Is there any association of glutathione S-transferase T1 (GSTT1) and glutathione S-transferase M1 (GSTM1) gene polymorphism with gastric cancers?

The glutathione S-transferases (GST) are enzymes catalyzing reactions including carcinogens. GSTT1 and GSTM1 genes are polymorphic in humans. The relations between polymorphism of some GST genes and cancer have been reported. In this study, we aimed to investigate the distribution of GSTT1 and GSTM1 polymorphisms in a group of gastric cancer patients. The study group consisted of 50 patients (21 females, 29 males) with gastric adenocarcinoma from the archives of the pathology department of a training hospital. Fifty-seven healthy control subjects were included in the study as a control group. DNA was extracted from peripheral venous blood of control subjects and from the paraffin blocks of cases. Genotyping of GSTT1 and GSTM1 genes was performed with duplex polymerase chain reaction. No differences in the frequencies of GSTM1 or GSTT1 null genotypes were observed between patients and healthy subjects (GSTM1: 52% vs. 43.85%, OR = 1.27, 95% CI: 0.55-2.96; GSTT1: 38.46% vs. 28.07%, OR = 0.72, 95% CI: 0.25-1.96). Moreover, simultaneous carriage of both genotypes was almost identical in both groups. GSTM1 or GSTT1 null genotypes were not different in diffuse or intestinal type gastric cancer. Our data suggest that the GSTM1 and GSTT1 polymorphisms are not associated with gastric cancer in a small group of the Turkish population.

Hyperammonemic encephalopathy in a patient with primary hepatic neuroendocrine carcinoma.

A 53-year-old male patient was admitted to our hospital with abdominal pain in the right upper quadrant. There was no change in laboratory investigations other than a slight increase in serum levels of alkaline phosphatase (ALP), alanine aminotransferase (ALT), and gamma glutamyl transferase (GGT). Computed tomography (CT) of the abdomen showed multiple hepatic nodular lesions in the liver. Tru-cut biopsy of the lesions was reported as well-differentiated neuroendocrine carcinoma. The patient received sandostatin treatment. After a few days, the patient was hospitalized in the intensive care unit with disturbance of consciousness and clinical features suggestive of encephalopathy. Serum ammonia level was found highly elevated. After the treatment with L-ornithine-L-aspartate, a remarkable improvement in the level of patient's sensorium occurred as well as a reduction in serum ammonia level within a few days. Transarterial chemoembolization (TACE) was performed one week later. The patient's condition began to worsen along with increase in serum ammonia level and he died because of hyperammonemic encephalopathy. There are case reports of hyperammonemia with some malignancies such as multiple myeloma, plasma cell leukemia, and leiomyosarcoma, or in some patients who have received chemotherapy. This case may suggest an association between hyperammonemia and neuroendocrine tumors.

Prognostic significance of thrombocytosis in node-negative colon cancer.

Several clinical studies have shown that thrombocytosis is a poor prognostic factor in some types of cancer, but data about the impact of thrombocytosis on prognosis in patients with colon cancer are very limited. We investigated the prevalence and prognostic effect of pre-operative thrombocytosis, defined as a platelet count > 400 x 10(9)/l, retrospectively in patients with node-negative colon cancer. Out of 198 patients, 24 (12.1%) had thrombocytosis, and its presence correlated with tumour depth and lymphatic invasion. Univariate analysis revealed that disease-free survival and overall survival were shorter in patients with pre-operative thrombocytosis than those without thrombocytosis. On multivariate analysis, thrombocytosis alone retained significance as a poor prognostic factor for both disease-free survival and overall survival. In conclusion, this study shows an association between thrombocytosis and poor survival in patients with node-negative colon cancer. The preoperative platelet count may help to identify patients with an unfavourable prognosis in this subgroup.