Histopathological spectrum of colorectal carcinomas

Introduction: Colorectal carcinomas are global oncologic problem faced by medical fraternity as it is the third most common carcinoma in men after lung and prostate carcinomas also second in women after breast carcinoma worldwide. 1998 to 2003, and the death rate decreased from 2.8% annually over the period 2001 to 2003. A great majority (98%) of all carcinomas in the colorectum are adenocarcinomas. The cause and pathogenesis of colorectal carcinomas are related to both environmental and genetic factors. Both gross as well as histopathological typing helps in definitive diagnosis and further management of the patient. Materials and Methods: This one year retrospective study included forty-three (43) cases of colorectal carcinomas. All the resected specimens received in the laboratory were immediately fixed in 10% formalin for at least 24 hours. Gross features of specimen were noted and multiple representative sections were taken for routine processing. After detailed study of sections under the light microscope the final diagnosis was given along with disease stage (Dukes classification). The patient details like age, sex, clinical diagnosis were obtained from the requisition forms that were sent along with the specimen. Results: There were total of forty-three (43) patients of colorectal carcinomas during the study one year. Male to female ratio was 1.15:1. Majority of the patients belonged to the age group of 58-67 years. The most common malignancy was adenocarcinoma followed by mucinous carcinoma and neuroendocrine carcinoma. The most common anatomical site involved was rectum. Conclusion: This study concludes that colorectal carcinomas are more common in 5th and 6th decade of life with slight male preponderance. The most common malignant lesion being moderately differentiated adenocarcinomas. The most common location being rectum with highest incidence of Dukes stage B. The histopathological examination remains the gold standard for the diagnosis and further management. © 2019 Published by Innovative Publication. This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by/4.0/)


Introduction
Colorectal carcinomas are global oncologic problem faced by medical fraternity as it is the third most common carcinoma in men after lung and prostate carcinomas also second in women after breast carcinoma worldwide. [1][2][3][4] The incidence in about 7/100000 in India. 3,5 and approximately 1.2 million new cases of colorectal adenocarcinomas and 6 lakh associated deaths, occur each year worldwide. 6,7 The overall incidence of colorectal carcinomas decreased at the rate of 2.1% per annum from 1998 to 2003, and the death rate decreased from 2.8% annually over the period 2001 to 2003. 8,9 A great majority (98%) of all carcinomas in the colorectum are adenocarcinomas. The cause and pathogenesis of colorectal carcinomas are related to both environmental and genetic factors. 3  diagnosis. 4,11 Both gross as well as histopathological typing helps in definitive diagnosis and further management of the patient. 6

Materials and Methods
This one year retrospective study included forty-three (43) cases of colorectal carcinomas diagnosed between January 2017 and December 2017. All the resected specimens received in the laboratory were immediately fixed in 10% formalin for at least 24 hours. Gross features of specimen were noted and multiple representative sections were taken for routine processing. Paraffin embedded of sections of 4 micrometer were taken and stained with Hematoxylin and eosin (H&E). After detailed study of sections under the light microscope the final diagnosis was given along with disease stage (Dukes classification). The patient details like age, sex, clinical diagnosis were obtained from the requisition forms that were sent along with the specimen. The location of the tumor was categorized as ascending, transverse, descending, sigmoid colon and rectum.

Results
There were total of forty-three (43) patients of colorectal carcinomas during the study one year. It included 23(53.48%) male and 20 (46.52%) female patients with a male to female ratio of 1.15:1. (Table 1) Majority of the patients, 16(37.21%) belonged to the age group of 58-67 years with the youngest being 18 years and oldest being 81 years old.

Discussion
The incidence of colorectal carcinomas are lower in India, being 5.9 and 5.3 per 100,000 in males and females respectively as compared to 32.9 and 24.4 per 100,000 in US. 1,12 Among the Asian population, Singaporeans have In the present study, the incidence of colorectal carcinomas was highest (37.21%) between the age group of 58-67 years which was comparable to the study done by Sharma P et al 3

Conclusion
This study concludes that colorectal carcinomas are more common in 5 th and 6 th decade of life with slight male preponderance. The most common malignant lesion being moderately differentiated adenocarcinomas. The most common location being rectum with highest incidence of Dukes stage B. The histopathological examination remains the gold standard for the diagnosis and further management.

Conflict of Interest
None.

Source of Funding
None.