Acid phosphatase locus 1 genetic polymorphism and cancer grading.

BACKGROUND: Currently, there is a surge of interest on the possible relationship between cancer and acid phosphatase locus 1 (ACP(1)), an enzyme involved in the modulation of growth factors and cellular metabolism. As far as the authors know, the possible relationship between ACP(1) genetic variability and cancer grading has not yet been considered. In this article, the authors have studied the relationship between ACP(1) genotype and grade in colon and endometrium cancers. METHODS: Seventy-one patients with colon cancer and 71 patients with endometrium cancer were studied. ACP(1) genotype was determined by DNA analysis. Three-way contingency table analysis was carried out according to Sokal and Rohlf. Other statistical analyses were performed using SPSS programs. RESULTS: There is a significant association between ACP(1) and cancer grade mainly due to ACP(1) genotypes carrying the *C allele that are much less represented in patients with low grade when compared with those with high grade. In both cancers, the concentration of S isoform is significantly lower in low grade than in high grade. The relationship between ACP(1) and grade is the same in the 2 cancers. CONCLUSIONS: Assuming the presence of diverse classes of cancer, the role of ACP(1) in the modulation of growth factors and cellular metabolism could have significant effects in less aggressive forms but not in more aggressive ones.

Surgical treatment of gastric outlet obstruction due to gastroduodenal tuberculosis.

Gastroduodenal tuberculosis is a very rare location of abdominal tuberculosis; it is usually secondary to pulmonary tuberculosis and is often associated with HIV infection. We report a case of a 45-year-old woman with no HIV infection and no evidence of pulmonary tuberculosis, with a history of duodenal ulcer treated for several months, who presented at the emergency department with severe gastric outlet obstruction of recent onset caused by ulcerohypertrophic antroduodenal tuberculosis. The lesion was misdiagnosed at endoscopy as a malignancy, although histological examination of biopsies showed only chronic inflammation. The diagnosis was established at surgery, when a frozen section of an enlarged lymph node showed the presence of giant cells and caseating granuloma. The treatment was gastric resection with Roux-en-Y gastrojejunal anastomosis. In this patient the rare gastroduodenal location of tuberculosis occurred as primary disease in the absence of other organ involvement.

Allergy and ACP1 genetic polymorphism.

The ACP1 (acid phosphatase locus 1) gene encodes a highly polymorphic low molecular weight protein tyrosine phosphatase (LMPTP) involved in the modulation of various signal transduction pathways including T-cell receptor. Previous studies suggest an association of this enzyme with allergic disorders. The aim of this study was to review our previous data and to confirm the association by further observations. Two new independent samples of individuals were studied from the population of Rome. ACP1 genotype was determined and history of allergic disorders was recorded. All allergic subjects had at least one positive prick test. Three-way contingency table analyses were performed by a log linear model. In all samples studied from different populations (Italian, English, and Chinese for a total of 958 subjects) we found that the proportion of allergic subjects was higher among genotypes with low enzymic activity than among genotypes with high activity. Concentration of IgE was negatively correlated with ACP1 enzymic activity. Carriers of ACP1 genotypes associated with low enzymic activity may be more susceptible to allergic disorders.

Laparoscopic suture repair of a perforated gastric ulcer in a severely cirrhotic patient with portal hypertension: first case report.

BACKGROUND: Open digestive surgery in cirrhotic patients is associated with high morbidity and mortality. Laparoscopy in this setting has the potential to reduce postoperative complications. Laparoscopic treatment of a perforated gastric ulcer in a severely cirrhotic patient with portal hypertension is herein described. METHODS: A 75-year-old woman affected by cirrhosis of the liver (Child class C) and chronic gastric ulcer presented with acute abdominal pain. The diagnosis of perforation was made with plain films of the abdomen and computed tomography. Diagnostic laparoscopy showed intense peritonitis due to a perforated ulcer of the anterior gastric wall, 2 cm proximal to the pylorus. Suture closure and placement of an omental patch were performed laparoscopically. RESULTS: Postoperative recovery was complicated by a minor leak of the gastric suture, managed by total parenteral nutrition. Closure of the gastric wound was demonstrated by Gastrografin studies on the 10th postoperative day. The patient was discharged on the 16th postoperative day. At 3-months follow-up, the patient is alive and free of gastric disease.