Assessment of apelin, apelin receptor, resistin, and adiponectin levels in the primary tumor and serum of patients with esophageal squamous cell carcinoma.

BACKGROUND: Disturbances in adipokine secretion are associated with the risk of cancer growth and progression. OBJECTIVES: The aim of the study was to evaluate the mRNA expression and protein levels of apelin, the apelin receptor, resistin, and adiponectin in the tumor tissues of surgically treated esophageal squamous cell carcinoma (ESCC) patients. Concentrations of serum adipokines were assessed in relation to ESCC progression. MATERIAL AND METHODS: The study group consisted of 53 patients with ESCC and 27 controls. In the ESCC group, 27 patients were surgically treated and 26 were treated with palliative procedures. RT-PCR and ELISA tests were used to measure the mRNA expression and protein level of adipokines in tissues and their concentration in serum. RESULTS: We found that mRNA expression and protein concentrations of apelin, the apelin receptor and resistin were significantly higher in tumor tissue than in control tissue. The protein concentration of apelin were significantly increased in the tumors of patients with lymph node metastasis (p < 0.005). Circulating levels of apelin, the apelin receptor and resistin were significantly higher in the cancer patients than in controls (p < 0.05 for all). The concentration of serum apelin receptor significantly decreased in patients with stage IV cancer, the presence of lymph node or distant metastasis (p < 0.05). CONCLUSIONS: Apelin may participate in lymphangiogenesis and the progression of ESCC. The apelin receptor is intensely produced in the early stage of cancer development and it may take part in the carcinogenic processes of ESCC.

Circulating Oxidized Low-Density Lipoproteins and Antibodies against Oxidized Low-Density Lipoproteins as Potential Biomarkers of Colorectal Cancer.

Introduction. The aim of the study was evaluation of the diagnostic utility of serum oxidized low-density lipoproteins (oxLDL), antibodies against oxLDLs (o-LAB), and CEA as risk markers of colorectal cancer (CRC). Material and Methods. The serum levels of study factors were measured in 73 patients with CRC and in 35 healthy controls who were gender- and BMI-matched to the study group. Concentrations of oxLDL, o-LAB, and CEA were detected in ELISA tests. Serum lipids, lipoproteins, and glucose levels were also coestimated. Results. Age and o-LAB were significant factors of CRC presence, but results of logistic regression analysis showed that both were weak predictors of CRC risk. Concentration of o-LAB was significantly higher in colon cancer than in rectal cancer, especially when the cancer was located in the right section of colon. Serum CEA levels were significantly elevated in the advanced stage of disease, primary tumor progression, angiolymphatic invasion, and presence of distant metastasis. Conclusions. Obtained results have demonstrated that oxLDL and o-LAB were not satisfactory risk markers of CRC. Although significant relation between o-LAB level and CRC is observed, it may be rather the result of individual differences in the host immune responses against cancer.

Increased level of serum prostaglandin-2 in early stage of esophageal squamous cell carcinoma.

INTRODUCTION: Prostaglandin-2 (PGE-2), one of the products of cyclooxygenase-2 (COX-2) induced catalysis, may play a critical role in the carcinogenesis of esophageal squamous cell carcinoma (ESCC). We investigated the efficacy of using serum PGE-2 concentration as a biomarker for this cancer type. MATERIAL AND METHODS: Prostaglandin-2 levels were analyzed in the serum of 65 ESCC patients and in 47 healthy individuals. The concentrations of cyclooxygenase-2 (COX-2) were measured in tumor tissues and normal tissues obtained from 31 surgically treated ESCC patients. RESULTS: Serum PGE-2 concentration was significantly higher in ESCC patients than in control patients (p = 0.004), especially in the early stages (I + II) of cancer (p < 0.0001). We observed significant inverse relationships between serum PGE-2 levels and: tumor stage, primary tumor progression, lymph and distant metastasis. The COX-2 concentration was significantly elevated in tumors as compared to normal tissues (p = 0.008). A significant correlation between serum PGE-2 and tumor COX-2 was observed (rho = 0.46, p = 0.009). However, ROC analysis showed that serum PGE-2 may be a weak prognostic factor for ESCC. CONCLUSIONS: Our results suggest that an elevated concentration of serum PGE-2 in the early stages of cancer may possibly be associated with tumor initiation and cancer development in ESCC. The exact role of these findings in early detection of this highly lethal cancer requires further research.

Serum levels of resistin, adiponectin, and apelin in gastroesophageal cancer patients.

UNLABELLED: The aim of the study was the investigation of relationship between cachexia syndrome and serum resistin, adiponectin, and apelin in patients with gastroesophageal cancer (GEC). MATERIAL AND METHODS: Adipocytokines concentrations were measured in sera of 85 GEC patients and 60 healthy controls. They were also evaluated in tumor tissue and appropriate normal mucosa of 38 operated cancer patients. RESULTS: Resistin and apelin concentrations were significantly higher in GEC patients than in the controls. The highest resistin levels were found in cachectic patients and in patients with distant metastasis. Serum adiponectin significantly decreased in GEC patients with regional and distant metastasis. Serum apelin was significantly higher in cachectic patients than in the controls. Apelin was positively correlated with hsCRP level. Resistin and apelin levels increased significantly in tumor tissues. Weak positive correlations between adipocytokines levels in serum and in tumor tissue were observed. CONCLUSIONS: Resistin is associated with cachexia and metastasis processes of GEC. Reduction of serum adiponectin reflects adipose tissue wasting in relation to GEC progression. Correlation of apelin with hsCRP can reflect a presumable role of apelin in systemic inflammatory response in esophageal and gastric cancer.

Achalasia--balloon dilation or surgery?

BACKGROUND: The optimal therapeutic schedule in patients with achalasia is still under discussion. The aim of this study was to review our institution's experience with myotomy and dilation in patients with achalasia. MATERIAL AND METHODS: Clinical data were available for 59 patients who had ever had myotomy (n=38), dilation (n=21), or both procedures (n=8) between 2000 and 2007. Patients were followed prospectively with objective (a barium esophagogram) and subjective (a simple survey that scored dysphagia and overall patient satisfaction with the procedure) diagnostic tools. In the group of patients after pneumatic dilatations, frequency of interventions was higher (1, 2) than in the myotomy group (0, 2) at 2-year follow-up. Patients after myotomy with recurrence of dysphagia were treated with dilations. RESULTS: Mean time of dysphagia occurrence was similar in both groups (10 months). The statistically significant differences in treatment outcomes in both groups were in favor of myotomy during 2-year follow-up. CONCLUSIONS: The data indicates that both methods of treatment might be useful in dysphagia control, but better results are obtained after myotomy. Repeat interventions are more frequent after endoscopic dilation. One method of treatment does not exclude the other. A short period of symptom relief after myotomy may suggest the myotomy was incomplete.

Concentration of serum interleukin-27 increase in patients with lymph node metastatic gastroesophageal cancer.

BACKGROUND: Cytokines, one of the key mediators of immune response, play an important role in cancer development. OBJECTIVES: The aim of this study was to evaluate the interleukin-27 (IL-27) concentration in the serum of patients with gastroesophageal cancer (GEC) and in patients with non-cancerous benign diseases of the upper digestive tract (NCD). We investigated the relationship between the serum IL-27 level and clinicopathological factors, and also the diagnostic utility of IL-27 as a marker of GEC presence. Additionally, we evaluated the concentrations of serum IL-27 in patients with esophageal squamous cell carcinoma before and after surgical tumor resection. MATERIAL AND METHODS: Serum samples from 84 GEC patients, 39 NCD patients and 33 healthy subjects were assayed. The levels of IL-27, IL-6, IL-12 and IFN-γ were determined using ELISA kits. RESULTS: The serum levels of IL-27 were significantly higher in the GEC patients than in the healthy control (p < 0.0001) and in NCD patients (p = 0.006). The concentrations of serum IL-27 were related to lymph node status (p = 0.044). ROC analysis showed a significant relationship between a high level of serum IL-27 and GEC presence (AUC = 0.766, p < 0.001). The concentrations of serum IL-27 were significantly higher in patients with esophageal squamous cell carcinoma 3 months after esophagectomy than before the operation (p = 0.003). CONCLUSIONS: Our results demonstrated that a high serum IL-27 level is associated with cancer presence and lymph node metastases in GEC. Significantly higher levels of IL-27 in patients with esophageal squamous cell carcinoma after tumor resection may imply that host immune cells are one of the important sources of circulating IL-27.

Partner relationships after mastectomy in women not offered breast reconstruction.

BACKGROUND: The present study assessed the degree to which undergoing a mastectomy without reconstructive surgery negatively impacts the patient's psychological state. We focus on body image and self-esteem as well as the influence of mastectomy on patient sex lives and partnership relations. METHODS: The participants were 60 women, either married or in a relationship, who had had a mastectomy because of breast cancer and no subsequent reconstructive surgery. A marital happiness questionnaire was used to evaluate the research problem. RESULTS: Surgery negatively impacted partnership relations for 33% of participants. In particular, 31% reported deterioration in attractiveness; 31%, a feeling of malaise; and 30%, that their partners perceived them as less attractive. Moreover, 80% in the youngest group reported that they covered their body during intimate contact, whereas 58% in the oldest age group reported the same behaviour. Deterioration in satisfaction with sex life and in the pleasure of sexual intercourse was indicated by 71% and 77%, respectively. Correspondingly, 71% also noticed a decrease in sexual activity, with 76% of participants aged 50-65 years reporting such a decline. The oldest women were also less satisfied with their sexual intercourse. CONCLUSIONS: Breast excision due to cancer negatively impacted the quality of sexual life for 71% of participants. Partnership relations after surgery remained unchanged for 67% of them. There was significant impact of surgery on the perception of one's own body.

Circulating leptin and inflammatory response in esophageal cancer, esophageal cancer-related cachexia-anorexia syndrome (CAS) and non-malignant CAS of the alimentary tract.

We investigated the association between esophageal cancer and cachexia-anorexia syndrome (CAS) of the alimentary tract and leptin, an adipocytokine crucial for body weight regulation, a modulator of inflammatory/immune response, implication of which in cancer and CAS development remains debatable. Circulating leptin was measured in 135 esophageal cancer patients (51 non-cachectic and 84 cachectic) and 83 controls (63 non-cachectic and 20 cachectic) and referred to cancer stage, CAS, and inflammatory and nutritional indices. Leptin was down-regulated in cancer patients and cachectic controls as compared to non-cachectic controls, with more pronounced hypoleptinemia in advanced cancers. Leptin correlated directly with BMI, TNF-alpha, albumin, and hemoglobin and indirectly with IL-6, IL-8, and hsCRP. The correlations, except for hsCRP, were more pronounced in females. BMI alone (females) and BMI and hsCRP (males) were independent predictors of leptin explaining over 60% of its variability. Following adjustment for BMI and gender, cancer-related CAS but not cancer itself negatively affected leptin. Leptin and BMI were independently associated with cancer-related and non-malignant CAS with diagnostic accuracy of 93% in identifying subjects with CAS. Pro-inflammatory, angiogenic and mitogenic properties of leptin do not seem to be important for esophageal cancer development but hypoleptinemia, independently from co-occurring reduction of adiposity, appears to be strongly associated with esophageal cancer-related CAS and non-malignant CAS of the alimentary tract.

[Non-epithelial tumors of the large intestine]. / Nienablonkowe nowotwory jelita grubego.

UNLABELLED: Colorectal cancer may arise from any kind of tissue constituting normal wall of the large intestine, however, in majority of cases, it is of epithelial origin. Endocrine, mesenchymal neoplasms and non-granulomatic lymphomas belong to rarely occurring cancers of the large intestine. Mesenchymal neoplasms may derive from muscles, nervous system, fibrous connective tissue, fat tissue and from blood and lymphatic vessels. The paper presents 3 cases of non-epithelial neoplasms of the large intestine (myosarcoma and 2 myomas). All cancers concerned women older than 50 years (mean age 64.6 +/- 11.4 years) and were localized in the right hemicolon. In all cases episodes of hemorrhage from the lower part of the digestive tract triggered the diagnostic procedures. Surgical treatment varied from hemicolectomy with lymphadenectomy to endoscopic excision of a small lipoma. Histopathological verification and immunohistochemical staining were obtained after their removal. Clinical course and intraoperative situation were decisive as to type of surgery. Although mesenchymal tumors are very rare among large intestine neoplasms, one should consider their occurrence while carrying preoperative diagnosis. CONCLUSION: Occurrence of other tumors than neoplasms should be taken into consideration while carrying preoperative diagnosis.

Development of the descending colon during the human foetal period.

The growth, changes in shape, topography and relation to the peritoneum of the descending colon were assessed on the basis of material taken from 178 foetuses of both sexes, aged from 72 to 236 days of pregnancy. The statistical analysis method demonstrated that the descending colon growth process occurs about a month earlier in female foetuses as compared to male ones. From the statistical point of view, the longitudinal growth of the descending colon significantly slows down in the 7th and 8th months of pregnancy, while the width of this part of the large intestine increases sharply towards the end of the foetal development period. The statistically important process of the descending colon rising over the surface of the left kidney and adrenal gland was noticed in male foetuses. This occurs approximately one month earlier in female foetuses as compared to males. The ascent of this part of the colon is accompanied by a change in its shape from straight, to curved and, finally, to wavy in the oldest age group of male foetuses. The changes in relation to the peritoneum are manifest in a gradual change in the position of this section of the intestine from the intraperitoneal, where more than 40% of the cases examined had a fully movable mesentery, to the extraperitoneal, with 14% of foetuses having a mesentery in the 8th month of pregnancy.

[Concentration of serum soluble forms of ICAM-1 (sVCAM-1) and VCAM-1 (sVCAM-1) in patients with chronic pancreatitis and in patients with pancreatic carcinoma]. / Stezenie rozpuszczalnych form czasteczek adhezyjnych ICAM-1 (sICAM-1) i VCAM-1 (sVCAM-1) w surowiçy chorych na przewlekle zapalenie trzustki i raka trzustki.

UNLABELLED: Cellular adhesion plays a major role in many biological processes--in cells' growth, their differentiation, migration and apoptosis. The aim of the paper is to evaluate the expression of two selected adhesion molecules at the Ig superfamily in their soluble forms (sICAM-1 and sVCAM-1) in patients with chronic pancreatitis and in patients with pancreatic carcinoma in comparison with a group of healthy people. Examinations were carried out on healthy people (n = 32), patients with chronic pancreatitis (n = 32) and with pancreatic cancer (n = 32). The selected adhesion molecules concentrations were assessed using immunoassay of solid phase (ELISA). RESULTS: sICAM-1 and sVCAM-1 values in the sera of patients with chronic pancreatitis and with pancreatic carcinoma were significantly higher (p < 0.01) in comparison with the results obtained in the control group. In the group of patients with chronic pancreatitis the results were significantly lower in comparison with concentration in the group of patients with pancreatic carcinoma (p < 0.05, p < 0.01). sICAM-1 and sVCAM-1 values in patients with remote metastases were higher than in patients without metastases (p < 0.01). CONCLUSIONS: Overexpression of sICAM-1 and sVCAM-1 is characteristic for chronic pancreatitis and pancreatic cancer. Values of sICAM-1 and sVCAM-1 concentrations in serum of patients with pancreatic cancer demonstrate connection with a state of clinical progression of tumour.

[Neuroendocrine pancreatic tumors]. / Neuroendokrynne nowotowory trzustki--opis przypadków.

Neuroendocrine tumors are an interesting group of neoplasmas of the digestive system. A possibility of appearance of syndromes connected with hormonal activity is their common feature. Some of them are not hormonally active and they do not manifest hormonal hyperactivity. The authors present 2 patients with malignant neuroendocrine pancreatic tumors in whom the lack of clinical syndromes connected with overproduction of hormone resulted in the establishment of the diagnosis in an advanced stage of the disease. The tumors were not clinically active but immunohistochemical examinations revealed the presence of hormones in cytoplasmatic granules. Both patients had positive immunostaining for VIP, NSE and chromogranin. Moreover, in one of the patients positive staining for ACTH and glucagon and in another for PGP 9.5 was obtained.

[Ca 19-9 antigen in differentiation of pancreatic inflammatory and neoplastic tumors]. / Antygen Ca 19-9 w róznicowaniu guzów zapalnych i raka trzustki.

Difficulties in differentiation between inflammatory and neoplastic tumors of pancreas cause that the diagnostics based on image examinations requires the assessment of neoplastic markers. The aim of the paper is to evaluate the usefulness of Ca 19-9 in differentiation of inflammatory and neoplastic pancreatic tumors. Examinations were carried out on a group of healthy people (n = 32), patients with chronic pancreatitis (n = 32) and patients with carcinoma of exocrine part of pancreas (n = 32). In all examined patients Ca 19-9 concentration was measured by ELISA method. Ca 19-9 level in serum higher than the upper limit of range in reference group was noted in 46.9% of patients with chronic pancreatitis and in 90.6% in the group of patients with pancreatic carcinoma. Concentrations higher than 90 U/ml and 150 U/ml were noted in 31.3% and 15.6% patients with chronic pancreatitis respectively. Ca 19-9 concentration median in patients with pancreatic carcinoma (255.45 U/ml) was significantly higher (p < 0.001) in comparison to the level in patients with chronic pancreatitis (33.25 U/ml). Optimal dividing concentration was 150 U/ml. There was quite high percentage of false positive results. It made Ca 19-9 less useful in the differentiation between inflammatory and neoplastic pancreatic tumors. Ca 19-9 concentration measured in serum 37 U/ml was the dividing concentration in the diagnostics of chronic pancreatitis and pancreatic carcinoma. It seems to be not sufficient therefore in my opinion the level of 90 U/ml and even 150 U/ml should be considered as a dividing one.