Cryptosporidium Infection and Human Colorectal Cancer

Lille Catholic University324 enrolled

Overview

It has been reported that Cryptosporidium parvum, a species of a protozoan frequently isolated from humans and animals, is able to induce digestive adenocarcinoma in a rodent model. Consistently, some epidemiological studies have reported an association with cryptosporidiosis in patients with colorectal adenocarcinoma. However, the correlation between cryptosporidiosis and human digestive cancer remains unclear at this time, and it is not known whether this intracellular parasite, considered an opportunistic agent, is able to induce gastrointestinal malignancies in humans. In order to add new arguments for a probable association between cryptosporidiosis and digestive human cancer, the main aim of this study is to determine prevalence and to identify species of Cryptosporidium among a French digestive cancer population.

Study Type

OBSERVATIONAL

Enrollment

324

Conditions

Colonic Neoplasms Cryptosporidiosis

Interventions

Detection of Cryptosporidium infectionDIAGNOSTIC_TEST

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: Cases: * Age ≥ 18 years old * Patients with colonic adenocarcinoma/intraepithelial neoplasia diagnosed prior to chemotherapy or radiotherapy who will undergo scheduled surgery. Patients with rectal cancer with indication for neoadjuvant treatment will still be included, but only biopsies used for diagnosis will be used * Patient capable of receiving informed information * Written informed consent * Affiliation to a social security scheme Controls: * Age ≥ 18 years old * Patients with endoscopic indication for benign pathology * Patients with indication for colectomy for benign pathology * Patients with digestive cancer (stomach, oesophagus, biliary, pancreatic, etc.) of any type other than colorectal cancer before chemotherapy or radiotherapy * Patient capable of receiving informed information * Written informed consent * Affiliation to a social security scheme Exclusion Criteria: * Patients undergoing pre-operative chemotherapy. * Patients who have already had chemotherapy for less than one year or other immunosuppressive treatment

Outcomes

Primary Outcomes

Prevalence of Cryptosporidium

A biopsy or a surgical sample will be collected from every participant which will be then screened for Cryptosporidium using a Polymerase chain reaction (PCR) in order to obtain a prevalence of positive individuals

Time frame: 3 years

Secondary Outcomes

Rate of occurrence of parasite development in the tumoral zone (yes/no) compared to the peri-tumoral zone.

A biopsy or a surgical sample containing the tumoral and peri-tumoral areas will be collected only from the cases which will be then screened for Cryptosporidium using PCR

Time frame: 3 years

Significance of the association between the histological grade of the lesion and the Cryptosporidium species

Significance of the association between the histological grade defined by the Vienna classification of tumors and the species of Cryptosporidium and the Cryptosporidium species.The main species of Cryptosporidium infecting humans are C. parvum and C. hominis, however, other species can also infect humans.

Time frame: 3 years

Significance of the association between the histological grade of the lesion and the parasitic charge in tissues

Significance of the association between the histological grade defined by the Vienna classification of tumors and the species of Cryptosporidium and the parasitic charge in the tissues that will be determined by quantitative polymerase chain reaction (qPCR)

Time frame: 3 years

The rate of change in the expression or localization of certain markers known or suspected to be involved in the process of carcinogenesis.

Some markers known to be associated to cancer development will be explored such as: Beta-catenin, P53, APC (adenomatous polyposis coli), etc.

Time frame: 3years

The association between the rate of lymphocytes (CD3, CD4, CD8, CD19 and CD4/CD8 ratio) and the presence of parasites in biopsies or surgical specimens

Because Cryptosporidium is an opportunistic agent that causes significant morbidity and mortality in immunocompromised patients, it is possible that individuals with malignancies, have a higher risk of developing infection with this parasite, especially when their immunosuppression is more severe. To rule out this possibility this association will be determined.

Time frame: 3 years

Rate of development of a neoplastic lesion in the human explants

A three-dimensional culture model will be developed using colon samples from healthy tissues of several control patients. An experimental Cryptosporidium infection will be tested in order to determine the development of neoplastic lesions in these human explants.

Time frame: 3 years

Cryptosporidium Infection and Human Colorectal Cancer

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts