Cryptosporidiosis in patients with colorectal cancer.

Parasitological examination of feces was carried out for 55 patients with diagnosed colorectal cancer before chemotherapy. Except for Cryptosporidium sp., no other intestinal parasites were found in the specimens; moreover, only the patients with watery diarrhea were Cryptosporidium sp.-positive by enzyme immunoassay. Prevalence of infection in the group of patients with diarrhea (23 persons) was 43.5%, whereas it was 18% for the entire group of patients under study. Coproantigens of this parasite were detected primarily in the patients with tumors located on the left side (in the sigmoid and descending colon).

[Strongyloidosis--a case report]. / Wegorczyca (strongyloidosis)--przypadek kliniczny.

A case of Strongyloides stercoralis infection was described.

[A patient with abdominal actinomycosis--diagnostic problems]. / Chora z promienica brzuszna--problemy diagnostyczne.

The difficulties in diagnosis of abdominal actinomycosis are presented. Clinical manifestations and colonoscopy suggested malignancy. Final diagnosis was made on the basis of pathological assessment of resected sigmoid. Authors underline that in case of "negative" pathomorphological results of material obtained during endoscopy from lesions suspected, benign disease should be consider including anctinomycosis and intraoperative pathomorphological examination should be performed.

Clinico-pathological characteristics of colorectal cancer and serum anti-p53 antibodies.

The purpose of this study was to correlate the presence of p53 antibodies in sera of patients with colorectal adenocarcinoma with size, site and stage of the tumour, age and sex of a patient and the level of carcinoembryonic antigen (CEA) in the serum. p53 antibodies were detected using enzyme-linked immunoabsorbent assay (ELISA). Serum p53 antibodies were detected in 30 of 145 patients (21%), mostly in Astler-Coller stage B1 (28% of patients). No association was found between p53 antibody status in stage A+B1+B2 vs stages C1+C2+D (22% vs 19%) i.e. between patients without and with metastases to regional lymph nodes and/or distant metastases. Serum p53 antibodies were detected in 9 of 34 patients (26%) with tumour localised in the right part vs 21 of 109 patients (19%) with tumours in the left part of the colon and in 18 of 96 (19%) of patients with tumours localised in rectosigmoideum vs 12 of 47 (26%) with tumours in the remaining colon. There was no significant correlation between serum anti p53 antibody and CEA statuses. Increased level of serum CEA was seen in 46/145 (32%) patients. Patients with C1+C2+D stage cancers had high serum CEA level more frequently than did patients with A+B1+B2 stage tumours (44% vs 19% respectively, p < 0.001). Of 102 cases with normal CEA level, 19 (19%) were positive for anti p53 antibodies. These results together with the literature data [11, 20] indicate that approximately 27% CEA negative patients may have serum p53 antibodies. Therefore simultaneous assessment of serum p53 antibodies and CEA seems to be useful for monitoring high risk patients and for postoperative patient monitoring.

Polymorphism of GSTM1 gene in patients with colorectal cancer and colonic polyps.

The frequency of the GSTM1 gene in patients with nonpolyposis colorectal cancer (CRC) (n = 70) and in subjects with colonic polyps (n = 27) was evaluated and compared with healthy individuals (n = 145). Patients with CRC were divided into the three groups: patients coming from the families with hereditary nonpolyposis colorectal cancer (HNPCC) (n = 17); patients with a high risk of HNPCC who were referred to as suspected of HNPCC (n = 25); patients with sporadic colorectal cancer without clinical features of hereditary tumours (n = 28). A simple polymerase chain reaction (PCR) - based assay to identify GSTM1 nulled and positive (non-nulled) genotype was used. No significant differences in frequency of nulled individuals were observed in both patients with HNPCC and patients suspected of HNPCC as well as in subjects with colonic polyps. The most interesting observation was made in the group of patients with sporadic CRC. Twenty individuals (71.4 %) of the group were GSTM 1 deficient which was significantly different from the control population (p < 0.04). The above data indicate that the absence of the GSTM1 gene is associated with a greater risk of sporadic colorectal cancer. There is an increase in the overall risk of approximately 2.5 as compared with the control population.

Flow cytometric DNA ploidy and cell proliferative activity in colorectal adenomatous polyps.

The retrospective flow cytometric analysis of 54 colorectal adenomatous polyps resected endoscopically from 43 patients was performed. The aim of the study, with the use of flow cytometry was to determine, DNA ploidy and proliferative activity of epithelial cells in a series of adenomas and to compare the results with classical histopathological criteria. Overall 30 tubular and 19 tubulo-villous/villous adenomas with different grade of dysplasia as well as 5 adenomatous polyps with carcinoma in situ (CIS) were examined. DNA aneuploidy was found in 4 of 54 polyps (7.4%), all with histological features of CIS. Proliferation rate increased significantly with the degree of dysplasia (9.0 +/- 3.1%; 16.3 +/- 4.3%; 22.1 +/- 4.1% in adenomas with mild, moderate and severe dysplasia respectively; p < 0.05). No significant differences in cell proliferative activity were found between groups of adenomas as compared to histological type and size. The results show that cell proliferative activity in colorectal adenomatous polyps depends strongly on the grade of dysplasia and does not show such a direct association with respect to histological type or size of adenomas. It may be concluded as well that DNA aneuploidy precedes histological changes of invasive carcinoma in colorectal adenomas and therefore flow cytometric DNA analysis may be of great value in defining more accurately the biological stage of neoplasmatic process in individual cases.

PCNA defined proliferative activity of epithelial tumor cells in adenomas of the colon.

Proliferative activity of epithelial tumor cells was evaluated with the use of immunohistochemistry and anti-PCNA monoclonal antibodies in alcohol fixed paraffin embedded sections of 44 colonic adenomas, including 33 tubular, 5 villous and 6 tubulovillous adenomas. The mean PCNA index was 24.7 +/- 10.9%, 24.8 +/- 6.2% and 24.8 +/- 14.0% in tubular, villous and tubulovillous adenomas respectively. In 12 tubular adenomas with dysplasia the mean PCNA index in areas with dysplasia was significantly higher (38.2 +/- 11.5%) as compared to areas without dysplasia (17.0 +/- 8.9%; p < 0.05). The results indicate that PCNA index of epithelial tumor cells is significantly increased in adenomas with high grade of dysplasia irrespective of histological type or size of the tumour.

[Late results after extensive resection of the small intestine]. / Wyniki odlegle po przebytej rozleglej resekcji jelita cienkiego.

In eight patients (two women and six men) aged from 31 to 80 years, extensive resection of the small intestine had been performed before many years. The most frequent causes of the operation were thrombosis and embolism of the superior mesenteric artery (three cases each). In all patients the small intestine was resected, at least partially, and in two patients also hemicolectomy with resection of Bauhin valve was performed. The most frequent complaint reported by the patients is periodical diarrhoea which becomes more intense particularly after fat consumption. Laboratory investigations and absorption tests were carried out in the patients at least one year after the operation. In all patients impaired absorption and hypoalbuminaemia were found. No significant correlation was found between the extent and time after the resection and the degree of intensity of the observed abnormalities.

PCNA/cyclin defined proliferative activity of epithelial cells in normal gastric mucosa and in chronic gastritis.

Proliferative activity - as measured by the length of proliferation zone and the proliferation index - was studied in 106 gastric biopsies including 27 biopsies with normal mucosa, 53 with chronic superficial gastritis and 26 with chronic atrophic gastritis. Proliferative activity was assessed with PCNA/cyclin monoclonal antibodies and immunohistochemistry in alcohol fixed paraffin embedded sections. Significantly increased mean proliferation index was found in chronic atrophic gastritis as compared with chronic superficial gastritis and normal mucosa. The PCNA/cyclin index that can easily be measured in paraffin embedded sections can be included as an additional criterion to existing histopathologic classifications of gastritis.

Increased PCNA/cyclin index correlates with severity of duodenitis defined by histological criteria.

The proliferative activity of crypt epithelial cells was studied in 64 duodenal biopsies using immunohistochemistry and proliferating cell nuclear antigen (PCNA)/cyclin monoclonal antibodies in alcohol-fixed paraffin-embedded sections. A positive correlation between duodenitis as defined by histological criteria and increased mean percentage of PCNA positive crypt cell nuclei (PCNA index) was found. The mean PCNA index in normal mucosa was 11.8 +/- 2.7% (mean +/- SD), in mild (grade 1) duodenitis 17.3 +/- 3.9%, in moderate (grade 2) 30.6 +/- 6.9%, and in severe (grade 3) duodenitis 41.1 +/- 8.5%. The inclusion of PCNA index, which is easily measured in paraffin-embedded sections, in the existing histopathological grading systems of duodenitis may improve their clinical relevance.

[Primary biliary liver cirrhosis in patients treated at Szczecin hospitals in 1978-1988]. / Pierwotna marskosc watroby w materiale szpitali szczecinskich w latach 1978-1988.

In the last decade, the primary, biliary liver cirrhosis was diagnosed in 17 female patients aged between 33 and 72 years. The most frequent complaint were itching and jaundice. Hepatomegaly and itching predominated in the clinical signs Laboratory tests have shown and increase in alkaline phosphatase activity, gamma-glutamyltranspeptidase, and alanine-aminotransferase activities, accelerated ESR and decrease in blood serum albumins. Immunological abnormalities were found in 15 patients, including 12 with antimitochondrial antibodies. Liver biopsy was carried out in all patients enabling to diagnose the primary cirrhosis in 14 of them. Duration of the disease was between 1 and 9 years. Immunosuppressive treatment was carried out in 10 patients, and symptomatic treatment in the remaining 7 patients. No difference in the effect of therapy on actual health state of patients was seen.