الفهرس 
Chapter 1: Colorectal cancer.Only 14 pages are availabe for public view
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Abstract
GI cancer is one of the most common causes of cancer-related deaths worldwide, and accounts for 40.6% of all reported cases (1).
CRC accounts for approximately 10% of all annually diagnosed cancers and cancer-related deaths worldwide (13).
It is the second most common cancer diagnosed in women and third most in men. In women, incidence and mortality are approximately 25% lower than in men. These rates also vary geographically, with the highest rates seen in the most developed countries (1).
Most CRC arise from a polyp, this process begins with an aberrant crypt, evolving into a neoplastic precursor lesion (a polyp), and eventual progressing to CRC over an estimated 10–15 years period (5).
In GIT clinic differentiating between IBD and functional bowel disorders, such as IBS, can often be difficult as they present with similar symptoms (257).
Regardless of considerable progress that has been made over the past years in diagnosis and management strategies of CRC, still many of the CRC patients are diagnosed in late stages and do not respond to treatment (256).
Cancer cells are characterized by a high glycolytic rate, which leads to energy regeneration and anabolic metabolism, a consequence of this is the abnormal expression of pyruvate kinase isoenzyme M2 (PKM2). Multiple studies have demonstrated that the expression levels of PKM2 are up regulated in numerous cancer types and IBD (11).
For all these considerations, the aim of this study was to assess the efficacy of fecal tumor M2-PK in cases with CRC so as to evaluate its potential use as a non-invasive tumor marker in CRC diagnosis and to evaluate the utility of the innovative fecal tumor M2-PK) test in our daily clinical routine, as a marker for the pre-selection of patients who should subsequently undergo colonoscopy for the diagnosis or exclusion of organic colonic diseases.
This prospective observational study was carried out on 135 consecutive patients who were attending the department of Tropical Medicine at Faculty of Medicine-Menoufia University, within the period between January 2018- and December-2019, and these patients represent groups:
group (1): consisted of 31 consecutive patients diagnosed, graded and staged by colonoscopy, histopathological examination and CT abdomen and pelvis.
group (2): consisted of 32 consecutive patients diagnosed as colonic polyps confirmed by colonoscopy and histopathology.
group (3): consisted of 30 consecutive patients diagnosed as IBD confirmed by colonoscopy and histopathology.
group (4): consisted of 42 patient diagnosed as IBS with normal colonoscopy.
The study protocol was approved by the Ethical Committee of Faculty of Medicine-Menofia University.
In this study we found significance results, the mean age of colorectal polyp’s patients (61.31 Ys) and CRC patients (59.29 Ys) and this highest mean age in compare to those suffering from IBD patients (33.9 Ys).
Furthermore, the prevalence of CR polyps and CRC was more common among male patients (81.3% and 93.5% respectively) in contrast to IBD which was more common among female patients (60%).
In this study, the prominent symptoms and signs occurring in CRC and CR polyp’s patients was chronic constipation, bleeding per rectum together with loss of weight.