Degradation components of basement membrane could be crucial for tumor invasion. A key role in this process has been assigned to cysteine proteases, i.e. cathepsins and matrix metalloproteinases. The purpose of this study was to investigate the relationship of the expression of MMP-9 and cathepsin B with tumor aggressiveness expressed by lymph node metastases and survival rates in gastric carcinoma patients. Slides of 5 μm-thick serial sections from 91 patients with primary gastric carcinoma were prepared and analyzed for MMP-9 and cathepsin B expression using anti-human monoclonal antibody (NCL-MMP-9 clone; dilution 1:40 and NCL-CATH-B clone; dilution 1:40). The patients were clinically monitored for 84 months. We found no association between the expression of MMP-9 and cathepsin B in main mass of tumor and patients' gender, tumor location, Lauren's classification or histological differentiation. Also no correlation was observed between the expression of MMP-9 in main mass of tumor and depth of invasion. A strong statistically significant association was found between the expression of MMP-9 and cathepsin B in main mass of tumor and lymph node involvement (p<0.001; p<0.001, respectively). However, we observed no correlation between the expression of MMP-9 and cathepsin B in main mass of tumor and lymph node involvement or 5-year overall survival. Our results may suggest that the expression of matrix metalloproteinase-9 (MMP-9) and cathepsin B is correlated with lymph node metastasis in advanced gastric carcinoma, but not with patients' postoperative survival.

Abstract:The current study objective was to assess the proliferation indices (PI) of Ki-67, PCNA and MCM2 proteins in advanced gastric cancer and in metastatic lymph node in correlation with certain clinicopathological features and with postoperative survival of patients. The study was conducted in a group of 100 patients with advanced gastric cancers. Involvement of local lymph nodes was present in 36 cases. Immunohistochemical investigations were carried out using monoclonal antibodies against Ki-67 (DAKO), PCNA (DAKO) and polyclonal antibody to MCM2 (Santa Cruz Biotechnology). Visualization of the antigen/antibody complex was performed using LSAB technique (biotin-streptavidin-peroxidase) followed by application of chromogene DAB (DAKO). Statistical analysis revealed no correlations of Ki-67, PCNA and MCM2 PI in tumour tissue or metastatic lymph node with patients' age and gender, tumour location, histological grade, macroscopic type according to Bormann's classification and histological grading by Lauren's and Goseki's classifications. Moreover, no correlation was observed of Ki-67 and MCM2 PI in tumour tissue with histological grading. No correlation was also noted between the proliferation indices of all the three proteins in the affected lymph node and grade of histological differentiation. Such clinicopathological parameters as patients' age and gender, histological grading by Lauren's and Goseki's classifications and lymph node involvement did not correlate with survival time of patients. Furthermore, no statistically significant correlation was shown of postoperative survival time with Ki-67 and MCM2 PI in tumour tissue and metastatic lymph nodes and with PCNA PI in the affected lymph nodes. However, a statistically significant correlation was found of Ki-67, PCNA and MCM2 PI in tumour tissue and metastatic lymph nodes with depth of wall invasion and local lymph node involvement. A statistically significant correlation was also noted between PCNA PI in the main mass of tumour and histological grading. The postoperative survival time of patients exhibited a statistically significant correlation with tumour location and macroscopic type according to Bormann's classification. Correlations on statistical borderline were noted between survival time and depth of gastric wall invasion and PCNA PI in the main mass of tumour.

Caecal volvulus is very rare causa of the intestinal obstruction. It ocures in 1-1,5% of all intestinal obstructions. It is known that there is only on treatment in this situation which is surgery. It is classified as an obstruction because of strangulation. We present a case of the 46 year old patient, who was operated because of intestinal obstruction. During the operation caecal volvulus has been found, with gangrene of the appendices.

Background: The invasion and metastases of gastric cancer (GC) depends on the activities of matrix metalloproteinases and tissue inhibitors of metalloproteinases. It was suggested that the concentration of plasma matrix metalloproteinase-9 (MMP-9) is better than the concentration of serum MMP-9 for prediction of evolution of GC. The aim of the present study was to compare the clinical usefulness of plasma and serum tissue inhibitor of metalloproteinases-1 (TIMP-1) in the diagnosis and prognosis of GC. Methods: Plasma and serum concentrations of TIMP-1, MMP-9 and carcinoembryonic antigen (CEA) were assayed in 73 patients with GC and 61 healthy controls. The diagnostic criteria and prognostic value for the measurands were defined. Results: Plasma and serum TIMP-1, MMP-9 and CEA were significantly higher in GC patients compared with healthy controls. The area under the ROC curve (AUC) (0.961), diagnostic sensitivity (89%) and accuracy (91%) of plasma TIMP-1 were higher than those for MMP-9 and CEA. An increased pre-treatment concentration of plasma TIMP-1 was a significant independent prognostic factor for the survival of patients with GC. Conclusions: These findings suggest that the plasma TIMP-1 is a better biomarker than the serum TIMP-1 and might be useful for the diagnosis of GC and prognosis of patient survival. Clin Chem Lab Med 2009;47:1133-9.

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We would like to recommend this method as an alternative to Roux-en-Y procedure because of its simplicity and safeness.

Ménétrier’s disease (MD) is a rare type of hypertrophic gastropathy involving the body of the stomach, which is characterized by thickening of the mucous membrane in the form of giant rugal folds, hypochlorhydria and protein loss. The potential for malignant transformation of this lesion remains a controversial topic. Therefore, in the present study, a case of a 51-year-old male exhibiting MD with coexisting advanced gastric cancer is described; a review of the literature is also presented. The present case emphasized that MD requires particular attention and should be regarded as a premalignant condition due to the previously documented cases of its coexistence with gastric cancer, in addition to the lack of knowledge regarding its pathogenesis and effective therapeutic management.

Gastric cancer is the second commonest cause of cancer-associated death in the world. Its molecular markers can be useful not only for diagnostic, but also prognostic purposes. The aim of the study was to assess the usefulness of soluble angiogenesis markers such as endoglin and VEGFR2 in gastric cancer patients and to compare these results with those of VEGF levels. As a secondary objective, we compared the concentrations of all three soluble markers in plasma and serum. The study was performed on 26 patients with gastric cancer (17 intestinal-type and 9 diffuse-type), and additionally in 2 patients with B cell lymphoma and 2 with gastro-intestinal stromal tumor. In summary, we showed increases in circulating VEGF-A in patients with both types of gastric cancer. The levels of VEGFR2 did not change significantly in patients with gastric cancer as compared to healthy subjects. Interestingly, after the operation greater levels of VEGFR2 were observed in patients without metastases. Both VEGF and VEGFR2 circulating levels were greater in patients with lymphoma, when compared to both gastric cancer patients and the control group. However, because of small number of patients, this requires further studies. Presented data suggests that endoglin does not seem to be a valuable tool in the assessment of gastric cancer invasion and spread.