Can neopterin be a useful immune biomarker for differentiating gastric intestinal metaplasia and gastric atrophy from non-atrophic non-metaplastic chronic gastritis? / ¿Puede la neopterina ser un biomarcador inmunológico para diferenciar la metaplasia intestinal gástrica y la atrofia gástrica de la gastritis crónica no atrófica y no metaplásica?

Introduction: Helicobacter pylori (H. pylori) is closely related to pre-neoplastic lesions such as gastric atrophy (GA), gastric intestinal metaplasia (GIM) and eventually gastric cancer (GC). The diagnosis of GIM and GA is usually based on endoscopic and histopathological features. Nowadays, there are no recognized good serological markers of GIM and GA. Neopterin is an important marker of cellular inflammation. In this study, we aimed to comparatively evaluate C-reactive protein (CRP) and neopterin levels in patients with GIM, GA and chronic gastritis, and to show the increased serum neopterin levels in GIM and GA according to non-atrophic and non-metaplastic chronic gastritis. Patients and methods: 98 patients with GIM and 68 patients with GA and 70 patients with non-atrophic non-metaplastic gastritis were included in the study. CRP and neopterin levels were assessed in patients and controls. Results: CRP and neopterin levels were significantly higher in patients with GIM and GA than in controls (p<0.05 and p<0.001, respectively). A multiple logistic regression analysis showed that high levels of serum neopterin were positively correlated with GIM and GA. According to the ROC curve analysis, the best cut-off value to differentiate between patients with GIM and/or GA from controls was ≥10.15nmol/l (p<0.001) for serum neopterin levels and ≥1.95mg/l (p<0.001) for serum CRP levels. Discussion: CRP and neopterin levels are significantly increased in GIM and GA. Neopterin may be a useful biomarker and diagnostic test for detecting GIM and GA in clinical practice. CRP levels may be helpful for this observation

Introducción: Helicobacter pylori (H. pylori) está estrechamente relacionado con lesiones preneoplásicas, como la atrofia gástrica (AG), metaplasia intestinal gástrica (MIG) y finalmente cáncer gástrico (CG). El diagnóstico de MIG y AG generalmente se basa en características endoscópicas e histopatológicas. Hoy día, no hay buenos marcadores serológicos reconocidos de MIG y AG. La neopterina es un marcador importante de inflamación celular. En este estudio, nuestro objetivo fue evaluar comparativamente la proteína C-reactiva (PCR) y los niveles de neopterina en pacientes con MIG, AG y gastritis crónica, y mostrar el aumento del nivel sérico de neopterina en MIG y AG sobre la base de gastritis crónica no atrófica y no metaplásica. Pacientes y métodos: Se incluyó en el estudio a 98 pacientes con MIG, 68 pacientes con AG y 70 pacientes con gastritis no atrófica y no metaplásica. Se evaluaron los niveles de PCR y neopterina en pacientes y controles. Resultados: Los niveles de PCR y neopterina fueron considerablemente más altos en los pacientes con MIG y AG que en los controles (p<0,05 y p<0,001, respectivamente). Un análisis de regresión logística múltiple mostró que el elevado nivel de neopterina sérica se correlacionó positivamente con MIG y AG. Según el análisis de la curva ROC, el mejor valor de corte para diferenciar entre pacientes con MIG y/o AG y controles fue ≥10,15nmol/l (p<0,001) para el nivel de neopterina sérica y ≥1,95mg/l (p<0,001) para el nivel de PCR en suero. Discusión: Los niveles de PCR y neopterina aumentan considerablemente en MIG y AG. La neopterina puede ser un biomarcador útil y una prueba de diagnóstico para detectar MIG y AG en el entorno clínico. Los niveles de PCR pueden ser útiles para esta observación

Can neopterin be a useful immune biomarker for differentiating gastric intestinal metaplasia and gastric atrophy from non-atrophic non-metaplastic chronic gastritis?

INTRODUCTION: Helicobacter pylori (H. pylori) is closely related to pre-neoplastic lesions such as gastric atrophy (GA), gastric intestinal metaplasia (GIM) and eventually gastric cancer (GC). The diagnosis of GIM and GA is usually based on endoscopic and histopathological features. Nowadays, there are no recognized good serological markers of GIM and GA. Neopterin is an important marker of cellular inflammation. In this study, we aimed to comparatively evaluate C-reactive protein (CRP) and neopterin levels in patients with GIM, GA and chronic gastritis, and to show the increased serum neopterin levels in GIM and GA according to non-atrophic and non-metaplastic chronic gastritis. PATIENTS AND METHODS: 98 patients with GIM and 68 patients with GA and 70 patients with non-atrophic non-metaplastic gastritis were included in the study. CRP and neopterin levels were assessed in patients and controls. RESULTS: CRP and neopterin levels were significantly higher in patients with GIM and GA than in controls (p<0.05 and p<0.001, respectively). A multiple logistic regression analysis showed that high levels of serum neopterin were positively correlated with GIM and GA. According to the ROC curve analysis, the best cut-off value to differentiate between patients with GIM and/or GA from controls was ≥10.15nmol/l (p<0.001) for serum neopterin levels and ≥1.95mg/l (p<0.001) for serum CRP levels. DISCUSSION: CRP and neopterin levels are significantly increased in GIM and GA. Neopterin may be a useful biomarker and diagnostic test for detecting GIM and GA in clinical practice. CRP levels may be helpful for this observation.

Prognostic role of Aurora-A expression in metastatic colorectal cancer patients.

PURPOSE: Aurora kinase family plays an important role in mitosis and cell cycle organization. Aurora-A is an important member of the aurora kinase family and its expression increases the genomic instability and contributes to carcinogenesis. In this study, the prognostic role of Aurora-A expression in colorectal cancer (CRC) was assessed. METHODS: Metastatic CRC patients, whose diagnoses were histopathologically confirmed and who were followed up at the Antalya Education and Research Hospital between 2008 and 2010, were included in the study. Aurora-A expression was assessed with immunohistochemistry. RESULTS: A total of 40 patients were included in the study. Aurora-A expression was determined as positive in 33 (82.5%) patients and as negative in 7 (17.5%). No significant correlation was determined between Aurora-A expression and tumor location, metastatic location and histological subtype (p=0.549, 0.511, and 0.709, respectively). Also, no significant correlation was determined between Aurora-A expression and overall survival (p=0.202). Median survival was 8.7 months (95) confidence interval/CI 6.9-10.4) in patients with negative Aurora-A expression, whereas it was 22.6 months (95% CI 12-33.3) in patients with positive Aurora-A expression (p=0.202). CONCLUSION: Despite the lack of statistical significance, we speculate that Aurora-A overexpression may have a positive effect on the survival of patients. With this regard, there is a need for further comprehensive studies examining the relation and effect of Aurora-A expression on survival and response to treatment.

Lack of any prognostic role of insulin-like growth factor-1 receptor in non-small cell lung cancer.

BACKGROUND: The purpose of this study is to determine whether the IGF1R expression has a prognostic role in non-small cell lung cancer. MATERIALS AND METHODS: Forty-seven patients histopathologically diagnosed with small cell lung cancer upon bronchoscopic biopsy or resection materials were included in the study. IGF1R expression was examined via immunohistochemical methods. In samples, >10% staining were assessed as positive and ≤10% as negative. Information about demographic datas and treatments was obtained by retrospective searches of patient files. RESULTS: IGF1R expression was determined as positive in 38 (80.9%) and as negative in 9 (19.1%) patients. There was no significant relation between IGF1R expression and histological sub-type, local invasion, lymph node and metastasis status (p=0.842, p=0.437, 0.064, 0.447, respectively). There was also no correlation with IGF1R expression and survival (p=0.141). CONCLUSIONS: There are conflicting results between IGF1R and its prognostic effects in the various studies. It has been claimed in some studies it is not related to prognosis as in our study, and in some studies it has been claimed that it is a good prognostic factor whereas in some studies it has been claimed as being a factor for worse prognosis. We think that IGF1R expression in non-small cell lung carcinoma patients deserves further analysis, because of its potential prognostic and predictive roles.

Expression of cyclooxygenase-2 and Bcl-2 in breast cancer and their relationship with triple-negative disease.

PURPOSE: Carcinogenesis is a multistep process with many factors being involved. The aim of this study was to investigate the role of cyclooxygenase-2 (COX-2) and Bcl-2 expression in patients with triple-negative breast cancer (TNBC) and, also whether any differences exist between TNBC and non-TNBC patients in relation with these two parameters. METHODS: This study included 50 patients with pathologically diagnosed TNBC and followed up at the Medical Oncology Clinic of Antalya Education and Research Hospital between 2008 and 2010. Thirty non-TNBC patients composed the control group. COX-2 and Bcl-2 expression was immunohistochemically investigated in both patient groups. RESULTS: COX-2 expression was positive in 26 (86.7%) of non-TNBC and 18 (90%) of TNBC patients (p=0.722). Compared with non-TNBC, TNBC correlated with higher Bcl-2 expression (p=0.005). Of the non-TBNC patients 86.7% and 50% of TNBC patients showed Bcl-2 expression. When Bcl-2 and COX-2 expression were considered together, a significant difference was found between the two groups (p=0.021). CONCLUSION: This study showed that increased COX-2 expression correlated with Bcl-2 expression both in TNBC and non-TNBC patients. Analysis of coexpression of Bcl- 2 and COX-2 may be meaningful for deciding treatment strategies for TNBC. Treatment strategies targeting Bcl-2 and COX-2 seem to be promising for this aggressive disease with no specific treatment.

Lack of relation of AKAP12 with p53 and Bcl-2 in colorectal carcinoma.

BACKGROUND: AKAP12 inhibits oncogenic proliferation, invasion, chemotaxis and neovascularization. Bcl-2 and p53 are two important apoptotic markers that play roles in apoptotic processes. It has been found that AKAP12 blocks the cell cycle and induces apoptosis in fibrosarcoma cells. In our study we assessed the relationship of AKAP12 with apoptotic markers, Bcl-2 and p53. MATERIALS AND METHODS: Our study included 45 cases that were histopathologically diagnosed with colorectal carcinoma from the tissue samples acquired by surgical resection. AKAP 12, Bcl-2, and p53 expression was examined by immunohistochemistry. RESULTS: A total of 45 colorectal adenocarcinoma patients - 17 (37.8%) females and 28 (62.2%) males - were included in this study. AKAP12 expression was found to be negative in 8 patients (17.8%), and positive in 37 patients (82.2%). Bcl-2 was found positive in 6 patients (13.3%) and p53 in 29 patients (55.6%). AKAP12 expression had no significant relation with Bcl-2 and p53 expression (p:0.939, p:0.079, respectively). CONCLUSIONS: Although various studies have pointed to apoptotic activity of AKAP12, the literature is limited regarding relations with p53 or Bcl-2 expression. In the present study, we found no relation in colorectal carcinomas.

Esophageal cancer, gastric cancer and the use of pesticides in the southwestern of Turkey.

BACKGROUND: Esophageal and gastric cancer generally have a poor prognosis and may share common risk factors. It has been demonstrated that the pesticide usage may contribute to development of many cancer types. In this study, the relation between amount of pesticides used in agriculture and esophageal and gastric cancer incidence was researched. MATERIALS AND METHODS: Findings from the data bank of the Ministry of Health Provincial Health Directorate Cancer Records Center between the years of 1998-2010 were used. All patients who were diagnosed with gastric and esophageal cancer histopathologically were included. Data for annual pesticide usage were obtained from Provincial Agriculture Directorate for the same time period. Statistical analysis was performed using the Spearman test. RESULTS: One thousand eight hundred and ninety-six patients were involved in the study, 1,233 males (65%) and 663 females (35%), 230 with esophageal cancer (12.1%) and 1,666 with gastric cancer (87.9%). No statistically significant relation was apparent between pesticide amount used and esophageal cancer (p: 0.87). CONCLUSIONS: In our study, there was no relationship between pesticide usage and esophageal or gastric cancer. However, the time between pesticide usage and cancer development was not known, qualifying the comparison.

Non-Hodgkin lymphoma and pesticide exposure in Turkey.

BACKGROUND: Non-Hodgkin lymphoma (NHL) is a solid tumour of lymphocytes, important elements in the immune system. According to 2006 data, in Turkey the incidence was 6.5 per 100,000 in males, and 4.4 in females. The relationship between the use of pesticides and development of NHL has been extensively investigated in many studies, and it has been demonstrated that the risk of NHL is increased by exposure to such compounds. Antalya is a region of intensive agricultural activity. In this study, the relationship between the incidence of lymphoma in Antalya and the amount of pesticides employed was investigated. MATERIALS AND METHODS: The study used data from 1995 to 2010 on the patients from the databank of TR Ministry of Health, Antalya Provincial Health Directorate, Cancer Registration Center and the patients who were histopathologically diagnosed with NHL during these years. RESULTS: The relationship between the amount of pesticide used and the incidence was studied with the Spearman correlation analysis and the p value was found as 0.05. The correlation coefficient was 0.497. An increase in the NHL incidence over the years was identified, with a 2.42-fold increment found from 1995 to 2005 and a 2.77 fold elevation from 1995 to 2010. The use of pesticides increased 1.89 fold over the same period. CONCLUSIONS: Our study investigated the relationship of the pesticides used with NHL patients diagnosed during the same year. Since the time elapsing after exposure to pesticides until the development of cancer is not clear, no comparison can be made at present. We believe that the increase in use of pesticides since 1995 may be associated with the increase in the incidence of NHLand therefore that further studies on the issue including measurements of serum pesticide levels, are required.

Erythrocytosis in a patient on hemodialysis for thirteen years.

Most hemodialysis patients exhibit renal anemia mainly due to erythropoietin deficiency as a result of impaired erythropoetin production in the kidney. However, erythrocytosis in patients with renal failure requiring hemodialysis is extremely rare. We report the development of erythrocytosis in a patient with a polycystic kidney disease on hemodialysis for 13 years. She had erythrocytosis with increased serum erythropoietin levels despite severe secondary hyperparathyroidism, which is known to depress erythrocytosis. Since neither renal disease (renal cell carcinoma) nor extrarenal diseases (hypoxia, hepatoma, cerebellar diseases) linked with erythropoietin production could be proven, this case might be one with inappropriate idiopathic erythropoietin production after 13 years of hemodialysis, the longest duration of dialysis in the literature before erythrocytosis was observed.