The usefulness of lactate dehydrogenase measurements in current oncological practice.

One of the hallmarks of cancer cells is increased energy requirements associated with the higher rate of cellular proliferative activity. Metabolic changes in rapidly dividing cancer cells are closely associated with increased uptake of glucose and abnormal activity of lactate dehydrogenase (LDH), which regulates the processing of glucose to lactic acid. As serum LDH levels were found to be commonly increased in cancer patients and correlated with poor clinical outcome and resistance to therapy, the determination of LDH has become a standard supportive tool in diagnosing cancers or monitoring the effects of cancer treatment. The aim of this review is to summarize the current knowledge about methods and the practical utility for measuring both the total LDH and LDH isoenzymatic activities in the diagnosis, prognosis and prediction of cancer diseases.

Esophageal anastomosis - how the granulation phase of wound healing improves the incidence of anastomotic leakage.

A two-stage esophagectomy with an interval for reconstruction of the esophagus creates an opportunity for the esophageal stump to recover from vessel injury and allows the formation of granulation tissue rich in proangiogenic factors, including transforming growth factor ß (TGF-ß) and vascular endothelial growth factor A (VEGF-A), which may have an impact on anastomosis healing. The present study comprised 25 patients (27 in total, 2 succumbed to complications following surgery) who underwent two-stage esophagectomy for squamous cell carcinoma in the Department of Gastrointestinal and General Surgery, Wroclaw Medical University (Wroclaw, Poland) between January 2007 and December 2012. Immunohistochemical staining for VEGF-A and TGF-ß was performed to evaluate esophageal wall specimens at the time of esophagostomy construction and prior to anastomosis, in which the cervical esophagus was connected with the colon or ileum. At the time of reconstructive surgery, a significant increase in microvessel density was observed in all esophageal specimens (P<0.03). Significant differences were also identified in the immunohistochemical staining intensity of TGF-ß and VEGF-A in the epithelium of all esophageal specimens between biopsies obtained from normal esophageal tissues at the time of esophagectomy and during reconstructive surgery. Delayed anastomosis construction provides an advantage for the esophageal stump to accumulate proangiogenic growth factors, which overlap with the subsequent proliferative stage of the anastomosed tissue and thus supports its recovery, creating an optimal environment for the healing of any fistulas.

Serum levels of resistin, adiponectin, and apelin in gastroesophageal cancer patients.

UNLABELLED: The aim of the study was the investigation of relationship between cachexia syndrome and serum resistin, adiponectin, and apelin in patients with gastroesophageal cancer (GEC). MATERIAL AND METHODS: Adipocytokines concentrations were measured in sera of 85 GEC patients and 60 healthy controls. They were also evaluated in tumor tissue and appropriate normal mucosa of 38 operated cancer patients. RESULTS: Resistin and apelin concentrations were significantly higher in GEC patients than in the controls. The highest resistin levels were found in cachectic patients and in patients with distant metastasis. Serum adiponectin significantly decreased in GEC patients with regional and distant metastasis. Serum apelin was significantly higher in cachectic patients than in the controls. Apelin was positively correlated with hsCRP level. Resistin and apelin levels increased significantly in tumor tissues. Weak positive correlations between adipocytokines levels in serum and in tumor tissue were observed. CONCLUSIONS: Resistin is associated with cachexia and metastasis processes of GEC. Reduction of serum adiponectin reflects adipose tissue wasting in relation to GEC progression. Correlation of apelin with hsCRP can reflect a presumable role of apelin in systemic inflammatory response in esophageal and gastric cancer.

Upregulated expression and activation of membrane­associated proteases in esophageal squamous cell carcinoma.

To better understand the role of membrane-associated proteolytic systems in the development of esophageal cancer, we studied the expression of two serine proteases, fibroblast activation protein-α (FAP-α) and dipeptidyl peptidase IV (DPPIV) and three metalloproteinases, matrix metalloproteinase (MMP)-2, MMP-9 and MT1-MMP in 24 primary esophageal squamous cell carcinoma (ESCC) tissues and paired non-cancer tissues. Using reverse-transcription PCR, western blotting and zymography, we showed that both serine proteases and all three metalloproteinases were highly altered in ESCC. A positive correlation between the expression of FAP-α and DPPIV and the activity of both gelatinases was found. This may indicate that these proteolytic systems are tightly linked to each other and collectively are involved in the process of ECM degradation that facilitates cancer cell invasion and metastasis.

An analysis of the impact of clinico-pathological features on long-term results following esophagectomy due to squamous cell carcinoma of the thoracic esophagus.

BACKGROUND: Squamous cell carcinoma of the esophagus is one of the neoplasms characterized by an exceptionally latent course, dynamic development and poor prognosis. The stage of the disease at the time of treatment is started the greatest impact on the long term results. OBJECTIVES: The aim of this study was to evaluate selected clinical-pathological features as prognostic factors for long term survival among patients who have undergone esophagectomies due to squamous cell carcinoma. The features analyzed were age, gender, the stage of the disease and the type of tumor. Long-term survival rates (2, 5 and 10 years) were analyzed in relation to the particular features. MATERIAL AND METHODS: The study group consisted of 65 patients diagnosed with squamous cell carcinoma of the thoracic esophagus who underwent esophagectomies between 1997 and 2008. The statistical analysis was performed with Statistca 8.0 software. Gehan-Wilcoxon, chi and Kaplan-Meier tests were carried out. RESULTS: The research did not find any statistically significant correlation between the patients' gender and survival time (Gehan-Wilcoxon p = 0.83; log-rank p = 0.86). The results showed no statistically significant correlation between the patients' age and survival time (Gehan-Wilcoxon p = 0.75; log-rank p = 0.47). The only statistically significant impact of the stage of the disease on the survival time was a correlation between the longer survival time and the stage I and II of the disease (Chi p = 0.15). The log-rank test revealed that survival time is significantly shorter in cases of involved nodes (Gehan-Wilcoxon p = 0.054; log-rank p = 0.014). CONCLUSIONS: Among the clinical-pathological features investigated, only metastases in regional lymph nodes had any significant impact on long-term survival.

[Abnormal metabolism of triglycerides fractions in chronic pancreatitis and results after the operation treatment]. / Zaburzenia metabolizmu triglicerydów obserwowane w przewleklym zapaleniu trzustki oraz wyniki po operacyjnym leczeniu tego schorzenia.

This study was undertaken to determine how fats digestion processes were damaged due to chronic pancreatitis, and identify, whether lipid metabolism improved after surgical treatment the patients with chronic pancreatitis. Total lipids, triglycerides, diglycerides and free fatty acids levels in serum and stool were analysed, using chemical tests, thin-layer chromatography and electrophoresis of serum lipoproteins. The patients before the operations showed higher total lipids and triglycerides concentrations, and lower concentrations of diglycerides and free fatty acids in stool. These patients had high triglycerides, chylomicrons, VLDL, LDL-CH concentrations, and low-diglycerides, free fatty acids, HDL-CH concentrations in serum. These data were statistically significant. After the operations and substitution therapy it was observed normalization of the total lipids and lipids fractions levels in stool and in serum. Concentrations of LDL-CH and HDL-CH fractions were irregular. We conclude, that these lipids parameters could be used in diagnosing and monitoring the results of chronic pancreatitis surgical treatment.