The impact of oncological package implementation on the treatment of rectal cancer in years 2013-2019 in Poland - multicenter study.

<b><br>Introduction:</b> In 2015, in Poland, the oncological package (OP) was established. This law constituted a fast track of oncological diagnosis and treatment and obligatory multidisciplinary team meetings (MDT).</br> <b><br>Aim:</b> The aim of this study was to analyze the impact of OP on rectal cancer treatment.</br> <b><br>Methods:</b> The study was a multicenter, retrospective analysis of data collected from five centers. It included clinical data of patients operated on due to rectal cancer between 2013 and 2019. For most analyses, patients were categorized into three groups: 2013-2014 - before OP (A), 2015-2016 - early development of OP (B), 2017-2019 - further OP functioning (C).</br> <b><br>Results:</b> A total of 1418 patients were included. In all time intervals, the majority of operations performed were anterior resections. There was a significantly lower local tumor stage (T) observed in subsequent time intervals, while there were no significant differences for N and M. In period C, the median of resected nodes was significantly higher than in previous periods. Four of the centers showed an increasing tendency in the use of preoperative radiotherapy. The study indicated a significant increase in the use of short-course radiotherapy (SCRT) and a decrease in the number of patients who did not receive any form of preoperative therapy in subsequent periods. In the group that should receive radiotherapy (T3/4 or N+ and M0), the use of SCRT was also significantly increasing.</br> <b><br>Conclusions:</b> In the whole cohort, there was a significant increase in the use of preoperative radiotherapy and a decrease in the T stage, changing with the development of OP. Nevertheless, this relation is indirect and more data should be gathered for further conclusions.</br>.

Quality of Life of Patients Depending on the Method of the Ggastrointestinal Tract Reconstruction after Gastrectomy for Stomach Cancer.

OBJECTIVE: The article provides the study results, the purpose of which was to check whether there is a relationship between the type of reconstructive surgery and the quality of life of patients. The results of reconstructive surgeries in 90 patients diagnosed with stomach cancer who underwent gastrectomy with D2 lymphadenectomy were analysed. METHODS: All patients were randomised into three groups, depending on the method of gastrointestinal tract reconstruction. The study also evaluated the quality of life of patients after gastrectomy using the QLQ-C30 and QLQ-OG25 questionnaires. RESULT: The study results did not demonstrate the superiority of one method of reconstructive surgery over another. Patients who underwent Omega reconstruction generally functioned better physically and emotionally, and complained less often of pain, insomnia and diarrhoea. Patients after gastrointestinal tract reconstruction using the Roux-en-Y method reported less nausea and vomiting, eating disorder and anxiety. CONCLUSION: Based on the obtained data, it was concluded that currently it is impossible to state unequivocally which method of gastrointestinal tract reconstruction improves the quality of life of patients after gastrectomy, however, it should be clearly noted that QLQ questionnaires are a useful tool for evaluation of the quality of life of patients after gastrectomy.

Histaminergic System and Inflammation-Related Genes in Normal Large Intestine and Adenocarcinoma Tissues: Transcriptional Profiles and Relations.

Transcriptional analyses such as microarray data have contributed to the progress in the diagnostics and therapy of colorectal cancer (CRC). The need for such research is still present because of the disease being common in both men and women with a high second position in cancer rankings. Little is known about the relations between the histaminergic system and inflammation in the large intestine and CRC. Therefore, the aim of this study was to evaluate the expression of genes related to the histaminergic system and inflammation in the CRC tissues at three cancer development designs: all tested CRC samples, low (LCS) and high (HCS) clinical stage, and four clinical stages (CSI-CSIV), to the control. The research was carried out at the transcriptomic level, analysing hundreds of mRNAs from microarrays, as well as carrying out RT-PCR analysis of histaminergic receptors. The following histaminergic mRNAs: GNA15, MAOA, WASF2A, and inflammation-related: AEBP1, CXCL1, CXCL2, CXCL3, CXCL8, SPHK1, TNFAIP6, were distinguished. Among all analysed transcripts, AEBP1 can be considered the most promising diagnostic marker in the early stage of CRC. The results showed 59 correlations between differentiating genes of the histaminergic system and inflammation in the control, control and CRC, and CRC. The tests confirmed the presence of all histamine receptor transcripts in both the control and colorectal adenocarcinoma. Significant differences in expression were stated for HRH2 and HRH3 in the advanced stages of CRC adenocarcinoma. The relations between the histaminergic system and inflammation-linked genes in both the control and the CRC have been observed.

Recommendations for modern perioperative care for elective surgery: consensus of panel of exerts.

INTRODUCTION: Correct surgical technique and perioperative care are two factors that can reduce the number of complications, improve treatment outcomes and shorten the length of hospital stay. The introduction of enhanced recovery protocols has changed the approach to patient care in some centers. However, there are significant differences among centers, and in some the standard of care has remained unchanged. AIM: the goal of the panel was to develop recommendations for modern perioperative care in accordance with current medical knowledge in order to reduce the number of complications associated with surgical treatment. An additional goal was to optimize and standardize perioperative care among Polish centers. MATERIALS AND METHODS: the development of these recommendations was based on a review of the available literature from the PubMed, Medline and Cochrane Library databases from January 1, 1985 to March 31, 2022, with particular emphasis on systematic reviews and clinical recommendations of recognized scientific societies. Recommendations were formulated in a directive form and were assessed using the Delphi method. RESULTS AND CONCLUSIONS: 34 recommendations for perioperative care were presented. They cover aspects of pre-, intra- and post-operative care. Implementation of the presented rules allows to improve the results of surgical treatment.

Salivary Concentrations of Chemerin, α-Defensin 1, and TNF-α as Potential Biomarkers in the Early Diagnosis of Colorectal Cancer.

Colorectal cancer is one of the most prevalent cancers worldwide. There is a great interest and need to find simple, inexpensive, and minimally invasive diagnostic tests. The aim of the study was to analyze the salivary concentrations of chemerin, α-defensin 1, and TNF-α in colorectal cancer (CRC) patients and in a healthy control group. The concentration of these proteins was simultaneously determined in the serum of subjects. We also aimed to assess the correlation of these results and selected clinicopathological features. This prospective study was comprised of 39 CRC patients and 40 control group patients. Salivary and serum concentrations were determined by enzyme immunoassays. The salivary and serum concentrations of chemerin, α-defensin 1, and TNF-α were significantly higher in cancer patients compared to the control group. No correlation was found between concentrations of the proteins and the clinical stage of cancer and tumor location. The ROC curve analysis showed that although salivary concentrations of all proteins showed 100% sensitivity and 100% specificity, serum concentrations of the analyzed proteins were characterized by 100% sensitivity and over 90% specificity. The assessment of chemerin, α-defensin 1, and TNF-α concentrations in saliva seem to have great potential as quick and useful biomarkers in the early diagnosis of CRC.

The transcriptional activity profile of inhibitor apoptosis protein encoding genes in colon cancer patients: A STROBE-compliant study.

ABSTRACT: The inhibitor of apoptosis family proteins (IAPs) plays a crucial role in the process of carcinogenesis by regulating apoptosis and maintaining the tissue balance.In this study, a transcriptomic analysis of IAP-encoding genes in colon cancer was performed using oligonucleotide microarrays.Adenocarcinoma and healthy colon tissue samples were collected from 32 patients (16 females and 16 males) who underwent surgery due to colon cancer. The mRNA was extracted from tissue samples and tested using oligonucleotide microarrays (Affymetrix). The results were validated using the qRT-PCR technique. Hierarchical grouping was used to allocate 37 samples of normalized mRNA concentrations into 4 groups, with statistically significant differences in gene expression between these groups. The group of genes associated with colon cancer, including IAP-encoding gene - BIRC5 (Survivin), was selected for further testing.Our study confirmed an increased expression of BIRC5 in colon cancer tissue when compared to the control group. Increased levels of Neuronal Apoptosis Inhibitory Proteins were detected only in low-stage colon cancer, while the expression of Human X Chromosome-Encoded inhibitor of apoptosis family proteins decreased in colon cancer.The transcriptional activity of IAP-encoding genes varied, depending on the severity of colon cancer. The concentration of mRNA, encoding BIRC5 was elevated in samples obtained from more advanced colon cancer. Hence BIRC5 could be used as a complementary parameter for the diagnosis and prognosis of colon cancer.

Potential biomarkers for the early diagnosis of colorectal adenocarcinoma - transcriptomic analysis of four clinical stages.

BACKGROUNDS: Colorectal cancer is the third most common cancer in economically developed countries. Molecular studies and, in particular, gene expression have contributed to advances in the diagnosis and treatment of many cancers. Genes can be molecular and therapeutic markers, but because of the large molecular diversity in colorectal cancer the knowledge is not yet fully established. Probably one of the most crucial processes during early cancer development is inflammation. The inflammatory response in the tumor is an important indicator of molecular etiology and later of cancer progression. OBJECTIVE: The aim of this work is to identify potential biomarkers for early stage of colorectal adenocarcinoma in patients' bowel tissues using transcriptomic analysis. METHODS: Expression of the inflammatory response genes of colorectal cancer at all clinical stages (I-IV) and control of the bowel were evaluated by oligonucleotide microarrays. RESULTS: Based on statistical analysis many differentially expressed genes were selected. LCK (LCK Proto-Oncogene, Src Family Tyrosine Kinase), GNLY (granulysin), SLC6A6 (Solute-Carrier Family 6 Member 6) and LAMP2 (Lysosomal Associated Membrane Protein 2) were specific for the early stage of the disease. These genes had the properties of the good biomarkers. CONCLUSIONS: The expression of LCK, GNLY, SLC6A6 and LAMP2 genes could be valuable potential diagnostic biomarkers of the early stage of colorectal adenocarcinoma.

Assessment of PI3K/AKT/PTEN signaling pathway activity in colorectal cancer using quantum dot-conjugated antibodies.

In certain patients with advanced colorectal cancer, loss of phosphatase and tensin homolog deleted on chromosome 10 (PTEN) activity is observed. PTEN is a major gatekeeper gene of the AKT serine/threonine kinase (AKT) signaling pathway responsible for the proliferative activity of cells. The assessment of AKT activity may be a prognostic factor or a predictor of response to the targeted therapies against particular signaling proteins. To precisely identify the cause and the place of the pathway deregulation, it is necessary to identify phosphorylation states and concentrations of several proteins located at different levels of the regulatory cascade. In the present study, we propose the simultaneous use of specific antibodies conjugated with different quantum dots to highlight the nature of AKT/PKB cascade deregulation in patients with colorectal cancer and the loss of PTEN expression in tumor tissue. Fifty patients with colorectal cancer of no specific location were enrolled in the study. The expression of the PTEN protein, and concentrations of phosphorylated/activated forms of 3-Phosphoinositide-dependent kinase 1 (PDK1) and AKT were assessed using quantum dot-conjugated antibodies. In patients with a diminished or complete loss of the PTEN expression in the tumor tissue increased levels of activated/phosphorylated forms of PDK1 (Phospho-PDK1-Ser241) and AKT (Phospho-AKT-Thr308) proteins were found, which are responsible for the permanent activation of the phosphoinositide 3-kinase/AKT/PTEN signaling pathway in certain cases of colorectal cancer.

Outbreaks of nosocomial infections in Poland in the years 2011-2015

INTRODUCTION: In hospitals outbreaks of nosocomial infections are recorded i.e. the occurrence of at least two clearly related cases of infections. In these outbreaks not only patients but also hospital staff are getting infected. Due to the fact, that nosocomial infections are inseparably related to the hospitalisation of the patients, there is a need to build a culture of active surveillance of emerging infections and their reporting to the authorities of the State Sanitary Inspection. MATERIAL AND METHODS: This article was developed on the basis of the information gathered in the report about the occurrence of outbreaks in entities carrying out the medical activities. This report is the result of the analysis of the preliminary reports submitted by the hospitals in the cases where there was a suspicion of or an epidemic outbreak and the final reports of the epidemic outbreak suppressions. RESULTS: In the years 2011-2015 in all hospitals in Poland a total number of 1 912 outbreaks of nosocomial infections was reported; in those outbreaks 15 282 patients and 1 226 medical personnel were infected. The biggest numbers of outbreaks of nosocomial infections were reported in the voivodeships: Masovia and Silesia. The most frequently etiological factor was Clostridium difficile; it caused 519 hospital outbreaks. Out of the viral factors, most of the outbreaks were due to the rotavirus - 359 of such instances. In addition to the numerous bacterial and viral factors, the outbreaks of nosocomial infections were also caused by fungi and parasites.

The influence of rifaximin on diverticulitis rate and quality of life in patients with diverticulosis.

Diverticulosis, its associated symptoms and complications are one of the most common pathologies of the gastrointestinal tract in more economically developed countries. Presence of diverticuli and their clinical consequences can be divided into four categories: 1) diverticulosis, i.e. an asymptomatic presence of diverticuli that are usually found by accident 2) symptomatic uncomplicated diverticulosis 3) diverticulitis (acute uncomplicated diverticulitis) 4) complications of diverticulitis (conditions requiring hospital stay). The aim of this study was to retrospectively analyze the efficacy of rifaximin in preventing diverticulitis in patients visiting proctology clinics. The diagnostic criterium for diverticulosis was confirmation by colonoscopy, barium enema or CT colography (virtual colonoscopy) as well as history of at least one documented episode of diverticulosis. History of diverticulosis was evaluated based on medical records, clinical symptoms, elevated level of CRP (>5.0) and/or diagnostic imaging (ultrasound, CT). After setting strict exclusion criteria, 248 patients were qualified for the study out of 686, and they were later divided into two groups: control group (group I - 145 patients) and studied group (group II - 103 patients receiving rifaximin prophylaxis). Diverticulitis rate was comparable in both groups over a period of 6 months before study (p = 0.1306) and 6 months of treatment (p=0.3044). Between the 6th and 12th month of treatment, a significantly lower rate of diverticulitis was noted in the group receiving rifaximin compared to control group (p<0.0001). Patients receiving rifaximin reported higher quality of life (which was assessed using the VAS scale) compared to control group after 12 months. The results confirmed the efficacy of riaximin in prevention of diverticulitis, even in the scheme of repeated courses every 3 months. Not only did application of rifaximin lower the rate of diverticulitis and its complications in patients after an episode of diverticulitis, but also it improved the patients' quality of life. It seems that diverticulitis prophylaxis based on rifaximin can be economically efficient, however, it requires further research.

Anastomotic leaks in gastrointestinal surgery and their prevention.

Anastomotic leak in the gastrointestinal tract is one of the most important complications of resection. They are the main cause of reoperation, their occurrence worsens the prognosis of the patient, increasing the proportion of direct mortality, as well as being a significant risk factor for recurrence of cancer. The risk of leaks within the gastrointestinal tract is greatly varied, depending on the location and extent of the resection, but also on patient, disease or a surgical procedure, including surgeon. To determine the potential risk of leakage can be significant for introduction some prophylactic actions. Some of them have the character of general recommendations, as proper nutrition of the patient in the perioperative period, while another part is directly connected to the surgical procedure. The second group includes protective stoma, the use of tissue glues, insertion transrectal drain for rectal anastomosis decompression, the use of stents or the use of collagen matrix coated with fibrinogen and thrombin. Important to reduce the proportion of leaks can be more precise and targeted prophylactic recommendations, based on the individualized determination of risk factors leaks. Further research for this purpose are necessary for this purpose, the big hope can be associated with data obtained through mobile applications.

Profile of Expression of Genes Encoding Matrix Metallopeptidase 9 (MMP9), Matrix Metallopeptidase 28 (MMP28) and TIMP Metallopeptidase Inhibitor 1 (TIMP1) in Colorectal Cancer: Assessment of the Role in Diagnosis and Prognostication.

BACKGROUND Studies on the pathomechanism of colorectal cancer (CRC) expansion indicate a significant role of metalloproteinases and their inhibitors in the extracellular matrix. The results of the analysis of a profile of transcriptional activity of genes encoding metalloproteinases were the basis of the hypothesis indicating changes in the expression of genes encoding MMP9, MMP28, and TIMP1 as an additional diagnostic and prognostic marker of CRC. MATERIAL AND METHODS The material consisted of samples obtained from resected tumors and healthy tissue samples from 15 CRC patients (aged 46-72 years) at clinical stages (CSs) I and II-IV. Gene expression analysis was done using microarrays. Microarray data analysis was done using the GeneSpring 11.5 platform. The results were validated using the qRT-PCR technique. RESULTS We found high levels of expression of MMP9 at each CS, as well as in the tissues at the early stage of CRC. Additionally, we observed high levels of expression of TIMP1 and low levels of MMP28 genes in CS II-IV. No statistically significant differences based on the stage of CRC were observed. CONCLUSIONS MMP9 gene profile may be a complementary diagnostic marker in CRC. The results suggest a crucial role of MMP9 at the early stage of carcinogenesis in the large intestine. The increase in MMP9 and TIMP1 mRNA concentration and the decrease in MMP28 in the large intestinal tissue may be a confirmation of cancer, but it may not indicate the advance of CRC.

Tumor-Associated Macrophages and Regulatory T Cells Infiltration and the Clinical Outcome in Colorectal Cancer.

The aim of the study is the assessment of the intensity of the infiltration of tumor-associated macrophages (TAMs) CD68+/iNOS- and Tregs CD8+/FoxP3+ in colorectal cancer (CRC) patients as prognostic factors with respect to disease-free survival (DFS) and overall survival (OS). In this retrospective study, tissue samples were obtained from 89 patients undergoing resection for CRC (stage IIA, pT3N0M0 and stages IIIB and IIIC, pT3N1-2M0). Recurrence was observed in 45 patients at the time of the follow-up (10 local recurrences, 35 distant metastases). In patients with recurrence the following were present: a tendency to an older average age at the time of diagnosis (p = 0.07), higher nodal involvement (p = 0.002) and more advanced clinical disease (p = 0.01). The analysis of the clinical data and immunohistochemical studies were performed with the methodology of identification of TAM and Treg subsets in histological sections, with the aim to use it in routine clinical management. Both DSF and OS were the clinical parameters assessed in the study. The presence of intense infiltration of TAMs in the tumor stroma was related to shorter DFS (p = 0.005) and OS (p = 0.006). The opposite tendency was observed in the tumor front (p = 0.061). The relative risks of recurrence and cancer-related death were more than twice higher in the group of patients with intense infiltration of TAMs in the tumor stroma (RR 2.05, 95% CI 1.33-3.14; p = 0.001 and RR 2.08, 95% CI 1.28-3.39; p = 0.003, respectively). Intense infiltration of Tregs in the tumor stroma was related to shorter DFS and OS (p < 0.0001). The relative risks of recurrence and death in a group of patients with intense infiltration of Tregs in the tumor stroma were more than 12 times higher than in patients with less intense infiltration (RR 12.3, 95% CI 5.44-27.9; p < 0.0001 and RR 12.5, 95% CI 4.9-32.4; p < 0.0001, respectively). Infiltration of TAMs CD68+/iNOS- and Tregs CD8+/FoxP3+ in the tumor stroma are negative prognostic factors with a positive correlation between them. Tregs may constitute an independent prognostic factor in patients with CRC.

Checklist in colorectal surgery - proposal of experts of the Polish Club of Coloproctology and National Consultant in general surgery.

A checklist is a collection of information that helps reduce the risk of failure due to limitations in human memory and attention. In surgery, the first Surgical Safety Checklist (SSC), created under the supervision of WHO (World Health Organization), was established in 2007 and covers three stages related to the patient's stay in the operating theater and operation: 1. Prior to initiation (induction) of anesthesia; 2. before cutting the skin; 3. before the patient leaves the operating room Colorectal surgery is particularly at high risk for complications and relatively high mortality. Elimination or, more likely, reducing the risk of complications by standardizing perioperative procedures may be particularly important in this group. The introduction of "dedicated" colorectal checklist surgery seems to be justified. The checklist proposed by the authors in colorectal surgery is divided into four stages, in which conscientious completion of checklists is intended to reduce the potential risk of complications due to hospitalization and surgical treatment. The presented checklist is obviously not closed, as a new publications or recommendations appear, some points may be modified, new issues may be added to the checklist. At present, however, it is a tool considering the well-known and confirmed elements of intraoperative procedures, the compliance of which may significantly reduce the rate of adverse events or surgical complications.

The epidemiological situation of chickenpox in the Silesian voivodeship in the years 2011-2015 in view of data of the situation in Poland / Sytuacja epidemiologiczna ospy wietrznej na terenie województwa slaskiego w latach 2011-2015 w swietle danych dotyczacych sytuacji w Polsce

INTRODUCTION: Despite the availability of preventive vaccination against chickenpox, this form of prevention is rarely used and is not available to the entire population of children. In order to evaluate an acquired immunity against the virus Varicella-Zoster examining of the presence of specific IgG antibodies to VZV in serum or plasma is required. The aim of this study was to assess the epidemiological situation of chickenpox in Slaskie Voivodeship in 2011-2015. MATERIAL AND METHODS: The evaluation of the epidemiological situation of chickenpox in the past five years was based on analysis of data from the bulletin "Infectious diseases and poisonings in Poland" for the period 2011-2014 and 2015 data, received from the Provincial Sanitary and Epidemiological Stations. Analysis of the vaccinated population was made on the basis of data available in the bulletin "Vaccinations in Poland" for the period 2011-2014 and 2015 data obtained from the NIPH-PZH. Samples of patients from Slaskie were tested with the use of Novalisa Varicella-Zoster Virus (VZV) IgG - ELISA (Novatec Immunodiagnostic GMBH, Germany). Samples were delivered to the Laboratory of the Provincial Sanitary and Epidemiological Station in the course of 2011-2015. RESULTS: Between 2011 and 2015, in Slaskie, 136 094 chickenpox cases were registered (14% of all occurring in Poland). Based on the number of cases, Slaskie is ranked second place, just after Mazowieckie, in which during the same period of time 143 392 illness were registered. The average annual incidence in Slaskie was 591 per 100 thousand residents. Between 2011 and 2015, a total of 360 serum samples were examined. The percentage of positive IgG in each year ranged between 59.6 and 75.7%. CONCLUSIONS: Promoting vaccination and preventing the sick children to contact the healthy ones as well as the protection of adults susceptible to infection can improve the epidemiological situation regarding incidences of chickenpox. Thanks to vaccines the risk of incidence of chickenpox can be reduced or even the incidences can be prevented. Information about acquired immunity, acquired before the pregnancy, allows to take the action in order to protect the mother from getting chickenpox in form of a preventive vaccination.

The "biological chamber" method ­ use of autologous platelet-rich plasma (PRP) in the treatment of poorly healing lower-leg ulcers of venous origin.

UNLABELLED: Wound healing is a complex pathophysiological process, in which platelets play a crucial role. Platelet alpha-granules release growth factors to the wound bed; the factors are necessary in the healing process. In chronic wounds, such as poorly healing lower-leg ulcers of venous origin, there is decreased activity of multiple growth factors, so the concept of exogenous delivery of such factors seems a logical strategy. Platelet-rich plasma therapy in patients with lower-leg ulcers of venous origin combined with conventional treatment methods (previously ineffective in these patients) seems, based on our observation, an important adjunct leading to recovery. The aim of the study was to present an original method of autologous platelet-rich plasma application through the creation of a sort of "biological chamber" containing a concentrate of growth factors. MATERIAL AND METHODS: The described therapy was implemented in 10 patients, who had been ineffectively treated for more than one year in the outpatient setting. Patients with exacerbation of inflammatory process, signs of wound infection and ankle brachial pressure index < 0.8 were excluded from the study. After the application of platelet-rich plasma, further treatment was continued with the use of moist therapy and compression therapy according to a uniform regimen. RESULTS: Complete healing was achieved within 4-10 weeks from the beginning of the product administration in all patients. CONCLUSION: The presented method seems technically simple, effective and relatively inexpensive.

Multiannual abdominal pain complicated by obstruction of the gastrointestinal tract in the course of cystic form of mesenteric lymhangioma of the small intestine.

Lymphangiomas constitute a group of very rare diseases and occur with a frequency of 1/250,000 to 1/20,000 of hospitalizations. Even though they are benign lesions, their complications may turn into a life-threatening condition. They usually occur in children (90%), they are either congenital or they appear before the child's second birthday. Occassionally they are found in adults. Lymphangiomas are usually localized around neck, but also near armpits and in the groin area. Less than 1% of lymphagiomas are detected in the retroperitoneal space and intestinal mesentery. Vascular lesions derived from lymphatic vessels can be divided into ordinary ones, usually known as capillary, cavernous, and cystic. The cystic tumor (lymphangioma mesenteri) is the least common. It occurs mostly in the retroperitoneal space, mesentery of the colon, or extremely rarely in the mesentery of the small intestine. Preoperative diagnosis is difficult due to non-specific clinical symptoms and noncharacteristic image in the diagnostic tests. Lymphangioma complications, such as intestinal obstruction or perforation, and persistent pain, are the cause of exploratory laparotomy. Final diagnosis requires microscopic examination of material collected during an operation. This article presented the case of a 40-year-old female, operated due to the obstruction of the gastrointestinal tract, in whose case the lymphangioma was recognised in postoperative histopathological examination of the tumor from the jejunal mesentery. Since patients with these tumors have good chances of complete recovery - if there are no serious complications - it appears that the optimal therapeutic procedure should be early surgery, which reduces the possibility of complications.

Expression Level of Genes Coding for Cell Adhesion Molecules of Cadherin Group in Colorectal Cancer Patients.

BACKGROUND: Colorectal Cancer (CRC) is one of the most frequently diagnosed neoplasms and also one of the main death causes. Cell adhesion molecules are taking part in specific junctions, contributing to tissue integrality. Lower expression of the cadherins may be correlated with poorer differentiation of the CRC, and its more aggressive phenotype. The aim of the study is to designate the cadherin genes potentially useful for the diagnostics, prognostics, and the treatment of CRC. MATERIAL AND METHODS: Specimens were collected from 28 persons (14 female and 14 male), who were operated for CRC. The molecular analysis was performed using oligonucleotide microarrays, mRNA used was collected from adenocarcinoma, and macroscopically healthy tissue. The results were validated using qRT-PCR technique. RESULTS: Agglomerative hierarchical clustering of normalized mRNA levels has shown 4 groups with statistically different gene expression. The control group was divided into 2 groups, the one was appropriate control (C1), the second (C2) had the genetic properties of the CRC, without pathological changes histologically and macroscopically. The other 2 groups were: LSC (Low stage cancer) and HSC (High stage cancer). Consolidated results of the fluorescency of all of the differential genes, designated two coding E-cadherin (CDH1) with the lower expression, and P-cadherin (CDH3) with higher expression in CRC tissue. CONCLUSIONS: The levels of genes expression are different for several groups of cadherins, and are related with the stage of CRC, therefore could be potentially the useful marker of the stage of the disease, also applicable in treatment and diagnostics of CRC.

Primary duodenal carcinoma--case report.

Duodenal carcinoma is a rare tumor of the gastrointestinal tract of an insidious and secretive course, often diagnosed during the advanced stage of the disease. The study presented a case of a female patient diagnosed with duodenal carcinoma, subjected to two-staged surgery. The initial surgical intervention consisted in the implementation of a gastrointestinal anastomosis, followed by radical surgery by means of Whipple's method performed after three years.