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Teresa Kinney Discussions of MIAMI's Global Program Compelled Me to Go to Congress

by | Dec 14, 2016
Last year I went to NAR in San Diego and I hear Teresa Kinney speak and she talked about all that was going on in MIAMI concerning global. So, I decided to become a global member and when I found out that this event was going on, it seemed a perfect compliment to my focus.

-Kim Jones Keller Williams, Baltimore


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    Part of my Esssay which I have bought about Colorectal Cancer and Novel Biomarkers
    This article reviews novel molecular biomarkers that can be used to predict survival of patients diagnosed with colorectal cancer.

    Traditionally, predicting survival of patients newly diagnosed with colorectal cancer relies primarily on cancer stage and/or anatomic extent of colorectal cancer. The common system for cancer staging is the American Joint Committee on Cancer (AJCC) staging system based on tumor invasiveness, number of lymph nodes, and metastasis. However, such a system does not provide a very accurate prediction at the individual level. Recently, several molecular markers have been proposed to be used together with the AJCC staging system to improve accuracy of prognosis for colorectal cancer patients, and to facilitate the choice of optimal treatment modality.

    Colorectal Cancer Research
    About 15-20% of colorectal cancers have high frequency of microsatellite instability (MSI). Microsatellite instability is characterized by inactivation of mismatch repair (MMR) genes. This occurs in both sporadic colorectal cancer and in hereditary non-polyposis colorectal cancer (HNPCC). Colorectal cancers with microsatellite instability are more likely to locate in the proximal colon and are often poorly differentiated (Malesci et al., 2007). They also have considerable lymphocytic infiltration, are of mucinous histological type and more likely to metastasize (Alexander et al., 2001).

    Colorectal cancers with microsatellite instability are more resistant to 5-FU therapy. Interestingly, Popat et al. (2005) conducted a meta-analysis (including more than 7000 patients) and showed that colorectal cancers with microsatellite instability have better overall survival in comparison to colorectal cancers with chromosomal instability.

    Other important genomic identification includes LOH18q and p53. Loss of 18q is observed in 60-70% of colorectal cancer cases. Aschele et al. (2004) showed that patients with advanced stage II or stage III colorectal cancer have poorer prognosis with loss of 18q. Mutation of p53 is observed in half of colorectal cancer cases. However, it is unclear whether mutation of p53 has any effect on clinical outcome.

    The use of gene expression profiling offers a method to identify patients with aggressive and treatment-resistant colorectal cancers. Eschrich et al (2005) used a cDNA microarray (with more than 30000 gene transcripts) and were able to predict 3-year survival with great accuracy. Eschrich et al (2005) also showed that use of molecular staging provides more accurate prognosis than Dukes staging.

    In summary, molecular and genomic prognostic factors have great promises. However, the most reliable prognostic system at this moment is still tumor stage.

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