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Volume 8 Journal of Gastrointestinal & Digestive System Gastro Meet 2018
August 06-07, 2018
August 06-07, 2018 Abu Dhabi, UAE
Gastroenterology and Digestive
Disorders
16th International Conference on
Pre malignant conditions of colonic carcinoma
Deepak Ghuliani
Maulana Azad Medical College, India
C olorectal Cancer (CRC), commonest gastrointestinal malignancy develops from the progression of acquired or hereditary
premalignant lesions. 75%of colorectal cancers are “sporadicwhile a potential genetic influence is identified in the remaining
25% of patients. The tumor results from complex interactions between several risk factors (environ¬mental, dietary, familial
and hereditary) which become relevant during the different stages of colorectal carcinogenesis. The Chromosomal Instability
(CIN)/Loss of Heterozygosity (LOH) pathway and the Microsatellite Instability (MIN)/Replication Error (RER) pathway are
two well-described genetic pathways leading to the development of colorectal adenocarcinoma. Most, if not all colonic cancers
develop from a precursor polyp. The most common neoplastic polyp with malignant potential is the adenoma .It follows the
adenoma-carcinoma sequence where inactivation of APC gene sets the stage for accumulation of genetic damage leading to
a malignancy. Carcinomas are found in 0% to 4% adenomas. Histologically divided as tubular, villous and tubulovillous- the
size and histology of adenomas are independent risk factors. Serrated polyps - another type of neoplastic polyp are mixed
hyperplastic and adenomatous polyps. The sessile and traditional serrated types are the definite precursors for colonic cancers.
Adenomas, may occur sporadically or as part of one of the hereditary syndromes like Familial Adenomatous Polyposis (FAP),
Attenuated FAP, Gardener’s and Turcot’s syndrome. FAP is the commonest adenomatous polyposis syndrome with 100 to 1000
polyps all over the colon, more in the left and associated with 1% of colonic cancers. Besides, several hamartomatous polyposis
syndromes like Peutz-Jeghers syndrome and Juvenile polyposis syndrome have markedly increased risk of colonic cancer with
development of extra-colonic manifestations, both malignant and non-malignant. Hereditary Non Polyposis Colonic Cancer
(HNPCC) is the most common familial colorectal syndrome associated with 2-3% of colorectal cancers. The associated colonic
cancer occurs at an early age (44 years), 70% are right sided with a 40% risk of synchronous and metachronous cancers. Other
premalignant conditions include inflammatory bowel diseases: Ulcerative colitis and Crohn’s disease where the risk is directly
proportional to extent and duration of disease. Thus early identification of these conditions not only provides the opportunity to
either prevent the progression to cancer or diagnose cancer at an early curable stage but also allows for appropriate surveillance
and management, which varies considerably between syndromes. Clinical testing for germline mutations should occur in the
setting of appropriate genetic counseling and offer predictive testing for family members.
Biography
Deepak Ghuliani is currently working as Professor of Surgery at MaulanaAzad Medical College, New Delhi has a special interest in Gastrointestinal and Endocrine surgery.
He is working as a General Surgeon, he has a vast experience in all types of gastrointestinal and hepatobiliary cases especially the GI Oncology. Besides clinical practice
he has a passion for teaching and all types of academic activities. He has several publications in National and International journals. He is working as Professor of Surgery
not only is he conducting research and teaching undergraduate and postgraduate medical students but also actively involved in conferences, CME’s, skills workshops,
updates in the role of speaker, chairperson, judge, trainer and also a quiz master.
Deepak Ghuliani, J Gastrointest Dig Syst 2018, Volume 8
DOI: 10.4172/2161-069X-C3-070