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Glucagonoma as a rare case of neuroendocrine tumor of the pancreas: a case report

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Zińczuk J., Lewoniewska S., Zaręba K., Pryczynicz A., Guzińska-Ustymowicz K.
Progress in Health Sciences
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2019
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vol. 1
169-173
EN
Introduction: Glucagonoma is a rare neuroendocrine tumor with characteristic features such as the presence of the glucagon-producing tumor, diabetes, and necrolytic migratory erythema. Case presentation: the 60-year-old patient was admitted to hospital with periodic pain in the right and middle upper abdominal appearing after eating. Laboratory tests presented a high glucose level and anemia. Tumor of the body and tail of the pancreas passing the organ pouch has been found during the surgery. Diagnosis of glucagonoma was confirmed in histopathological examination in immunohistochemical stainings: a positive reaction was observed with chromogranin, synaptophysin and CEA. The proliferative activity of Ki-67 was less than 1%. Staining for glucagon also was positive so confirmed the presence of neuroendocrine tumor - glucagonoma. Conclusions: Glucagonoma sometimes may occur without characteristic features which may cause delayed diagnosis. Early diagnosis of glucagonoma is important because it increases the chances of successful recovery.
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Physiotherapy in women after breast cancer treatment – review

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Skutnik K., Ustymowicz W., Zubrewicz K., Zińczuk J., Kamińska D., Pryczynicz A.
Progress in Health Sciences
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2019
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vol. 1
162-168
EN
Introduction: Breast cancer is the most common malignant tumor in women in the Polish region. Surgery is a basic method of breast cancer treatment. Surgery often carries a lot of unwanted changes as follows: limitation of mobility in the shoulder joint on the operated side, secondary lymphoedema, post mastectomy pain syndrome (PMPS), reduction of muscle strength or disorders in body posture. Therefore, the implementation of physiotherapeutic activities that are designed to prevent and eliminate postoperative complications seems very important. The main aim of this work was to present physiotherapeutic management in women after mastectomy based on the analysis of available literature. The physiotherapeutic process can be divided into three periods: early hospital, early ambulatory and the late ambulatory period. In the first period, active slow exercises, self-support of the upper limb on the operated side and breathing exercises on the thoracic track are used to prevent circulatory disorders, pulmonary complications, and edema. The early ambulatory period includes corrective exercises, general improvement exercises, stretching and learning of automatic massage of the upper limb of the operated side. The last period should be enriched by recreational methods of physical activity such as swimming, cycling or Nordic walking to maintain physical fitness, proper mobility of the shoulder girdle and improve the patient's psychophysical state. It is very important the patient regular continues the rehabilitation program after curing of breast cancer as well. In the case of secondary lymphoedema of the upper limb, comprehensive rehabilitation physiotherapy is used, consisting of manual lymphatic drainage, healing exercises, compression therapy, and skin care. Conclusions: Physiotherapy in women after breast cancer surgery is a complex and long-term process. Physiotherapeutic methods are effective in treating complications after surgery of breast cancer surgery. It is necessary to constantly update the physio-therapy knowledge in women after breast cancer surgery.
3
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Spigelian hernia: a case report

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Martyniuk M., Ustymowicz W., Zińczuk J., Pryczynicz A., Guzińska-Ustymowicz K., Kędra B., Zaręba K.
Progress in Health Sciences
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2019
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vol. 2
53-56
EN
Spigelian hernias constitute a minute fraction of all abdominal hernias. In this monography, we present a case report of this relatively seldom seen phenomenon which some general surgeons never get to see during their medical career.
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Symptoms of colorectal cancer contributes to its localization and advancement

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Nizioł M., Kostrzewska B., Kamińska D., Domurat M., Zińczuk J., Misiura M., Guzińska-Ustymowicz K., Pryczynicz A.
Progress in Health Sciences
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2019
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vol. 1
76-82
EN
Introduction: Colorectal cancer is one of the most common cancers occurring in Poland. Unfortunately, this cancer is most often diagnosed at the time of great advancement. This is caused by the appearance of specific symptoms only in the late stages of cancer. Also, such low detection of early stages of adenocarcinoma may be caused by disregarding of slight symptoms. Purpose: To analyse symptoms in patients with colorectal cancer and correlate with chosen clinical-pathological parameters. Materials and methods: The study group consisted of 46 patients diagnosed with colorectal cancer. Information on symptoms associated with cancer (subjective and objective) have been selected from patients' medical history. The presence of these symptoms was correlated with the age and sex of patients, tumor location, histological type of cancer, grade of histological malignancy (G), stage of tumor (T stage), presence of lymph node metastases and distant metastases. Results: It has been shown that the presence of pain complaints described by the patient are associated with the occurrence of cancer in the colon. The painfulness and pathological resistance diagnosed by the physician are more often associated with cancer located in the colon. In the case of tumors located in the rectum, faecal admixtures appear more frequently. It has also been shown that the presence of admixtures of blood and mucus in the stool is associated with more advanced local tumors, infiltrating pericolorectal tissues (T3 + T4). Conclusions: Familiarity with clinical symptoms of colorectal cancer could make patients more sensitive to more often screening for cancer. Analysis of these symptoms could indicate to the physician the location or stage of the cancer.
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Immunohistochemical Fascin-1 expression correlate with lymph node and distant metastases in pancreatic ductal adenocarcinoma

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Pryczynicz A., Nizioł M., Miniewska K., Kamińska D., Kuczyńska P., Zińczuk J., Zaręba K., Guzińska-Ustymowicz K.
Progress in Health Sciences
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2018
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vol. 8(2)
124-130
EN
Introduction: Pancreatic cancer is characterized by its aggressiveness and poor prognosis. Furthermore, mortality is one of the highest among all types of cancers. It has been observed that the expression of Fascin-1 (the actin-bundling protein which enables the motility of cells) is higher in cancer cells and is correlated with invasiveness and metastasis. Purpose: To investigate the expression of Fascin-1 in histopathological specimens from patients treated for pancreatic cancer and its relationship with histopathological parameters. Materials and methods: The study was performed on a group of 52 patients diagnosed with pancreatic cancer in the Medical University of Bialystok Clinical Hospital. The expression of Fascin-1 was evaluated in tissue samples using the immunohistochemical method and was rated as “present” or “absent”. The analysis of histopathological parameters was performed in correlation with Fascin-1 expression. Results: Fascin-1 expression was observed in the cytoplasm of cancer cells in 42/52 cases (80.8%). Fascin-1 expression occurred more frequently among patients with lymph node metastases (92.6%) than without this type of metastases (68%) (p=0.024). Likewise, the expression of the investigated protein was observed more often with the presence of distant metastases (100%) than without those metastases (74.4%) (p=0.043). There were no statistically significant differences about age, sex, histological type of cancer, grade of histological differentiation, desmoplasia, inflammatory infiltration, foci of hemorrhage, necrosis, and MVD. Conclusion: The expression of Fasicn-1 is correlated with the presence of metastases and can be a useful marker of pancreatic cancer involvement.
6
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Expression of EpCAM protein in gastric cancer cells may contribute to its histogenesis

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Nizioł M., Kuczyńska P., Misiura M., Zińczuk J., Zaręba K., Ustymowicz W., Ćwiklińska-Dworakowska M., Baszun M., Jelski S., Guzińska-Ustymowicz K., Pryczynicz A.
Progress in Health Sciences
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2018
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vol. 8(1)
74-79
EN
Introduction: EpCAM protein belongs to adhesion molecules of epithelial cells. It mediates in the homophile adhesion cell-cell reactions. EpCAM protein expression can be observed in the majority of healthy normal cells. However, mutations in EpCAM gene may lead to an increased risk of cancer development. The aim of the study was to assess EpCAM protein expression in the correlation with chosen clinical and histological parameters in gastric cancer. Materials and Methods: EpCAM protein expression was evaluated immunohistochemically in 88 patients diagnosed with gastric cancer. Results: An increase in EpCAM protein expression was demonstrated in cancer cells compared to normal gastric mucosa (59.3% cancers with the positive expression of EpCAM protein). The increased EpCAM protein expression was observed in patients with a histological type of adenocarcinoma without a mucinous component than in those with adenocarcinoma with a mucinous component (p=0.028). The higher expression of this protein was observed also in the intestinal type according to the Lauren classification (p=0.037). The expression of the protein was lower in the diffuse type of cancer. Additionally, an increase in EpCAM protein expression was revealed in cancers infiltrating to the blood vessels (p=0.013). Conclusions: A correlation between EpCAM expression and adenocarcinoma without a mucinous component as well as the intestinal type according to the Lauren classification may prove a role of this protein in the histogenesis of gastric cancer. Moreover, its positive expression is related to cancerous cells infiltrating to the blood vessels, which may suggest a role of EpCAM protein in the early stages of gastric cancer metastases.
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Significance of mucin expression in pancreatic intraepithelial neoplasia (PanIN) – precursor lesions of pancreatic ductal adenocarcinoma (PDAC)

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Zińczuk J., Zaręba K., Pryczynicz A., Kuczyńska P., Boroń Z., Ustymowicz W., Maciorkowska M., Ćwiklińska-Dworakowska M., Baszun M., Jelski S., Guzińska-Ustymowicz K.
Progress in Health Sciences
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2018
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vol. 8(1)
63-73
EN
Purpose: To evaluate chosen mucins (mucin 1, 4, 5AC) expression in pancreatic intraepithelial neoplasia, which is a precursor lesion of pancreatic ductal adenocarcinoma. Materials and methods: The study group included 70 patients operated on due to inflammation, cysts and pancreatic ductal adenocarcinoma with pancreatic intraepithelial neoplasia revealed additionally. Mucin 1, 4 and 5AC expression was assessed by immunohistochemical method using polyclonal antibodies. Results: Statistical analysis proved a positive correlation between the expression of mucin 1, 4 and 5AC proteins and the presence and staging of pancreatic intraepithelial neoplasia (p<0.001). Statistically significant correlations were determined between mucin 1, 4 and 5AC and the location of PanIN lesion in the pancreas. Positive correlations were found between mucin 5AC expression and the type of a basic disease (p=0.014). Differences in the expression of MUC 1, 4 and 5AC proteins between healthy pancreatic ducts and various stages of pancreatic intraepithelial neoplasia were statistically significant (p<0.001). Conclusions: Overexpression of mucin 1, 4 and 5AC is related to the presence of pancreatic intraepithelial neoplasia. This suggests that overproduction of mucus is a phenomenon occurring early in the process of carcinogenesis in the pancreas and has its beginning in precancerous lesions of an early stage.
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