الفهرس 
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Abstract
Human cancer colon is a common malignancy worldwide. CRC is already the third leading cause of cancer death in the world. It is the second most common diagnosed cancer in females and the third in males, with almost 835,000 deaths in 2015. Its incidence is steadily rising in developing nations. Also known as colorectal adenocarcinoma.
Livin is a novel member of the IAP family, which has two splicing variants that contain open reading frames of 298 and 280 amino acids.
Livin is not expressed or low expressed in most of terminal differentiated tissues of normal adults, but highly specific overly expressed in certain malignant tumors, such as esophageal cancer, gastric cancer, liver cancer, intestinal cancer, prostatic cancer, bladder cancer, renal carcinoma, lymphadenoma, neuroblastoma and leukemia.
Proapoptotic BCL-2 modifying factor (BMF) gene is a member of BH3-only proteins, but, its role in apoptosis signaling, and oncogenesis, still unclear. In many cell lines, BMF serves a role in initiating cell apoptosis by binding to B-cell lymphoma (Bcl)2, Bcl-xL and Bcl-w proteins, and showed pro-apoptotic potential in many cell lines and cell death assays.
Knockdown of BMF gene and other members of the pro-apoptotic BH3-only proteins, facilitates tumor progression, and permits the survival of malignant clones. Over-expression of Bmf in B-CLL cells causes rapid apoptosis. There was a significant association between up regulation of livin and down regulation of BMF expressions with more aggressive tumor (advanced TNM stage), rapid progression with metastasis and decreased overall survival in cancer colon patients, hence these genes can serve as significant prognostic markers of poor outcome in colon cancer patients.
The aim of the work is to study the correlation between proapoptotic Bcl-2 modifying factor (BMF) and Livin gene expression in colon cancer.
The studied subjects were categorized into the following three groups:
group I: It included 50 patients with colorectal cancer.
group II: It included 50 patients with colorectal adenoma.
group III: 50 tissue specimens of accompanying normal colon mucosa from same patients in group I for comparison.
Patients with preoperative chemo or radiotherapy or diagnosed with previous colorectal tumors or with tumors located elsewhere were excluded from the study.
Method:
In our study livin gene and BMF gene mRNA expression levels in different colorectal tissue specimens (50 cancer, 50 benign and 50 paired normal mucosa samples) were assessed.
The hallmark finding in this study, is the reciprocal correlation between the up regulation of livin gene and down regulation of BMF gene expressions in colon cancer tissues.
Results:
There was a statistically significant difference between studied groups. Patients with Colorectal cancer had higher haemoglobin than benign colorectal lesions cases and control group.
There was a statistically significant difference between studied groups and BMF gene expression. BMF gene expression is down regulated in colorectal cancer cases than benign colorectal lesions cases and control group.
Correlation between BMF gene expression and laboratory investigations in each group was estimated using Spearman coefficient method and the following were concluded from the results:
o BMF gene expression was positively correlated with TTP and overall survival in CRC cases.
o No correlation with other laboratory investigation nor other groups.
o There was negatively statistically significant between BMF gene expression and Livin gene expression in CRC cases.
There were high statistically significant relation between BMF gene expression, stage and metastasis in CRC patients.
There was high statistically significant relation between BMF gene expression and fate.
There were statistically significant relation between BMF gene expression, CEA and toxicity.
There was a statistically significant difference between studied groups and Livin gene expression. Livin gene expression is up regulated in Colorectal cancer cases than benign colorectal lesions cases and Control group
Correlation between Correlation between Livin gene expression and laboratory investigations in each group was estimated using Spearman coefficient method and the following were concluded from the results:
o In CRC cases, Livin gene expression was positively correlated with BMI.
o Livin gene expression was negatively TTP, overall survival and BMF gene expression in CRC patients.
o While in group III, Livin gene expression was negatively correlated with urea.
o No correlation with other laboratory investigation.
Livin gene expression had statistically significantly relation with the tumor stage and presence of metastasis, toxicity and fate.