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Cancer of the gallbladder – own experience

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Gryko M., Dawidziuk T., Sawicka E., Cepowicz D., Kamocki Z., Masiulaniec P., Kędra B.
Progress in Health Sciences
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2014
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vol. 4
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issue 1
153-157
XX
Gallbladder cancer is a relatively rare cancer of the gastrointestinal tract, most commonly detected (approximately 95% of cases) in the most advanced clinical stage IV and burdened with high mortality rate. This is mainly due to the nonspecific symptoms in the early stages of the disease. The remaining cases of gallbladder cancer are usually detected after surgery due to gallstone disease. Gallstones, their size and pancreatic juice reflux into the gallbladder are risk factors in the development of gallbladder cancer. In this paper the authors carried out a retrospective research based on an evaluation of a group of 38 patients treated surgically due to the gallbladder cancer in the years 2005-2012 in the Second Department of General and Gastroenterological Surgery in Białystok Medical University Hospital. In this group there were 29 women and 9 men, in age between 48-86 years. Although women suffered from gallbladder cancer more often than men, their survival rate was significantly better after the surgery. The research showed some benefits of extended surgical procedures even in patients with advanced stages of the disease, while the effectiveness of surgical treatment depends mainly on the possibility of radical resection of the primary lesion and, eventually, the resection of lymph nodes and other infiltrated tissues.
2
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Hiatus hernia – Late complication after gastrectomy followed by double tract reconstruction (DTR): a case report

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Bandurski R., Gryko M., Dawidziuk T., Zaręba K., Cepowicz D., Kędra B.
Progress in Health Sciences
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2014
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vol. 4
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issue 1
265-268
XX
In patients with dyspeptic symptoms who have been treated for gastric cancer, other medical conditions apart from cancer recurrence should be considered. A long small-bowel loop left after esophagogastric anastomosis, flaccid diaphragmatic crura, and several external factors such as hard physical exertion can promote the development of postoperative hiatus hernia. The authors of this paper present a rare case of hiatus hernia considered a late complication of primary surgery performed due to gastric cancer. The 63-year-old patient had undergone total gastrectomy with double tract reconstruction (DTR) six years earlier. Gastrectomy was performed with extended lymphadenectomy (>D2). Histopathologic examination of tumor specimens showed mucinous adenocarcinoma with no lymph node metastasis and no distant metastases (pathologic staging: pT2, pN0, pM0). After six years, the patient was admitted to the 2nd Department of General and Gastroenterologic Surgery with abdominal pains, malaise, weight loss and feeling of fullness after small meals. Diagnostic procedures performed showed the presence of hiatus hernia, a very rare complication after this particular surgery, with no features of cancer recurrence. The patient was underwent surgery and the hernia was successfully repaired.
3
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The expression of apoptosis-related proteins in patients with ulcerative colitis

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Niewiarowska K., Lebelt A., Gryko M., Pryczynicz A., Famulski W., Czyżewska J., Kemona A., Piekarska-Dymicka V., Jagodzińska D., Guzińska-Ustymowicz K.
Progress in Health Sciences
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2014
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vol. 4
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issue 1
75-82
XX
Purpose: Recent literature data indicate a key role of apoptosis in the pathogenesis of inflammatory bowel disease. The aim of the study was to evaluate the expression of Bax, Bid, Bcl-2 and Bcl-xl in non-dysplastic and dysplastic epithelium in inflamated mucosa of patients with ulcerative colitis. Methods: The study consists of 18 patients with diagnosed ulcerative colitis. The expression of proteins was determined immunohistochemically. Results: Lack of Bax expression in normal epithelium of the inflamed intestinal mucosa (94.4%) and a weak expression of this protein were found in dysplastic glandular cells (67%). The Bax expression of dysplastic epithelium correlates with reduced severity of chronic inflammation (p<0.005). Bid expression in non-dysplastic glands was found in 67% of cases vs. 16% in dysplastic epithelium that was associated with the occurrence of epithelial erosions or ulcers (p<0.05). Moderate cytoplasmic expression of Bcl-xl was noted in 27.7% of patients in normal epithelium and in 66.1% within dysplastic lesions. Bcl-xl expression in dysplastic glandular cells correlated with the presence of neutrophils in the lamina propria (p <0.05). Conclusions: The immunohistochemical expressions of Bax, Bcl-2 and Bcl-xl increase and Bid protein expression decreases in dysplastic glandular tubes as compared to non-dysplastic intestinal epithelium in inflamed mucosa, which may suggest an imbalance of controlled cell death in ulcerative colitis.
4
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Comparison of expression of selected proteins in the cells of intestinal and diffuse type gastric cancer – immunohistochemical analysis

84%
Gryko M., Prycznicz A., Dawidziuk T., Zińczuk J., Cepowicz D., Kamocki Z., Kedra B., Guzińska-Ustymowicz K.
Progress in Health Sciences
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2014
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vol. 4
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issue 1
158-164
XX
Introduction: Despite the progress in gaining knowledge about carcinogenesis, it is still unclear what processes are directly responsible for the differentiation of gastric cancer into its intestinal or diffuse form. Dividing of these two forms is based on one of the oldest, yet still commonly used classifications – the classification of Lauren. There are many factors that may influence the formation of gastric tumors of various aggressiveness. Purpose: To evaluate the expression of proteins: fragile histidine triad (FHIT), E-cadherin, α-catenin, γ-catenin, cathepsin B, epidermal growth factor (EGF), HER-2, MMP-9, MCM-2, Bak, Bax, BID, Bcl-XL, p53, FasL, Bcl-2, caspase-8, procaspase-3 in gastric cancer cells, depending on the type of tumor by Lauren classification. Materials and methods: Study group consisted of 91 patients treated surgically for gastric cancer in the Second Department of General and Gastroenterological Surgery, Medical University of Bialystok in years between 2000 and 2006. Results: It is shown, that the expression of E-cadherin was significantly higher in the Lauren I gastric cancer cells than in Lauren II. In case of caspase-8 there has been significantly less frequent expression of this protein in Lauren I gastric cancer cells compared to Lauren II. The authors describe no statistically significant differences in the expression of other proteins taken into consideration. Conclusions: These results suggest the role of adhesion and apoptosis-related proteins in the development of two different types of gastric cancer according to Lauren’s classification.
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