الفهرس | Only 14 pages are availabe for public view |
Abstract Colon diseases, such as colitis, salmonellosis, shigellosis, travellers’ diarrhoea, diverticular disease (DD), inflammatory bowel syndrome (IBS), inflammatory bowel disease (IBD), and colorectal cancer, have a significant global impact on both men’s and women’s health (CRC). Environmental and genetic factors influence the onset and progression of many colonic diseases. IBD is a chronic inflammatory disease of the gastrointestinal tract, characterized by repetitive episodes of inflammation of the gastrointestinal tract caused by an abnormal immune response to gut microflora. IBD is classified into two subtypes: ulcerative colitis (UC) and Crohn’s disease (CD). In addition, one of the most common gastrointestinal diseases is irritable bowel syndrome (IBS). IBS is defined as the presence of abdominal pain or discomfort with altered bowel habits in the absence of any other underlying disease. Since its discovery, IBS diagnosis has evolved, and today the Rome IV diagnostic criteria are used to diagnose IBS. Symptoms of IBS can be managed with a variety of medications and nonpharmaceutical agents, depending on the subclass. Nonetheless, IBS treatment should be tailored to the individual, and a strong patient-physician relationship remains an important factor in management. Colorectal cancer (CRC) is the most common malignancy of the gastrointestinal tract/bowel or large intestine, the third most common cancer diagnosed, and the third leading cause of cancer-related death worldwide. CRC is frequently regarded as a common disease affecting the elderly, with the majority of cases studied between the fifth and sixth decades and a male predominance. It is a multifactorial disease process, with genetic factors, environmental exposures (including diet), and inflammatory conditions of the digestive tract all contributing to its aetiology. Systemic inflammation is associated with changes in quantity and composition of circulating blood cells. Recent studies have reported that the number and ratio of complete blood cell (CBC) subset in inflammatory diseases. Red blood cell distribution width (RDW), an indicator of the size variability of circulating red blood cells, has been associated with various inflammatory conditions. Platelet distribution width (PDW) is a marker of platelet unequal red blood cells, which describes the size distribution of platelets produced by megakaryocytes and increases with platelet activation. PDW has been associated with coronary heart disease, liver steatosis, irritable bowel syndrome and diabetic nephropathy. All of these diseases are related with increased inflammation. So, the present study aimed to evaluate the utility of Red Cell Distribution Width (RDW), Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) as potential laboratory non invasive biomarkers in colonic diseases patients (Irritable bowel syndrome and inflammatory bowel disease and cancer colon patients). The present case control study included 300 patients have symptoms and clinical signs of colonic diseases, were diagnosed by colonoscopy examination by expert gastroenterologists, they were divided into 100 patients with irritable bowel disease, 100 patients with inflammatory bowel disease, 100 patients with cancer colon compared to healthy controls in Menoufia Faculty of Medicine Hospital from Oct. 2021 to Feb. 2023 Regarding platelet count in the present study, IBD group only showed significantly higher platelet count when compared to control group. While MPV was significantly lower among IBS and IBD, significantly higher cancer colon groups when compared to control group. Regarding the inflammatory markers in the current study, IBD and cancer colon groups sowed significantly higher ESR when compared to control group, while all colonic diseases groups showed significantly higher CRP when compared to control group. Regarding IBD in our study, MPV and PDW was significantly lower in active versus remitted UC and CD as well as in active versus remitted CD. While MPV and PDW did not differ significantly between UC versus CD cases. RDW-CV did not differ significantly between UC versus CD, neither remitted nor relapsed. Regarding colon cancer cases, RDW-CV did not differ significantly between grades of endoscopy, Tumor stages, nodal stages, or metastatic stages. While MPV and PDW significantly lower in II and III grades when compared to I grade. PDW tend to decrease significantly with increased tumour stages, nodal stages, and metastasis stages. For discrimination between IBS patients and control group. RDW showed high accuracy AUC, while MPV and PDW showed moderate accuracy AUCs. While for discrimination between IBD patients and control group. RDW and MPV showed moderate accuracy. While PDW showed low accuracy AUC for discrimination between cancer colon patients and control group. RDW showed moderate accuracy AUCs While MPV and PDW showed low accuracy AUCs. For discrimination between active and remitted IBD in our study, PDW showed high accuracy AUC, MPV showed moderate accuracy AUC. While RDW showed low accuracy AUC. The current study showed that higher ESR, CRP, MPV, were considered cancer colon risk predictors on top of IBS. Moreover, higher ESR, MPV, PDW were considered cancer colon risk predictors on top of IBD. While higher RDW, lower PDW were considered risk predictors for higher cancer stage. |