Új stratégia kidolgozásának szükségessége a vastag- és végbélrákos betegek követésére; a mikroRNS-ek (miRNS) mint a korai felismerés lehetséges új biomarkerei - A betegszervezetek társszerepének előnyös hatása a túlélésre

Abstract

According to international statistics, CRC is one of the leading cause of death both in the USA and Europe (14-15 % of all tumors). They have already been mentioned in the literature as the disaster of the western (welfare) society before. Undoubtedly, however, that European CRC mortality shows a downward tendency in the last two decades primarily in the western European countries to which the effective screening programs also contribute. Unfortunately, in the European mortality statistics, Hungary and the Czech Republic is with terrible data represented. In our country annually the number of the new cases reported (for both gender) is approximately 9.000. The number of death is yearly is 5000, stagnant. The five-year survival data in the international literature are very varied, in the USA 65%, in Europe 55%. Higher or lower data exists also. Data from the northern countries sow a favorable picture. According to the data of the Hungarian National Cancer Registry 5 year survival of colon and rectum carcinoma (both gender) is 40%. Half of all cancer death happens already in the first year. The public health importance of CRC is therefore outstanding. The delay (or the early detection) is vital in the aspect of the CRC patient’s survival. After the healing surgery, the fundamental aspects of the patient follow up are the detection of the recurrent tumor as soon as possible, the recognition of its metastases, the detection of an accidental second primer tumor, as well as the reassuring and the improvement of the quality of life of the patient. Unfortunately, there is no consensus in the literature regarding the optimal follow up. Furthermore the selection and association of the strategic elements to ensure intensive and less intensive follow up show significant difference. However, the intense demand and the waiting for the early detection, for the extensive examination of the suitable molecular tests of the „sub-clinical” recurrence and in general for the headway of the non-invasive follow-up models cannot be disputed — neither for better expectation concerning improved survival. However, it cannot be disputed that there would be a significant demand for extensive molecular testing suitable for early detection, for the subclinical recurrence or usually for the expansion of non-invasive follow-up methods Neither for better expectation concerning improved survival.