Assessing Putative Markers of Colorectal Cancer Stem Cells: From Colonoscopy to Gene Expression Profiling.

Cancer stem cells (CSCs) are proposed to be involved in colorectal cancer (CRC) initiation, growth, and metastasis. The aim of our pilot study was to assess possible correlations between the clinicopathological characteristics of CRC patients and CSCs gene expression patterns, in order to provide insight into new methods for patient stratification and targeted therapeutic strategies. Our study involved 60 CRC patients, and the following three specific CSC genes were targeted: PROM1/CD133, ALCAM/CD166 and HCAM /CD44. Data are presented as relative mRNA expression of target genes to GAPDH. The expression of total CD133 and CD166 was assessed in paired samples of CRC tumors and adjacent tissue, while CD44 was assessed in similar samples. The qRT-PCR analysis detected all three targeted genes to different extents, in both normal and tumor tissue. In nine cases (15.69%), total CD133 had a higher expression in tumor tissue, whilst in 28 cases (47.06%) the expression was higher in non-malignant peritumor tissue. The total CD166 expression was increased in tumor tissue compared with paired non-invaded peritumor samples in eight cases (13.73%), whilst in eight cases (13.73%) the expression was higher in non-malignant peritumor tissue. Total CD44 expression was higher in tumor tissue compared with paired non-invaded peritumor samples in 47 cases (78.95%). In the remaining cases the difference between paired samples was biologically insignificant. In conclusion, our study suggests that qRT-PCR is feasible in assessing the gene expression profiles of CSCs from CRC, and a promising pathway to be followed for determining how often a person needs screening by colonoscopy and at which age to start. This could improve CRC diagnosis and early patient stratification, and open the way for new oncologic treatment development.

An unusual onset of Crohn's disease with oral aphthosis, giant esophageal ulcers and serological markers of cytomegalovirus and herpes virus infection: a case report and review of the literature.

Isolated esophageal ulcerations in Crohn's disease pose a great challenge in diagnosing and providing the correct treatment. We present the case of a 23-year-old woman with recurrent episodes of oral aphthosis, dysphagia, odynophagia and heartburn. Upper digestive endoscopy revealed an irregular mucosa with multiple ulcerations with irregular margins within the mid-esophagus. Immunoglobulin G (IgG) for cytomegalovirus and herpes virus were both positive. Four years after, she presented with the same symptoms and the involvement of ileo-colonic lesions, with pathological findings helped establish the Crohn's disease diagnosis. Crohn's disease represents an idiopathic chronic inflammatory gut disease, which can affect any part of the digestive tract. The onset by esophageal disease and no intestinal involvement is rare and challenging for a proper diagnosis.

EFSUMB Recommendations for Gastrointestinal Ultrasound Part 3: Endorectal, Endoanal and Perineal Ultrasound.

This article represents part 3 of the EFSUMB Recommendations and Guidelines for Gastrointestinal Ultrasound (GIUS). It provides an overview of the examination techniques recommended by experts in the field of endorectal/endoanal ultrasound (ERUS/EAUS), as well as perineal ultrasound (PNUS). The most important indications are rectal tumors and inflammatory diseases like fistula and abscesses in patients with or without inflammatory bowel disease (IBD). PNUS sometimes is more flexible and convenient compared to ERUS. However, the technique of ERUS is quite well established, especially for the staging of rectal cancer. EAUS also gained ground in the evaluation of perianal diseases like fistulas, abscesses and incontinence. For the staging of perirectal tumors, the use of PNUS in addition to conventional ERUS could be recommended. For the staging of anal carcinomas, PNUS can be a good option because of the higher resolution. Both ERUS and PNUS are considered excellent guidance methods for invasive interventions, such as the drainage of fluids or targeted biopsy of tissue lesions. For abscess detection and evaluation, contrast-enhanced ultrasound (CEUS) also helps in therapy planning.

Unusual triple combination of prostate, lung and skin cancer.

Multiple malignancies are an increasing combination in the recent years in cancer patients, due to prolonged survival rate and to the advances in diagnostic techniques and therapeutic management. We present the case of a patient diagnosed with prostate cancer and metachronous in one year with basal cell carcinoma of the skin and small lung cell carcinoma with lymph nodes and pararectal metastasis. To our best knowledge, this is the only case presented in the medical literature with these three different types of primary malignancy. In conclusion, multiple malignancies in the same patients are a real challenge to the physician, because an early diagnosis and specific treatment modalities are essential for successful patient management and increasing life expectancy.

Interleukin-8 mRNA Expression in Locally Advanced Colorectal Cancer Patients.

PURPOSE: Interleukin-8 (IL-8) has been proven to promote progression of malignant tumours and control angiogenesis processes. We aim to determine and compare interleukin-8 (IL-8) gene expression level in colorectal tumors (CCR) and peritumoral samples obtained through endoscopic biopsy. MATERIAL AND METHODS: Total mRNA was obtained from both tumoral and peritumoral tissue samples collected from patients diagnosed with colorectal cancer. Through Quantitative Real Time PCR, IL-8 gene expression was assessed in both pathologic tissue and adjacent normal mucosa. RESULTS: In our cohort, IL8 expression was higher in adjacent normal mucosa than in tumoral tissue, in all the samples. Further studies on larger groups are required to validate our results.

Narrow band imaging endoscopy for detection of precancerous lesions of upper gastrointestinal tract.

Gastric cancer (GC) is an important health problem despite the advances in surgery and chemotherapy and although the incidence is decreasing, GC is still considered the second most common cause of deceases produced by cancer. Survival rates in gastric cancer are low, mainly because most patients are often diagnosed in late stages. The current interest in the diagnostic of GC is the detection of early gastric cancer. Advances in high-resolution endoscopic techniques such as narrow band imaging (NBI) allow the detection of early precancerous lesions like polyps or metaplastic mucosa. Performing only white light imaging endoscopy in order to detect gastric cancer can lead to omission or misdiagnose of a considerable number of early gastric cancers. NBI endoscopy associated with other high-resolution examinations is viable in detecting early gastric cancer, though few studies also indicate that the endoscopist's expertise plays an important factor as well.