Presence of pink-color sign within 1 min after iodine staining has high diagnostic accordance rate for esophageal high-grade intraepithelial neoplasia/invasive cancer

BACKGROUND/AIM

The dramatic color change after iodine staining (from white-yellow to pink after 2-3 min), designated as the "pink-color sign" (PCS), is indicative of esophageal high-grade intraepithelial neoplasia (HGIN) or an invasive lesion. However, no study has yet examined the association between the time of PCS appearance and histopathology. We investigated the association between the time of PCS appearance and esophageal histopathology in 456 lesions of 438 patients who were examined for suspected esophageal cancer.

MATERIALS AND METHODS:

The records of 495 consecutive patients who had suspected esophageal cancer based on gastroscopy and who underwent Lugol's chromoendoscopy from January 2015 to March 2018 were retrospectively reviewed. The time of PCS appearance was recorded in all patients, and tissue specimens were examined.

RESULTS

We examined 456 lesions in 438 patients. Use of PCS positivity at 2 min for the diagnosis of HGIN/invasive cancer had a sensitivity of 84.1%, a specificity of 72.7%, and an accuracy of 80.4%. We classified the PCS-positive patients in whom the time of PCS appearance was recorded (168 lesions) into 4 groups: 0-30, 31-60, 61-90, and 91-120 s. Based on a 60-s time for appearance of the PCS, the area under the receiver operating characteristic curve was 0.897, indicating good validity. At the optimal cutoff value of 60 s, the sensitivity was 90.2% and the specificity was 82.3%. The appearance of the PCS within 60 s had a diagnostic accordance rate of 88.6%, significantly higher than appearance of the PCS within 2 min (79.7%, P < 0.05).

CONCLUSION

Appearance of the PCS within 1 min after iodine staining has a higher diagnostic accordance rate for esophageal HGIN/invasive cancer than appearance of the PCS at 2 min.

Effect of bifidobacterial adhesin on intestinal microflora and bacterial translocation induced by ischemia-reperfusion injury in rats

AIM: To observe the effect of bifidobacterial adhesin on intestinal microflora and bacterial translocation induced by ischemia-reperfusion (I/R) injury in rats.

METHODS: Seventy-two SD rats were randomly divided into a sham operation group (n = 24), an I/R model group (n = 24) and an experiment group (n = 24; treated with bifidobacterial adhesin). The rats were sacrificed 6 h, 1, 4 and 7 d after inducing I/R. The changes of intestinal microflora and bacterial translocation were observed, and the blood level of endotoxin was measured.

RESULTS: In the I/R model group, the numbers of Enterrococci (6.63 lgN/g ± 1.06 lgN/g vs 5.26 lgN/g ± 1.08 lgN/g, 9.44 lgN/g ± 1.37 lgN/g vs 5.30 lgN/g ± 1.12 lgN/g, 8.56 lgN/g ± 1.35 lgN/g vs 4.99 lgN/g ± 0.96 lgN/g, 8.23 lgN/g ± 1.01 lgN/g vs 5.18 lgN/g ± 1.03 lgN/g, P < 0.05) and Enterobacilli (7.86 lgN/g ± 1.17 lgN/g vs 6.39 lgN/g ± 0.85 lgN/g, 9.49 lgN/g ± 1.23 lgN/g vs 6.64 lgN/g ± 1.44 lgN/g, 8.76 lgN/g ± 0.86 lgN/g vs 6.52 lgN/g ± 1.13 lgN/g, 8.89 lgN/g ± 1.09 lgN/g vs 6.71 lgN/g ± 0.98 lgN/g, P < 0.05) in the feces of rats increased significantly at all time points, the numbers of Clostridium perfringens increased significantly on days 1 (6.47 lgN/g ± 1.43 lgN/g vs 4.51 lgN/g ± 1.22 lgN/g, P < 0.05), 4 (6.70 lgN/g ± 1.16 lgN/g vs 4.71 lgN/g ± 0.89 lgN/g, P < 0.05) and 7 (6.55 lgN/g ± 1.29 lgN/g vs 4.46 lgN/g ± 0.79 lgN/g, P < 0.05), while the numbers of Bifidobacterium (6.13 lgN/g ± 1.28 lgN/g vs 9.02 lgN/g ± 1.10 lgN/g, 5.59 lgN/g ± 1.22 lgN/g vs 8.66 lgN/g ± 0.99 lgN/g, P < 0.05) and Lactobacillus (6.07 lgN/g ± 1.09 lgN/g vs 9.08 lgN/g ± 1.04 lgN/g, 5.35 lgN/g ± 1.26 lgN/g vs 8.89 lgN/g ± 0.97 lgN/g, P < 0.05) decreased significantly on days 4 and 7 compared with those in the control subjects. The numbers of Enterrococci (6.37 lgN/g ± 1.04 lgN/g vs 8.56 lgN/g ± 1.35 lgN/g, 5.42 lgN/g ± 0.92 lgN/g vs 8.23 lgN/g ± 1.01 lgN/g, P < 0.05) and Enterobaci (7.55 lgN/g ± 1.03 lgN/g vs 8.76 lgN/g ± 0.86 lgN/g, 7.16 lgN/g ± 0.86 lgN/g vs 8.89 lgN/g ± 1.09 lgN/g, P < 0.05) in the experiment group were significantly lower than those in the I/R model group on days 4 and 7. The numbers of Clostridium perfringens on days 1, 4 and 7 (5.95 lgN/g ± 1.24 lgN/g vs 4.51 lgN/g ± 1.22 lgN/g, 6.08 lgN/g ± 1.07 lgN/g vs 4.71 lgN/g ± 0.89 lgN/g, 5.87 lgN/g ± 0.82 lgN/g vs 4.46 lgN/g ± 0.79 lgN/g, P< 0.05) were significantly higher in the experiment group than in the control group, but had declined compared to those in the I/R group. The numbers of Bifidobacterium (8.56 lgN/g ± 0.85 lgN/g vs 8.45 lgN/g ± 0.86 lgN/g, 7.89 lgN/g ± 1.47 lgN/g vs 8.78 lgN/g ± 1.06 lgN/g, 8.67 lgN/g ± 1.13 lgN/g vs 9.02 lgN/g ± 1.10 lgN/g, 8.75 lgN/g ± 0.96 lgN/g vs 8.66 lgN/g ± 0.99 lgN/g, P > 0.05) and Lactobacillus (9.16 lgN/g ± 0.94 lgN/g vs 8.91 lgN/g ± 1.06 lgN/g, 8.56 lgN/g ± 1.21 lgN/g vs 9.11 lgN/g ± 1.13 lgN/g, 9.16 lgN/g ± 1.08 lgN/g vs 9.08 lgN/g ± 1.04 lgN/g, 9.01 lgN/g ± 0.95 lgN/g vs 8.89 lgN/g ± 0.97 lgN/g, P > 0.05) showed no significant changes at all time points in the experiment group. The values of endotoxin (1.43 EU/mL ± 0.32 EU/mL vs 0.21 EU/mL ± 0.18 EU/mL,1.84 EU/mL ± 0.24 EU/mL vs 0.30 EU/mL ± 0.23 EU/mL,1.69 EU/mL ± 0.35 EU/mL vs 0.26 EU/mL ± 0.21 EU/mL,1.73 EU/mL ± 0.31 EU/mL vs 0.28 EU/mL ± 0.19 EU/mL, P < 0.05) and bacterial translocation rates in the liver (50% vs 0, 66.67% vs 16.67%, 83.33% vs 0, 83.33% vs 0, P < 0.05), spleen (33.33% vs 0, 50% vs 0, 66.67% vs 0, 66.67% vs 0, P < 0.05) and mesenteric lymph nodes (66.67% vs 0, 83.33% vs 0, 100% vs 16.67%, 100% vs 0, P < 0.05) in the I/R model group were significantly higher than those in the control group, while these parameters were significantly lower in the experiment group than in the I/R model group at all time points (endotoxin: 0.57 EU/mL ± 0.23 EU/mL vs 1.43 EU/mL ± 0.32 EU/mL, 0.71 EU/mL ± 0.16 EU/mL vs 1.84 EU/mL ± 0.24 EU/mL, 0.41 EU/mL ± 0.22 EU/mL vs 1.69 EU/mL ± 0.35 EU/mL, 0.35 EU/mL ± 0.12 EU/mL vs 1.73 EU/mL ± 0.31 EU/mL, P < 0.05; bacterial translocation in the liver: 16.67% vs 50%, 33.33% vs 66.67%, 50% vs 83.33%, 33.33% vs 83.33%, P < 0.05; spleen: 0 vs 33.33%, 16.67% vs 50%, 33.33% vs 66.67%, 33.33% vs 66.67%, P < 0.05; mesenteric lymph nodes: 50% vs 66.67%, 50% vs 83.33%, 50% vs 100%, 33.33% vs 100%, P < 0.05).

CONCLUSION: Bifidobacterial adhesin can improve the intestinal flora imbalance, reduce bacterial translocation and endotoxemia occurrence, and protect intestinal mucosal barrier function in rats after intestinal I/R injury.

Protective effect of Bifidobacterial secretory adhesin on intestinal epithelial cells in vitro: a morphological observation

AIM: To observe the effect of Bifidobacterial secretory adhesin on the morphology of human intestinal epithelial cells in vitro.

METHODS: After human intestinal epithelial cells were pretreated with adhesin and then incubated with LPS or H₂O₂, cell morphological changes were observed by light microscopy, electron microscopy and acridine orange staining.

RESULTS: Light microscopic analysis showed that cells became smaller and rounder with abundant granules in the cytoplasm after treatment with LPS or H₂O₂. In addition, some cells shed and floated on culture medium. Acridine orange staining and electron microscopic analysis showed that LPS or H₂O₂ induced the apoptosis of Lovo cells. Ultrastructural changes consist of nuclear condensation, margination and fragmentation of nuclear chromatin. Pretreatment with adhesion significantly improved the above morphological changes and reduced the number of apoptotic cells in cells treated with LPS or H₂O₂.

CONCLUSION: Bifidobacterial adhesin could protect intestinal epithelial cells from LPS- and H₂O₂-induced damage.

Construction and identification of eukaryotic expression plasmid pcDNA3.1(+)-MCP-1 and pcDNA3.1(+)-Gro α

AIM: To construct and identify the eukaryotic expression plasmid for rat MCP-1 and Groα.

METHODS: Accoding to the published MCP-1 Groα cDNA sequence in GeneBank, a pair of primers were respectively designed and synthesized. The total RNA was isolated froml rats with acute pancreatitis. After amplification with reverse transcription polymerase chain reaction (RT-PCR), the product was cloned into pGEM-T easy vector using TA cloning followed by Bam HⅠ and Eco RⅠdigestion. The target sequences were then subcloned into a highly efficient eukaryotic expression vector pcDNA3.1(+). The recombinants were finally sequenced and identified by restrictive endonuclease digestion.

RESULTS: pcDNA3.1(+)-MCP-1 and pcDNA3.1(+)-Groα eukaryotic expression vectors were successfully constructed, and they were identified by PCR, double restrictive endonuclease digestion and sequence analysis. The target fragment MCP-1 was the same as AF058786 in GenBank and the fragment Groα was different from NM_030845 (nt92-nt94) in GenBank. Repeated tests confirmed that NM_030845 (nt21-nt23) in GenBank was not correct.

CONCLUSION: The MCP-1 and Groα eukaryotic expression vectors are successfully constructed and identified.

Competitive inhibition of adherence of enterotoxigenic Escherichia coli, enteropathogenic Escherichia coli and Clostridium difficile to intestinal epithelial cell line Lovo by purified adhesin of Bifidobacterium adolescentis 1027

AIM: To observe competitive inhibition of adherence of enterotoxigenic Escherichia coli (ETEC), enteropathogenic Escherichia coli (EPEC) and Clostridium difficile (C. difficile) to intestinal epithelial cell line Lovo by purified adhesin of Bifidobacterium adolescentis 1027 (B. ado 1027).

METHODS: The binding of bacteria to intestinal epithelial cell line Lovo was counted by adhesion assay. The inhibition of adherence of ETEC, EPEC and C. difficile to intestinal epithelial cell line Lovo by purified adhesin of B. ado 1027 was evaluated quantitatively by flow cytometry.

RESULTS: The purified adhesin at the concentration of 10 µg/mL, 20 µg/mL and 30 µg/mL except at 1 µg/mL and 5 µg/mL could inhibit significantly the adhesion of ETEC, EPEC and C. difficile to intestinal epithelial cell line Lovo. Moreover, we observed that a reduction in bacterial adhesion was occurred with increase in the concentration of adhesin, and MFI (Mean fluorescent intensity) was decreased with increase in the concentration of adhesin.

CONCLUSION: The purified adhesin of B. ado 1027 can inhibit the adhesion of ETEC, EPEC and C. difficile to intestinal epithelial cell line Lovo in a dose-dependent manner.

[Uptake and distribution of adriamycin in multidrug-resistant LoVo/Adr cells]

OBJECTIVE

To investigate adriamycin (Adr) uptake and distribution features in multidrug-resistant LoVo/Adr cells and explore the drug-resistance mechanism of the cells.

METHODS

Adr uptake in LoVo/Adr cells was observed by flow cytometry and the distribution of the drug examined by fluorescence microscope. Immunohistochemical method was employed to detect the expression of P-glycoprotein (P-gp) by the cells.

RESULTS

In comparison with that in LoVo/Adr cells, Adr level in LoVo cells was significantly higher, but after treatment with verapamil, the former cells showed an increased Adr level. Adr distributed mainly in the nucleus in the drug-sensitive LoVo cells, with only a small quantity in the cytoplasm, while in multidrug-resistant LoVo/Adr cells, significantly reduction of Adr quantity in the nucleus and relative increase in the cytoplasm were observed. In response to verapamil treatment, the Adr uptake in LoVo/Adr cells increased and the distribution of the drug was similar to that in sensitive cells. P-gp expression was positive in LoVo/Adr cells, while negative in LoVo cells.

CONCLUSION

Abnormal Adr uptake and distribution in drug-resistant cells is related to P-gp expression which is one of the mechanisms for multidrug resistance.