Melanosis coli in patients with colon cancer.

INTRODUCTION: Melanosis coli is a benign lesion affecting the mucosa of the large intestine. There is a relationship between the presence of melanosis and anthraquinone laxative use. Melanosis coli is also observed in patients with colon cancer, but there is doubt whether these two conditions are related. AIM: To analyze the correlation between melanosis and colon cancer. MATERIAL AND METHODS: We analyzed retrospectively 436 patients undergoing colon cancer surgery. There were 246 women and 190 men. Patients were divided into three age groups: under 50 years, between 51 and 65 years, and over 66 years. We analyzed sections of the cancer and intestinal mucosa from the tumor's proximal (2-5 cm) and distal (8-10 cm) zone. RESULTS: Melanosis coli was present in 52 patients, which represents 11.9% of patients with colon cancer. More often it was present in women. The most common location of melanosis and colon cancer was the terminal part of the large intestine. In patients below 50 years of age in both sexes melanosis coli did not occur. In men, melanosis was more common in the age group over 66 years. Intensity of pigmentation was higher in the tumor's distal zone. CONCLUSIONS: The incidence of melanosis coli increases with age, similar to that of colon cancer. Melanosis was not present inside tumors, in almost half of the cases it was not present in the proximal zone, and the degree of pigmentation increased in distal zone. The cause-effect relationship between melanosis coli and colon cancer remains uncertain.

Gastritis - facts and doubts.

INTRODUCTION: Many clinicians consider chronic gastritis to be equivalent to Helicobacter pylori infection. However, it is known that there are numerous other causes of the condition. AIM: Determination of the incidence of gastritis in patients with dyspepsia referred for diagnostic endoscopy of the upper part of the digestive tract, identification of the parts of the stomach most frequently affected by the inflammation, as well as the impact of an insufficient number of collected samples on the correct diagnosis. MATERIAL AND METHODS: Upper gastrointestinal endoscopy due to dyspepsia was performed in 110 patients. In the course of gastroscopy two biopsy specimens were collected for histopathological examination and towards H. pylori infection from the lesser and greater curvature in the antrum 3 cm from the pyloric sphincter, in the body - 4 cm proximally to the stomach angular incisure on the lesser curvature, and in the middle of the greater curvature, as well as in the subcardiac region on the side of the lesser and greater curvature. RESULTS: In patients with dyspepsia H. pylori-negative chronic gastritis is more common than gastritis with accompanying H. pylori infection. Collection of too small a number of biopsy specimens results in failure to detect inflammatory changes and/or H. pylori infection, which may be limited to one part of the stomach. Biopsy specimens of gastric mucosa should be collected in compliance with the assumptions of the Sydney System. Helicobacter pylori infection in people with dyspepsia is now being reported more rarely than in the past (36%). CONCLUSIONS: In patients with dyspepsia chronic H. pylori-negative gastritis is more common than gastritis with an accompanying H. pylori infection. Helicobacter pylori infection is not always equivalent to the presence of chronic gastritis.

[Serum lipids concentration and colorectal cancer]. / Stezenie lipidów w surowicy a rak jelita grubego.

The authors present current concepts concerning the relationships between plasma lipid concentration and incidence of colorectal cancer. Pharmacological reduction of cholesterolaemia may decrease mortality of cardiovascular causes' simultaneously increasing mortality of non-vascular causes. Discussion concerns the idea of preclinical action of the neoplasm on lowering cholesterol level as well as hypothesis of increased biliary secretion of cholesterol metabolites, that may have cancerogenic effect. Cholesterol plasma concentration and its impact on aetiopathogenesis of colorectal cancer still need to be investigated.

[Sporadic Burkitt's lymphoma (BL) with stomach involvement associated with Helicobacter pylori infection--case report and literature review]. / Sporadyczny chloniak Burkitta z zajeciem zoladka i towarzyszaca infekcja Helicobacter pylori--opis przypadku i przeglad literatury.

UNLABELLED: Extranodal lymphomas represent up to 40% of all lymphomas and their prevalence is still increasing. Sporadic BL is rare. It occurs mainly in young men and is associated with viral infection in only about 30% of cases. Most frequently it affects the digestive tract. CASE REPORT: 46-year-old patient was admitted to hospital due to painless tuberous changes of right occipital region and cheek, weakness and non-specific abdominal pain. Clinical examination revealed hepatomegaly. Leucocytosis, raised level of transaminases and LDH were found. Imaging investigations disclosed the enlargement of epigastric lymph nodes and thickening of stomach wall. FNAB of the cheek's tumor allowed to suspect a lymphoma. Biopsy specimens taken from the stomach, cheek and bone marrow confirmed the diagnosis of BL. Microscopic examination revealed cellular infiltration consisting of monomorphic, lymphoid cells with round or oval nuclei containing a few nucleoli with scanty cytoplasm. Mitoses, also atypic, were very numerous. Immunohistochemistry staining was very characteristic for this type of lymphoma: CD20, CD79a, CD10, C-myc, IgM positive, MIB positive in 100% of neoplasmatic cells. There was no evidence of EBV infection. In gastric specimens Helicobacter pylori infection was found. CONCLUSION: Clinical features of sporadic BL are often very non-typical. It is important to diagnose BL in its early stage, because it responds well to treatment and there is a chance of full recovery. Relation between H. pylori infection and BL is probable but demands further investigations.

Impaired glucose metabolism in colorectal cancer.

OBJECTIVE: Some studies have found that people with type 2 diabetes mellitus are at increased risk of neoplasms, especially colorectal cancer (CRC). In other studies it is also suggested that there is a higher incidence of diabetes mellitus in patients with CRC. The aims of this study were to assess whether the incidence of type 2 diabetes mellitus and impaired glucose tolerance (IGT) are higher in subjects with CRC and to determine the difference between diabetic subjects and healthy controls regarding glucose metabolism (glycaemia, insulinaemia, serum levels of C-peptide) as well as insulin resistance and sensitivity. MATERIAL AND METHODS: The study included a total of 80 subjects: 40 enrolled patients (20 M, 20 F) with newly diagnosed sporadic colorectal cancer and 40 subjects with endoscopically excluded CRC or adenomas serving as controls. Subjects were matched for gender, age and body mass index (BMI) (age +/- 5 years BMI +/- 1 kg/m2). A 75-g oral glucose tolerance test was performed after an overnight fast. Samples for glycaemia, serum levels of C-peptide and insulin were taken at 0, 30, 60, 90, 120 and 150 min of the study. HOMA-IR, EIR, EIR/HOMA-IR indexes were calculated. RESULTS: There was a significantly higher incidence of impaired glucose metabolism (IGM-diabetes mellitus or IGT) in CRC subjects. No differences were found in levels of glucose, insulin or C-peptide. Insulinaemia and C-peptide curves showed a shift typical of diabetes, in the form of a delayed insulin release peak. The HOMA-IR, EIR as well as the EIR/HOMA-IR indexes showed no differences between groups. CONCLUSIONS: A significantly higher incidence of IGM appears to occur in CRC patients than in the healthy population. This phenomenon is not dependent on age and body-weight, which may suggest that it is cancer that predisposes to diabetes rather than the other way round. The neoplastic process in the colon is not associated with hyperinsulinaemia or insulin resistance, but in CRC patients, pancreatic B-cell dysfunction typical of the early stages of diabetes is seen.