Prothymosin-alpha and Ki-67 expression in pituitary adenomas.

INTRODUCTION: Prothymosin alpha (PTMA), a nuclear oncoprotein involved in cell cycle regulation, is used as a prognostic marker in many cancers. The histopathology of pituitary carcinomas and locally invasive adenomas is indistinguishable from that of benign tumors. A new marker is needed to differentiate these lesions. We evaluated PTMA in pituitary adenomas to determine its usefulness as a prognostic factor of tumor proliferation. MATERIAL/METHODS: We conducted a retrospective analysis of a group of 27 patients, including 15 females (56%) and 12 males (44%) with a mean age of 58.6±12 years, who underwent pituitary tumor surgery between 2003 and 2012. The Ki-67 and PTMA-nuclear (PTMA-n) and PTMA-cytoplasmic (PTMA-c) indices were determined by immunohistochemical staining. We studied histopathological features, clinical symptoms, and magnetic resonance imaging or computed tomography performed before surgery and one year following surgery to evaluate tumor size and progression. RESULTS: The expression of Ki-67 was revealed in 77.8% of adenomas, PTMA-n in 81.5% and PTMA-c in 92.6%. The mean value of the Ki-67 index was 1.8%, PTMA-n was 1.84%, and PTMA-c was 35.6%. There was a significant positive correlation between Ki-67 and PTMA-n (p=0.009). We did not find any correlation between Ki-67, PTMA-c, and tumor progression. PTMA-n was found to be correlated with tumor size (p=0.045) and was higher in the case of gonadotropinomas (p=0.026). CONCLUSIONS: The positive nuclear expression of Ki-67 and PTMA was observed in the majority of pituitary adenomas. Neither the expression of Ki-67 nor that of PTMA-c was related to tumor recurrence or local invasion.

[Could the cytokines concentration be a marker of IBD activity and be useful in evaluation of IBD differentiation?]

Background: In inflammatory bowel disease (IBD) the imbalance between cytokines pro- and antinflammatory is observed. The aim of this study was the assessment of interleukin-10 (IL-10), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) concentration usefulness in the evaluation of the activity of ulcerative colitis (UC) and Cohn's disease (CD). Methods: 35 patients diagnosed with UC and 39 with CD were examined. The control group (CG) consisted of 35 healthy volunteers. Diagnosis of the disease was confirmed by videocolonoscopy and histopathological evaluation of intestinal biopsies. Disease activity of UC was assessed according to the Mayo Scoring System and by the Crohn Disease Activiti Index (CDAI) in CD patients. Among patients with UC 18 (51%) had severe, 14 (40%) moderate and 3 (9%) mild disease. Among patients with CD 7 (18%) was diagnosed with high, 27 (69%) moderate, and 5 (13%) with low activity of the disease. WBC, PLT, serum concentration of TNF-α, IL-6 i IL-10 were determined. Results: The average concentration of TNF-α in UC patients was: 14.3 (IQR=12.6), in CD: 12.6 (IQR=11.9), in the CG: 3.1 (IQR=1.7). The average concentration of IL-6 in UC was: 19.6 (IQR=21), in CD: 10.8 (IQR=7.6), in CG : 3.2 (IQR=1.6). The average concentration of IL-10 in UC was: 14.4 (IQR=5.9), in CD: 10.4 (IQR=9.3), in the CG: 3.3 (IQR=2.5). In the IBD TNF-α, IL-6 and IL-10 concentration was significantly higher than in CG. However, IL-10 was significantly higher in UC than CD. In patients with UC statistically significant positive correlation between the concentration of TNF-α, IL-6 and IL-10 and disease activity was noticed. There were no correlation between TNF-α, IL-6 and IL-10 concentration and CD activity. Conclusion: Determination of TNF-α, IL-6 and IL-10 serum concentration can be used for noninvasive evaluation of inflammation activity in patients with IBD. IL-10 concentration may be helpful in differentiation of UC and CD.

PTTG and Ki-67 expression in pituitary adenomas.

INTRODUCTION: The unpredictable biology of pituitary adenomas makes it a therapeutic challenge. Moreover ,histopathology of pituitary carcinomas and locally invasive adenomas are indistinguishable from benign tumors and a new marker which would enable to differentiate those lesions is vital. The aim of the study was to evaluate Ki-67 and PTTG (pituitary tumour--transforming gene) expression in pituitary adenomas and their applicationas markers of tumour aggressiveness. MATERIAL AND METHODS: A retrospective analysis of 55 patients: 32 females(58%) and 23 males (42%), mean age 50 ± 16 years who underwent pituitary tumor surgery between 2003-2012. Ki-67 and PTTG indices were determined by immunohistochemical staining. Magnetic resonance imaging or computed tomography was performed beforehand and one year after surgery to figure a potential tumour progression, tumour size and correlation to adjacent tissues. RESULTS: The expression of Ki-67and PTTG was revealed in cell nucleiin 88% and 85% of adenomas, respectively. The median Ki-67 and PTTG indices were 1.4 and 1.0, respectively(p = 0.006). In the group with macroadenoma as compared with the group with microadenoma, median Ki-67 index was higher (1.4% vs. 1.03%; p = 0.02). We did not find correlation between both Ki-67 and PTTG indices and tumour progression. Tumours with positive immunostaining towards FSH revealed lower Ki-67 and PTTG indices than the rest with a negative one (0.6% vs.1.84%, p = 0.0004 and 0.67% vs 1.23%,p = 0.047; respectively). However, PTTG index was higher in the group with acromegaly as compared to the group with clinically non-functioning pituitary adenoma (NFPA) (1.28% vs.0.35%; p = 0.02). CONCLUSIONS: Positive nuclear expression of Ki-67 and PTTG was observed in the majority of pituitary adenomas. Only higher Ki-67 expression was related to the tumour invasiveness found on MRI/CT. Tumour progressionwas not related to both Ki-67 and PTTG expression.

TGF-ß1 and granulocyte elastase in the evaluation of activity of inflammatory bowel disease. A pilot study.

INTRODUCTION: The aim was to assess the usefulness of TGF-ß1 and elastase in the evaluation of activity of ulcerative colitis (UC) and Crohn's disease (CD). MATERIAL AND METHODS: 32 patients diagnosed with UC, 31 with CD and 30 healthy volunteers were enrolled in this study. Diagnosis of the disease was confirmed by videocolonoscopy and histopathological evaluation of intestinal biopsies. Disease activity was assessed by use of the Mayo Scoring System for Assessment of Ulcerative Colitis Activity in UC patients and by CDAI in CD patients. hsCRP was determined by the immunonephelometric method, TGF-ß1 and elastase plasma concentration by ELISA. The results of the study were analyzed using Statistica and R statistical language. RESULTS: In UC a positive correlation between disease activity and platelet level, hsCRP and TGF-ß1 concentration was noted. Elastase concentration in UC patients was significantly higher than in CD, but there was no correlation with the activity of the disease. In CD patients we observed a positive correlation between disease activity and leukocytes, platelet levels and elastase concentration, and a very low correlation with hsCRP and TGF-ß1. DISCUSSION: Determination of TGF-ß1 can be used for evaluation of inflammatory activity in UC and it is connected with elevated concentrations of CRP and platelets. To a lower extent TGF-ß1 can also be used for evaluation of inflammatory activity in CD. Examination of elastase concentration may be useful in the assessment of CD activity. Plasma elastase concentration may be helpful in UC and CD differentiation. The preliminary results of this investigation seem promising; nevertheless, more studies are necessary.

[Morphological changes of the colon in patients with irritable bowel syndrome]. / Zmiany morfologiczne jelita grubego u osób z zespolem jelita drazliwego.

INTRODUCTION: Irritable bowel syndrome (IBS) is a common disease belonging to the group of chronic functional gastrointestinal disorders. Variety of symptoms and lack of macroscopic and structural pathologies in colon, make IBS a challenge both in diagnosis and in medication. According to the last reports, the role of chronic minimal inflammation in colon mucosa is becoming more relevant. AIMS: The aim of this study was to verify the microscopic and macroscopic changes in colon mucosa in patients with IBS. METHODS: A retrospective study of microscopic changes and macroscopic lesions in colon, due to endoscopy biopsies in the group of 89 patients diagnosed with IBS in an average age of 47 years. RESULTS: Mild inflammation of colonic mucosa in lamina propria was observed in 92% patients, 34% presented other inflammatory cells. No statistical relationship between macroscopic lesions (in 44% cases) and lymphatic infiltration was observed. CONCLUSIONS: Low grade inflammation of lamina propria in colon was observed among patients with IBS. Beside the edema of the lamina propria, no correlation between macroscopic and microscopic changes was found. Despite the fact that IBS is a functional disorder, in many patients occur morphological changes in colon mucosa. Further studies are necessary.

Non-invasive diagnosis of steatosis, inflammatory changes and liver fibrosis in patients with non-alcoholic fatty liver diseases. Pilot study.

INTRODUCTION: Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of abnormal liver enzymes in adult patients consulted by hepatologists. Due to the high prevalence of this disease, most often associated with obesity, it is necessary to assess the risk of NAFLD, monitoring the progression of the disease and the effectiveness of treatment. MATERIAL AND METHODS: We evaluated the intensity of steatosis, inflammatory activity and fibrosis in 36 patients with NAFLD (fatty liver in abdominal ultrasound examination), using non-invasive tests: SteatoTest, ActiTest and FibroTest. We compared the prevalence of metabolic disorders and hypertension between women and men. RESULTS: There were no significant differences in analysed parameters of metabolic disorders between women and men. In both studied groups, the intensity of steatosis and inflammatory changes was similar. However, in the male group, the intensity of liver fibrosis was higher. CONCLUSIONS: The tests helped to detect advanced liver fibrosis in patients who were diagnosed with liver steatosis in ultrasound examination. Non-invasive diagnostics of liver injury may be useful in screening to select groups of patients requiring liver biopsy, as well as in monitoring the course of the disease and assessment of the treatment effectiveness. Early detection of liver disease may improve the prognosis of these patients.