The clinical significance of p53 accumulation in gastric carcinoma.

BACKGROUND: Alterations in the expression of p53 tumor suppressor protein is a frequent event in human cancer but the practical implications of this phenomenon are yet to be fully exploited. The objective of this study was to determine the value of p53 accumulation as a marker of tumor progression and prognosis of gastric carcinoma patients and to evaluate whether this parameter can be properly assessed prior to surgery. METHODS: The expression of p53 was studied immunohistochemically in 200 gastric carcinomas using paraffin embedded surgical specimens and endoscopic biopsies. The correlation between p53 expression in tumor tissue, selected clinicopathologic variables, and the course of the patients' disease were analyzed. RESULTS: Results showed that 42.5% of the gastric carcinomas expressed elevated levels of p53 protein. P53 accumulation positivity correlated with increasing tumor stage and size (P < 0.001 and P = 0.025, respectively). P53 positive tumors had a higher propensity for lymph node and distant metastases (P < 0.001). P53 accumulation was also more frequently detected in carcinoma from proximal rather than distal stomach (P = 0.027). In patients receiving potentially curative resection for advanced cancer, p53 accumulation was an independent parameter and the strongest for poor prognosis (RR = 3.7, P < 0.001). There was complete concordance between immunohistochemical detection of p53 in endoscopic and surgical material. CONCLUSIONS: A preoperative assessment of p53 expression in gastric carcinoma can be helpful to identify patients at high risk of metastatic spread to regional lymph nodes and independently to identify those with especially poor prognosis. When combined with routine procedures, this simple and inexpensive test might allow appropriate planning of better treatment strategies.

[Primary biliary cirrhosis--an attempt to evaluate the usefulness of selected tests in differential diagnosis]. / Pierwotna marskosc zólciowa watroby--próba oceny przydatnosci wybranych badan w diagnostyce róznicowej.

Seven cases of the primary biliary cirrhosis are presented. The diagnostic problems in early stages of the primary biliary cirrhosis as well as the value of both biochemical and serologic test have been discussed with particular attention to the value of liver biopsy.

[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.

[A case of pulmonary ossification]. / Przypadek kostnienia plucnego.

A case of pulmonary osteogenesis in a 82 year old male is presented. The patient was treated for generalized atherosclerosis, chronic bronchitis, emphysema and obscure gastrointestinal bleeding. Osteogenesis was diagnosed during autopsy. The multiple lesions were not demonstrable by radiological methods. Microscopical examination showed in the osteogenetic lesions bone marrow formation.

Immunoglobulin-containing plasma cells in acute hepatitis.

Imunoglobulin(Ig)-containing plasma cells in human liver were investigated in different aetiological and histological forms of acute hepatitis. Liver specimens from 93 patients with acute hepatitis (A, B, non-A, non-B and drug-induced) were studied by conventional microscopy and by immunoperoxidase staining for IgG, IgA and IgM in paraffin sections. Plasma cells were found in 78 of 93 specimens and Ig-containing cells in 75. IgG-containing cells were significantly more abundant in acute hepatitis with bridging necrosis than in other forms (p less than 0.01), and there were more IgA-containing cells than in the classical and periportal forms (p less than 0.05). IgG-containing cells were more numerous in acute hepatitis with periportal or panacinar necrosis than in the classical form (p less than 0.05). IgG- and IgA-containing cells were less abundant in drug-induced hepatitis than in viral hepatitis (p less than 0.05). Among the viral groups the largest number of IgG-containing cells was found in non-A, non-B hepatitis, while IgA-containing cells were most abundant in type A. These differences were not statistically significant. IgM-containing cells were very scanty in all groups studied. It is concluded that Ig-producing plasma cells are common in acute viral hepatitis and presumably play a part in antibody-dependent immune reactions in this disease.

[Dandy-Walker syndrome in a 6-year-old child]. / Zespól Dandy-Walkera u 6-letniego dziecka.

The authors describe a case of Dandy-Walker syndrome. In the light of morphological examination it seems that the membrane obturating the IV ventricle is derived from the posterior medullary velum. Of essential significancy for the development of Dandy-Walker syndrome may be increased pressure in the ventricular system which appears probably at the time of cerebellum development as suggested by data from the literature and the observations of the authors. The importance of cranial trauma for the manifestation of clinical features of increased intracranial pressure in the child developing normally up to the age of 6 years.