Biological activity and clinical implications of the matrix metalloproteinases.

The family of human matrix metalloproteinases (MMPs) comprises several tightly regulated classes of proteases. These enzymes and their specific inhibitors play important roles in tumour progression and the metastatic process by facilitating extracellular matrix degradation. As scientific understanding of the MMPs has advanced, therapeutic strategies focusing on blocking these enzymes by matrix metalloproteinase inhibitors have rapidly developed. Low molecular weight tissue inhibitors of matrix metalloproteinase (TIMPs) represent a new therapeutic approach for the treatment of individual types of cancer. This paper aims to briefly summarize current knowledge about the role of MMPs in select non- tumorous lesions, tumor invasion and metastasis. The perspectives in therapeutic intervention in cancer are also mentioned. The role of MMPs in diagnosis and prognosis of colorectal and thyroid cancer is discussed in detail.

[The rectal carcinoma treatment history]. / Historie lécby karcinomu rekta.

The authors demonstrate a history of the rectal carcinoma surgical therapy, based on the available literature data or on oral information. Furthermore, they add their own experience with treatment of the rectal carcinoma, the disorder, which in the Czech Republic and, namely, in the Northern Moravian region, has one of the highest worldwide incidence rates.

[Safe distance of the inferior resection line in the rectal carcinoma surgery]. / Bezpecná vzdálenost dolní resekcní linie pri operaci karcinomu rekta.

The authors present results of a study of a distal intramural spread of the rectal carcinoma beneath its aboral margin, which was conducted over several years. The authors closely cooperated with the Pathological Anatomy Institute of the Faculty Hospital in Ostrava, where each preparation was examined not only macro- and microscopically, but also the tumor's microscopic spread beneath its macroscopic margin was assessed in standard distances of 2 mm, 5 mm, 1 cm, 2 cm and 5 cm. The study did not record tumorous spread at the distance of 5 cm from the aboral margin of the tumor. The authors also confirmed that the distal intramural spread of the tumor is fairly rare and, at the same time, it signifies a highly advanced and aggressive disorder with a poor prognosis. Therefore, the authors favor management with a maximum quantity of the sphincter- saving procedures, with a sufficiently radical mesorectal excision, which they consider the essential method of the radical surgical treatment. Furthermore, the authors have not recorded cases of the differenciated adenocarcinoma spread, even at the distance of 2 mm from the aboral margin of the tumor. All positive findings of the distal intramural spread have been recorded in medium- low differenciated adenocarcinomas.

The highest incidence in the world of rectal cancer is in Czech Republic.

Czech Republic is among the countries with the highest incidence of rectal cancer. The aim of the prospective study was to monitor the surgical treatment of patients with the diagnosis of rectal cancer. Certain aspects were examined: mainly the safety distance of the lower resection line during the operation of rectal cancer, the types of operations carried out, the amount of lymphatic nodes spotted in mesorectum and the possibility of laparoscopic utilization. In our study we focused on patients with rectal cancer who were operated within the three-year period (2000-2002) at the Department of Surgery at University Hospital of Ostrava. During this time there were 188 patients with rectal cancer treated. In the trial we shaved proved that in the direction from aboral margin of tumour the possibility of submucosal spread decreases in accordance with the literature. The submucosal spread of tumour occurs in 11.8% of cases. The spread of the tumour was not found at a distance of 5 cm below the bottom margin of tumour. In cases of microscopical positivity below the bottom margin of tumour there was a middle or low differentiated adenocarcinoma. The spread of well differentiated adenocarcinoma was not found. (Tab. 4, Fig. 5, Ref. 18.)

[Virtual colonoscopy as a part of the algorithm of the facultative examinations prior to the colorectal carcinoma procedure]. / Virtuální kolonoskopie jako souciást algoritmu fakultativních vysetriení pred operací kolorektálního karcinomu.

The authors present their own initial experience with virtual colonoscopy. Both benign and malignant stenosing processes of the colon and rectum, which make examining oral parts of the colon using colonoscopy or irrigography impossible, are the main indication for the procedure described. The authors' first experience with this method is totally positive. The more experienced the examiners, the better interpretation of the findings not only by radiologists but also by operating surgeons. In certain indications, the examination has its firm place in the algorithm of the facultative examinations prior to the colorectal carcinoma surgical procedures.

[Surgical management of advanced stages of rectal carcinomas]. / Chirurgická lécba pokrocilých stadií rektálního karcinomu.

The authors present a summary of literature data and their own experience with management of locally advanced rectal carcinomas. They prefer advanced surgical procedures, such as pelvic exenterations, and urge for preserving "quality of life".

[Inflammatory fibroid polyps of the stomach (case report)]. / Zánetlivý fibroidní polyp zaludku (kazuistika).

Three cases of inflammatory fibroid polyps of the stomach are presented. Immunoreactivity for vimentin, actin, and for hystiocytic markers confirmed the myofibroblastic and hystiocytic origin of the lesions, as research has shown.

Oncocytic papillary carcinoma with lymphoid stroma (Warthin-like tumour) of the thyroid: a distinct entity with favourable prognosis.

AIMS: We report the clinicopathological and immunohistochemical characteristics of 12 cases of a recently recognized entity, oncocytic papillary thyroid carcinoma (PC) with lymphoid stroma (Warthin-like tumour). METHODS AND RESULTS: The cases were retrieved from the surgical pathology files of our departments. There were 11 female patients and one male patient; they ranged in age from 45 to 85 years (mean 64.2 years). The immunohistochemical profile demonstrated positivity of tumour cells for cytokeratins, thyroglobulin, Leu-M1 and anti-mitochondrial antigen. S100 protein-positive stromal dendritic/Langerhans cells were uniformly present. Polymerase chain reaction, in situ hybridization, and immunohistochemistry for Epstein-Barr virus (EBV) detection revealed no significant positive signal. MIB-1 labelling index was low, compatible with that of 'classical' PC. CONCLUSIONS: Warthin-like tumour is a rare variant of PC, occurring predominantly in elderly women. Its histological features are distinct and well recognizable, differentiating this tumour from a more aggressive tall-cell variant of PC. The apparent indolent behaviour seems to be consistent with the presence of dendritic/Langerhans cells and with low proliferative activity. A possible role of EBV in pathogenesis of this lesion was not proven. Further studies are necessary to determine the prognosis and metastatic potential of this neoplasm.

[Simultaneous occurrence of papillary carcinoma, oncocytic carcinoma and malignant lymphoma of the thyroid gland in a female patient with Hashimoto's disease]. / Soucasný výskyt papilárního karcinomu, onkocytárního karcinomu a maligního lymfomu stítné zlázy u pacientky s Hashimotovou strumou.

A 51-year-old woman was admitted for a painless enlargement of the thyroid lasting over 6 months. Hashimoto's thyreoiditis was diagnosed and three tumors were found: oncocytic carcinoma, malignant lymphoma and papillary carcinoma. In the right lobe, oncocytic carcinoma and high grade malignant lymphoma composed of cells with irregular, lobulated nuclei were found. The lymphoma was confined to the thyroid gland. The oncocytic carcinoma invaded the capsule and the surrounding tissues. In the left lobe, there was a papillary carcinoma.