HER-2/neu and E-cadherin expression and microsatellite instability in gastric dysplasia

Gastric dysplasia [GD] is a precursor lesion of gastric adeno-microsatellite instability [MSI] and the diffuse type is associated with down regulation of E-cadherin. HER-2/neu is over-expressed in some cases of gastric cancer. In this study, MSI and expression rates of HER-2/neu and E-cadherin in GD were evaluated. Paraffin blocks of 21 cases of low grade dysplasia [LD], 11 cases of high grade dysplasia [HD] and 25 cases of indefinite for dysplasia [ID] were collected. After deparaffinization and antigen retrieval, the sections were incubated with antibodies against E-cadherin, hMLH1, hMSH2 and HER-2/neu. The streptavidin-biotin complex method was used followed by peroxidase enzyme development with diaminobenzidine. HER-2/neu was positive in six cases of HD [50%], four LD [21%] and two ID [9%]. E-cadherin was absent in two cases of LD and showed normal expression in all HD and ID cases. hMLH1 expression was absent or markedly decreased only in the zones of dysplasia in HD [3/11], LD [3/21] and Id [4/25]. Absence or diminished expression of hMSH2 was seen in HD [3/11], LD [2/21] and ID [3/25] cases. HER-2/neu expression showed close association with diminished expression of hMLH1 or hMSH2 [p<0.05]. Stepwise increase in the expression rate of HER-2/neu was seen in ID, LD and HD cases implying its role in cancer evolution. The absence of hMLH1 and hMSH2 in GD may predispose individuals to over-expression of other oncogenes such as HER-2/neu. Abnormal of E-cadherin is not frequent finding in GD

Changing epidemiology of esophageal cancer in Fars province, Iran

Esophageal carcinoma is one of the most lethal gastrointestinal [GI] malignant tumors worldwide. The disease is known to have a high incidence in northern Iran; however, its condition in the South is not much clear. In this retrospective study we investigated the epidemiology and time trends of esophageal carcinoma in Fars Province, South of Iran. In a retrospective study, we reviewed pathologic reports of all laboratories in Fars Province, South of Iran, from March 1997 to March 1999 to find cases of esophageal carcinoma. Annual and average incidence in different age groups were calculated for both sexes, based on four censuses results. Esophageal carcinoma was the third most common GI cancer in Fars, with an average incidence of 2.95 per 100,000 in the population older than 15 years. The incidence of esophageal carcinoma was found to drop by 64% during the study period. This was mainly due to the decreased incidence of squamous cell carcinoma. Females developed squamous cell carcinoma in relatively younger age as compared to males. Our region in the South of Iran is one of the low incidence areas of esophageal carcinoma as compared to that of northern borders of the country and other parts of the world with some special features

Irritable bowel syndrome: clinical manifesrtations and relation to lactase deficiency

Eight hundred and four medical students, selected by multistage random sampling, filled a questionnaire, adapted from Manning's criteria for irritable bowel syndrome [IBS]. More than 16% of students were found to fulfil the criteria for IBS. H2 breath test, both fasting and after ingestion of 50 gm lactose, was performed on the 64 students with, and 115 without IBS. There was a statistically significant correlation between the prevalence of IBS and age [p<0.001], while no correlation was found with sex, or marital status. Food intolerance, history of acid peptic disease, and symptoms of dyspepsia were more frequent in students with IBS [p<0.001]. Twenty-five% of the students with IBS had nocturnal symptoms. Lactose intolerance was present in 8% of the study group, with no correlation with IBS. It is concluded that IBS is a common gastrointestinal disorder in Iran and some features are probably different from those described in other geographic regions