The amplification of c-erb-B2 in cancer-free surgical margins is a predictor of poor outcome in oral squamous cell carcinoma.

The tumour subtype, TNM classification, and histopathological data are sometimes not sufficient for understanding and assessing the behaviour of oral cancers. In an attempt to find additional markers of tumour biology and behaviour, this study sought to determine the incidence and consequently the relevance of c-erb-B2, c-Myc, and H-ras gene alterations in tumour-free margins of oral squamous cell carcinoma (OSCC). Fifty samples of OSCC were analyzed for c-erb-B2 and c-Myc amplification by real-time polymerase chain reaction and for H-ras point mutations by sequencing. A relatively high incidence of genetic lesions was detected: 22% of cases had c-erb-B2 and 30% had c-Myc amplification, whilst only 12% harboured H-ras mutations. Kaplan-Meier analysis and the log-rank test showed statistically significant differences in 5-year survival rates and relapse between patients with tumour margins positive for c-erb-B2 amplification and those with margins that were negative (P=0.002). H-ras and c-Myc alterations could not be associated with tumour behaviour. Molecular analysis of margins, targeting cancer genes, could identify additional, independent predictors of risk and outcome in OSCC.

Current approach to epithelial ovarian cancer based on the concept of cancer stem cells.

Epithelial ovarian cancer (EOC) is the most common ovarian malignancy. EOCs comprise a diverse group of neoplasms, exhibiting a wide range of morphological characteristics, genetic alterations, and biological behaviors. Currently, there is no effective screening for early detection of EOCs and more than two-thirds of EOC patients are diagnosed with advanced stage disease. The major limiting factors in the treatment of EOC patients are recurrence and chemoresistance. Recent studies suggest that EOCs, like other solid tumors, contain distinct populations of cells that are responsible for tumor initiation, maintenance and growth. These cells, termed cancer stem cells (CSCs), display some of the features of normal stem cells and are thought to evade current chemotherapeutic strategies for the treatment of EOCs. Distinguishing CSC-associated antigen profiles may elucidate novel, more sensitive biomarkers for early detection of EOCs and provide molecular targets for the development of new treatment modalities. This review summarizes the current approaches to EOCs based on the concept of CSCs and evaluates their clinical relevance.

Bcl-2 expression in oral squamous cell carcinoma.

Apoptosis is a genetically regulated process involved in tissue size regulation, morphogenesis, and elimination of genetically damaged cells. A pallet of genes is involved in the control of apoptosis, such as bcl-2 family whose oncogenic potential has been demonstrated in oral tumorigenesis. Different members of bcl-2 family may promote or inhibit apoptosis by synthesizing anti- and proapoptotic proteins. One of antiapoptotic proteins, bcl-2, with a crucial role in apoptosis regulation was the object of our study. By means of immunohistochemistry we estimated the level of overexpression of bcl-2 proteins in a series of the 26 formalin fixed, paraffin-embedded samples of oral squamous cell carcinoma (OSCC). Analyzed tumors originated from different sites of oral cavity; 7/26 belonged to stage II, 14/26 to stage III, and 5/26 to stage IV. Immunoreactivity was scored according to the percentage and intensity of positive cytoplasmic bcl-2 staining. All tumors had low percentage of positively stained bcl-2 cells, with mean values for lower/higher intensity of 8.3 +/- 2.5/34.4 +/- 7, 7.5 +/- 1.1/31.9 +/- 4.3, and 8.4 +/- 5.8/31.5 +/- 5.8 within stages II, III, and IV, respectively. Low level of bcl-2 expression in our sample seems to be associated with higher survival rate: 77% for the 5-year follow-up period. Comparing clinicopathologic and risk factors data within each and between three groups of analyzed tumors (lip-tongue P = 0.58, tongue-floor of the mouth, P = 0.21, lip-floor of the mouth, P = 0.50) there was no significant difference. However, our results suggest that the level of bcl-2 expression could be a valuable predictor of tumor behavior and disease outcome.

[Guidelines for cleaning and disinfection/sterilization of endoscopes]. / Preporuke za ciscenje i dezinfekciju/sterilizaciju endoskopa.

Endoscopy is a diagnostic and therapeutic method which is being increasingly used in various fields of medicine, especially in minimal invasive surgery. During the endoscopic procedure, endoscopes are contaminated with patient's microbial flora. After each procedure and before the next patient, endoscope should be reprocessed in a way to be safe from post-procedural infection. Endoscopes are divided in two categories (the borders between them are not always clear-cut): high-risk category endoscopes which enter the sterile tissue, and medium-risk category which come in contact with mucosal surface. High-risk endoscopes should be sterilized or high-level disinfected, and medium-risk should be high-level disinfected. The first and the most important step in endoscope reprocessing is thorough manual cleaning of all parts of dismantled endoscope and of all channels in water and (enzymatic) detergent. The second step is disinfection of endoscope fully immersed in 2% glutaraldehyde for 20 minutes at room temperature. The third step is thorough rinsing in sterile water or tap water followed by 70% ethanol, depending on the next endoscopic procedure. Steps 2-4 can be done in the machine. During endoscopy as well as during endoscope reprocessing, strict preventive measures should be followed for health care workers protection.

IgG serology pattern in long-term follow-up of patients successfully treated for Helicobacter pylori eradication.

A long-term specific IgG serology pattern after successful eradication of Helicobacter pylori using Pyloriset EIA-G with acid-glycine extracted antigen is shown. A total of 214 HP-seropositive dyspeptic patients, mean age 51, were included. Despite individual variability among patients, calculation of antibody decline in each individual, 2, 4, 6, 12, 18, and 24 months after treatment, the authors observed that overall mean decline in the group as a whole was 49%, 67%, 78% 87%, 91%, and 93%, respectively. Unlike Cutler and coworkers, the authors found a regular constant IgG-decline in successfully treated patients until seroconversion. The time to reach seroconversion was found to depend on the pretreatment level of specific IgG. In the groups of patients with baseline IgG less than 1300, 42/44 (95%) seroconverted within the first year of monitoring. When long-term monitoring is needed, unnecessary multiple biopsies can be avoided by use of quantitative IgG serology.