Background and objectives: T regulatory lymphocytes (Treg) are one of the subsets of T-lymphocytes involved in the interaction of neoplastic tumors and the host immune system, and they may impair the immune reaction against cancer. It has been shown that Treg are increased in the peripheral blood of patients with various cancers. In colorectal cancer, the prognostic role of Treg remains controversial. Colorectal cancer is a heterogenous disease, with many variations stemming from its primary tumor location. The aim of this study is to analyse the relationship between the amount of Treg in the peripheral blood of patients with left-sided colorectal cancer in various stages of disease and long-term survival. Materials and Methods: A prospective analysis of 94 patients with left-sided colorectal cancer and a group of 21 healthy volunteers was carried out. Treg levels in peripheral blood were analysed using flow cytometry. Results: There was a statistically significant difference between the amount of Treg in the Ist and IInd TNM stages (p = 0.047). The number of Treg in the entire study group was significantly lower than in the control group (p = 0.008) and between patients in stages II and III and the control group (p = 0.003 and p = 0.018). The group of pT3+pT4 patients also had significantly lower Treg counts in their peripheral blood than the control group (p = 0.005). In the entire study group, the level of Treg cells in the peripheral blood had no influence on survival. The analysis of the TNM stage subgroups also showed no difference in survival between patients with “low” and “high” Treg counts. Conclusion: The absolute number of Treg in the peripheral blood of patients with left-sided colorectal cancer was significantly decreased in comparison to healthy controls, especially for patients with stage II+III disease. Treg presence in the peripheral blood had no impact on survival.

Introduction. The Vipera berus (common viper) is the only species of venomous snake found in Poland. The aim of this study was to determine to what extent coagulopathy has occurred as a post-bite complication. Materials and method. The medical records of 138 adult patients in the Sucha Beskidzka hospital with the diagnosis of snake bite between 2001-2014 were retrospectively analyzed. Demographic, clinical and laboratory data were collected. Antivenom was given to all patients, except one, with snake bites, but laboratory test were taken prior to administration of antivenom. Obtained results were compared to those of the control group, composed of 176 adults hospitalized in the same period for an elective laparoscopic cholecystectomy. Results. The mean platelet count in the study group was 239.94×109/L (SD=56.56) and 248.77×109/L (SD=57.82) in the control group. In 98% of the study group and 100% of the control group the platelet value (PLT) fell within laboratory norms (130 to 420×109/L), 2 patients after snake bites had a PLT lower than normal, and thrombocytosis was not observed in either group. A reference range of 0.85-1.3 INR below normal was found in 2 patients in the study group and 15 from the control group, while values above the normal range were found in 8 patients (6.7%) from the snake bite group and no patients from the control group. In the study group, the INR ranged from 0.78-1.43 with a mean of 1.046 (SD=0.14), while in the control group the range was from 0.79-1.28, with a mean of 0.95 (SD=0.08). There was a significant difference in INR between the study and control groups (p<0.0001). Conclusions. The bite from V. berus does not result in severe thrombocytopenia, with only a moderate increase in INR values observed in about 7% of patients.

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Introduction. Current knowledge about colorectal cancer (CRC) identifies tumor immunogenicity as one of the more important issues. In cancers, a prerequisite for immune system activation is the presentation of tumor associated antigen (TAA) epitopes to immunocompetent cells. HLA-A2 is one of the antigens in the context of which TAAs are present, but data on the possible impact of HLA-A2 antigen expression on the survival of patients with colorectal cancer are scarce and sometimes contradictory. The aim of this study was to analyse the relationship between HLA-A2 expression in patients with left-sided colorectal cancer in various stages of disease and their long-term survival, and to answer the question of whether a lack of HLA-A2 expression is actually a negative prognostic factor. Material and methods. A prospective analysis of 58 patients with left-sided colorectal cancer was carried out. Expression of HLA-A2 was determined by patient blood lymphocyte staining, and analysed using flow cytometry. Results. In the study group, patients with HLA-A2 expression lived statistically longer than HLA-A2 negative patients (p = 0.027). There was no significant difference in overall survival between the HLA-A2+ and HLA-A2-groups with stage II and III left-sided CRC. However, the Cox proportional hazard model showed that a lack of HLA-A2 expression was a negative prognostic factor in the group of radically operated patients without distant metastases. Conclusions. HLA-A2 status may affect the clinical course of patients with left-sided colon and rectal cancer, although left-sided tumors are less immunogenic than right-sided ones. HLA-A2-positive patients with left-sided colorectal cancer lived statistically longer than those who were HLA-A2-negative (p = 0.027). Lack of HLA-A2 expression was a negative prognostic factor in the group of radically operated patients.