Expression of Interleukin-23 in Ulcerative Colitis & Colorectal Carcinoma: An Immunohistochemical Study with Clinico-Pathologic Correlation

Abstract

Inflammatory bowel disease (IBD) comprises 2 disorders: ulcerative colitis (UC) and Crohn’s disease (CD). In Egypt, ratio of UC/CD is 6:1. UC is a chronic disease characterized by diffuse inflammation of the rectal and colonic mucosa. UC involves the rectum in 95% of cases and may be extended continuously and circumferentially to more proximal parts of the large intestine. Most UC studies have shown a male predominance. UC has a bimodal age distribution, the peak age of onset is 15 to 30 years old with a second, smaller peak occurring in individuals aged 50 to 70 years. Early diagnosis of colonoscopic biopsies by routine H&E examination represents a challenge especially in early cases before full blown microscopic picture is apparent. Early UC can be missed and diagnosed as chronic active non-specific colitis with wasting the opportunity of the patient to have strict follow up and early proper management. Cancer of the colon is the 4th most common cancer in the world, while cancer of the rectum is the 8th most common. Together, CRCs are the 3rd most commonly diagnosed form of cancer globally, comprising 11% of all cancer diagnoses. In Egypt, a rapid increase in CRC incidence has been observed with an unusually high rate under age 40, and a main cancer subsite in the rectum.