Expression of immunohistochemical markers of progression in pre-cancerous and cancerous human colon: correlation with serum vitamin D levels.

BACKGROUND/AIM: We aimed to evaluate vitamin D levels in blood, as well as the immunohistological expression of ß-catenin, p21 activated kinase (PAK1), p53 and Ki67 in relation to histological type and grading of colonic tumors. RESULTS were compared to the expression in normal and adenomatous colon. MATERIALS AND METHODS: We analyzed colorectal specimens from 20 patients with colorectal tumors for expression of ß-catenin, PAK1, p53 and Ki67. Associations between the expression of these markers and levels of vitamin D in serum were analyzed. RESULTS: The average 25-hydroxy-vitamin D (25OHD) level in a healthy population was 20.53 ng/ml, while that in patients with colorectal cancer was 5.99 ng/ml. The average vitamin D level in patients with positive nuclear ß-catenin was 4.58 ng/ml, which was lower than that of patients with negative nuclear ß-catenin expression. Patients with positive nuclear PAK1 also had low vitamin D levels in their blood (4.51 ng/ml). Patients with positive nuclear p53 had significantly lower vitamin D levels (4.18 ng/ml), compared to patients without nuclear p53 expression. In patients with Ki67 expression in at least 50% of cells, the average vitamin D level was 6.27 ng/ml, while in patients with Ki67 staining in fewer than 50% of cells, the average vitamin D levels in serum was double (13.42 ng/ml).

The influence of the type of ulcers in the degree of atrophic gastritis.

PURPOSE: Chronic Gastritis is the most common manifestation of infection with Helicobacter pylori. Changes in the gastric mucosa have tendency to progress towards mucosal atrophy, most likely in patients with gastric ulcer. We have explored the frequency of the presence of atrophic gastritis in patients with gastric and duodenal ulcers. MATERIAL AND METHOD: We included 175 patients in a prospective study, 119 of whom were patients with duodenal ulcer and 56 suffered from gastric ulcer. The mean age of the patients with duodenal ulcer was 42.27 years, while patients with gastric ulcer had a mean age of 51.87 years. Biopsy was done on all patients with gastric and duodenal ulcer for histopathological examination, in order to confirm the presence of atrophic gastritis. All examined patients were positive for H. Pylori status. RESULTS: The presence of gastritis by type of ulcer, duodenal or gastric, was as follows: type without atrophy 20% and 0%, mild atrophy 61% and 14% and severe atrophy 22% and 86%, respectively. CONCLUSIONS: In patients with duodenal ulcers more often occurs mild atrophic gastritis (p < 0001). In the patients with gastric ulcers most often occur alterations with more pronounced gastric atrophy (p < 0.01).

Effectiveness of proton pump inhibitors in the treatment of patients with endoscopic esophagitis.

Gastroesophageal reflux disease (GERD) is a common disorder, typically diagnosed by a history of chronic heartburn. Proton pump inhibitors (PPIs) eliminate symptoms and heal esophagitis more frequently and more rapidly than other agents. The aims of this study were to evaluate the effectiveness of proton pump inhibitors (PPIs) in terms of symptom resolution and endoscopic healing in patients with erosive reflux disease. In this prospective study we included 380 patients with positive history for the main symptoms of erosive reflux disease. Symptoms were evaluated before and after treatment with PPI on the period of three months and were recorded with heartburn system score and regurgitation score. All patients were classified according to Los Angeles classification for erosive reflux disease, before and after the three months treatment with PPI and were conducted for their healing of erosive oesophagitis in the finish of the treatment. Before the treatment, 95% of patients were with heartburn, 90% with regurgitation and 70% with epigastric pain. Quantification for pyrosis and regurgitation were obtained in each patient. After treatment of these patients with PPIs, resolution for pyrosis was from 95% to 25%, for regurgitation from 90% to 20% and for epigastric pain from 70% to 10%. In 71.67% of patients was found complete healing of erosive oesophagitis and minimal progression in 1.05% of patients. Results of this study showed that PPI treatment of patients with erosive reflux disease can influence on very good symptomatic and mucosal resolution after three months. Epigastric pain was shown not to bee specific for erosive reflux disease.