RESUMEN
Skeletal metastases are severe complications in the course of cancer, and they indicate a worse prognosis. The use of modern imaging techniques allows rapid diagnosis of bone metastases. Properly selected diagnostic imaging (scintigraphy, positron emission tomography, whole body MRI) allows us to evaluate the number of metastatic foci in the skeletal system. Complementary imaging examinations (X-ray, computed tomography, magnetic resonance imaging) determine the extent of metastasis and its character: osteolytic, osteoblast, mixed). Hypercalcaemia is a symptom of low specificity for metastatic bone disease (a result of osteolysis); nevertheless, it is a significant complication in oncological treatment and worsens the prognosis of the patient. A biopsy is the final stage of the diagnostic process, which allows us to assess cell and tissue changes. Guided biopsies are performed under the control of musculoskeletal imaging methods (CT, MRI) and they are the most promising tools in bone metastases diagnosis. The development of guided biopsy techniques has led to the conclusion that they should be standard in diagnosing bone metastases. Liquid biopsy (LB) seems to be the most promising diagnostic method for detection of bone metastases. LB based on tumour-specific DNA mutation gives an opportunity for early detection and assessment of the molecular heterogeneity of the overall disease.
RESUMEN
The Wnt/Fzd/ß-catenin signaling pathway plays a significant role in physiology and pathology of the liver. The role of ß-catenin is linked mainly to the canonical pathway of the system. Phosphorylation of ß-catenin and abnormalities in function of the E-cadherin-catenin unit lead to loss of intercellular junctions, progression in liver fibrosis, and development of cirrhosis and hepatocellular carcinoma (HCC). Progression of liver diseases is noted to be accompanied by disturbances in ß-catenin expression (mainly with its overexpression), with its cytoplasmic or nuclear translocation and with lowered expression of E-cadherin. Increase in transcriptional activity of ß-catenin is associated mainly with mutations of CTNNB1. Detailed mechanisms of HCC development are not known. More ß-catenin mutations are manifested in hepatitis C virus (HCV)-associated than in HBV-related HCC. In recent years the role of nonstructural proteins and of the core protein of HCV has been accentuated in induction of the Wnt pathway. HCV proteins affect in a double manner expression of E-cadherin, including modulation of the Wnt pathway and reduction of E-cadherin expression at the transcriptional level. This review presents current data on mechanisms of hepatocarcinogenesis involving participation of the Wnt canonical pathway and, in particular, interaction of Wnt pathway components with HCV genome products in the process.