A Study of the Surface Mucus Changes Overlying the Transitional Mucusa of the Distal Colon in Malaysian Patients

Background of the study: Colorectal cancer (CRC) which is the third most diagnosed cancer throughout the world is steadily rising in the Asian countries with the incidence rates mimicking the western counterparts. The pre-neoplastic nature of the Transitional Mucosa (TM) adjoining CRC lacks conclusive evidence so far. Pertaining to this, the study of the mucus layer, the functional component of the colonic mucosa overlying the TM is the subject of interest in this research. The normal samples were biopsied from normal subjects by colonoscopy. Ten cases of CRCs of the distal colon who underwent anterior resection were chosen for this study. Three samples were taken 2ms, 5cms and 10cms from the colorectal cancer of the distal colon in the proximal margin. These samples were processed and viewed under the scanning electron microscope (SEM) to look for the changes in the mucus layer. The findings show that the changes were consistently found 2cms from the tumor and only one case showed changes up to 5cms. The statistical tests using SPSS version 18 revealed that there was no association between the surface mucus changes and the age, gender, race, site of tumor, differentiation of tumor and clinical staging of the patients. It was concluded that there was no correlation between the structural and functional changes of the surface mucus overlying the distal colon during carcinogenesis. Furthermore, it can be stated that the functional change may be as a result of the structural change due to a nearby tumor.