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Sędłak K, Rawicz-Pruszyński K, Mlak R, Van Sandick J, Gisbertz S, Pera M, Dal Cero M, Baiocchi GL, Celotti A, Morgagni P, Vittimberga G, Hoelscher A, Moenig S, Kołodziejczyk P, Richter P, Gockel I, Piessen G, Da Costa PM, Davies A, Baker C, Allum W, Romario UF, De Pascale S, Rosati R, Reim D, Santos LL, D'ugo D, Wijnhoven B, Degiuli M, De Manzoni G, Kielan W, Frejlich E, Schneider P, Polkowski WP. Textbook Oncological Outcome in European GASTRODATA. Ann Surg 2023; 278:823-831. [PMID: 37555342 DOI: 10.1097/sla.0000000000006054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
OBJECTIVE To assess the rate of textbook outcome (TO) and textbook oncological outcome (TOO) in the European population based on the GASTRODATA registry. BACKGROUND TO is a composite parameter assessing surgical quality and strongly correlates with improved overall survival. Following the standard of treatment for locally advanced gastric cancer, TOO was proposed as a quality and optimal multimodal treatment parameter. METHODS TO was achieved when all the following criteria were met: no intraoperative complications, radical resection according to the surgeon, pR0 resection, retrieval of at least 15 lymph nodes, no severe postoperative complications, no reintervention, no admission to the intensive care unit, no prolonged length of stay, no postoperative mortality and no hospital readmission. TOO was defined as TO with the addition of perioperative chemotherapy compliance. RESULTS Of the 2558 patients, 1700 were included in the analysis. TO was achieved in 1164 (68.5%) patients. The use of neoadjuvant chemotherapy [odds ratio (OR) = 1.33, 95% CI: 1.04-1.70] and D2 or D2+ lymphadenectomy (OR = 1.55, 95% CI: 1.15-2.10) had a positive impact on TO achievement. Older age (OR = 0.73, 95% CI: 0.54-0.94), pT3/4 (OR = 0.79, 95% CI: 0.63-0.99), ASA 3/4 (OR = 0.68, 95% CI: 0.54-0.86) and total gastrectomy (OR = 0.56, 95% CI: 0.45-0.70), had a negative impact on TO achievement. TOO was achieved in 388 (22.8%) patients. Older age (OR = 0.37, 95% CI: 0.27-0.53), pT3 or pT4 (OR = 0.52, 95% CI: 0.39-0.69), and ASA 3 or 4 (OR = 0.58, 95% CI: 0.43-0.79) had a negative impact on TOO achievement. CONCLUSIONS Despite successively improved surgical outcomes, stage-appropriate chemotherapy in adherence to the current guidelines for multimodal treatment of gastric cancer remains poor. Further implementation of oncologic quality metrics should include greater emphasis on perioperative chemotherapy and adequate lymphadenectomy.
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Affiliation(s)
- Katarzyna Sędłak
- Department of Surgical Oncology, Medical University of Lublin, Lublin, Poland
| | | | - Radosław Mlak
- Department of Preclinical Sciences, Body Composition Research Laboratory, Medical University of Lublin, Lublin, Poland
| | - Johanna Van Sandick
- Department of Surgical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Suzanne Gisbertz
- Department of Surgery, University Medical Center, Amsterdam, The Netherlands
| | - Manuel Pera
- Department of Digestive Surgery, Hospital Universitario del Mar, Barcelona, Spain
| | - Mariagiulia Dal Cero
- Department of Digestive Surgery, Hospital Universitario del Mar, Barcelona, Spain
| | - Gian Luca Baiocchi
- Department of Clinical and Experimental Sciences, Surgical Clinic, University of Brescia, and Third Division of General Surgery, Spedali Civili di Brescia, Brescia, Italy
| | - Andrea Celotti
- Department of Clinical and Experimental Sciences, Surgical Clinic, University of Brescia, and Third Division of General Surgery, Spedali Civili di Brescia, Brescia, Italy
| | - Paolo Morgagni
- Department of General Surgery, Morgagni-Pierantoni Hospital, Forlì, Italy
| | | | | | - Stefan Moenig
- Department of General, Visceral and Thoracic Surgery, Agaplesion Markus Hospital, Frankfurt, Germany
| | | | - Piotr Richter
- Department of Surgery, Jagiellonian University Medical College
| | - Ines Gockel
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany
| | - Guillaume Piessen
- Department of Digestive and Oncological Surgery, University Lille, and Claude Huriez University Hospital, Lille, France
| | | | - Andrew Davies
- Department of Upper Gastrointestinal and General Surgery, Guy's and St Thomas' Hospital, London, UK; School of Cancer and Pharmaceutical Sciences, King's College; Department of Molecular Medicine and Surgery and Upper Gastrointestinal Surgery, Karolinska Institute, Stockholm, Sweden, London, UK
| | - Cara Baker
- Department of Upper Gastrointestinal and General Surgery, Guy's and St Thomas' Hospital, London, UK; School of Cancer and Pharmaceutical Sciences, King's College; Department of Molecular Medicine and Surgery and Upper Gastrointestinal Surgery, Karolinska Institute, Stockholm, Sweden, London, UK
| | - William Allum
- Department of Surgery, Royal Marsden NHS Foundation Trust, London, United Kingdom
| | | | | | - Ricccardo Rosati
- Department of Gastrointestinal Surgery, San Raffaele Hospital, Milan, Italy
| | - Daniel Reim
- Department of Surgery, TUM School of Medicine, Technical University of Munich, Germany
| | - Lucio Lara Santos
- Department of Surgical Oncology, Experimental Pathology and Therapeutics Group, Portuguese Institute Of Oncology, Porto, Portugal
| | - Domenico D'ugo
- Department of General Surgery, Fondazione Policlinico Gemelli, Rome, Italy
| | - Bas Wijnhoven
- Department of General Surgery, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Maurizio Degiuli
- Surgical Oncology and Digestive Surgery, Department of Oncology, University of Turin, San Luigi University Hospital, Orbassano, Turin 10049, Italy
| | - Giovanni De Manzoni
- Department of Surgery, General and Upper G.I. Surgery Division, University of Verona, Verona, Italy
| | - Wojciech Kielan
- Department of General and Oncological Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Ewelina Frejlich
- Department of General and Oncological Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Paul Schneider
- Department of Infectious Diseases and Pulmonary Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
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Prządka P, Buczak K, Frejlich E, Gąsior L, Suliga K, Kiełbowicz Z. The Role of Mesenchymal Stem Cells (MSCs) in Veterinary Medicine and Their Use in Musculoskeletal Disorders. Biomolecules 2021; 11:1141. [PMID: 34439807 PMCID: PMC8391453 DOI: 10.3390/biom11081141] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/27/2021] [Accepted: 07/30/2021] [Indexed: 12/11/2022] Open
Abstract
Regenerative medicine is a dynamically developing field of human and veterinary medicine. The animal model was most commonly used for mesenchymal stem cells (MSCs) treatment in experimental and preclinical studies with a satisfactory therapeutic effect. Year by year, the need for alternative treatments in veterinary medicine is increasing, and other applications for promising MSCs and their biological derivatives are constantly being sought. There is also an increase in demand for other methods of treating disease states, of which the classical treatment methods did not bring the desired results. Cell therapy can be a realistic option for treating human and animal diseases in the near future and therefore additional research is needed to optimize cell origins, numbers, or application methods in order to standardize the treatment process and assess its effects. The aim of the following work was to summarize available knowledge about stem cells in veterinary medicine and their possible application in the treatment of chosen musculoskeletal disorders in dogs and horses.
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Affiliation(s)
- Przemysław Prządka
- Department of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Science, Pl. Grunwadzki 51, 50-366 Wroclaw, Poland; (K.B.); (Z.K.)
| | - Krzysztof Buczak
- Department of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Science, Pl. Grunwadzki 51, 50-366 Wroclaw, Poland; (K.B.); (Z.K.)
| | - Ewelina Frejlich
- 2nd Department of General Surgery and Surgical Oncology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland;
| | - Ludwika Gąsior
- Vets & Pets Veterinary Clinic, Zakladowa 11N, 50-231 Wroclaw, Poland;
| | - Kamil Suliga
- Student Veterinary Surgical Society “LANCET”, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Science, Pl. Grunwaldzki 51, 50-366 Wroclaw, Poland;
| | - Zdzisław Kiełbowicz
- Department of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Science, Pl. Grunwadzki 51, 50-366 Wroclaw, Poland; (K.B.); (Z.K.)
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Kotulski KK, Bartczak-Kotulska J, Rudno-Rudzińska J, Kielan W, Frejlich E, Hap W. The sense of coherence and sense of satisfaction with life in patients hospitalized in Polish and Irish surgical departments. ADV CLIN EXP MED 2021; 30:813-822. [PMID: 34286516 DOI: 10.17219/acem/94156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND The concept of the sense of coherence (SOC) - the global orientation of life, created by Aaron Antonovsky - is increasingly popular. This study within the field of health psychology examines the situation of patients awaiting surgery in Poland and Ireland. OBJECTIVES To investigate the relationship between the strength of the SOC and its components (comprehensibility, manageability and meaningfulness) and the level of satisfaction with life (SWL) of patients hospitalized in surgical departments in hospitals in Poland and Ireland. MATERIAL AND METHODS The research was conducted in a group of 60 surgical patients, including 30 hospitalized in Poland and 30 in Ireland. The tools utilized were the Sense of Coherence Questionnaire for Adults SOC-29 and the Satisfaction with Life Scale (SWLS). Polish versions of both questionnaires were also used. RESULTS We obtained the following results:- for comprehensibility: in patients undergoing surgery in hospitals in Poland, the mean (M) = 46.3, standard deviation (SD) = 9.8, minimum value (Min) = 28, and maximum value (Max) = 63; in Irish patients, M = 50.8, SD = 9.2,Min = 33, and Max = 71;- for manageability: in patients undergoing surgery in hospitals in Poland, the M = 49.7, SD = 5.07, Min = 37, and Max = 58; in Irish patients, M = 49.3 SD = 6.39, Min = 38, and Max = 63;- for meaningfulness: in patients undergoing surgery in hospitals in Poland, M = 45.5, SD = 4.24, Min = 37, and Max = 54; in Irish patients, M = 44.9 SD = 5.74, Min = 34, and Max = 56. CONCLUSIONS The results of the study confirmed the assumption that a general SOC correlates with SWL. However, they did not confirm the hypothesis that differences in the strength of patients' SOC, its components and their level of SWL depend on the country of hospitalization.
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Affiliation(s)
- Krzysztof Kamil Kotulski
- Clinic of General and Oncological Surgery, Jan Mikulicz-Radecki University Teaching Hospital, Wrocław, Poland
| | | | - Julia Rudno-Rudzińska
- Clinic of General and Oncological Surgery, Jan Mikulicz-Radecki University Teaching Hospital, Wrocław, Poland
| | - Wojciech Kielan
- Clinic of General and Oncological Surgery, Jan Mikulicz-Radecki University Teaching Hospital, Wrocław, Poland
| | - Ewelina Frejlich
- Clinic of General and Oncological Surgery, Jan Mikulicz-Radecki University Teaching Hospital, Wrocław, Poland
| | - Wojciech Hap
- Clinic of General and Oncological Surgery, Jan Mikulicz-Radecki University Teaching Hospital, Wrocław, Poland
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Dzierżek P, Kurnol K, Hap W, Frejlich E, Diakun A, Karwowski A, Kotulski K, Rudno-Rudzińska J, Kielan W. Assessment of changes in body composition measured with bioelectrical impedance in patients operated for pancreatic, gastric and colorectal cancer. Pol Przegl Chir 2020; 92:8-11. [PMID: 32310821 DOI: 10.5604/01.3001.0013.7951] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
ntroduction: A proper level of nutrition is significant in the period of convalescence in patients subject to major surgical procedures, particularly due to neoplastic disease. Bioelectrical Impedance Analysis, or BIA is a widely used method in assessing body mass composition. BIA measurement is easy, quick, cheap and repetitive. MATERIAL AND METHODS We assessed the body composition of 56 patients (25 women and 31 men) hospitalized and operated at the Department of General and Oncological Surgery of the Wroclaw Medical University in the years 2017-2018 using bioelectric impedance. RESULTS The average body weight loss in the 4th postoperative day was 1.32% of body mass and on the day of release from hospital - 4.23% of body mass in relation to body mass upon admission. The percentage of body fat (FM - Fat Mass) in patients admitted to the department is above the normal range. The change in body composition in hospitalized patients mainly concerns the amount of adipose tissue and the amount of extracellular and intracellular water (ECW - Extracellular Water; ICW - Intracellular Water). CONCLUSIONS Bioelectrical impedance can be an easy and effective method of assessing body composition and its change in patients undergoing major surgery. Amongst the analyzed groups, patients operated for pancreatic cancer lose the largest percentage of body weight until discharge from the department. Loss of body mass mainly occurs as loss of fat mass (FM).
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Affiliation(s)
- Przemysław Dzierżek
- II Katedra i Klinika Chirurgii Ogólnej i Onkologicznej, Uniwersytecki Szpital Kliniczny we Wrocławiu
| | - Krzysztof Kurnol
- II Katedra i Klinika Chirurgii Ogólnej i Onkologicznej, Uniwersytecki Szpital Kliniczny we Wrocławiu
| | - Wojciech Hap
- II Katedra i Klinika Chirurgii Ogólnej i Onkologicznej, Uniwersytecki Szpital Kliniczny we Wrocławiu
| | - Ewelina Frejlich
- II Katedra i Klinika Chirurgii Ogólnej i Onkologicznej, Uniwersytecki Szpital Kliniczny we Wrocławiu
| | - Agata Diakun
- II Katedra i Klinika Chirurgii Ogólnej i Onkologicznej, Uniwersytecki Szpital Kliniczny we Wrocławiu
| | - Adrian Karwowski
- II Katedra i Klinika Chirurgii Ogólnej i Onkologicznej, Uniwersytecki Szpital Kliniczny we Wrocławiu
| | - Krzysztof Kotulski
- II Katedra i Klinika Chirurgii Ogólnej i Onkologicznej, Uniwersytecki Szpital Kliniczny we Wrocławiu
| | - Julia Rudno-Rudzińska
- II Katedra i Klinika Chirurgii Ogólnej i Onkologicznej, Uniwersytecki Szpital Kliniczny we Wrocławiu
| | - Wojciech Kielan
- II Katedra i Klinika Chirurgii Ogólnej i Onkologicznej, Uniwersytecki Szpital Kliniczny we Wrocławiu
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Hap W, Frejlich E, Rudno-Rudzińska J, Kotulski K, Kurnol K, Hap K, Skalski A, Kielan W. Pilonidal sinus: finding the righttrack for treatment. Pol Przegl Chir 2017; 89:68-75. [DOI: 10.5604/01.3001.0009.6009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Pilonidal cyst is a troublesome condition affecting usually young people. It significantly influences quality of life and causes low self-esteem. Despite its known pathophysiology and numerous therapeutic methods available, pilonidal cysts still constitute a significant problem in general surgery. A large number of surgical techniques indicates the lack of a single method that ensures therapeutic success, and frequent complications cause both patient’s dissatisfaction and frustration of the operator. In many cases, therapy is based on methods developed in a given healthcare center and their efficacy is usually not scientifically verified. Search for optimal strategy is also impeded by lack of an unambiguous clinical classification. In this article, we reviewed publications on various methods of managing pilonidal cyst, and we also presented surgical treatment used in our department. However, we did not manage to point out a surgical method with efficacy high enough to become standard treatment. It indicates the need for further search for new techniques that will give chances for successful treatment of pilonidal cyst.
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Affiliation(s)
- Wojciech Hap
- II Katedra i Klinika Chirurgii Ogólnej i Onkologicznej, Uniwersytet Medyczny we Wrocławiu, Kierownik: prof. dr hab. Wojciech Kielan
| | - Ewelina Frejlich
- II Katedra i Klinika Chirurgii Ogólnej i Onkologicznej, Uniwersytet Medyczny we Wrocławiu, Kierownik: prof. dr hab. Wojciech Kielan
| | - Julia Rudno-Rudzińska
- II Katedra i Klinika Chirurgii Ogólnej i Onkologicznej, Uniwersytet Medyczny we Wrocławiu, Kierownik: prof. dr hab. Wojciech Kielan
| | - Krzysztof Kotulski
- II Katedra i Klinika Chirurgii Ogólnej i Onkologicznej, Uniwersytet Medyczny we Wrocławiu, Kierownik: prof. dr hab. Wojciech Kielan
| | - Krzysztof Kurnol
- II Katedra i Klinika Chirurgii Ogólnej i Onkologicznej, Uniwersytet Medyczny we Wrocławiu, Kierownik: prof. dr hab. Wojciech Kielan
| | - Katarzyna Hap
- Katedra i Klinika Nefrologii i Medycyny Transplantacyjnej, Uniwersytet Medyczny we Wrocławiu, Kierownik: prof. dr hab. Marian Klinger
| | - Adam Skalski
- II Katedra i Klinika Chirurgii Ogólnej i Onkologicznej, Uniwersytet Medyczny we Wrocławiu, Kierownik: prof. dr hab. Wojciech Kielan
| | - Wojciech Kielan
- II Katedra i Klinika Chirurgii Ogólnej i Onkologicznej, Uniwersytet Medyczny we Wrocławiu, Kierownik: prof. dr hab. Wojciech Kielan
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Rudno-Rudzińska J, Kielan W, Frejlich E, Kotulski K, Hap W, Kurnol K, Dzierżek P, Zawadzki M, Hałoń A. A review on Eph/ephrin, angiogenesis and lymphangiogenesis in gastric, colorectal and pancreatic cancers. Chin J Cancer Res 2017; 29:303-312. [PMID: 28947862 PMCID: PMC5592818 DOI: 10.21147/j.issn.1000-9604.2017.04.03] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Erythroprotein-producing human hepatocellular carcinoma receptors (Eph receptors) compose a subfamily of transmembrane protein-tyrosine kinases receptors that takes part in numerous physiological and pathological processes. Eph family receptor-interacting proteins (Ephrins) are ligands for those receptors. Eph/ephrin system is responsible for the cytoskeleton activity, cell adhesion, intercellular connection, cellular shape as well as cell motility. It affects neuron development and functioning, bone and glucose homeostasis, immune system and correct function of enterocytes. Moreover Eph/ephrin system is one of the crucial ones in angiogenesis and lymphangiogenesis. With such a wide range of impact it is clear that disturbed function of this system leads to pathology. Eph/ephrin system is involved in carcinogenesis and cancer progression. Although the idea of participation of ephrin in carcinogenesis is obvious, the exact way remains unclear because of complex bi-directional signaling and cross-talks with other pathways. Further studies are necessary to find a new target for treatment.
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Affiliation(s)
| | | | | | | | - Wojciech Hap
- 2-nd Department of General and Oncological Surgery
| | | | | | - Marcin Zawadzki
- 2-nd Department of General and Oncological Surgery.,Pathology Department, Wrocław Medical University, Borowska 213, 50-556 Wrocław, Poland
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Pelzer O, Tobiasz K, Berezowski P, Nyc R, Frejlich E, Kielan W. Colorectal Cancer In The Elderly Patient. Pol Przegl Chir 2015; 87:417-24. [PMID: 26495919 DOI: 10.1515/pjs-2015-0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Indexed: 11/15/2022]
Abstract
Colorectal neoplasms present a serious diagnostic and therapeutic problem. Continuously increasing morbidity affects the elderly people in particular and considering the aging of the society and enhanced impact of the factors with a proved role in carcinogenesis, this tendency is predicted to remain unchanged in the near future. Therefore, it seems justified to thoroughly analyze the specificity of this patient group accordingly adjust the diagnostic and therapeutic procedures. The elderly patients require an interdisciplinary care both in the preparation and postoperative period. A multispecialty senior staff case meeting seems thus essential to determine the most beneficial treatment approach. Development of additional algorithms for the elderly patient with colorectal cancer is warranted.
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Donizy P, Rudno-Rudzinska J, Kaczorowski M, Kabarowski J, Frejlich E, Kielan W, Matkowski R, Halon A. Disrupted Balance of MMPs/TIMPs in Gastric Carcinogenesis-Paradoxical Low MMP-2 Expression in Tumor and Stromal Compartments as a Potential Marker of Unfavorable Outcome. Cancer Invest 2015; 33:286-93. [PMID: 25965559 DOI: 10.3109/07357907.2015.1024316] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The aim of the study was to find correlations between MMP/TIMP reactivity and the expression of angiogenic factors, and relationships between these parameters and clinicopathological features of gastric cancer patients. Receiver Operating Characteristic curve analysis was used to find cut-off points that enabled fair decision-making in survival analysis. Low levels of MMP-2 expression in tumor and stromal compartments were significantly associated with poor prognosis-the probability that a patient would die within 60 months of surgery if their MMP-2 was low, and was about 0.8 in both neoplastic and stromal compartments.
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Affiliation(s)
- Piotr Donizy
- 1Department of Pathomorphology and Oncological Cytology
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Rudno-Rudzińska J, Donizy P, Frejlich E, Kotulski K, Dzięgiel P, Hałoń A, Kielan W. Lymphangiogenesis in early and advanced gastric cancer: is there any difference? J Gastroenterol Hepatol 2014; 29 Suppl 4:107-11. [PMID: 25521742 DOI: 10.1111/jgh.12733] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
BACKGROUND AND AIM Gastric cancer (GC) in Poland is on the third place of men's mortality and on the fifth place of women's mortality in malignant neoplasms, and the percentage of diagnosed early GC is less than 20%. In this study, the relationship among lymphatic vessel density, marked with D2-40, expression of vascular endothelial growth factor (VEGF)-C/D, VEGF receptor 3 VEGFR-3, and the stage of GC patient were investigated. METHODS This study examined the relationships between the peritumoral lymphatic vessels (PTL) density and intratumoral lymphatic vessels (ITL) density stained immunohistochemically with D2-40/podoplanin, the expression of VEGF-C/D and VEGFR-3, and the stage of 58 GC patients. RESULTS Lymphatic vessel density measured by D2-40 decreases outside the tumor (PTL) and increases within the tumor (ITL) as the staging grows from I to III, whereas in the case of patients belonging to stage IV group, lymphatic vessel density decreases outside the tumor as well as within the tumor in comparison with the stage III group (not statistically significant). We observed a difference between morphology of the vessels within the tumor (ITLs) and vessels that are located outside the tumor (PTLs). PTLs were enlarged and unsqueezed as opposed to ITLs, which were collapsed. CONCLUSIONS (i) There is no significant correlation between the density of ITL nor PTL marked with D2-40 and the stage of GC. (ii) We did not observe relationship between expression of VEGF-C/D and VEGFR-3 and the stage of GC. (iii) Further studies are needed to fully determine the role of PTL and ITL.
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Affiliation(s)
- Julia Rudno-Rudzińska
- Second Department of General and Oncological Surgery, Wrocław Medical University, Wrocław, Poland
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Donizy P, Rudno-Rudzinska J, Halon A, Dziegala M, Kabarowski J, Frejlich E, Dziegiel P, Kielan W, Matkowski R. Intratumoral but not peritumoral lymphatic vessel density measured by D2-40 expression predicts poor outcome in gastric cancer--ROC curve analysis to find cut-off point. Anticancer Res 2014; 34:3113-3118. [PMID: 24922680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Neolymphangiogenesis, a process of lymphatic vessel development in neoplastic tissue, may be a key event in the transmission of cancer cells into lymph nodes. The current study examined the relationship between lymphatic vessel density (LVD) measured by podoplanin (D2-40) expression, clinicopathological parameters and patient survival in gastric cancer. MATERIALS AND METHODS D2-40 expression was examined by immunohistochemistry in formalin-fixed paraffin-embedded tissue specimens obtained from 60 patients with gastric cancer. D2-40 immunoreactivity was analyzed in intratumoral and peritumoral compartments of tumors and correlated with tumor grade, type in Lauren's classification, lymph node status, distant metastasis, presence of ulceration, inflammatory infiltration, angio-invasion, lymphangio-invasion and patient survival using a Receiver Operating Characteristic (ROC) curve analysis to find cut-off points that enabled fair decision making in survival analysis. RESULTS The mean values of intratumoral and peritumoral LVD were 6.63 and 11.25, respectively. Enhanced intratumoral LVD measured by D2-40 immunoexpression was correlated with the presence of lymph node metastases (p=0.04). Our study revealed a statistically significant correlation between intratumoral LVD measured by D2-40 expression and survival of patients with gastric cancer: an intratumoral LVD higher than 4.68 is significantly correlated with unfavorable prognosis, with a probability of death of approximately 80%. No significant relationship was identified between peritumoral LVD, lymph node status and survival in patients with gastric cancer. CONCLUSION A high intratumoral LVD measured by D2-40 expression in specimens from primary tumors is strongly associated with lymph node metastasis and predicts worse clinical outcome. Increased intratumoral D2-40 immunoreactivity is a putative predictor of aggressive gastric cancer behavior.
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Affiliation(s)
- Piotr Donizy
- Department of Pathomorphology and Oncological Cytology, Wroclaw Medical University, Wroclaw, Poland
| | - Julia Rudno-Rudzinska
- Second Department of General and Oncological Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Agnieszka Halon
- Department of Pathomorphology and Oncological Cytology, Wroclaw Medical University, Wroclaw, Poland
| | - Mateusz Dziegala
- Department of Pathomorphology and Oncological Cytology, Wroclaw Medical University, Wroclaw, Poland
| | - Jedrzej Kabarowski
- Department of Pathomorphology and Oncological Cytology, Wroclaw Medical University, Wroclaw, Poland
| | - Ewelina Frejlich
- Second Department of General and Oncological Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Piotr Dziegiel
- Department of Histology and Embryology, Wroclaw Medical University, Wroclaw, Poland Department of Physiotherapy, Wroclaw University School of Physical Education, Wroclaw, Poland
| | - Wojciech Kielan
- Second Department of General and Oncological Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Rafal Matkowski
- Department of Oncology and Division of Surgical Oncology, Wroclaw Medical University, Wroclaw, Poland Lower Silesian Oncology Centre, Wroclaw, Poland
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Frejlich E, Rudno-Rudzińska J, Janiszewski K, Salomon L, Kotulski K, Pelzer O, Grzebieniak Z, Tarnawa R, Kielan W. Caspases and their role in gastric cancer. ADV CLIN EXP MED 2013; 22:593-602. [PMID: 23986221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Caspases (Cysteine Aspartate Specific Proteases) are a group of cysteine-containing proteolytic enzymes produced by the cells of living organisms. They participate in immunological functions, proliferation, cell migration and organization. Caspases also influence the secretion of various regulative factors. Moreover, they are responsible for cellular maturation and reconstruction, and for regulating the number and quality of cells initiating the apoptosis of old cells or those that cannot play their normal role due to abnormalities. Multiple pathological processes are associated with disorders in the activity of caspases. Changes in expression of individual caspases have been observed in gastric cancer. The expression of some caspases is also correlated with particular histological traits and the frequency of metastases, which suggests their possible use as a prognostic factor. It has also been discovered that some somatic mutations in caspase coding genes might lead to inhibition of apoptosis and the progression of the disease. Gene polymorphism may be a gastric cancer risk factor, but may also play a protective function. Considering the less than satisfactory effects of conventional therapeutic methods, the search for alternative ways to activate apoptosis - through gene therapy or selective activation of individual elements of the apoptotic pathways - constitutes a promising direction for studies of new therapeutic strategies. Caspases, enzymes playing a central role in the process of programmed cellular death, may possibly be a key to the development of a more effective anti-cancer therapy.
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Affiliation(s)
- Ewelina Frejlich
- 2nd Department of General and Oncological Surgery, Wroclaw Medical University Hospital, Wrocław, Poland
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12
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Rudno-Rudzinska J, Kielan W, Grzebieniak Z, Dziegiel P, Donizy P, Mazur G, Knakiewicz M, Frejlich E, Halon A. High density of peritumoral lymphatic vessels measured by D2-40/podoplanin and LYVE-1 expression in gastric cancer patients: an excellent prognostic indicator or a false friend? Gastric Cancer 2013; 16:513-20. [PMID: 23238856 PMCID: PMC3824260 DOI: 10.1007/s10120-012-0216-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 11/03/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND One of the most important prognostic indicators in gastric cancer is the presence of metastases in lymph nodes. Even now, little is known about lymphangiogenesis in neoplastic tissue, and little is also known about the transmission of a neoplastic cell from the tumor mass into a lymphatic vessel. METHODS This study examined the relationships between the density of lymphatic vessels (LVD) stained immunohistochemically with lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1) and D2-40 (podoplanin) antibodies, the expression of vascular endothelial growth factor (VEGF)-C/D, selected clinical and pathomorphological factors, and the 5-year overall survival of gastric cancer patients. RESULTS Statistical analysis showed no impact of increased intratumoral or peritumoral LVD on gastric cancer patient survival, irrespective of the protein used to stain lymphatic vessels. Analysis showed that the probability of overall survival was decreased in the cases with enhanced VEGF-D immunoreactivity (P = 0.0045). CONCLUSION The study showed that the studied markers cannot be used to determine the required extent of the surgical procedure, as they have no statistically significant correlation with the degree of progression of the cancer, the stage of the disease assessed according to the TNM 5th classification of malignant tumors, clinicopathological features, and patient survival. VEGF-D is the only marker that can be regarded as an unfavorable prognostic indicator for patients with advanced gastric cancer.
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Affiliation(s)
- Julia Rudno-Rudzinska
- 2nd Department of General and Oncological Surgery, Wroclaw Medical University, Borowska 213, 50-556 Wrocław, Poland
| | - Wojciech Kielan
- 2nd Department of General and Oncological Surgery, Wroclaw Medical University, Borowska 213, 50-556 Wrocław, Poland
| | - Zygmunt Grzebieniak
- 2nd Department of General and Oncological Surgery, Wroclaw Medical University, Borowska 213, 50-556 Wrocław, Poland
| | - Piotr Dziegiel
- Department of Histology and Embryology, Wroclaw Medical University, Wrocław, Poland ,Department of Histology and Embryology, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Donizy
- Department of Pathomorphology and Oncological Cytology, Wroclaw Medical University, Wrocław, Poland
| | - Grzegorz Mazur
- Department and Clinic of Haematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wrocław, Poland
| | - Monika Knakiewicz
- 2nd Department of General and Oncological Surgery, Wroclaw Medical University, Borowska 213, 50-556 Wrocław, Poland
| | - Ewelina Frejlich
- 2nd Department of General and Oncological Surgery, Wroclaw Medical University, Borowska 213, 50-556 Wrocław, Poland
| | - Agnieszka Halon
- Department of Pathomorphology and Oncological Cytology, Wroclaw Medical University, Wrocław, Poland
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13
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Frejlich E, Rudno-Rudzińska J, Hałoń A, Kielan W, Grzebianiak Z. [Difficult and unusual diagnostic and therapeutic gastric Schwannoma case]. Wiad Lek 2013; 66:249-252. [PMID: 24483032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Schwannoma is a rare, usually benign, generally slow growing, asymptomatic mesenchymal neoplasm derived from nerve cells. In the gastrointestinal tract the most common localization is stomach and the gastric schwannomas represent about 0.2% of all gastric neoplasms. We present a case of 44-years-old male admitted to 2nd Department of General Surgery and Oncological Surgery Medical University for treatment of a submucosal gastric tumor detected in upper gastrointestinal endoscopy, endoscopic ultrasonography and computed tomography (CT). Patient presented with no gastrointestinal disorders and the random endoscopy revealed a gastric tumor, but the biopsy of the lesion showed no carcinomas' cells and the suspicion of GIST. CT confirms the presence of the 5 cm large gastric tumor and intraabdominal lymphadenopathy. The patient was directed to surgery because of the malignant risk. The subtotal gastrectomy with BII anastomosis was performed and no perioperative complications were observed. The postoperative histopathological examination revealed a typical morphology and immunophenotype of tumor. The neoplastic cells were immunoreactive with S-100 protein, but lacked immunoreactivity with CD 117, CD 34 and smooth-muscle actin (SMA). The histopathologic features and immunohistochemical staining pattern were consistent with a gastric schwannoma. The lymph nodes resected, during the operation revealed reactive inflammatory changes without evidence of neoplastic cells and any malignancy. 10-month after the surgery patient has no complains but the follow up will be continued. This case underscores the importance of including gastric schwannomas in the differential diagnosis when preoperative imaging studies reveal a submucosal, exophytic gastric mass.
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Affiliation(s)
- Ewelina Frejlich
- Klinika Chirurgii Ogólnej i Chirurgii Onkologicznej, Uniwersytecki Szpital Kliniczny we Wrocławiu.
| | - Julia Rudno-Rudzińska
- Klinika Chirurgii Ogólnej i Chirurgii Onkologicznej, Uniwersytecki Szpital Kliniczny we Wrocławiu
| | - Agnieszka Hałoń
- Zakład Patomorfologii i Cytologii Onkologicznej, Uniwersystet Medyczny we Wrocławiu
| | - Wojciech Kielan
- Klinika Chirurgii Ogólnej i Chirurgii Onkologicznej, Uniwersytecki Szpital Kliniczny we Wrocławiu
| | - Zygmunt Grzebianiak
- Klinika Chirurgii Ogólnej i Chirurgii Onkologicznej, Uniwersytecki Szpital Kliniczny we Wrocławiu
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