Clinical usefulness of K-RAS mutation detection in colorectal cancer and in surgical margins of the colon.

The incidence of K-RAS gene mutations in tumour and surgical margins was investigated in 63 patients with adenocarcinomas of varied clinical stage and histological grade. Point mutations of codon 12 K-RAS gene were detected, using the PCR-RFPL technique in cancer tissue in 23 patients (36.5%) and in colon margin mucosa in 1 patient (3.7%), out of 27 examined subjects. No significant correlations were found between the mutations and clinical features. Tumours, located in the left colon, and mucinous neoplasms displayed a higher incidence of mutations. No correlation was observed with either Dukes or TMN clinical advancement.

Granulocyte-macrophage-colony stimulating factor in patients with colorectal cancer.

Granulocyte-macrophage-colony stimulating factor (GM-CSF) belongs to the group of glycoproteins called colony-stimulating factors (CSFs). It has been shown that the activity of CSFs is not limited to the hematopoietic cells but can also affect the proliferation of colon carcinoma cell lines. The purpose of this investigation was to compare the serum level of GM-CSF in colorectal cancer patients to a control group, to assess the level of GM-CSF in relation to the level of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9), and to define the sensitivity, the specificity and the predictive values of GM-CSF in colorectal cancer. In this study, the serum level of tumour markers was measured in 30 patients with colorectal cancer and in 20 healthy subjects. GM-CSF was assayed using ELISA system, CEA and CA 19-9 were measured by MEIA. The serum levels of CEA, CA 19-9 and GM-CSF were higher in the patients with colorectal cancer than in the control group. The sensitivities of CEA (63%) and CA 19-9 (56%) were lower than the GM-CSF sensitivity (80%). The specificities of tumour markers were 70% (CEA, GM-CSF) and 75% for CA 19-9. The GM-CSF predictive v values were higher than the CEA and CA 19-9 values. These results suggest that GM-CSF may be useful as tumour marker in colorectal cancer, but further studies are needed.

[Clinical-morphologic evaluation of treatment results for rectal cancer using Dixon's method]. / Kliniczno-morfologiczna ocena wyników leczenia raka odbytnicy metoda Dixona.

69 patients with rectal cancer were operated in years 1987-1996. Anastomosis was performed using stapler in 35 patients or hand suture in 34 patients. The authors analysed influence of the anastomosis technique and additional treatment on early and long-term postoperative results.

Surgical treatment of prolapse of the rectum--evaluation of distant results.

In the years 1972-1995 41 patients suffering from prolapse of the rectum were operated according to the Moore method. The method is based on the observations which suggest that the cause of prolapse is intestinal intussusception which can be prevented by translocating the anus under the pubic joint. The observation time is from 1 to 23 years. Two patients were reoperated; one-as a result of a recurrence of rectal prolapse and one due to a post-operative adhesive ileus. One patient died as result of peritonitis following an overlooked microperforation in the rectal wall. In the case of the remaining patients, the treatment was fully successful. Regular defecation cycle as well as incontination of stool and flatus returned and the anal sphincters almost fully regained their tension in comparison to the pre-operative state. Early and distant results of surgery of prolapse of the rectum are satisfactory.

Study of lithogenicity of bile among patients suffering from cholecystolithiasis and among patients not suffering from this disease.

On the basis of biochemical and morphological research, the authors decided to attempt to determine the degree of lithogenicity of the bile among patients suffering from cholecystolithiasis (100 patients) and those not suffering from this disease (31 patients). Having analyzed the obtained data, it can be concluded that the degree of lithogenicity of bile is influenced by the concentration of cholesterol, bile acids and phospholipids as well as the damage of the liver and of the wall of the gallbladder as well as its kinetics. Lithogenic bile was noticed in 84% of the patients of group I and in 54% in group II. However, the degree of lithogenicity was significantly higher in patients suffering from cholecystolithiasis. According to the authors, the degree of lithogenicity is the deciding factor in the creation of bile stones.

[Value of laparoscopy in the diagnosis of liver cirrhosis and chronic hepatitis]. / Wartosc laparoskopii w diagnostyce marskoscii przewleklego zapalenia watroby.

The purpose of the study was evaluation of laparoscopy in the diagnosis of cirrhosis and chronic hepatitis. The studied material comprised 197 cases of cholestasis in which for diagnostic-prognostic purposes laparoscopy was done. During visual observation of the abdominal cavity in 81 cases cirrhosis and in 25 chronic hepatitis was diagnosed. The reliability of the laparoscopic diagnosis was verified by the microscopic verification of the material obtained by guided biopsy of the liver or during operation. Among 81 cases of cirrhosis diagnosed during laparoscopy histological confirmation was obtained in 68 cases (83.9%). In the group of 25 cases with laparoscopic diagnosis of chronic hepatitis the diagnosis was confirmed histologically in 21 (84%) cases. The authors believe that laparoscopy extends the diagnostic possibilities in liver diseases. However reliable diagnosis can be obtained by microscopic examination of liver fragments obtained by guided biopsy or operation.