The colon, also known as the large intestine, has the purpose of absorbing water as well as store waste materials in the form of faeces. The colon is susceptible to different types of cancer, the most common one being the adenocarcinoma. The adenocarcinoma have been found o comprise of close to ninety percent of all colon cancers. Adenocarcinomas have been found to begin the process of infiltration of the colon on the submucosa level. This is via the abnormal glands that will further infiltrate the colon to access the extramural tissue. A normal histology is such that the epithelium exhibits low cuboidal cells (Priolli et al. 2014, 389). The tubes are also expected to have minimal branching, thus they are tightly packed. The colons crypts will also have fibroblast sheath with the surface opening up into a more defined series of grooves. The grooves, innominate in nature, represent a mucosal area that will normally have a central crypt.s
A normal histology in a submucosa level will have loose tissue with minimal infiltrate that are considered inflammatory. The muscularis propria will often have an inner circular layer as well as longitudinal layer on the outer parts (Priolli et al. 2014, 391). The histology should also provide information alluding to a regular muscularis mucosa, which is the membrane, should be thin (Priolli et al. 2014, 392). The endocrine cells in the colon as observed in the microscope serve as the base of the aforementioned crypts (Galvan et al., 2014, 13). The eosinophilic cytoplasm on the other hand serves as absorptive cells, and will often be located in the microvillus (Galvan et al., 2014, 15). The M-cells will have a flattened surface, which will ensure an aggregated overlying lymphoid (Kaser et al. 2015, 277). The Paneth cells will be located at the base of the mentioned crypts, strategically placed to function as secretory cells (Kaser et al. 2015, 283). The colon with adenocarcinoma will have thick M-cells as viewed under the microscope. The Paneth cells will also thicken and fill the crypts. The eosinophilic cytoplasm will deform to cause less absorption as a result of broken membranes (Kaser et al. 2015, 285).
The purpose of this essay is to determine how histology reports of colon adenocarcinoma influence the general prognosis, prediction, and thus the treatment of the cancer. The essay will discuss a general colon adenocarcinoma which will be appropriated by the identification of normal colon histology versus adenocarcinoma histology. The paper delves into the requirements for a successful histology. The paper also helps in identifying the different degrees of cellular differentiation as well as how this is a determining factor for a prognosis. The essay attempts a cellular level analysis of the cellular changes that predict adenocarcinoma as well as determine the effectiveness of histological test. The paper will discuss different findings on a cellular level, as well as future expectations in the process of histology.
In order to perform a holistic histology, a colon lumen will be analysed (Zhan et al. 2014, 883). This is after it has been cleaned to remove any faeces and then fixated in formalin. The analysis process will begin with a cellular differentiation analysis. This is because this is a determining factor when looking at the prognosis of an individual with colon adenocarcinoma (Ban et al. 2014, 127). Other factors to consider include the tumour size, presence of signet morphology, presence of invasion, as well as lymph node involvement.
Cellular differentiation among cancerous cells is crucial in the testing and prognosis of the colon adenocarcinoma (Sundstrom et al. 2015, 3479). The faster the rate of differentiation among the cancerous cells, the higher the chances there will be an invasion among other cells as well as the lymph node invasion. A faster rate of differentiation will translate to a prognosis that will require a radical treatment that may include an invasive operation to remove the infected part. However, a decrease in differentiation results in a malignant tumour that can easily be treated using non invasive methods such as chemotherapy or radiotherapy coupled with prescribed medication (RohitKumar et al. 2015, 530). The fact that the colon adenocarcinoma occurs among glandular cells increases the chances that the individual will have signet morphology. The use of H&E in the testing adenocarcinoma will affirm this as the cells will exhibit several rings under the microscope. The ink will clearly provide boundaries among the rings within the cell, predicting the presence of mucin in the patients cancerous cells (Knudsen et al. 2015, 33). Lymph node involvement happens when the adenocarcinoma is attacked by the white blood cells. The resulting materials are concentrated in the lymph nodes as the body attempts to attack the cancerous tissue (Akbari et al. 2015, 863). This results in the spread of the cancer to the lymph nodes, making the cancerous infection even more dangerous. The presence of invasion involves both the lymph nodes as well as adjacent cells within the vicinity of the adenocarcinoma. Invasion will result from a consistent differentiation of the adenocarcinoma.
There are different ways of diagnosing colon adenocarcinoma; these include macroscopy, microscopy, and immunochemistry (Calvo et al. 2015, 310). The next step in the diagnosis process would include the staging and finally the identification of tumour budding. A histology report will enable one to determine whether the patient is exhibiting the key determining factors that are congruent with a tumour/cancer (Florianova et al. 2013, 230). The histology report stating a well differentiated cell will show that the individual cells have assumed their real structure, one that supports the glandular role. However, a less differentiated cell will have abnormal properties which identify a cancerous cell (Imai et al. 2015, 189). Differentiation is determined in histology by the use of H&E to identify the key features of the cell, and thus its functionality stage (Leon et al. 2015, 1180). H&E is the key to this because it provides a visual map of the cellular structure of the cells within the biopsied tissue. The stain has different shades under the view of the microscope, making it easier to determine the quality of the differentiation as well as the diagnosis process (Tan et al. 2015, 7). A detailed cellular examination is made possible as a result of the haematoxylin stains on the cellular nuclei. By placing the H&E on the biopsied sample, the individual performing the test has allowed one to determine the staging of the cancer as well as the presence or lack thereof budding tumours (Yoshiaki et al. 2015, 3). This helps the practitioner to make a comprehensive diagnosis and thus prescribe the most appropriate recuperative measures (Vaque et al. 2015, 9). There are advances developments in the detections and diagnosis of colon adenocarcinoma. These include Immunohistochemistry and genetic screening. Both have introduced a new frontier in the testing for colon adenocarcinoma among other types of cancer (Shebaby et al. 2015, 747). Immunohistochemistry is the techniques that uses the search for certain elements such as amino acids as a means of detecting the presence of infectious cells. Genetic screening/testing is the sequencing of an individuals DNA with the intent of determining their possibility of determining their susceptibility towards different types of diseases.
On a cellular level, it has been found that the use of H&E is a key factor in ensuring that the data collected is factual. The use of H&E is also essential in determining the stag of the cancer. This is determined via the cellular layering, as well as its signet morphology (Chung et al. 2015 41). The findings of the histology as well as the research into the methods mentioned herein clearly depict that ones prognosis is highly dependent on the processes used to detect the colon adenocarcinoma. This is because the processes used determine the prognosis and thus the most appropriate treatment plan. However, as it has been mentioned before, all the testing methods require the use of a biopsy in order to obtain credible results (Sawhney et al. 684). This can be both invasive and painful for the patient. These strategies are also not efficient in the prevention of the colon adenocarcinoma. This has necessitated the development of new testing methods such as IHC and gene screening. In both cases, the testing strategy is swift and non-invasive. While the two are yet to be implemented on a massive scale, the fact is that they would make it easy to test for colon adenocarcinoma as well as other types of cancer. These strategies also make it possible to detect the colon adenocarcinoma at an earlier stage, thus helping in mitigating or even preventing the effects of the cancer (Cinar et al 2015, 34).
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