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"ABSTRAK Kanker kolorektal merupakan salah satu penyakit kanker yang angka kejadiannya semakin meningkat. Tujuan penelitian ini menganalisis faktor-faktor yang berhubungan dengan kualitas hidup penderita kanker kolorektal. Penelitian pre eksperimental korelasional deskriptif dengan menggunakan desain kajian potong lintang dengan tehnik total sampel yang menderita kanker kolorektal. Sampel berjumlah 50 orang yang diperoleh dari RS di Kota Makassar. Data dianalisis dengan menggunakan uji korelasi Pearson dan Spearman untuk melihat hubungan serta uji Chi square untuk melihat perbedaan. Hasil penelitian menunjukkan bahwa ada hubungan antara fatigue dengan kualitas hidup penderita kanker kolorektal (p˂ 0,05), ada hubungan antara depresi dengan kualitas hidup penderita kanker kolorektal (p˂ 0,05), dan ada perbedaan status perkawinan dengan kualitas hidup penderita kanker kolorektal (p˂ 0,05) sehingga melalui uji regresi linear didapatkan depresi merupakan faktor yang paling berhubungan dengan kualitas hidup penderita kanker kolorektal (p˂ 0,05). Aspek psikis merupakan komponen penting yang perlu diperhatikan dalam merawat pasien kanker kolorektal untuk mendapatkan kualitas hidup yang lebih baik.ABSTRACTDepression Related to Life Quality of Colorectal Cancer Patients in Makassar City Hospital. Colorectal cancer is a cancer which incidence increased year by year. This research aimed to analyse factors related to the quality of life of patients with colorectal cancer. The research applied descriptive pre-experimental correlations with a cross-sectional study design with a total sample technique of colorectal cancer. A sample of 50 people was obtained from the hospital in the city of Makassar. Data were analyzed using the Pearson and Spearman correlation test to find out the relationship, and Chi square test to find out the difference. The results showed that there was a relationship between fatigue and the quality of life of patients with colorectal cancer (p˂0,05) there was a relationship between depression and quality of life of patients with colorectal cancer (p˂0,05), and there were differences in marital status and quality of life for cancer patients colorectal (p˂0,05), so that through a linear regression test found depression was the most associated factor with quality of life of patients with colorectal cancer (p˂0,05). The important point during taking care of patients with colorectal cancers is consent in the psychological aspects to have a better quality of life."

"ABSTRACTWe conducted this study to establish whether drinking alcohol alters the risk of early-onset colorectal cancer (CRC) in Japanese patients with Lynch syndrome (LS). The subjects were 66 LS patients with pathogenic mutation of mismatch repair genes (MLH1, MSH2, and MSH6) from the nationwide Japanese retrospective multicenter study. Cox proportional hazards modeling was used to investigate the factors correlating with early-onset CRC diagnosis, using clinical data such as gender, tobacco use, alcohol consumption, body mass index, gene mutation (MLH1, MSH2 vs MSH6), and family cancer history. Alcohol was significantly correlated with an increased risk of early-onset CRC [HR 2.44, 95% CI 1.13-5.16 (p = 0.02)], but tobacco use was not [HR 0.8, 95%CI 0.38-1.62 (p = 0.53)]. These findings suggest that alcohol consumption is correlated with an earlier onset of CRC in Japanese patients with LS."

"Angka kejadian kanker kolorektal sebagai penyakit keganasan menduduki urutan kedua setelah kanker payudara pada wanita dan kanker paru pada pria.Karsinoma pada daerah kolon asenden dan tranversus biasanya menyebabkan perdarahan sedikit demi sedikit dan tidak dapat dideteksi oleh mata serta tidak menyebabkan rasa sakit.Tes kolon albumin merupakan tes imunokimia pertama untuk menentukan adanya albumin yang berasal dari darah pada penyakit kolorektal dan tes ini tidak memerlukan persiapan diit. Sampai saat ini pemeriksaan darah samar dalam tinja masih banyak menggunakan bensidin, o-tolidin, guaiak, tetapi untuk pemeriksaan dengan cara tersebut banyak kendalanya.Dalam penelitian ini dilaporkan hasil penelitian banding kedua pemeriksaan di atas terhadap 18 tinja penderita dengan suspek keganasan kolorektal. Kahan penelitian diambil dari 11 orang laki-laki dan 7 orang perempuan yang berusia antara 21-54 tahun. Dilakukan pula uji diagnostik dengan memakai kontrol pasangan penderita. Dengan tabel kontingensi 2 X 2 diperoleh sensitivitas 100%, spesifisitas 93,7% dan akurasi 96,77%

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Colon Albumin Test as a Screening Test for Colorectal Cancer

Colorectal cancer is the second most cancer found preceded by breast cancer in woman and lung cancer in men. Cancer of the ascending and transverse colon usually did not cause profuse bleeding that could be observed macroscopically and did not cause pain.

The colon albumin test is a novel immunochemical test to detect albumin caused by bleeding in the colorectal regions. ND diet restriction is required before performing this test. Although the gold standard tests using benzidine, o-tolidin or guaiac were still commonly used, many obstacles were also reported.

In this study, a comparative examination was done on 18 stool amples were obtained from 18 subjects with suspicious of colorectal cancer. Specimens were taken from 11 males and 7 females, 21 until 54 years old. Diagnostic test was done using matched controls. Using 2 X 2 contingency table it was found a 100%, sensitivity, 93,7% spesificity and 96,7% accuracy."

"ABSTRAKKanker kolorektal menempati urutan ketiga terbanyak dari kasus kanker pada laki-lakidan menempati urutan kedua pada wanita di seluruh dunia. Karakteristik enzimatikkanker kolorektal menunjukkan adanya peningkatan enzim M2PK tumor. Penelitian inibertujuan untuk mengevaluasi pemeriksaan M2PK tumor pada feses pasien tersangkakeganasan kolorektal dibandingkan dengan pemeriksaan histopatologi sebagai bakuemas, menggunakan nilai titik potong baru dan nilai titik potong berdasarkan manufaktur.Desain penelitian adalah desain potong lintang dengan penyajian data secara deskriptifanalitik. Subjek penelitian terdiri dari 86 pasien dewasa yang menjalankan kolonoskopi.Pemeriksaan M2PK tumor pada feses dilakukan menggunakan kit ScheBo Tumor M2-PK Stool Test dengan metode ELISA. Proporsi M2PK tumor pada feses pasientersangka kanker kolorektal pada penelitian ini didapatkan sebesar 72,09%. Nilai titikpotong baru untuk pemeriksaan M2PK tumor didapatkan sebesar 14,18 U/ml dengansensitivitas 59,26%, spesifisitas 59,32%, NPP 40,00% dan NPN 76,09%. Hasil ujidiagnostik menggunakan nilai titik potong M2PK berdasarkan manufaktur (≥4 U/ml)didapatkan sensitivitas 92,59%, spesifisitas 37,29%, NPP 40,32%, dan NPN 91,67%.Berdasarkan hasil tersebut, maka pemeriksaan M2PK tumor pada feses dengan nilai titikpotong 4 U/ml dapat digunakan, terutama sebagai uji penapisan (screening) kankerkolorektal, sedangkan pemeriksaan M2PK sebagai uji diagnostik kanker kolorektal masihmembutuhkan penelitian lebih lanjut."

"Colorectal cancer (CRC) is one of the top three leading causes of death in both men and women. However, screening can help detect and prevent CRC. Multiple guidelines recommend CRC screening using stool-based screening and direct visualization via colonoscopy. Anatomically, women have a longer total colonic length, especially in the transverse colon, which makes it redundant; thus it is more difficult to perform complete endoscopy in women. Women also have a higher risk of developing right-sided colon cancer of the flat and depressed type, which is harder to detect than the other types. Moreover, women are less likely to undergo colonoscopy due to embarrassment, especially when the procedure is performed by male gastroenterologists, and the lack of available female gastroenterologists further complicates the problem. The current COVID-19 pandemic also decreases patients’ willingness to undergo screening due to the fear of contracting the COVID-19. Delay in diagnosis leads to more advanced tumors upon detection and ultimately decreases the survival rate, especially in women, as they have lower 1-year survival rate when CRC is detected in its later stages than in men. Innovative options for CRC screening have recently emerged, including colon capsule endoscopy, which can be performed in a clinic and may reduce the need for colonoscopy. However, sex-specific CRC screening guidelines and tools are not available. The objective of this review is to identify the barriers and challenges faced when performing screening colonoscopy in women, especially during the pandemic and to encourage the development of sex-specific CRC screening."

"Pendahuluan: Insiden kanker kolorektal di Indonesia mencapai 12,8 setiap 100.000 penduduk usia dewasa dan merupakan penyebab dari 9,5% kematian akibat kanker. 40–80% dari semua pasien kanker kolorektal mengalami malnutrisi. Penelitian ini bertujuan mengetahui prevalensi status nutrisi pada kanker kolorektal dan hubungan karakteristik klinis kanker kolorektal dengan status nutrisi pada pasien yang akan menjalani operasi.Metode: Penelitian ini merupakan penelitian observasional dengan metode potong lintang. Populasi terjangkau dari penelitian ini adalah pasien kanker kolorektal yang dilakukan tindakan operatif di RSUPN dr. Cipto Mangunkusumo, Jakarta dan dilakukan admisi pada September-Desember 2022 dengan kriteria inklusi dan eksklusi yang sudah ditentukan. Instrumen yang digunakan adalah Mini Nutritional Assessment (MNA). Analisis data bivariat menggunakan Chi-square dilanjutkan multivariat dengan uji regresi logistik.Hasil: Terdapat 71 pasien dengan diagnosis kanker kolorektal di RSUPN dr. Cipto Mangunkusumo pada periode September-Desember 2022 yang akan menjalani operasi. Karakteristik subjek pada pasien kanker kolorektal sendiri didapatkan sebagian besar pasien memiliki usia 64-78 tahun(57,7%), berjenis kelamin laki-laki (52,1%). Untuk stadium klinis, terlihat sebagian besar pasien memiliki stadium III, IV (78,9%), dengan panjangtumor 1-10,9 cm (76,1%), dan lokasi kanker berada di rectum (59,2%). Untuk hasil kadar CA19-9, terlihat bahwa sebagian besar pasien dengan kadar CA19-9 normal (62,0%) dan kadar CEA meningkat (66,2%). Sedangkan status nutrisi pada kanker kolorektal sebagian besar memiliki status berisiko mengalami malnutrisi (52,1%) diikuti memiliki status malnutrisi (43,7%). Hasil uji bivariat didapatkan karakteristik klinis kanker kolorektal yang bermakna adalah panjang tumor dengan nilai p < 0,05. Hasil multivariat didapatkan variabel bebas yang diteliti dalam penelitian ini hanya memberikan pengaruh sebesar 16,9% terhadap status nutrisi.Kesimpulan: Kebanyakan kanker kolorektal memiliki risiko malnutrisi dan terdapat hubungan secara statistik dan paling kuat antara panjang tumor dengan status nutrisi pada pasien yang akan menjalani operasi.

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Introduction: The incidence of colorectal cancer in Indonesia reaches 12.8 per 100,000 adult population and is the cause of 9.5% of cancer deaths. 40–80% of all colorectal cancer patients are malnourished. This study aims to determine the prevalence of nutritional status in colorectal cancer and the correlation between clinical characteristics of colorectal cancer and nutritional status in patients undergoing surgery.

Methods: This research is an observational study with a cross sectional method. The reachable population of this study were colorectal cancer patients who underwent surgery at RSUPN dr. Cipto Mangunkusumo, Jakarta and admission will take place from September-December 2022 with predetermined inclusion and exclusion criteria. The instrument used is the Mini Nutritional Assessment (MNA). Bivariate data analysis using Chi-square followed by multivariate logistic regression test.

Results: There were 71 patients with a diagnosis of colorectal cancer at RSUPN dr. Cipto Mangunkusumo in the September-December 2022 period who will undergo surgery. Clinical characteristics of colorectal cancer patients themselves showed that most of the patients were 64-78 years old (57.7%), male (52.1%). For clinical stages, it can be seen that the majority of patients have stages III, IV (78.9%), with a large tumor mass of 1-10.9 cm (76.1%), and the location of the cancer is in the rectum (59.2%) ). For the results of CA19-9 levels, it can be seen that most of the patients with normal CA19-9 levels (62.0%) and CEA levels were increased (66.2%). While the nutritional status in colorectal cancer most of them have at risk of malnourished (52.1%) followed by having malnourished(43.7%). The results of the bivariate test showed that the length of tumor was significant a p value <0.05. The multivariate results showed that the independent variables examined in this study only had a 16.9% correlation on nutritional status.

Conclusion: Most colorectal cancers are at risk of malnourished and there is a statistically strongest correlation between tumor mass and nutritional status in patients undergoing surgery."

"Insiden dan mortalitas dari colorectal cancer (CRC) terus meningkat. Beberapa metode skrining CRC umumnya bersifat invasif dan tidak nyaman. Single Nucleotide Polymorphism (SNP) dapat dimanfaatkan sebagai marker untuk skrining CRC dengan tingkat invasif yang rendah. Penelitian ini bertujuan untuk memvalidasi asosiasi antara SNP ?X? dengan kerentanan terhadap CRC sporadik. Desain penelitian menggunakan studi potong lintang. Jumlah sampel dan daya uji pada kelompok CRC sporadik dan kontrol ditentukan dengan menggunakan Epi Info versi 3.5.1. DNA genomik diperoleh dari sampel darah kedua kelompok, kemudian dilakukan PCR dan sequencing untuk melacak genotip SNP "X" dengan ukuran amplikon 979 pb.Hasil analisis statistik menunjukkan nilai PValue genotip TT terhadap Non TT sebesar 0,025 (P<0,05), dengan Odds Ratio (OR) 0,193<0,420<0,911. Setelah dikoreksi dengan binary logistic regression, didapatkan P-Value sebesar 0,047 dengan OR 0,188<0,431<0,988). P-Value genotip GT terhadap Non GT 0,890 dengan OR 0,561<0,963<1,652. P-Value genotip GG terhadap Non GG 0,076 dengan OR 0,949<1,628<2,793. Hasil menunjukkan adanya asosiasi antara genotip TT pada SNP ?X? dengan menurunnya kerentanan terhadap CRC sporadik. Studi lanjutan pada populasi lainnya di wilayah Indonesia perlu dilakukan untuk pemetaan pola variasi genetik di SNP ?X?, dan untuk mengetahui pengaruhnya di gen-gen terdekat yang berkorelasi terhadap CRC sporadik.

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The incidence and mortality of colorectal cancer (CRC) increase rapidly. Some CRC screening methods are invasive and generally uncomfortable. Single Nucleotide Polymorphism (SNP) can be utilized as a marker for CRC screening with low level of invasiveness. This study aimed to validate the association between SNP "X" with susceptibility to sporadic CRC. This study is a crosssectional study. Number of samples and power in CRC and control groups were determined using Epi Info v3.5.1. Genomic DNA were obtained from whole blood samples, and followed by PCR (979 bp amplicon) and direct sequencing to determine the genotype pattern.Statistical analysis showed that P-Value of genotype TT vs Non TT is 0.025 (P<0.05), with Odds Ratio (OR) 0.193<0.420<0.911. P-Value after adjustment using binary logistic regression was 0.047 with OR 0.188<0.431<0.988. P-Value of genotype GT vs Non GT was 0.890 with OR 0.561<0.963<1.652. P-Value of genotype GG vs Non GG was 0.076 with OR 0.949<1.628<2.793. There was a significant association between TT genotype at the SNP "X" with decreased susceptibility to sporadic CRC. Further study will be needed to identify genetic variation patterns in the SNP "X" in other populations in Indonesia region, and to investigate its effect to the nearest genes and its correlation to sporadic CRC."

"Karsinoma kolorektal merupakan salah satu kanker dengan beban penyakit yang tinggi di dunia. Berbagai penelitian mengenai efek anti-tumor vitamin D telah dilakukan sejak hubungannya dengan kanker kolorektal terungkap. Studi ini bertujuan untuk mencari secara sistematis penelitian mengenai efek anti-tumor vitamin D pada kanker kolorektal untuk memahami mekanisme molekuler di balik aktivitasnya. Sebuah tinjauan sistematis dilakukan dengan mencari di database elektronik PubMed untuk penelitian asli yang mempelajari efek pemberian vitamin D pada kanker kolorektal. Studi yang menyelidiki mekanisme di balik efek tersebut memenuhi syarat untuk evaluasi. Dua puluh tujuh studi dimasukkan untuk analisis dengan rentang tanggal publikasi dari 1987 hingga 2017. Studi in vitro dan in vivo mengungkapkan bahwa pemberian vitamin D mampu menekan proliferasi, menginduksi apoptosis, mempertahankan diferensiasi sel, mengurangi respons proinflamasi, menghambat angiogenesis, dan menghambat perkembangan metastasis. Penambahan kalsium ke suplementasi vitamin D juga ditemukan meningkatkan aktivitas anti-tumor vitamin D melalui cross-talk antara jalur pensinyalan mereka. Vitamin D dapat menghambat pertumbuhan dan perkembangan kanker kolorektal melalui jalur genomik (mengatur transkripsi gen pro- dan anti-tumor) atau non-genomik (mencegah aktivasi jalur pensinyalan pro-tumor secara langsung).

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Colorectal carcinoma is one of the cancers with a high disease burden globally. Since its relationship with colorectal cancer has been revealed, various studies on the antitumor effect of vitamin D have been conducted. This study aims to systematically search for research on the anti-tumor effect of vitamin D on colorectal cancer to understand the molecular mechanism behind its activity. A systematic review was carried out by searching the PubMed electronic database for original research studying the effects of vitamin D administration on colorectal cancer. Studies investigating the mechanism behind these effects are eligible for evaluation. Twenty-seven studies were included for analysis with publication date ranges from 1987 to 2017. In vitro and in vivo studies revealed that administration of vitamin D could suppress proliferation, induce apoptosis, maintain cell differentiation, reduce pro-inflammatory responses, inhibit angiogenesis, and inhibit the development of metastases. The addition of calcium to vitamin D supplementation was also found to increase vitamin D anti-tumor activity through cross-talk between their signaling pathways. Vitamin D can inhibit the growth and development of colorectal cancer through genomic pathways (regulating transcription of pro- and anti-tumoral genes) or non-genomic (directly prevents activation of pro-tumor signaling pathways)."

"Terdapat sebanyak 14,1 juta kasus kanker didiagnosis dan sebanyak 8,2 juta individu meninggal setiap tahunnya dari total ±32,6 juta pengidap kanker, menurut GLOBOCAN 2012. Kanker kolorektal memberikan 9,7% dalam kasus kanker dan insidesinnya pada usia <50 tahun menjadi meningkat 13% (2000-2014). Ekspresi siklooksigenase-2 (COX-2) yang berlebihan merupakan salah satu meaknisme yang terlibat dalam patogenesis kanker kolorektal. Sayangnya, pengobatan kanker menggunakan inhibitor enxim COX, NSAID, memiliki beberapa efek samping yang prominen seperti perdarahan gastointestinal, komplikasi kardiovaskular, dan nefrotoksisitas yang diinduksi NSAID. Dalam beberapa tahun terakhir, tanaman herbal telah mengundang perhatian banyak peneliti karena mudah didapat, murah, memiliki potensi dalam pencegahan kanker, dan memiliki toksisitas yang rendah. Hal ini memicu peneliti untuk mencari apakah ekstrak etanol biji delima mampu menurunkan ekspresi COX-2 pada sel HCT116.Ektrak biji delima (Punica granatum) dimaserasi dalam etanol. Satu kelompok tidak mendapatkan perlakuan (kontrol negatif) sementara tiga kelompok lainnya diberi ekstrak ekstrak biji delima dalam tiga dosis berbeda (50, 100, dan 200 ppm). Pengaruh pemberian ekstrak etanol biji delima pada ekspresi COX-2 dalam sel HCT116 dinilai melalui perhitungan H-score dari pewarnaan imunositokimia.Ekstrak etanol biji delima (Punica granatum) menunjukkan hasil dapat menurunkan ekspresi COX-2 yang ditunjukkan melalui penurunan nilai H-score dengan rerata nilai H-score sebesar 159,07 . Dan nilai p < 0,005Penelitian ini membuktikan bahwa terjadi penurunan ekspresi protein COX-2 pada sel HCT116 setelah pemberian ekstrak etanol biji delima (Punica granatum).

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14.1 million new cancer cases are diagnosed annually in 2012. And about 8.2 million people are dying every year worldwide while 32.6 million people are living and afflicted with cancer, according to GLOBOCAN. Colorectal cancer (CRC) contributes to 9.7% of all cancer cases and in population <50 years old its incidence increased by 13% (2000-2014). Excessive expression of COX-2 plays a role in the pathogenesis of CRC. Unfortunately, current cancer treatment using COX enzyme inhibitor, NSAIDs is known for its multiple adverse effects, including gastrointestinal bleeding, cardiovascular complications, and NSAID induced nephrotoxicity. In recent years, medicinal herbs have become popular among researchers for its easily obtainable nature, cheap, promising cancer preventing properties, and low toxicity. Thus, reseacher would like to investigate whether ethanol extract from pomegranate seed can reduce the expression of COX-2 in HCT116 cell.

Ethanol extract from pomegranate (Punica granatum) seed was prepared for maceration in ethanol. One group was given no treatment (negative control) while the other three groups were given ethanol extract from pomegranate seed in three different doses (50, 100, 200 ppm). The effect of ethanol extract of pomegranate seed on inhibition of COX-2 expression in the HCT116 cell was then assessed by counting the H-score from immunocytochemistry staining.

The ethanol pomegranate (Punica granatum) extract was shown able to decrease expression of COX-2, which was shown by decresing the H-score with average H-score 159.07. P <0,05

This study revealed there is a decrease in COX-2 protein expression in HCT116 cells after administration of ethanol pomegranate."