RESUMEN
BACKGROUND: MAGE genes encode for tumor-rejection antigens and are expressed in tumors of different histologic types but not in normal tissues, with the exception of testis and placenta. The aim of this study was to evaluate the frequency of MAGE-1 and -2 expression in gastric and in cardial carcinomas; these conditions have been described as two distinct diseases, having different etiologies, epidemiologic patterns, and gene mutations. METHODS: Two groups of patients were studied: patients with distal gastric carcinoma and patients with carcinoma of the cardia. A group of patients with intestinal metaplasia in the gastric mucosa and controls were also included. All of them underwent upper GI endoscopy. Paired biopsy specimens were taken for routine histology and for RNA extraction, to study the expression of MAGE-1 and -2 genes. RESULTS: None of the intestinal metaplastic samples or controls expressed MAGE-1 and -2 at detectable levels. Whereas 40% of the gastric cancer patients expressed either MAGE-1 or -2, 26.6% transcribed both. In the cardial cancer group, 20% of the cases expressed at least one MAGE, and only 6.6% expressed both genes. These results might reinforce the concept that cancer of the cardia is a distinct neoplastic disease with regard to esophageal and gastric (distal) carcinomas. CONCLUSIONS: Here we show that MAGE gene expression occurs in advanced stages of gastric and cardial cancer and therefore appears to be a late event. This might point to a reconsideration of their potential role in cancer immunotherapy.
Asunto(s)
Antígenos de Neoplasias/genética , Cardias , Regulación Neoplásica de la Expresión Génica , Proteínas de Neoplasias/genética , Neoplasias Gástricas/genética , Adulto , Anciano , Anciano de 80 o más Años , Vacunas contra el Cáncer , Femenino , Humanos , Intestino Delgado/patología , Masculino , Antígenos Específicos del Melanoma , Metaplasia , Persona de Mediana Edad , Datos de Secuencia Molecular , Reacción en Cadena de la PolimerasaRESUMEN
We analyze the cell kinetics of colorectal adenomas by tritiated thymidine (3HTdR) autoradiographic method and anti-proliferating cell nuclear antigen (PCNA) antibodies. A total of 46 patients who underwent prior endoscopic polypectomy for colorectal adenomas were reevaluated by colonoscopy for 4 years. Thymidine labeling index (T-LI) in index adenomas ranged from 1.40 to 38.0% (median value: 10. 75%); PCNA labeling index (PCNA-LI) in index adenomas ranged from 0 to 27.0% (median value: 1.95%). Among the 46 patients studied, 16 developed recurrent adenomas (Group A) and 30 were free of recurrent adenomas (Group B). The T-LI and PCNA-LI comparisons between Groups A and B were statistically significant (p < 0.0001, chi2 test). These results demonstrate that T-LI and PCNA-LI in colorectal adenomas might be helpful to predict the development of metachronous adenomas and hence to plan the follow-up of patients with adenomatous polyps after polypectomy.
Asunto(s)
Pólipos Adenomatosos/patología , Neoplasias Colorrectales/patología , Antígeno Nuclear de Célula en Proliferación , Timidina , Pólipos Adenomatosos/inmunología , Pólipos Adenomatosos/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Autorradiografía , División Celular , Colonoscopía , Neoplasias Colorrectales/inmunología , Neoplasias Colorrectales/cirugía , Endoscopía , Femenino , Humanos , Técnicas para Inmunoenzimas , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Pronóstico , Antígeno Nuclear de Célula en Proliferación/inmunologíaRESUMEN
BACKGROUND: The role of growth factors/receptors in the etiopathology and/or development of gastric cancer has recently come under scrutiny, since overexpression or amplification of the EGF system has been found in many intestinal type gastric cancers and related to a more aggressive behavior. Since these gastric carcinomas appear to develop from intestinal metaplasia, a study was planned to investigate whether overexpression of the EGF-receptor gene also occurred in intestinal metaplastic mucosa. METHODS: Patients underwent upper GL endoscopy. Gastric biopsies for routine histology, Helicobacter pylori detection, quantification of intestinal metaplasia and EGF-R expression analysis were performed. A 30mer EGF-R specific oligonucleotide was end-labeled and used to probe a dot blot filter containing the RNA from the bioptic samples. RESULTS: Though all the gastric samples transcribed the EGF-R gene to a detectable level, overexpression of the EGF-R gene was found in the metaplastic mucosa in a minority of patients. CONCLUSIONS: These preliminary findings suggest that overexpression of the EGF-R gene is infrequent in the metaplastic gastric mucosa.
Asunto(s)
Receptores ErbB/biosíntesis , Receptores ErbB/genética , Mucosa Gástrica/metabolismo , Expresión Génica , Mucosa Intestinal/metabolismo , ARN/análisis , Anciano , Biopsia , Northern Blotting , Enfermedad Crónica , Femenino , Mucosa Gástrica/patología , Gastritis/complicaciones , Gastritis/patología , Gastroscopía , Humanos , Intestinos/patología , Masculino , Metaplasia/complicaciones , Metaplasia/metabolismo , Metaplasia/patología , Persona de Mediana Edad , Sondas de Oligonucleótidos/químicaRESUMEN
The endoscopic management of four selected patients with inveterate esophageal perforations or leaks is presented. One patient had a perforation of the cervical esophagus following endoscopic removal of a foreign body already treated with surgical drainage; two patients had a leak following diverticulectomy and esophagogastrostomy, respectively, persistent after multiple surgical repairs; the last patient had a spontaneous perforation of the thoracic esophagus persistent after two transthoracic repairs. The mean time elapsed between the diagnosis of perforation and the endoscopic treatment was 19 days. In one patient, transesophageal drainage of a mediastinal abscess was performed. In the other three patients, a stent was placed to seal the leak in combination with gastric and esophageal aspiration. Two of these patients underwent endoscopy in critical condition and could have not been candidates for major surgical procedures. All patients received enteral nutrition. No morbidity or mortality related to the endoscopic procedure was recorded; the treatment was effective in all patients who recovered and resumed oral feeding within 3 weeks. We conclude that endoscopic transesophageal drainage and stenting are effective procedures in the management of patients with inveterate esophageal perforations or leaks.
Asunto(s)
Endoscopía , Perforación del Esófago/cirugía , Anciano , Drenaje , Endoscopía/métodos , Nutrición Enteral , Perforación del Esófago/etiología , Esofagoscopía , Femenino , Gastrostomía , Humanos , Masculino , Persona de Mediana Edad , StentsRESUMEN
The use of inflatable intragastric balloons is a new non-intensive approach in the treatment of obesity when poor results are obtained by more conservative treatment. The intragastric balloons are certainly less hazardous than bariatric surgery but their long term effect on body-weight reduction it is not still proved. Several types of balloons are currently in use. The two used most widely are the Garren-Edwards Gastric Bubble and the Ballobes Balloon. The Authors report their experience with these two types of anti-obesity gastric-balloon in 60 grossly obese patients.