HER2 gene assessment in liquid biopsy of gastric and esophagogastric junction cancer patients qualified for surgery.

BACKGROUND: Amplification of HER2 gene (ERBB2) and overexpression of HER2 protein on cancer cells are found in 10-26% of gastric cancer (GC) and esophagogastric junction cancer (EGJC). Gene copy number variation (CNV) could be detected in these patients in liquid biopsy and in cancer cells. METHODS: We analysed HER2 gene CNV used qPCR method in 87 sera collected from GC and EGJC patients before surgical treatment and in 40 sera obtained from healthy donors. HER2 gene CNV was also assessed in formalin-fixed paraffin-embedded (FFPE) tumor tissue. Furthermore, we assessed the number of HER2 gene copies and HER2 expression in cancer cells using the fluorescent in situ hybridization method (FISH) and immunohistochemistry (IHC). RESULTS: We found that the HER2 gene copy number in liquid biopsy was higher in GC and EGJC patients compared to healthy people (p = 0.01). Moreover, EGJC patients had higher number of HER2 gene copies than healthy donors (p = 0.0016). HER2 CNV examination could distinguish healthy individuals and patients with gastric or esophagogastric junction cancers with sensitivity and specificity of 58% and 98% (AUC = 0.707, 95% CI 0.593-0.821, p = 0.004). We found that patients with a high copy number of the HER2 gene in the tumor tissue assessed by qPCR (but not by FISH) have significantly more often a high number of HER2 gene copies in liquid biopsy (p = 0.04). CONCLUSIONS: We suggested that HER2 testing in liquid biopsy could be used as an auxiliary method to analysis of HER2 status in tumor tissue in gastric or esophagogastric junction cancers.

Surgical care in Poland after COVID-19 outbreak: a national survey.

B a c k g r o u n d: During COVID-19 pandemic, it is necessary to collect and analyze data concerning management of hospitals and wards to work out solutions for potential future crisis. The objective of the study was to investigate how surgical wards in Poland are managing during rapid development of the COVID-19 pandemic. M e t h o d s: An anonymous, online survey was designed and distributed to surgeons and surgery residents working in surgical departments during pandemic. Responders were divided into two groups: Group 1 (responders working in a "COVID-19-dedicated" hospital) and Group 2 (responders working in other hospitals). Results: Overall, 323 responders were included in the study group, 30.03% of which were female. Medical staff deficits were reported by 21.15% responders from Group 1 and 29.52% responders from Group 2 (p = 0.003). The mean number of elective surgeries performed weekly prior to the pandemic in Group 1 was 40.37 ± 46.31 and during the pandemic was 13.98 ± 37.49 (p < 0.001). In Group 2, the mean number of elective surgeries performed weekly before the start of the pandemic was 26.85 ± 23.52 and after the start of the pandemic, it was 7.65 ± 13.49 (p <0.001). There were significantly higher reported levels of preparedness in Group 1 in terms of: theoretical training of the staff, equipping the staff and adapting the operating theater to safely perform procedures on patients with COVID-19. Overall, 62.23% of responders presume being infected with SARS-CoV-2. C o n c l u s i o n s: SARS-CoV-2 pandemic had a significantly negative impact on surgical wards. Despite the preparations, the number of responders who presume being infected with SARS-CoV-2 during present crisis is high.

Assessment of a gastric arterial network for oesophageal substitute by means of pulse oximetry.

Insufficient vascularisation of substitutes in the operative reconstruction of the oesophagus is one of the main causes of the occurrence of anastomotic leaks. In the present study, the blood oxygenation of gastric substitutes for the oesophagus was evaluated before and during the reconstruction. A pulse oximeter was used for the assessment (S&J Medico Teknik AIS, Albertslund, Denmark). Oxygenation in the examined places ranged from 79% to 98%. The values of blood oxygenation in places C1 (fundus of the stomach after the formation of the substitute) and C2 (fundus of the stomach after the formation and stretching of the substitute) were significantly lower than those in analogous places in the stomach before the transformation (C/C1 p < 0.02; C/C2 p < 0.03, Fisher test). There were no correlations between pulse oximetry values observed and the presence of anastomosis leak.