We conclude that serum concentration of adiponectin and resistin may play an important role in colon carcinogenesis. We also assume that leptin may possibly have the prognostic value useful in clinical practice and its concentration is independent of BMI value.

Preoperative plasma leptin concentration cannot be used as a predictor of weight reduction following RYGBP. Preoperative body weight is a reliable predictor of post-RYGBP weight loss.

Patients with resectable pancreatic head cancer based on preoperative imaging studies and high D-dimer level may be considered unresectable due to occult hepatic metastases. These patients may benefit from diagnostic laparoscopy to avoid exploratory laparotomy.

In conclusion, GDF-15 is more accurate than Ca19-9 in differentiating pancreatic mass due to chronic pancreatitis from pancreatic adenocarcinoma. Interleukin 17 and 23 cannot be considered as PDAC biomarkers. GDF-15 concentration in serum should be further investigated in order to assess their usefulness in pancreatic adenocarcinoma diagnosis.

Background. Proper diagnosis of pancreatic lesion etiology is a challenging clinical dilemma. Studies suggest that surgery for suspected pancreatic ductal adenocarcinoma (PDAC) reveals a benign lesion in 5% to 13% of cases. The aim of our study was to assess whether routinely used biomarkers such as CA19-9, Ca125, Ca15-3, and CEA, when combined, can potentially yield an accurate test predicting pancreatic lesion etiology. Methods. We retrospectively analyzed data of 326 patients who underwent a diagnostic process due to pancreatic lesions of unknown etiology. Results. We found statistically significant differences in mean levels of all biomarkers. In logistic regression model, we applied levels CA19-9, Ca125, and Ca15-3 as variables. Two validation methods were used, namely, random data split into training and validation groups and bootstrapping. Afterward, we built ROC curve using the model that we had created, reaching AUC = 0,801. With an optimal cut-off point, it achieved specificity of 81,2% and sensitivity of 63,10%. Our proposed model has superior diagnostic accuracy to both CA19-9 (p = 0,0194) and CA125 (p = 0,0026). Conclusion. We propose a test that is superior to CA19-9 in a differential diagnosis of pancreatic lesion etiology. Although our test fails to reach exceptionally high accuracy, its feasibility and cost-effectiveness make it clinically useful.

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BackgroundSeveral recent studies provide evidence that D-dimer (DD) concentration in peripheral blood correlates negatively with overall survival (OS) in patients with pancreatic ductal adenocarcinoma (PDAC). Contrarily, there are recent evidence indicating that preoperative plasma fibrinogen, but not D-dimer might represent a prognostic factor in non-metastatic gastrointestinal cancers.MethodsIn a single-center prospective study, we enrolled 62 patients undergoing surgery for pathologically confirmed PDAC without detectable venous thrombosis. Intraoperatively, the sample of the blood from the portal vein was obtained. DD concentration in these samples was measured. Patients were followed postoperatively until time of death from any cause.ResultsWe found that OS for patients with portal blood DD values above 2700 (ng/mL) (n = 22 from 62 patients) was higher by 158% than that for the patients (n = 42) with DD values ≤ 2700 (416 days versus 161 days, p = 0.05). On the contrary to the studies investigating DD concentration in peripheral blood, we have found that patients with higher DD level in the portal vein had longer mean OS than patients with lower ones.ConclusionsFurther investigation is necessary both to confirm our results in a larger patient population and to elucidate the mechanism for the correlation between portal blood D-dimer concentrations and survival time. Along with other authors, we conclude that portal circulation is characterized by unique, biological environment that requires further evaluation.

Słowa kluczowe: rak jelita grubego, insulina, insulinopodobny czynnik wzrostu I, gastryna, śródbłonkowy czynnik wzrostu naczyń. Key words: colon cancer, insulin, insulin-like growth factor I, gastrin, vascular endothelial growth factor.Adres do korespondencji: dr n. med. Aleksandra Kaczka, Klinika Chorób Przewodu Pokarmowego, Uniwersytet Medyczny, ul. Kopcińskiego 22, Polska, tel.: +48 42 678 64 80, Artykuł oryginalny/Original paper StreszczenieWstęp: Kancerogeneza jelita grubego jest procesem wieloetapowym, w który zaangażowane są liczne czynniki wzrostu. Cel: Ocena stężenia wybranych czynników wzrostowych w surowicy pacjentów z polipami gruczolakowatymi i rakiem jelita grubego (RJG). Materiał i metody: U 23 chorych na RJG, 36 pacjentów z gruczolakami jelita grubego (GJG) i 16 zdrowych osób oznaczono stężenia insuliny, insulinopodobnego czynnika wzrostu I (insulin-like growth factor I -IGF-I), śródbłonkowego czynnika wzrostu naczyń (vascular endothelial growth factor -VEGF) i gastryny. Wyniki: Stężenie VEGF u chorych na RJG było większe w porównaniu z wartościami obserwowanymi u zdrowych osób (624,81 ±113,99 pg/ml vs 331,43 ±52,87 pg/ml; p < 0,05) i pacjentów z GJG (426,18 ±59,71 pg/ml). Duże stężenia VEGF stwierdzono w szczególności u chorych na RJG w stopniu C i D według klasyfikacji Dukesa (788,82 ±178,85 pg/ml vs 453 ±74,83 pg/ml dla stopnia A i B według Dukesa; p < 0,05) i nie różniły się one w zależności od stopnia zróżnicowania czy lokalizacji guza. Średnie stężenie gastryny było istotnie statystycznie większe u chorych na RJG w porównaniu z pacjentami z GJG i osobami zdrowymi (odpowiednio: 98,25 ±15,91 μU/ml vs 64,72 ±6.14 μU/ml i 67,86 ±8,13 μU/ml; p < 0,05). Znamiennie statystycznie większe stężenia gastryny wystę-powały u chorych z dystalną lokalizacją guza w porównaniu z proksymalną (115,46 ±23,26 μU/ml vs 68,13 ±23,26 μU/ml; p < 0,05) oraz w guzach w stopniu zaawansowania A i B według Dukesa. Nie stwierdzono statystycznie istotnych róż-nic w stężeniach insuliny i IGF-I między badanymi grupami. AbstractIntroduction: Colon carcinogenesis is a multi-step process in which many growth factors are involved. Aim: Evaluation of the serum concentrations of selected growth factors in patients with colonic adenomas (CA) and colon cancer (CC). Material and methods: In 23 patients with CC, 36 patients with CA and in 16 healthy persons serum concentrations of insulin, insulin-like growth factor I (IGF-I), vascular endothelial growth factor (VEGF) and gastrin were analysed. Results: The VEGF serum levels were elevated in patients with CC compared with healthy patients (624.81 ±113.99 pg/ml vs. 331.43 ±52.87 pg/ml; p < 0.05) and patients with CA (426.18 ±59.71 pg/ml). Elevated VEGF levels were observed particularly in Duke's C and D stage (788.82 ±178.85 pg/ml vs. 453 ±74.83 pg/ml for Duke's A i B; p < 0.05). Mean gastrin concentration was significantly higher in patients with CC than in patients with CA and in the control group (respectively: 98.25 ±15.91 μU/ml vs. 64.72 ±6.14 μU/ml and 67.86 ±8.13 μU/ml; p < 0.0...