Synchronous Double Malignant Tumors Consisting of Stomach and Hodgkin's Lymphoma with Collision between Gastric Adenocarcinoma and Hodgkin's Lymphoma in the Stomach

We report the rare case of a 72-year-old man with double cancers (gastric adenocarcinoma and Hodgkin's lymphoma) with collision between gastric adenocarcinoma and Hodgkin's lymphoma. Abdominal computed tomography showed increased wall thickness in the fundus region of the stomach and multiple lymph node swellings in the lesser curvature, periceliac and left cardial regions. Upper gastrointestinal endoscopy showed an ulcer approximately 5 cm in diameter with a malignant appearance in the fundus region of the stomach. On histopathologic examination, two completely different tumors were recognized in the stomach. One tumor was a poorly differentiated adenocarcinoma characterized by poorly developed tubular structures associated with prominent lymphoid infiltration of the stroma. The other tumor was found to have proliferated in the wall of the stomach, with diffuse granulomatous lesions and bordering the adenocarcinoma. Large atypical lymphoid cells with prominent nucleoli and enlarged mononuclei or multinuclei were seen in the latter tumor. Hodgkin's lymphoma was also found in the swollen lesser curvature lymph nodes. As a result, gastric adenocarcinoma and metastasis of Hodgkin's lymphoma were collided in the stomach. In conclusion, this case might be helpful in exploring the occurrence mechanism of tumor collision between lymphoma and carcinoma.

Durable complete response of metastatic gastric cancer with anti-Met therapy followed by resistance at recurrence

A 48 year-old female with chemo-refractory metastatic gastric cancer to the liver was treated on a Phase I clinical trial with MetMAb, a monoclonal antibody targeting the Met tyrosine kinase receptor. The primary tumor had high MET gene polysomy and evidence for an autocrine production of HGF, the growth factor ligand of Met. A complete response was obtained lasting two years; the cancer recurred as a peritoneal deposit invading into the transverse colon and a gastrohepatic ligament node. Compassionate use of MetMAb therapy at recurrence achieved a mixed response--a partial response of the two initial lesions, but with development of multiple new foci of carcinomatosis. Tissue and serum studies evaluating the Met signaling pathway did correlate with MetMAb treatment response initially and at the time of recurrence.

SIGNIFICANCE

This research brief is the first to describe a durable complete response obtained with a molecularly targeted monoclonal antibody, MetMAb, to the receptor tyrosine kinase, Met, in a patient with chemorefractory metastatic gastric cancer. It is also the first to report biomarkers that predicted therapeutic response to Met inhibition.

Loss of fragile histidine triad and amplification of 1p36.22 and 11p15.5 in primary gastric adenocarcinomas

AIM: To investigate the genomic copy number alterations that may harbor key driver genes in gastric tumorigenesis.

METHODS: Using high-resolution array comparative genomic hybridization (CGH), we investigated the genomic alterations of 20 advanced primary gastric adenocarcinomas (seventeen tubular and three mucinous) of Chinese patients from the Jilin province. Ten matching adjacent normal regions from the same patients were also studied.

RESULTS: The most frequent imbalances detected in these cancer samples were gains of 3q26.31-q27.2, 5p, 8q, 11p, 18p, 19q and 20q and losses of 3p, 4p, 18q and 21q. The use of high-resolution array CGH increased the resolution and sensitivity of the observed genomic changes and identified focal genetic imbalances, which included 54 gains and 16 losses that were smaller than 1 Mb in size. The most interesting focal imbalances were the intergenic loss/homozygous deletion of the fragile histidine triad gene and the amplicons 11q13, 18q11.2 and 19q12, as well as the novel amplicons 1p36.22 and 11p15.5.

CONCLUSION: These regions, especially the focal amplicons, may harbor key driver genes that will serve as biomarkers for either the diagnosis or the prognosis of gastric cancer, and therefore, a large-scale investigation is recommended.

Normal carcinoembryonic antigen indicates benefit from perioperative chemotherapy to gastric carcinoma patients

AIM: To evaluate pretreatment serum carcinoembryonic antigen (CEA) as a predictor of survival for patients with locally advanced gastric cancer receiving perioperative chemotherapy.

METHODS: We retrospectively studied a cohort of 228 gastric cancer patients who underwent D2 gastrectomy combined with chemotherapy at the Sun Yat-sen University Cancer Center between January 2005 and December 2009. Among them, 168 patients received 6-12 cycles of oxaliplatin-based adjuvant (post-operative) chemotherapy, while 60 received perioperative chemotherapy (2 cycles of FOLFOX6 or XELOX before surgery and 4-10 cycles after surgery). Serum CEA was measured using an enzyme immunoassay. The follow-up lasted until December 2010.

RESULTS: In the group that had elevated serum CEA, the difference in survival time between patients receiving perioperative chemotherapy and those receiving adjuvant chemotherapy had no statistical significance (P > 0.05). However, in the group that had normal serum CEA, patients receiving perioperative chemotherapy had a longer survival time. In multivariate analysis, T staging and lymph node metastatic rate were independent prognostic factors for the patients. Perioperative chemotherapy improved the overall survival of patients who had a normal pretreatment CEA level (P = 0.070).

CONCLUSION: Normal pretreatment serum CEA is a predictor of survival for patients receiving perioperative chemotherapy.

Significance of SLP-2 expression in gastric adenocarcinoma

AIM: To investigate the expression of stomatin-like protein 2 (SLP-2) in gastric adenocarcinoma and to analyze its significance.

METHODS: The expression of SLP-2 mRNA and protein was detected by RT-PCR in 40 cases and by immunohistochemistry in 45 cases of human gastric adenocarcinoma and adjacent tumor-free tissue, respectively. The relationship between SLP-2 expression and clinicopathologic characteristics of gastric adenocarcinoma was then analyzed.

RESULTS: The expression of SLP-2 mRNA and protein in gastric adenocarcinoma was significantly higher than that in adjacent tumor-free tissue (68.9% vs 26.7%, 1.12 ± 0.47 vs 0.63 ± 0.31, both P < 0.01). SLP-2 expression in gastric adenocarcinoma was associated with lymph node metastasis and TNM stage (χ² = 5.32, 4.78, both P < 0.05), but not with other clinicopathologic characteristics (all P > 0.05).

CONCLUSION: The expression of SLP-2 is increased in gastric adenocarcinoma. SLP-2 may play important roles in the occurrence, development and metastasis of gastric adenocarcinoma.

Comparisons of Gastric Cancer Treatments: East vs. West

There has been a large amount of speculation concerning the differences in the outcomes in patients who have gastric cancer in the Eastern and Western worlds. The differences in biology, surgical and adjuvant treatment have been used to explain such differences. There are clear differences observed in the histology (diffuse vs. intestinal), tumor location (proximal vs. distal), environmental exposures, dietary factors and Helicobacter pylori status. A higher incidence of gastric cancer in the East has led to screening programs, and leading to an earlier stage at presentation. Surgical treatment differs in that the extended lymph node dissection is routinely practiced in the Asian countries. Additionally, different adjuvant therapeutic regimens are used in both regions. The purpose of this review is to describe the differences in both presentation and treatment between the East and the West.

Association between CDH1 gene polymorphisms and tongue coatings in patients with gastric adenocarcinoma

AIM: To investigate the association between CDH1 gene polymorphisms and tongue coatings in patients with gastric adenocarcinoma.

METHODS: PCR-RFLP method was used to detect the polymorphisms of the CDH1 gene in 387 patients with gastric adenocarcinoma and 392 normal control subjects.

RESULTS: The percentages of subjects not eating on time, those eating salty flavor, and smoking subjects were higher in the gastric adenocarcinoma group than in the control group (χ² = 9.124, P = 0.010; χ² = 74.409, P < 0.001; χ² = 18.019, P < 0.001). The frequencies of regularly eating soy products and fresh fruit in the gastric adenocarcinoma group were significantly lower than those in the control group (χ² = 10.669, P = 0.014; χ² = 59.905, P < 0.001). The frequencies of mutated genotypes of rs13689 and rs17690554 and yellow tongue coating were significantly higher in the case group than in the control group (χ² = 4.064, P = 0.044; χ² = 5.868, P = 0.015).

CONCLUSION: CDH1 gene polymorphisms may be associated with the change in tongue coatings in patients with gastric adenocarcinoma.

Clinical significance of expression of ANXA2 and ANXA4 in gastric adenocarcinoma

AIM: To investigate the expression of annexin A2 (ANXA2) and annexin A4 (ANXA4) in human gastric adenocarcinoma (GAC) and to explore the relationship between their expression and biological behaviors of GAC.

METHODS: The expression of ANXA2 and ANXA4 was detected by immunohistochemistry in a tissue microarray containing 75 pairs of GAC and matched tumor-adjacent tissue specimens.

RESULTS: The positive rates of ANXA2 and ANXA4 expression in GAC were significantly higher than those in tumor-adjacent tissue (33.1% vs 1.3%, 68.0% vs 25.5%, both P < 0.05). The expression of ANXA2 was positively correlated with that of ANXA4 in GAC (r = 0.335, P = 0.003). The expression of ANXA2 and ANXA4 was closely associated with invasion depth, lymph node metastasis, TNM stage and differentiation grade in GAC (all P < 0.05), but not with sex, age or distant metastasis (all P > 0.05). Tumor size had a correlation with the expression of ANXA2 (P < 0.05), but not with that of ANXA4 (P > 0.05).

CONCLUSION: Overexpression of ANXA2 and ANXA4 may play a synergistic role in the carcinogenesis, invasion and metastasis of GAC. ANXA2 and ANXA4 may be used as targets for GAC therapy and markers for prognostic prediction.

Proteomic analysis of gastric cancer and immunoblot validation of potential biomarkers

AIM: To search for and validate differentially expressed proteins in patients with gastric adenocarcinoma.

METHODS: We used two-dimensional gel electrophoresis and mass spectrometry to search for differentially expressed proteins in patients with gastric adenocarcinoma. A set of proteins was validated with immunoblotting.

RESULTS: We identified 30 different proteins involved in various biological processes: metabolism, development, death, response to stress, cell cycle, cell communication, transport, and cell motility. Eight proteins were chosen for further validation by immunoblotting. Our results show that gastrokine-1, 39S ribosomal protein L12 (mitochondrial precursor), plasma cell-induced resident endoplasmic reticulum protein, and glutathione S-transferase mu 3 were significantly underexpressed in gastric adenocarcinoma relative to adjacent non-tumor tissue samples. On the other hand, septin-2, ubiquitin-conjugating enzyme E2 N, and transaldolase were significantly overexpressed. Translationally controlled tumor protein was shown to be differentially expressed only in patients with cancer of the gastric cardia/esophageal border.

CONCLUSION: This work presents a set of possible diagnostic biomarkers, validated for the first time. It might contribute to the efforts of understanding gastric cancer carcinogenesis.

Relationships among changes in tongue coating, levels of serum soluble E-cadherin, clinical examination parameters and gastric adenocarcinoma

AIM: To investigate the relationship between serum soluble E-cadherin (sE-cad) levels and changes in tongue coating in patients with gastric adenocarcinoma and healthy controls.

METHODS: This was a case-control study involving 266 gastric adenocarcinoma cases and 252 healthy controls. Serum levels of sE-cad were measured by ELISA. The correlations among serum sE-cad levels, clinical examination parameters and type of tongue coating were analyzed using nonparametric tests.

RESULTS: Serum levels of sE-cad were significantly higher in gastric adenocarcinoma cases than in healthy controls (P < 0.01), in patients before operation than in those after operation (P < 0.05), and in patients with metastasis than in those without metastasis (P < 0.05). The levels of sE-cad were highest in patients with white thick coating, followed by those with white thin coating, yellow thick coating, yellow thin coating and exfoliative coating (P < 0.05), whereas the order in healthy controls was yellow thin coating, yellow thick coating, white thin coating, white thick coating and exfoliative coating (P > 0.05). The proportion of gastric adenocarcinoma cases with abnormal clinical examination parameters was higher than that of healthy controls (P < 0.05). Especially, gastric adenocarcinoma cases with thick and thin coatings and abnormal total protein had higher levels of sE-cad than healthy controls (P < 0.05).

CONCLUSION: The changes in thick and thin coatings and levels of total protein and sE-cad in serum can offer clues for diagnosis and treatment of gastric adenocarcinoma.

Influence of age and gender on association between -765G > C COX-2 genetic polymorphism and gastric adenocarcinoma risk: a case-control study in Iran

AIM

The purpose of this study was to investigate the possible influence of age and gender on association between -765G > C COX-2 genetic polymorphism and gastric adenocarcinoma risk in Iranian patients.

BACKGROUND

The promoter polymorphism of COX-2 gene -765G > C has been described to play an important role in many cancers such as gastric cancer.

PATIENTS AND METHODS

We carried out single-nucleotide polymorphism analysis in Iranian samples including 91 patients and 91 control normal using PCR- RFLP technique.

RESULTS

Statistical analysis revealed no significant association between GG, GC and CC genotypes and risk of gastric adenocarcinoma. However differences were considered significant (P=0.043) for female subjects with C carrier genotypes (GC and CC) and gastric adenocarcinoma when compared with male patients (P=0.645) and control groups (P=0.653). Also, there was a statistically significant difference between increasing of age and susceptibility for gastric adenocarcinoma (Odd Ratio=1.125, 95% CI=1.089-1.162).

CONCLUSION

These results suggested that Iranian C carrier females can be more susceptible for gastric adenocarcinoma in comparison with control group. Also increasing of age should be considered as a risk factor for this disease.

Acral-type Malignant Acanthosis Nigricans Associated with Gastric Adenocarcinoma

Acanthosis nigricans is a symmetric eruption characterized by the presence of a hyperpigmented, velvety cutaneous thickening, that can develop on any part of the body, but characteristically affects the flexural areas of the body. The velvety hyperkeratotic lesions can be located on the dorsum of the hands and feet in dark-skinned people in the form of a variant of acanthosis nigricans called as acral acanthotic anomaly or acral type acanthosis nigricans. Although acanthosis nigricans is associated with malignant tumors, particularly gastric carcinoma, acral type acanthosis nigricans has never been reported to be associated with gastric adenocarcinoma. In our present study, we describe a case of 58-year-old man with acral type acanthosis nigricans and its association with carcinoma of the stomach; a marked improvement was seen in the skin condition of the patient with chemotherapy.

Prognostic significance of erythropoietin and erythropoietin receptor in gastric adenocarcinoma

AIM: To investigate the expression of Erythropoietin (Epo) and its receptor (EpoR) in gastric adenocarcinoma (GAC) and the correlation with angiogenesis and clinicopathological features.

METHODS: The expressions of Epo, EpoR and vascular endothelial growth factor (VEGF), as well as microvessel density were evaluated in 172 GAC biopsies by immunohistochemical staining. The correlations between these parameters and patient’s clinicopathological features were analyzed statistically.

RESULTS: The proportion of Epo and EpoR alterations in GAC was higher than that in adjacent normal mucosa (P = 0.035 and 0.030). Epo high-expression was associated with EpoR high-expression, Lauren type, extensive lymph node metastasis and advanced stage of GAC (P = 0.018, 0.018, 0.004 and 0), while EpoR expression was linked with older age, World Health Organization type, extensive lymph node metastasis and advanced stage (P = 0.001, 0.013, 0.008 and 0.001). VEGF high expression was significantly correlated with EpoR low-expression, Lauren type, extensive lymph node metastasis and advanced stage (P = 0.001, 0.001, 0.001 and 0.007). The expression of Epo or EpoR was associated with microvessel density (P = 0.004 and 0.046). On multivariate analysis, only lymph node metastasis, abnormal Epo expression and tumor nodes metastases stage were independently associated with survival. In addition, a strong association with the immunohistochemical expression of EpoR and the angiogenic protein, VEGF, was noted.

CONCLUSION: Increased expression of Epo and EpoR may play a significant role in the carcinogenesis, angiogenesis and progression of GAC. Epo may be an independent prognostic factor.

Significance of expression of p-FAK and paxillin in gastric adenocarcinoma

AIM: To investigate the expression of phosphorylated focal adhesion kinase (p-FAK) and paxillin in gastric adenocarcinoma and to analyze their clinical significance.

METHODS: Immunohistochemistry was used to detect the expression of p-FAK and paxillin in 85 gastric adenocarcinoma specimens and 20 normal gastric specimens.

RESULTS: The positive rates of both p-FAK and paxillin expression in gastric carcinoma were significantly higher than those in normal gastric tissue (47% vs 5%; 70% vs 30%, both P < 0.05). Both p-FAK and paxillin expression was related to tumor differentiation, invasion depth, lymph node metastasis and clinical stage (all P < 0.05), but not to age and gender (both P > 0.05). A positive correlation was also noted between the expression of p-FAK and paxillin in gastric carcinoma (r = 0.505, P < 0.05).

CONCLUSION: P-FAK and paxillin play significant roles in the development and progression of gastric adenocarcinoma. Expression of p-FAK and paxillin can be used as useful parameters for clinical assessment of tumor biological behavior and prognosis in patients with gastric adenocarcinoma.

Regulatory effect of IFN-γ on the survivin signaling pathway in gastric adenocarcinoma

AIM: To characterize the role of survivin in the pathogenesis of gastric adenocarcinoma and to investigate the regulatory effect of interferon-γ (IFN-γ) on the survivin signaling pathway in gastric adenocarcinoma.

METHODS: Protein expression was examined by immunohistochemistry. After IFN-γ and antisense oligonucleotide against survivin were used to treat SGC7901 cells, mRNA and protein expression was tested by RT-PCR and immunocytochemistry, respectively, and apoptosis was determined by Hoechst 33258 staining. Statistical analysis was performed using the Spearman's rank correlation test and student's t-test.

RESULTS: There was a positive correlation between caspase-7 and survivin expression (P = 0.03) as well as between caspase-7 and p21^waf (P = 0.02) expression in gastric adenocarcinoma. Treatment with survivin antisense oligonucleotide down-regulated the protein expression of survivin (P < 0.05) but had no significant impact on caspase-7 and p21^waf protein expression (both P > 0.05). IFN-γ treatment down-regulated the mRNA expression of survivin (P < 0.05) but up-regulated the mRNA expression of caspase-7 and p21^waf (both P < 0.05). Treatment with either IFN-γ or survivin antisense oligonucleotide had no significant impact on cell apoptosis.

CONCLUSION: Although the expression of survivin is correlated with that of caspase-7 and p21^waf, survivin can not regulate apoptosis in gastric adenocarcinoma by regulating caspase-7 and p21^waf expression. IFN-γ can regulate apoptosis in gastric adenocarcinoma by down-regulating survivin expression and up-regulating caspase-7 and p21^waf expression.

Alterations of tumor-related genes do not exactly match the histopathological grade in gastric adenocarcinomas

AIM: To investigate the diverse characteristics of different pathological gradings of gastric adenocarcinoma (GA) using tumor-related genes.

METHODS: GA tissues in different pathological gradings and normal tissues were subjected to tissue arrays. Expressions of 15 major tumor-related genes were detected by RNA in situ hybridization along with 3’ terminal digoxin-labeled anti-sense single stranded oligonucleotide and locked nucleic acid modifying probe within the tissue array. The data obtained were processed by support vector machines by four different feature selection methods to discover the respective critical gene/gene subsets contributing to the GA activities of different pathological gradings.

RESULTS: In comparison of poorly differentiated GA with normal tissues, tumor-related gene TP53 plays a key role, although other six tumor-related genes could also achieve the Area Under Curve (AUC) of the receiver operating characteristic independently by more than 80%. Comparing the well differentiated GA with normal tissues, we found that 11 tumor-related genes could independently obtain the AUC by more than 80%, but only the gene subsets, TP53, RB and PTEN, play a key role. Only the gene subsets, Bcl10, UVRAG, APC, Beclin1, NM23, PTEN and RB could distinguish between the poorly differentiated and well differentiated GA. None of a single gene could obtain a valid distinction.

CONCLUSION: Different from the traditional point of view, the well differentiated cancer tissues have more alterations of important tumor-related genes than the poorly differentiated cancer tissues.

Thrombotic microangiopathy with severe renal failure in adenocarcinoma

Kidney disease frequently complicates malignancy and its treatment. The spectrum of renal disease in cancers includes acute kidney injury, chronic kidney disease and tubular disorders. Thrombotic microangiopathy (TMA) is an uncommon initial clinical presentation of malignancies. Renal failure is an extremely rare feature of cancer-associated TMA syndromes in the absence of chemotherapy. Here, we report a patient who presented to the hospital for the first time with TMA and severe renal failure requiring hemodialysis and was diagnosed with gastric adenocarcinoma.

Hemidystonia as an initial manifestation of leptomeningeal metastasis

A 76-year-old woman gradually developed action dystonia of the left hand and foot. Leptomeningeal metastasis of the right fronto-parietal area associated with gastric adenocarcinoma was found on the brain magnetic resonance imaging (MRI) and positron emission tomography (PET) studies. We discuss the mechanisms involved in the development of secondary hemidystonia and review dystonia associated with cortical lesions.

Role of IFN-γ-STAT1 pathway in human gastric adenocarcinoma

AIM: To investigate relationships among STAT1, Caspase-7 and p21^waf in gastric adenocarcinoma tissue and gastric adenocarcinoma cell SGC7901, and to shed light on features of IFN-γ-STAT1 pathway in gastric adenocarcinoma.

METHODS: Gastric adenocarcinoma tissue was tested by immunohistochemical method. SGC7901 cell was treated with IFN-γ and STAT1 antisense oligonucleotides, and mRNA and protein expression was detected using RT-PCR, immunocytochemistry and image analysis methods. Apoptosis was determined by Hoechest 33258.

RESULTS: Caspase-7 was positive correlation with STAT1 and p21^waf (r = 0.32, 0.22, both P < 0.05) in gastric adenocarcinoma tissue. IFN-γ promoted mRNA and protein expression of STAT1, Caspase-7 and p21^waf was up-regulated in SGC7901 cell (P < 0.05). After treatment with IFN-γ along with varied concentrations of STAT1 antisense oligonucleotides, significantly lower STAT1 mRNA and protein expression was observed than IFN-γ used alone in SGC7901 cells, which showed a concentration-dependent manner (P < 0.05); significantly lower Caspase-7 and P21^waf protein expression was observed than IFN-γ used alone in SGC7901 cell in a concentration-dependent manner (P < 0.05). However, mRNA expression of Caspase-7 was down-regulated first and then up-regulated, while mRNA expression of p21waf was up-regulated first and then down-regulated.

CONCLUSION: There is a IFN-γ-STAT1 pathway in gastric adenocarcinoma tissue and SGC7901 cell line. IFN-γ-STAT1 could up-regulate the expression of Caspase-7 and p21^waf in gastric adenocarcinoma, but could not induce apoptosis. The downstream molecular of IFN-γ- STAT1 pathway has different expression features in mRNA and protein expression level in gastric adenocarcinoma.

Concomitant gastric adenocarcinoma and stromal tumor in a woman with polymyalgia rheumatica

Gastrointestinal stromal tumors (GISTs) are rare neoplasms (1%) of the gastrointestinal tract and to our knowledge only rare cases of synchronous presentation of gastric carcinomas and GISTs are reported in the literature. A 72-year-old female with a simultaneous presentation of gastric adenocarcinoma and GIST is presented. Moreover, due to polymyalgia rheumatica the patient received corticosteroids as treatment for the last 3 years. The concomitant occurrence of these neoplasms may involve common carcinogenic factors and there could be an association with polymyalgia rheumatica either as a paraneoplastic presentation or due to its treatment with corticosteroids.

MYC and gastric adenocarcinoma carcinogenesis

MYC is an oncogene involved in cell cycle regulation, cell growth arrest, cell adhesion, metabolism, ribosome biogenesis, protein synthesis, and mitochondrial function. It has been described as a key element of several carcinogenesis processes in humans. Many studies have shown an association between MYC deregulation and gastric cancer. MYC deregulation is also seen in gastric preneoplastic lesions and thus it may have a role in early gastric carcinogenesis. Several studies have suggested that amplification is the main mechanism of MYC deregulation in gastric cancer. In the present review, we focus on the deregulation of the MYC oncogene in gastric adenocarcinoma carcinogenesis, including its association with Helicobacter pylori (H pylori) and clinical applications.

Properties of autofluorescence, absorption coefficient and scattering coefficient spectra for human gastric adenocarcinoma tissues

AIM: To investigate the characteristics of autofluorescence, absorption coefficient spectrum and scattering coefficient spectrum for human gastric adenocarcinoma tissues.

METHODS: Twenty-eight samples of human gastric adenocarcinoma taken from tumorous regions and non-tumorous regions were used. Autofluorescence, absorption coefficient and scattering coefficient spectra for gastric wall tissues were measured.

RESULTS: Peak value of autofluorescence spectrum for gastric adenocarcinoma was significantly lower than that for non-tumorous gastric wall tissues and double-peak was present. Absorption coefficient for gastric adenocarcinoma tissues with a spectral range of 300-720 nm wavelength, was significantly lower than that for non-tumorous gastric wall tissues (P < 0.01). Scattering coefficient for gastric adenocarcinoma tissues, with a spectral range of 480-1100 nm wavelength, was significantly lower than that for non-tumorous gastric wall tissues (P < 0.01).

CONCLUSION: Autofluorescence, absorption coefficient and scattering coefficient spectra can differentiate gastric adenocarcinoma tissues from non-tumorous gastric wall tissues effectively.

Polymorphism of -765G > C COX-2 is a risk factor for gastric adenocarcinoma and peptic ulcer disease in addition to H pylori infection: A study from northern India

AIM: To investigate -765G > C COX-2 polymorphism and H pylori infection in patients with gastric adenocarcinoma, peptic ulcer disease (PUD) and non-ulcer dyspepsia (NUD).

METHODS: We enrolled 348 adult patients (62 gastric adenocarcinoma, 45 PUD and 241 NUD) undergoing upper gastrointestinal endoscopy at two referral centers between September, 2002 and May, 2007. H pylori infection was diagnosed when any of the four tests (RUT, culture, histopathology and PCR) were positive. Genotyping for -765G > C polymorphism of COX-2 was performed by PCR-RFLP analysis.

RESULTS: Frequency of C carrier had significant association with gastric adenocarcinoma as compared to NUD [77.4% vs 29%, P < 0.001, odds ratio (OR) 8.20; 95% confidence interval (95% CI), 4.08-16.47] and PUD (77.4% vs 31.1%, P < 0.001; OR 8.04; 95% CI, 3.25-19.90). Risk of gastric adenocarcinoma was significantly higher in patients having C carrier with (OR 7.83; 95% CI 3.09-19.85) and without H pylori infection (OR 7.06; 95% CI, 2.61-19.09). Patients with C carrier and H pylori infection had significant risk for the development of PUD (P < 0.001; OR 5.65; 95% CI, 2.07-15.34).

CONCLUSION: -765G > C COX-2 polymorphism with or without H pylori could be a marker for genetic susceptibility to gastric adenocarcinoma. COX-2 polymorphism in presence of H pylori infection might be useful in predicting the risk of PUD.

Activator protein-1 involved in growth inhibition by RASSF1A gene in the human gastric carcinoma cell line SGC7901

AIM: To investigate the role of Ras association domain family protein 1 isoform A (RASSF1A) in gastric tumorigenesis.

METHODS: Through over-expression of RASSF1A gene in the SGC7901 cell line which was induced by a lipofectamine-mediated gene transfer approach. Activator protein-1 (AP-1) DNA binding activity was measured by electrophoretic mobility shift assay (EMSA).

RESULTS: Compared with the control clones, cells over-expressing RASSF1A exhibited significant inhibition of cell growth with G₁ cell cycle arrest in vitro and in vivo. The over-expression of RASSF1A significantly inhibited AP-1 activity in SGC7901 cells (0.981 ± 0.011 vs 0.354 ± 0.053, P < 0.001). In addition, both Western blot analysis and immunocytochemistry demonstrated that RASSF1A down-regulated the expression of c-Fos (0.975 ± 0.02 vs 0.095 ± 0.024, P < 0.001) but not c-Jun.

CONCLUSION: Over-expression of RASSF1A inhibits the growth of SGC7901 cells by negatively regulating the AP-1 activity, the latter in turn negatively signals cell proliferation.

H pylori: Treatment for the patient only or the whole family?

AIM: To compare the effects of treatment of H pylori-infected individuals with the effects of treatment of individuals as well as all H pylori-infected family members.

METHODS: H pylori-positive patients with similar demographic specifications were prospectively randomized with respect to treatment, with a triple regimen of either patients and all H pylori-positive family members living together (groupI) or patients only (group II). Nine months after treatment, all patients were assessed for H pylori positivity.

RESULTS: There were 70 H pylori-positive patients in each group; patients in groupsIand II lived with 175 and 190 H pylori-positive relatives, respectively. Age, sex and H pylori positivity rate were similar in both groups of relatives. Nine months after 14 d standard triple therapy, H pylori positivity was 7.1% in groupIpatients and 38.6% in group II patients [P < 0.01, OR = 8.61 95% confidence interval (CI): 2.91-22.84].

CONCLUSION: The present results indicate bad environmental hygienic conditions and close intra-familial relationships are important in H pylori contamination. These findings indicate all family members of H pylori-positive individuals should be assessed for H pylori positivity, particularly in developing countries where H pylori prevalence is high; they also suggest patients, their spouses and all H pylori-positive family members of H pylori-positive individuals should be treated for H pylori infection.