Selected parameters of nutritional status in patients with pancreatic head cancer - own experience.

Introduction: Around 200,000 new cases of pancreatic cancer are diagnosed yearly worldwide. It is the fourth most common cause of cancer deaths. Pancreatic cancer has a high mortality rate due to unspecific symptoms being responsible for late diagnosis. Aim: In this study, the authors analysed selected nutritional parameters and the severity of anaemia in patients diagnosed with pancreatic head cancer. Material and methods: Data were collected upon admission to the 2nd Clinical Department of General, Gastrointestinal, and Oncological Surgery in the University Clinical Hospital in Bialystok, Poland and retrospectively with the help of correctly collected anamnesis. Results: It has been shown that most patients with pancreatic cancer are malnourished at the time of diagnosis. Body mass index (BMI) is the least valuable parameter primarily. Weight loss has been determined to be the most accurate predictor of the patient's metabolic status, although it should never be the only parameter. Although these factors do not suggest an inflammatory process, serum protein levels and albumin concentration should be considered. Conclusions: When assessing the nutritional status of patients with pancreatic cancer, many predictive factors should be considered. BMI seems to be the least accurate parameter for assessing nutritional status in patients diagnosed with cancer. However, when combined with weight loss and serum albumin levels, it can be quite useful as a prognostic factor.

New Insights on the Progesterone (P4) and PGRMC1/NENF Complex Interactions in Colorectal Cancer Progression.

The literature data regarding the risk of colorectal cancer (CRC) in the context of hormone therapy (HT), including both estrogen-progestogen combinations and estrogen alone, are inconclusive. The precise relationship underlying the action of progesterone (P4) and progesterone receptors in CRC has yet to be determined. We characterized the expression profiles of both nuclear and membrane progesterone receptors and their potential cofactors in CRC tissues. Additionally, we analyzed the P4 and NENF treatment effects on the cell proliferation and invasion of DLD-1 and HT-29 colorectal cancer cells. We observed a weak expression of the nuclear P4 receptor (PGR), but an abundant expression of the P4 receptor membrane component 1 (PGRMC1) and neuron-derived neurotrophic factor (NENF) in the CRC tissues. P4 treatment stimulated the proliferation of the DLD-1 and HT-29 CRC cells. The co-treatment of P4 and NENF significantly increased the invasiveness of the DLD-1 and HT-29 cells. A functional analysis revealed that these effects were dependent on PGRMC1. AN immunocytochemical analysis demonstrated a cytoplasmic co-localization of PGRMC1 and NENF in the CRC cells. Moreover, the concentration of serum NENF was significantly higher in CRC patients, and P4 treatment significantly increased the release of NENF in the DLD-1 cells. P4 or NENF treatment also significantly increased the IL-8 release in the DLD-1 cells. Our data may provide novel insights into the action of P4 and PGRMC1/NENF in CRC progression, where NENF may act as a potential PGRMC1 co-activator in non-classical P4 signaling. Furthermore, NENF, as a secreted protein, potentially could serve as a promising circulating biomarker candidate for distinguishing between colorectal cancer patients and healthy individuals, although large-scale extensive studies are needed to establish this.

Could circulating biomarkers of nitrosative stress and protein glycoxidation be useful in patients with gastric cancer?

Background: Nitrosative stress leads to protein glycoxidation, but both processes may be strongly related to the cancer development. Therefore, the aim of this study was to assess the nitrosative stress and protein glycoxidation products in patients with gastric cancer in comparison with healthy controls. We are also the first to evaluate the diagnostic utility of nitrosative stress and protein glycoxidation markers in gastric cancer patients in respect to histopathological classifications (TNM, Lauren's and Goseki's classification) and histopathological parameters such as histological type, histological differentiation grade, presence of vascular or neural invasion, desmoplasia and Helicobacter pylori infection. Methods: The study included 50 patients with gastric cancer and 50 healthy controls matched for sex and age. Nitrosative stress parameters and protein glycoxidation products were measured colorimetrically/fluorometrically in plasma or serum samples. Student's t-test or Mann-Whitney U-test were used for statistical analysis. Results: NO, S-nitrosothiols, nitrotyrosine, kynurenine, N-formylkynurenine, dityrosine, AGE and Amadori products were significantly increased whereas tryptophan fluorescence was decreased in patients with gastric cancer compared to the healthy control. Nitrosative stress and glycoxidation products may be useful in diagnosis of gastric cancer because they differentiate patients with gastric cancer from healthy individuals with high sensitivity and specificity. Some of the determined parameters are characterised by high AUC value in differentiation of GC patients according to the histopathological parameters. Conclusions: Gastric cancer is associated with enhanced circulating nitrosative stress and protein glycation. Although further research on a tissue model is needed, plasma/serum biomarkers may be dependent on tumour size, histological type, tumour invasion depth, presence of lymph node and distant metastasis, vascular and neural invasion and Helicobacter pylori infection. Thus, circulating biomarkers of nitrosative stress/protein glycoxidation may have potential diagnostic significance in gastric cancer patients.

Preoperative Glutamine Supplementation in Gastric Cancer-Thrombocyte Phagocytic Activity and Early Postoperative Outcomes.

BACKGROUND: The aim of this study was to determine the phagocytic activity of thrombocytes in patients with gastric cancer and to assess the effect of oral and parenteral preoperative glutamine-based immunonutrition on nutritional status, thrombocyte phagocytic activity, and early postoperative outcomes. METHODS: Patients suffering from invasive gastric cancer had been treated with preoperative immunonutrition with glutamine, and they were compared to patients without nutritional treatment. Nutritional status, percentage of weight loss, and BMI were assessed. Levels of total protein, albumin, cholesterol, triglycerides, platelets, and their phagocytic ability were measured twice. Postsurgical complications were assessed via the Clavien-Dindo classification. RESULTS: Group I consisted of 20 patients with an oral glutamine-10 g daily. Group II had 38 patients who received intravenous glutamine, 1.5 mL per kg body weight of Dipeptiven. Group III consisted of 25 patients who did not receive preoperative immunonutrition. In total, 47% of patients in Group I, 54% of patients in Group II, and 33% of patients in Group III were malnourished. In Group I, the percentage of phagocytizing platelet (%PhP) was 1.1 preoperatively and 1.2 postoperatively. The phagocytic index (PhI) was 1.0 and 1.1. In Group II, %PhP was 1.1 and 1.2 and PhI was 1.0 and 1.1. In Group III, the %PhP was 1.0 and 1.2 and PhI was 1.0 and 1.1. An increase in triglyceride level was observed in both immunonutrition groups. There was a decline in total protein and albumin level in Group II. In Group III, there was a decline in total protein, albumin, and cholesterol level. The total platelet count and PhI were increased in both immunonutrition groups. There was also a rise in %PhP in Group II. In Group III, there was a rise in blood platelet level, %PhP, and PhI. The complication rates were 53% in Group I, 29% in Group II, and 40% in Group III. CONCLUSIONS: In invasive gastric cancer, laboratory nutritional parameters are significantly reduced, causing malnutrition in 44.7% of patients. Oral glutamine supplementation inhibited the postoperative decline in protein metabolism parameters; however, this did not affect the reduction in the percentage of postoperative complications. Glutamine used preoperatively significantly reduced the percentage of serious surgical complications, regardless of the way it was supplemented. Patients with invasive gastric cancer have a significant decrease in platelet phagocytic activity. The administered preoperative parenteral nutrition and the surgical procedure itself influenced the improvement of the phagocytic activity of blood platelets. Glutamine did not have this effect, regardless of the route of administration.

Diagnostic significance and utility of circulating redox biomarkers in patients with gastric cancer - preliminary study.

BACKGROUND: This study aimed to evaluate the redox status, antioxidant barrier, and oxidative damage to proteins, lipids, and DNA in patients with gastric cancer (GC). We are also the first to assess the diagnostic utility of redox parameters in patients with GC with respect to histopathological parameters. METHODS: Fifty patients with gastric cancer and 50 healthy controls matched for sex and age were included in the study. The antioxidant barrier, redox status, and oxidative damage products were measured in serum/plasma samples using colorimetric or spectrophotometric methods. RESULTS: The activity of superoxide dismutase - SOD (p < 0.05) was significantly higher, whereas the activities of catalase - CAT (p < 0.0001), glutathione peroxidase - GPx (p < 0.0001), glutathione reductase - GR (p < 0.0001), and reduced glutathione - GSH (p < 0.05) were considerably lower in GC patients than in the control group. The levels of total oxidant status - TOS (p < 0.0001), oxidative stress index - OSI (p < 0.0001), advanced oxidation protein products - AOPP (p < 0.0001), ischaemia modified albumin - IMA (p < 0.01), lipid hydroperoxides - LOOH (p < 0.0001), 8-IsoProstane - 8-Iso-P (p < 0.0001), and DNA/RNA (p < 0.0001) were significantly higher, and the levels of total antioxidant capacity - TAC (p < 0.0001) and total thiols (p < 0.0001) were considerably lower in patients compared to the healthy controls. Some redox parameters are characterized by high AUC values in patients with differentiated GC according to histopathological parameters. CONCLUSIONS: Gastric cancer is strongly linked to a systemic redox imbalance and increased oxidative damage to proteins, lipids, and DNA. Redox biomarkers are potential diagnostic indicators of gastric cancer advancement.

Gastric cancer is associated with redox imbalance and increased oxidative damage to proteins, lipids and DNA.Histopathological parameters of the tumour, such as size, histological type, histological differentiation grade, tumour invasion depth, presence of lymph node and distant metastasis, Lauren and Goseki classification, and presence of vascular and neural infiltration, are associated with the level of antioxidants and oxidative damage products of proteins, lipids, and DNA.Determination of redox parameters may be useful in the assessment of the tumour progression.

Laparoscopic organ-sparing surgery for cystic lesions of the spleen - own observations.

<b>Introduction:</b> Splenic cysts are quite rare. In this publication, authors focus on presenting their own observations related to the management of patients with such lesions. </br></br> <b> Aim:</b> To evaluate the effectiveness of laparoscopic procedures in the case of patients with splenic cysts. </br></br> <b>Material and methods:</b> The study included patients treated surgically for cystic lesions located in the spleen at the 2^nd Department of General, Gastroenterological and Oncological Surgery of the Medical University of Bialystok over the years 2017-01.2020. </br></br> <b>Results:</b> All patients were referred for elective excision of the spleen lesion (the size of the lesions ranged from 7 to 15 cm - based on CT examination). In all cases, excision of the anterior wall of the cyst was performed with the help of advanced surgical tools. The duration of the procedure ranged between 65 and 100 minutes. No significant blood loss was observed. No postoperative complications were found. </br></br> <b>Conclusions:</b> In conclusion, sparing laparoscopic surgery for cystic lesions of the spleen seem to be safe and rarely associated with complications or relapses. Extending the scope of the procedure to total splenectomy should also not pose a major problem.

May the Nitrosative and Carbonyl Stress Promote Inflammation in Patients with Colorectal Cancer?

Purpose: Overproduction of reactive nitrogen species (RNS) causes the nitrosative stress, which plays a vital role in the development of metabolic, inflammatory, and cancerous diseases. However, the role of nitrosative and carbonyl stress in the biology of colorectal cancer (CRC) is still not well understood. Therefore, this study evaluated nitrosative stress, protein and DNA oxidation/glycoxidation, and pro- and anti-inflammatory cytokines in CRC patients compared with healthy controls. Patients and Methods: Fifty-five CRC patients (21 women, 34 men) and 55 healthy controls matched for sex and age were included in the experiment. Nitrosative stress parameters (nitric oxide (NO), peroxynitrite, S-nitrosothiols, and nitrotyrosine), protein oxidation (total thiols) and glycoxidation products (kynurenine N-formylkynurenine, dityrosine, Amadori products, and amyloid), and DNA damage markers (8-hydroxydeoxyguanosine (8-OHdG)), as well as levels of pro- and anti-inflammatory cytokines, were measured in serum or plasma samples. Results: The levels of NO, peroxynitrite, S-nitrosothiols, nitrotyrosine, total thiols, kynurenine, N-formylkynurenine, dityrosine, Amadori product, amyloid, and 8-OHdG, as well as IL1α, IL1ß, IL6, IL10, and TNF-α, were significantly higher in CRC patients than in controls. Oxidation and glycoxidation products were positively correlated with pro-inflammatory (IL1α, IL1ß, IL6, TNFα) and anti-inflammatory cytokines (IL10), indicating that redox damages may promote inflammation in CRC patients. Many redox biomarkers differentiate patients with CRC from healthy individuals with high sensitivity and specificity. Conclusion: Correlations of chosen oxidative products with pro-inflammatory (IL1α, IL1ß, IL6, TNFα) and anti-inflammatory cytokines (IL10) suggest that redox damages may promote inflammation in CRC patients. Thus, our research is the first point for further clinical trials focusing on the evaluation of the diagnostic utility of nitrosative stress biomarkers in a larger group of CRC patients.

Association of Tumour Microenvironment with Protein Glycooxidation, DNA Damage, and Nitrosative Stress in Colorectal Cancer.

PURPOSE: In this study, we evaluated the total antioxidant capacity, nitrosative stress, and protein/DNA oxidation and glycoxidation products in patients with colorectal cancer regarding histopathological parameters associated with the tumour microenvironment, such as inflammatory infiltration and tumour budding and compare all determined parameters between tumours located in the right and left side of the colon and normal mucosa. PATIENTS AND METHODS: Ferric reducing antioxidant power (FRAP), nitrosative stress (myeloperoxidase (MPO), nitrogen oxide (NO), peroxynitrite, and nitrotyrosine), protein oxidation products (protein carbonyls (PC), total thiols, and ischemia modified albumin (IMA)), protein glycooxidation products (tryptophan, kynurenine, N-formylkynurenine, dityrosine, Amadori product, advanced glycation end products (AGE)) and 8-hydroxydeoxyguanosine (8-OHdG) were measured in homogenates from normal and cancerous tissue of 30 patients with colorectal cancer. RESULTS: Levels of FRAP (p=0.0009), IMA (p=0.0002), kynurenine (p<0.0001), N-formylkynurenine (p<0.0001), dityrosine (p<0.0001), Amadori products (p=0.0024), AGE (p<0.0001), MPO (p<0.0001), NO (p<0.0001) and nitrotyrosine (p=0.0011) were increased, whereas PC (p=0.0004), tryptophan (p<0.0001), 8-OHdG (p<0.0001) and peroxynitrite (p=0.0003) were decreased in the left-side tumour compared to the right-side tumour and normal mucosa. CONCLUSION: Our results showed that colorectal cancer is related with disturbances in antioxidant defense and increased oxidative and nitrosative damages to proteins and DNA. These parameters may be useful for evaluation the progression and differentiation of the tumour location. We also demonstrated that redox indicators may depend on the histological type of the tumour and may influence tumour invasion depth, presence of lymph node and distant metastasis, vascular and neural invasion, inflammatory infiltration, and tumour budding, which are part of the tumour microenvironment.

Immunohistochemical Analysis of the Expression of Adhesion Proteins: TNS1, TNS2 and TNS3 in Correlation with Clinicopathological Parameters in Gastric Cancer.

Tensins belong to the group of adhesion proteins that are involved in cell adhesion and migration, actin cytoskeleton maintenance and intercellular communication. TNS1, TNS2 and TNS3 proteins expression was evaluated in 90 patients with gastric cancer by immunohistochemistry method. TNS1 was more frequently present in non-differentiated tumors compared to poorly and moderately differentiated tumors (p = 0.016). TNS1 was also more often observed in metastatic tumors compared to those without distant metastases (p = 0.001). TNS2 was more common in moderately differentiated tumors than in poorly or non-differentiated ones (p = 0.041). TNS2 expression was also more frequently present in tumors with peritumoral inflammation (p = 0.041) and with concomitant H. pylori infection (p = 0.023). In contrast, TNS3 protein was more prevalent in moderately than in poorly and non-differentiated tumors (p = 0.023). No significant relationship was found between tensins' expression and the overall survival rate of patients. TNS1 protein expression is associated with a poor-prognosis type of GC. Higher expression of TNS2 is accompanied by peritumoral inflammation and H. pylori infection, which favor the development of GC of a better prognosis, similarly to higher TNS3 protein expression.

Increased tensin 4 expression is related to the histological type of gastric cancer.

BACKGROUND: Gastric cancer (GC) is one of the most common malignant tumors worldwide. Tensin 4 (TNS4) is an adhesive protein belonging to the tensin family. This protein is located in focal adhesion sites. The TNS4 gene is considered an oncogene in numerous cancers. This protein plays an important role in adhesion, migration and proliferation of cells. AIM: To evaluate expression of TNS4 protein in GC tissues and analysis of the clinical and histopathological parameters as well as the overall survival rate of patients. METHODS: The expression of TNS4 was assessed in 89 patients using immunohistochemistry. RESULTS: Positive expression of TNS4 was observed in 49 of 89 patients (55.06%). Higher TNS4 expression was more common in GC tumors with a diameter ≥ 5 cm (P = 0.040). We demonstrated that an increase in TNS4 expression was more frequent in tumors of the histological type without mucinous components than in tumors from mucosal cancers (P = 0.023). Furthermore, TNS4 expression was higher in moderately differentiated tumors than in poorly differentiated and non-differentiated tumors (P = 0.002). Increased TNS4 expression was also noted in the intestinal type of GC according to Lauren's classification (P = 0.020). No statistically significant correlation was found between the expression of TNS4 and the overall survival rate of patients. CONCLUSION: TNS4 expression was significantly higher in tumors with a diameter ≥ 5 cm of the moderately differentiated intestinal type (according to Lauren's classification) of GC without a mucinous component. Therefore, increased TNS4 expression is related to the histological type of GC with a better prognosis.

Can factors that influence nodal dissemination in patients with colorectal cancer be identified? Own experience.

INTRODUCTION: As one of the most common causes of cancer deaths in Poland, colorectal cancer, remains a mystery when factors affecting local and distant lymph node metastasis are concerned. AIM: In this study the authors have analysed possible correlations between the number of regional (and distant) lymph nodes affected by cancer, location and stage of the primary tumour, levels of oncological markers CA19-9 and CEA, and the patients age, sex, body mass index (BMI), and other clinical symptoms. MATERIAL AND METHODS: A special questionnaire was created for this study, and a group of 100 men and women was selected. All patients in the study group had undergone surgery due to colorectal cancer. RESULTS: There were no statistically significant relationships between age, and number and location of metastases (p > 0.05). Primary tumour assessment did not show a statistically significant relationship with the presence of metastases to regional lymph nodes (p > 0.05). There was also no statistically significant correlation between tumour localisation and lymph node metastases (p > 0.05) or between tumour size, BMI, occurrence of physical symptoms, and involvement of distant lymph nodes (p > 0.05). The highest CEA was observed in a patient with nine regional lymph node metastases (612.46 ng/ml) and the lowest in one with metastases to two regional nodes (0.2 U/ml). CEA value above 5 ng/ml was found in 35.74% of patients with regional lymph node metastases. A statistically significant relationship was reported (p < 0.05). CONCLUSIONS: The location of the primary tumour, and its pathological stage and size does not seem to have a direct correlation with the occurrence of regional lymph node metastases. Metastasis to distant lymph nodes seems to be a consequence of metastases in regional nodes. Elevated CEA tumour marker values are significantly related to metastases in regional lymph nodes. The elevation of CA 19-9 and CEA tumour markers significantly correlates with the presence of metastasis to distant lymph nodes. The location of the primary tumour determines the formation of metastases in distant lymph nodes.

Pro-Oxidant Enzymes, Redox Balance and Oxidative Damage to Proteins, Lipids and DNA in Colorectal Cancer Tissue. Is Oxidative Stress Dependent on Tumour Budding and Inflammatory Infiltration?

This study is the first to assess redox homeostasis in patients with colorectal cancer (CRC) in respect to histopathological parameters associated with the tumour microenvironment such as tumour budding and inflammatory infiltration. Pro-oxidant enzymes (NADPH oxidase (NOX), xanthine oxidase (XO)), antioxidant barrier (Cu,Zn-superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione reductase (GR), reduced glutathione (GSH)), redox status (total antioxidant (TAC)/oxidant status (TOS)) and oxidative damage products (advanced glycation end products (AGE), advanced oxidation protein products (AOPP), malondialdehyde (MDA) and 8-hydroxydeoxyguanosine (8-OHdG)) were determined in both the normal and cancerous tissue of 29 CRC patients. The activity of NOX (p < 0.01) and XO (p = 0.01), as well as SOD (p < 0.0001), CAT (p < 0.0001) and TAC level (p < 0.01) were significantly higher in tumour tissue than in normal colon mucosa. Oxidative damage products (AGE-p < 0.01, AOPP-p < 0.001, MDA-p < 0.001, 8-OHdG-p < 0.0001) were also higher in cancerous colon tissue. Furthermore, we observed that CAT (p < 0.05) and XO (p < 0.05) activity depends on the intensity of inflammatory infiltration. Oxidative stress index (OSI) (p < 0.05) and MDA (p < 0.01) values were significantly higher in patients with tumour budding (TB) > 5 versus cases with TB < 5. However, OSI level did not differ significantly between cancer and normal tissue. Our results confirm that CRC is associated with enzymatic/non-enzymatic redox imbalance and increased oxidative damage to proteins, lipids and DNA. The determination of these biomarkers could be useful for the evaluation of the tumour progression.

Actin-Bundling Proteins (Actinin-4 and Fascin-1) are Involved in the Development of Pancreatic Intraepithelial Neoplasia (PanIN).

BACKGROUND: Fascin-1 and actinin-4 are involved in key processes of tumor cell adhesion, migration and metastasis. Actinin-4 plays an important role in promotion of cell proliferation, whereas fascin-1 regulates cellular motility. Its over-expression leads to the loss of cell adhesion and metastasis. The aim of our study was to assess fascin-1 and actinin-4 expression in normal pancreatic ducts and in pancreatic intraepithelial neoplasia (PanIN) - precursor lesion of pancreatic ductal adenocarcinoma (PDAC). MATERIALS AND METHODS: The study involved 70 patients treated surgically due to PDAC, cysts and pancreatitis, who had also been diagnosed with pancreatic intraepithelial neoplasia. Fascin-1 and actinin-4 expressions were evaluated using the immunohistochemistry method. RESULTS: A statistically significant relationship was observed between the expression of fascin-1 and actinin-4 (cytoplasmic) and patients' age (P = 0.01, P = 0.002, respectively). The expression of fascin-1 and actinin-4 was associated with the diagnosis (P <0.001, P = 0.04, respectively). Statistical analysis revealed correlations of fascin-1 and actinin-4 expressions with the presence and grade of PanIN (P < 0.001, P = 0.002, respectively). The expression of these proteins was observed in each degree of PanIN and increased with the pancreatic intraepithelial neoplasia progression. CONCLUSIONS: The expression of fascin-1 and actinin-4 is connected with the degree of PanIN advancement and depends on the type of the primary disease. Overexpression of these proteins may be linked to cytological and architectural abnormalities observed in advanced PanIN. Elevated expression of fascin-1 and actinin-4 indicates the role of these proteins in the progression from PanIN to PDAC.

Gas gangrene as a surgical emergency - own experience.

In this paper the authors would like to present a correct procedure in both surgical and hyperbaric treatment of patients with gas gangrene admitted to a surgical department during ER. Gas gangrene is not very common these days, but when it comes to dealing with gangrenous infection in the emergency it is quite likely to make errors in both diagnostic and therapeutic manners. When there is a gas gangrene in a patient at the emergency time plays crucial role and the proper application of procedures is vital for the patient's survival. 10 cases made the study group here, all of them were patients diagnosed and treated surgically due to gas gangrene. As shown here, It is important to perform a revision of surgical wounds after few hours since primary surgery and to begin hyperbaric treatment as quickly as possible. The findings and suggestions included in this study are supported by own experience of The 2nd Department of General and Gastrointestinal Surgery of Medical University in Bialystok, Poland.

Antioxidant Barrier, Redox Status, and Oxidative Damage to Biomolecules in Patients with Colorectal Cancer. Can Malondialdehyde and Catalase Be Markers of Colorectal Cancer Advancement?

This study is the first to assess the diagnostic utility of redox biomarkers in patients with colorectal cancer (CRC). Antioxidant barrier (Cu,Zn-superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione reductase (GR), uric acid (UA), reduced glutathione (GSH)), redox status (total antioxidant (TAC)/oxidant status (TOS), ferric reducing ability (FRAP)), and oxidative damage products (advanced glycation end products (AGE), advanced oxidation protein products (AOPP), malondialdehyde (MDA)) were measured in serum/plasma samples of 50 CRC patients. The activity of SOD was significantly higher whereas the activity of CAT, GPx and GR was considerably lower in CRC patients compared to the control group (p < 0.0001). Levels of UA, TOS, and OSI and concentrations of AGE, AOPP, and MDA were significantly higher, and the levels of GSH, TAC, and FRAP were considerably lower in CRC patients compared to the healthy controls (p < 0.0001). AUC for CAT with respect to presence of lymph node metastasis was 0.7450 (p = 0.0036), whereas AUC for MDA according to the depth of tumour invasion was 0.7457 (p = 0.0118). CRC is associated with enzymatic/non-enzymatic redox imbalance as well as increased oxidative damage to proteins and lipids. Redox biomarkers can be potential diagnostic indicators of CRC advancement.

Expression of Chosen Carcinoembryonic-Related Cell Adhesion Molecules in Pancreatic Intraepithelial Neoplasia (PanIN) Associated with Chronic Pancreatitis and Pancreatic Ductal Adenocarcinoma (PDAC).

Aims: Carcinoembryonic antigen-related cell adhesion molecules (CEACAMs) are members of the glycosylphosphatidylinositol (GPI)-linked immunoglobulin (Ig) superfamily and take part in regulation of cell adhesion, tumor suppression and angiogenesis. Overexpression of CEACAM 1, 5 and 6 is widely described in several gastrointestinal epithelial tumors. The aim of study was to evaluate the expression of CEACAM 1, CEACAM 5 and CEACAM 6 in the most common precursor lesions of pancreatic ductal adenocarcinoma -pancreatic intraepithelial neoplasia (PanIN). Methods and results: The study group consisted of 32 patients treated for chronic pancreatitis and 38 patients with pancreatic ductal adenocarcinoma who also had pancreatic intraepithelial neoplasia. The expression of CEACAM was performed by immunohistochemical method and evaluated using 3-point scale: 0 - lack of positive reaction in pancreatic intraepithelial neoplasia, 1 (weak and moderate) - reaction present in 1-30% epithelial cells in PanIN and 2 (strong) - reaction present in >30% epithelial cells in PanIN. Expression of CEACAM 1, 5 and 6 increased with increasing degree of advancement of PanIN. Differences in expression of CEACAM 1, 5 and 6 between normal pancreatic ducts and different degrees of PanIN were statistically significant (p<0.001). We observed relationship between CEACAM1 expression and localization of PanIN in different parts of the pancreas. Conclusions: CEACAM 1, CEACAM 5 and CEACAM 6 expression appears to be an early event in pancreatic carcinogenesis. Moreover, expression of CEACAM 1, 5 and 6 may represent a useful biomarker that may aid in the identification of precancerous lesions in the pancreas.

Stomach cancer in young people - a diagnostic and therapeutic problem.

INTRODUCTION: According to statistics, gastric cancer remains one of the most common causes of death due to neoplastic disease in the world's population. It is a common conception that this type of cancer mostly affects people in their fifth or sixth decade of life. So, when it comes to young people, for example in their twenties or early thirties, who present to a doctor with symptoms suggesting a cancer of the gastrointestinal tract, these are quite often ignored because of their young age. AIM: In this study we at The Second Department of General and Gastroenterological Surgery of the Medical University of Bialystok, Poland decided to enlighten the problem of stomach cancer in people under 40 years old as a cause of death and complications most likely because of an incorrect diagnosis at the beginning of therapy. MATERIAL AND METHODS: Major analysis involved 350 cases of gastrointestinal tumours treated surgically, of which 14 cases (7 men and 7 women) were patients aged 18-39 years diagnosed with different stages of gastric cancer. RESULTS: Statistical analysis has shown that gastric cancer in women occurred much earlier than in men, and the average survival time was 16 months after the surgery. CONCLUSIONS: Because of the false suggestion that gastric cancer affects mostly older people, there is a risk of ignoring the symptoms in young people and finding advanced neoplastic lesions at the time of diagnosis, which has a negative effect on long-term treatment results.

Expression of chosen cell cycle and proliferation markers in pancreatic intraepithelial neoplasia.

INTRODUCTION: Pancreatic ductal adenocarcinoma is one of the most aggressive tumours that develops from precursor lesions, most frequently including pancreatic intraepithelial neoplasia (PanIN). Deregulation of the cell cycle, responsible for uncontrolled cell proliferation, is an important phenomenon in the development of this cancer. AIM: To evaluate the cell cycle and the expression of proliferation markers, namely Ki67, PCNA, and cyclin D1 in pancreatic intraepithelial neoplasia at its different stages of progression. MATERIAL AND METHODS: The study group consisted of 70 patients with different pancreatic diseases (pancreatic ductal adenocarcinoma, pancreatitis, and pancreatic cysts), who also had pancreatic intraepithelial neoplasia. Expression of Ki67, PCNA, and Cyclin D1 was analysed immunohistochemically using appropriate antibodies. RESULTS: Statistically significant differences were demonstrated in Ki67, PCNA, and Cyclin D1 expression between normal pancreatic ducts and various stages of PanIN (p < 0.001). Expression of these proteins increased from normal pancreas to PanIN 1, 2, and 3. Expression of these proteins was higher in stages PanIN 1, 2, and 3 compared to normal pancreas. The expression of Ki67, PCNA, and cyclin D1 was associated with age (p < 0.001), Ki67 and PCNA with sex (p < 0.001), and PCNA with the type of primary disease (p = 0.031). Simultaneously, a directly proportional relationship was established between the expression of all proteins examined (p < 0.001). CONCLUSIONS: An increase in the expression of Ki67, PCNA, and cyclin D1 suggests that these proteins may enhance epithelial cell proliferation and may influence the development of pancreatic intraepithelial neoplasia. Moreover, immunohistochemical assessment of Ki67, PCNA, and cyclin D1 expression may be helpful in the differential diagnosis of PanIN.

Immunohistochemical expression of Fascin-1 in colorectal cancer in relation to clinical and pathological parameters.

INTRODUCTION: Fascins are a group of proteins taking part in the maintenance of a proper structure of the cellular cytoskeleton. Fascin-1 is an actin-bundling protein present in neurons, fibroblasts, endothelial, smooth muscle, dendritic and mesenchymal cells whereas lack of its expression is characteristic of epithelial cells. Fascin-1 overexpression can be observed in neoplastic cells. Therefore, the aim of this study was to assess the expression of Fascin-1 protein in patients with colorectal cancer (CRC) and to analyze associations between Fascin-1 ex-pression and clinical-pathological parameters. MATERIAL AND METHODS: The study material included postoperative samples (tumor and unchanged colon tissue) ob-tained from 51 CRC patients. Fascin-1 expression was assessed in the paraffin sections by immunohistochemistry. RESULTS: A statistically significant correlation was found between the histological type of cancer and the expres-sion of Fascin-1 (p = 0.012). Increased expression of Fascin-1 in CRC was more frequent in adenocarcinoma type without the mucosal component with a better prognosis and decreased expression of this protein correlated with infiltration of cancer cells to blood and lymphatic vessels (p = 0.038). CONCLUSIONS: Our findings indicate a potential role of Fascin-1 in the pathogenesis of colon cancer; however, further studies will show whether this protein plays a role in the infiltration of colorectal cancer cells.