspase-3 activity can be used to preoperatively select patients who will not benefit from radiation therapy. COX-2 expression in rectal cancer is only of prognostic significance in irradiated rectal cancer patients, not in non-irradiated. Liver metastases in an animal model show deminished growth in the abcence of COX-2 expression and prostaglandin production. Show less