[Ectopic pancreas mimicking advanced gastric malignancy--case report]. / Trzustka ektopowa imitujaca zaawansowany nowotwór zoladka--opis przypadku.

Ectopic pancreas is the most common type of ectopic tissue in gastrointestinal tract. It is typically asymptomatic, presenting as a small submucosal lesion in prepyloric region of stomach. The diagnosis is usually incidental, during gastroscopy. The patient with symptomatic heterotropic pancreas, mimicking gastric malignancy was described.

[Serum anti-p53 antibodies in gastric cancer patients]. / Przeciwciala przeciwko bialku p53 u chorych na raka zoladka.

UNLABELLED: Mutation of the p53 gene belongs to the most common genetic alteration in human cancer. Prognostic significance of serum anti-p53 antibodies in patients with gastric cancer is still a matter of controversy. The aim of the study was to estimate the presence of anti-p53 antibodies in serum of gastric cancer patients and relationship between anti-p53 antibodies and chosen clinical and pathomorphological data age, sex, localization of cancer, histology, stage of disease, metastases to lymph nodes and the time of survival. MATERIAL AND METHOD: Serum samples from 71 patients with gastric cancer were analyzed by specific enzyme-linked immunosorbent assay (ELISA) to determine the presence of serum anti-p53 antibodies. The results were statistically compared with clinical and pathological features and postoperative survival. RESULTS: Anti-p53 antibodies were detected in 16 (23%) gastric cancer patients. The presence of p53 antibodies was connected with intestinal tumor type (p < 0.05) and older age (p = 0.0035). There were no association between anti-p53 antibodies, stage and the time of survival. CONCLUSION: These results suggest that in gastric cancer patients serum anti-p53 antibodies detected by ELISA are not predictor of prognosis.

[Acceptance of screening colonoscopy in the prevention of colorectal cancer in relation to some demographic factors]. / Akceptowalnosc przesiewowych badan kolonoskopowych w profilaktyce raka jelita grubego w zaleznosci od niektórych czynników demograficznych.

UNLABELLED: Colorectal cancer is a quite common neoplasm. Screening colonoscopies and polypectomies can decrease the incidence of that neoplasm by 75%. Discovering the most frequent reasons and most convincing sources of information about the examinations is important for success of screening programme. OBJECTIVES: The aim of this study was to find the connection between some demographic factors, the source of information about the examination and the consent for colonoscopy. MATERIAL AND METHODS: Two groups of subjects, aged 40-65, were included: 1000 subjects, who gave their consent for colonoscopy and 200 subjects, who refused the examination. The sources of information were two kinds of questionnaires: fulfilled before colonoscopy and in case of lack of consent for the examination, which included demographic data, the reason of undergoing or refusal of colonoscopy and the source of information about the examination. RESULTS: The higher educated were the subjects, the more often they agreed for the examination; among subjects after university 87%, and among subjects with elementary education 71% gave their consent for colonoscopy. The most convincing sources of information were the medial sources; 100% of subjects, who found out about the examination from television and radio, gave their consent for colonoscopy. The most frequent reason of undergoing the examination was prophylaxis (54.6%), and the most frequent reasons of refusal was fear of pain (33.5%). CONCLUSIONS: Educational level and the source of information about the examination are the factors that have an important influence on undergoing screening colonoscopy. Identifying the influence of some demographic factors on the consent for colonoscopy and the efficacy of each source of information seems to be very important for the success of screening colonoscopy programme and therefore for discovering adenomatous polyps and colorectal cancer.

[p53 protein in primary gastric carcinoma and coexisting metastases]. / Bialko p53 w pierwotnym raku zoladka i wspólistniejacych przerzutach.

AIM: The expression of p53 protein was compared in primary gastric carcinomas and coexisting regional and distant metastases. The purpose of the study was to evaluate whether p53 staining in regional lymph-node metastases might improve the value of p53 as a prognostic marker and determine the behaviour of its protein during gastric cancer progression. MATERIAL AND METHODS: 60 gastric cancer patients were included into the study. In all patients the expression of p53 was assessed in primary tumours and in regional lymph-node metastases. Additionally in 12 patients the p53 expression was determinated in distant metastases. The number of all secondary tumours studied was 153. Formalin fixed, paraffin embedded material and three-stage immunohistochemical methods were used. RESULTS: p53 accumulation was detected in 24 (40%) of primary gastric carcinomas. In each patient p53 expression in primary regional and distant metastatic tumours was identical. CONCLUSIONS: Our results show that assessment of p53 in lymphnode metastases does not improve prognostic value of p53 in gastric carcinoma and support the view that p53 alterations occur before and maintain during metastatic spread.

[Nutritional status of patients in hospitals in Poland. More thorough assessment of nutritional status of adult patients]. / Stan odzywienia pacjentów w szpitalach w Polsce. II. Poglebiona ocena stanu odzywienia pacjentów doroslych.

The purpose of the study was a more thorough assessment of the nutrition state of patients admitted to hospitals in Poland. The study was carried out in four hospitals at teaching centre level, in four hospitals at province level, and in four county hospitals. The patients for the study were selected randomly from 3310 adult patients (every 10th patient admitted to these hospitals). For the study 210 patients (122 women and 88 men) were qualified. Their mean age was 54 +/- 16 years (range 15-82 years). The patients were subjected to various biochemical tests including determination of antioxidant vitamins (vitamins A, E and C), vitamin B12, folic acid, ferritin, and homocysteine and blood lipids. Vitamin deficiency accepted as vitamin malnutrition was found in the case of vitamin C in 51.8% of the patients, folic acid in 32%, vitamin E in 10%, vitamin B12 in 6.8%, vitamin A in 1.4%. Vitamin deficiency was equally frequent in patients with malnutrition, overweight or with obesity. Lipid profile disturbances were found in 51% and high homocysteine level in 63% of the studied patients.

The risk of gastric cancer in carriers of CHEK2 mutations.

CHEK2 is a tumor suppressor gene whose functions are central to the induction of cell cycle arrest and apoptosis following DNA damage. Mutations in CHEK2 have been associated with cancers at many sites, including breast and prostate cancers, but the relationship between CHEK2 and gastric cancer has not been extensively studied. In Poland, there are four known founder alleles of CHEK2; three alleles are protein truncating (1100delC, IVS2G>A, del5395) and the other is a missense variant (I157T). We examined the frequencies of four Polish founder mutations in the CHEK2 gene in 658 unselected gastric cancer patients, in 154 familial gastric cancer patients and in 8,302 controls. A CHEK2 mutation was seen in 57 of 658 (8.7 %) unselected patients with gastric cancer compared to 480 of 8,302 (5.8 %) controls (OR 1.6, p = 0.004). A CHEK2 mutation was present in 19 of 154 (12.3 %) familial cases (OR = 2.3, p = 0.001). The odds ratio for early onset (<50 years) gastric cancer was higher (2.1, p = 0.01), than for cases diagnosed at age of 50 or above (OR 1.4, p = 0.05). Truncating mutations of CHEK2 were associated with higher risk (OR = 2.1, p = 0.02) than the missense mutation I157T (OR = 1.4, p = 0.04). CHEK2 mutations predispose to gastric cancer, in particular to young-onset cases.

[Endoscopic septotomy treatment of Zenker's diverticulum]. / Terapia uchylka Zenkera metoda septotomii endoskopowej.

UNLABELLED: The Zenker's diverticulum is the pathology of pharyngo-esophageal region with its neck proximal to the cricopharyngeal muscle. The Zenker's diverticulum is the rare finding in upper endoscopy, but choice of treatment may bring some problems. Nowadays, the flexible endoscopy has been in focus of interest for treatment of Zenker's diverticulum. METHODS: Our first experience in management of Zenker's diverticulum include 40 patients, age 67-82 years old. All patients had symptoms such as dysphagia, aspiration pneumonia or sputum at night. The procedure consist of endoscopic incision of septum between esophageal lumen and diverticulum using argon beamer until its high was less than 0.5 cm. RESULTS: all patients became free of symptoms. Each patient complained of sore throat after treatment. No serious complications were observed. Only one case of retropharyngeal space emphysema and two cases of perforation were observed, both of them were treated with antybiotics and nasogastric tube feeding. CONCLUSION: It seems that this method is save and efficacious for treatment of Zenker's diverticulum.

The association between the interleukin-1 polymorphisms and gastric cancer risk depends on the family history of gastric carcinoma in the study population.

OBJECTIVES: The association between interleukin-1 polymorphisms, H. pylori and increased gastric cancer risk remains controversial. AIMS: To compare the prevalence of these polymorphisms in individuals with two mutually exclusive diseases connected with infection, gastric cancer, and duodenal ulcer. METHODS: 121 gastric cancer and 119 duodenal ulcer patients. Genomic DNA was typed for polymorphisms at position -511, -31 in the interleukin-1beta gene (IL-1 beta) using primer extension and mass-spectrometry. Analysis of the variable number of tandem repeats in intron 2, in its receptor antagonist gene (IL-1RN) was performed by PCR and agarose gel electrophoresis. RESULTS: All subjects were successfully genotyped for the three gene loci. IL-1 beta-511 was found to be in reverse linkage disequilibrium with IL-1 beta-31. The differences between gastric cancer and duodenal ulcer patients concerned only heterozygous variant of IL-1beta and were related to family history of gastric cancer, tumor stage, histology, site. Thus, CT carriers were found to have a higher risk of sporadic [OR 2.21 (95% CI, 1.22-3.99)], early [OR 2.81 (95% CI, 1.14-6.93)], diffuse [OR 2.48, (95% CI 1.21-5.09)] or non-cardia gastric cancer [OR 1.88 (95% CI 1.06-3.33)]. Furthermore, CT genotype was significantly more prevalent in gastric cancer patients with negative than in those with a positive family history (p = 0.039). CONCLUSIONS: The association between the interleukin-1 polymorphisms and gastric cancer risk depends on the family history of gastric carcinoma in the study population. This phenomenon may be in part responsible for differences in results of interleukin-1 studies performed on populations with low and high gastric cancer prevalence.

[Colorectal cancer in twins. Report of two cases]. / Rak jelita grubego u blizniat. Opis przypadku.

Colorectal cancer is one of the most common neoplasms that often occurs in several members of family. In this communication we present the case of synchronous colorectal cancers with similar localization and similar clinical course in monozygotic twins.

Nuclear pedigree criteria for the identification of individuals suspected to be at risk of an inherited predisposition to gastric cancer.

Gastric cancer is the second most frequently diagnosed malignancy worldwide and therefore represents a significant healthcare burden. Environmental and genetic factors are involved in the development of gastric cancer. To date only one clear genetic predisposition has been identified involving mutations in the E-cadherin gene. The disease phenotype in patients harbouring E-cadherin mutations appears to be specifically related to diffuse gastric cancer. Little is known genetically about the other forms of gastric cancer. Since there is a growing awareness about the necessity of early intervention criteria have been developed that aid the identification of hereditary forms of gastric cancer. The aim of the current study was to identify minimal inclusion criteria so that nuclear pedigree families can be provided with risk assessment and/or genetic testing.The results reveal that inclusion features described herein such as (a) gastric cancer diagnosed before 46 years of age; (b) two gastric cancers among first degree relatives diagnosed over the age of 50 are useful in identifying suspected hereditary gastric cancer patients.

Progastrin and cyclooxygenase-2 in colorectal cancer.

Colorectal cancers (CRCs) are one of the most common forms of cancer in Poland and one of the leading causes of death. The tumors have been attributed to genetic, dietary, and other environmental factors, but recently growth factors such as gastrin have also been implicated in the carcinogenesis. The relationship between plasma amidated and nonamidated gastrin in CRCs is controversial. This study was designed (1) to determine the plasma levels of progastrin and amidated gastrin in 50 CRC patients before and 3-6 months after removal of the tumor, (2) to determine the tumor concentrations of these gastrin peptides and the level of expression for gastrin mRNA and gastrin/CCK(B) receptor mRNA, (3) to examine the expression of cyclooxygenase COX-1 and COX-2 mRNA in CRC tissue, and (4) to compare the prevalence of Hp and its cytotoxic protein, CagA, and cytokines (TNFalpha, IL-1beta, and IL-8) in CRCs, before and after removal of tumor. It was found that the CRC, its resection margin, and the plasma contained severalfold higher levels of progastrin than of amidated gastrins and that the removal of the CRC tumor resulted in a marked reduction in plasma progastrin level without a significant alteration in plasma levels of amidated gastrins. Both gastrin and CCK(B)-R mRNA were detected in the cancer tissue and resection margin by RT-PCR, and similarly, COX-1 and COX-2 mRNA were expressed in these tissues of most CRCs. The seroprevalence of Hp, especially that expressing CagA, and levels of IL-1beta, but not other cytokines, were significantly higher in CRC patients than in 100 age-, gender-, and profession-matched controls and did not change significantly about 3-6 months after tumor resection. We conclude that (1) the CRC and its margin contain large amounts of progastrin and show gene expression of gastrin, CCK(B)-R, and COX-2; (2) removal of the CRC markedly reduces the plasma concentrations of progastrin; (3) the Hp infection rate is higher in CRC, and this may contribute to colorectal cancerogenesis via enhancement of progastrin and gastrin release; and (4) plasma progastrin concentrations might serve as a biomarker of CRC.