[The determination of tissue CEA in colorectal adenocarcinomas: an immunohistochemical study]. / Determinación del CEA tisular en adenocarcinomas colorrectales: un estudio inmunohistoquímico.

We carried out a CEA immunohistochemical study on 80 colorectal carcinomas, using the PAP methodology. Also we studied peritumoral "normal" mucosa on 69 cases. All tumoral (80/80) and the major part of normal colonic mucosa (68/69) cases stained positively. We present our experience with this immunohistochemical staining using a qualitative semi-quantitative evaluation, as an easy and reliable procedure. This permits to obtain, by immunostaining, a better homogeneous group of tumours (Apical, Mixed and Cytoplasmic, or Weak and Strong), necessary to further correlation with various tumoral parameters. On the basis of this evaluation, we found: A staining of weak intensity (65/68) of Apical type (55/68) in the vast majority of the normal, peritumoral mucosa. In tumors we found a prevalence of strong intensity (67/80), in relation to its major content of CEA. With respect to the type of immunostaining, although Apical staining (32/80) exists the Cytoplasmic (34/80) is predominant together with the Mixed type (14/80). This is expression of the alterations in secretion and distribution of the tissue CEA. We analyze the difficulties of such classification caused by the tumoral heterogeneity and we include other data whose significance is not always clear.

[A correlation between serum levels of preoperative CEA and CEA immunohistochemical staining in colorectal carcinoma]. / Correlación entre niveles séricos de CEA preoperatorios y tinción inmunohistoquímica del CEA en el carcinoma colorrectal.

We analyzed the distribution of tissue CEA in 80 colorectal adenocarcinomas with the PAP immunohistochemical technique. We used a qualitative method with a double grading criterion--topography and intensity of staining--as well as a semiquantitative method in the immunostaining interpretation. We applied a pattern of immunostaining: apical, cytoplasmic or mixed, to each tumor. Likewise, we obtained the pre-operatory serum levels of CEA. The normal value in our laboratory is less than 10 ng/ml. We correlated the immunostaining pattern with the serum levels of CEA, obtaining a global statistical significant correlation (p < 0.01), as well as apical versus cytoplasmic correlation (p = 0,0,3). The apical staining pattern agreed with this CEA levels < 10 ng/ml, whereas the cytoplasmic staining was associated with high frequency with CEA levels > 10 ng/ml. In conclusion the immunohistochemical staining for tissular CEA permits to improve the prognostic efficiency of serum CEA levels.

[Angiodysplasia of the colon and Crohn's disease. A study with vascular resin casts]. / Angiodisplasia de colon y enfermedad de Crohn. Estudio con moldes vasculares de resina.

All the previous studies which have associated arteriovenous malformations of the colon with chronic inflammatory disease have always been performed on a diseased intestine. This study, which uses the intravascular injection of resin, shows morphological evidence that angiodysplasia of the colon and intestinal inflammatory disease can coexist independently. This fact suggests that in cases of severe hemorrhage in a patient with inflammatory disease of the small intestine, it cannot simply be assumed that it originates in the macroscopically abnormal intestine, and that angiographic examination is a wise measure to rule out the possibility of arteriovenous malformations in the "normal" intestine.

[Surgical treatment of Zenker's diverticulum. Apropos of 14 cases]. / Tratamiento quirúrgico del divertículo de Zenker. A propósito de 14 casos.

We present our experience in the surgical treatment of 14 cases of Zenker's diverticulum, diagnosed from January, 1969 to December, 1988. In 11 cases we performed one stage diverticulectomy; in 4 cases, manometric findings required cricopharyngeal myotomy. In 3 cases surgical treatment was not indicated; 2 patients had liver cirrhosis and high surgical risk and the third patient declined the treatment. Current treatment is discussed.

[Presentation of 6 cases of cystadenocarcinoma of the pancreas]. / Aportación de seis casos de cistoadenocarcinomas de páncreas.

Cystadenocarcinomas represent approximately 1% of the pancreatic tumors and are difficult to diagnose clinically and by pathology. Due to their rarity, published series are small. We present 6 cases of pancreatic cystadenocarcinoma collected over a period of 15 years at the Visceral Surgery Service of the Valencia University Hospital. The better evolution and prognosis of these tumors in comparison with pancreatic adenocarcinomas is noteworthy.

[Peptic stenoses of the esophagus]. / Estenosis pépticas del esófago.

The authors present a series of 32 cases of reflux peptic strictures of the esophagus. The mean age of the patients is 54 years, with a 3/1 predominance of males. The etiologic antecedent was hiatal hernia in every case, with a clinical time of evolution of 29 months, dysphagia being the most frequent symptom (100%). Complementary diagnosis was based fundamentally on endoscopy and barium transit, explorations that also allow exclusion of other pathologies. All the patients underwent medical treatment, this being the only treatment in 4 cases. The other 28 cases were treated surgically. The technique used was, in the cases in which the esophagus could be dilated, dilatation associated with an antireflux technique, and when not dilatable, resection with reconstruction using stomach (Sweet) or colonoplasty. The global mortality was two patients (5.2%). Patients were followed-up for a minimum of 2 years and the global results have been good, with recurrence in 3 cases (7.7%). Postoperative dysphagia appeared in 17 cases (44.7%), in all of the transitory.