Expression of cytokeratin-19 (CK19) in the classical subtype of papillary thyroid carcinoma: the experience of one center in the Silesian region

Introduction. Cytokeratin-19 (CK19) is recognized as a reliable tumor marker of papillary thyroid carcinoma (PTC). The general prognosis in the classical subtype of PTC (CSTPTC) remains favorable, but some cases can be very aggressive. The aim of this study was to evaluate the localization and intensity of immunohistochemical CK19 expression in CSTPTC and its associations with the clinical and pathological characteristics of patients with CSTPTC in the Silesian region. Material and methods. All the available clinical and histopathological data for 149 patients with CSTPTC from the Silesian region were retrospectively analyzed. The group consisted of 135 (90.6%) women and 14 (9.4%) men (mean age and SD: 52.3 ± 15.0). All these patients with CSTPTC underwent surgery at the same center between 2008 and 2013; the follow-up period was 24 to 90 months (mean and SD: 47 ± 20). Results. In 142 (95.3%) of the patients with CSTPTC, positive cytoplasmic staining of CK19 was found. A higher expression of CK19 was observed in the group of patients without the recurrence of the disease (p = 0.015). CK19 expression was not associated with age, gender, tumor focality, disease stage, tumor size (pT), lymph node involvement (pN), or distant metastases (pM). Conclusions. Decreased CK19 expression in CSTPTC cases with relapse suggests that it plays a role in the carcinoma progression of CSTPTC. The association between lower CK19 expression and patients’ unfavorable postoperative course could suggest its possible role as a marker of CSTPTC poor prognosis

Circulating Oxidized Low-Density Lipoproteins and Antibodies against Oxidized Low-Density Lipoproteins as Potential Biomarkers of Colorectal Cancer

Introduction. The aim of the study was evaluation of the diagnostic utility of serum oxidized low-density lipoproteins (oxLDL), antibodies against oxLDLs (o-LAB), and CEA as risk markers of colorectal cancer (CRC). Material and Methods. The serum levels of study factors were measured in 73 patients with CRC and in 35 healthy controls who were gender- and BMI-matched to the study group. Concentrations of oxLDL, o-LAB, and CEA were detected in ELISA tests. Serum lipids, lipoproteins, and glucose levels were also coestimated. Results. Age and o-LAB were significant factors of CRC presence, but results of logistic regression analysis showed that both were weak predictors of CRC risk. Concentration of o-LAB was significantly higher in colon cancer than in rectal cancer, especially when the cancer was located in the right section of colon. Serum CEA levels were significantly elevated in the advanced stage of disease, primary tumor progression, angiolymphatic invasion, and presence of distant metastasis. Conclusions. Obtained results have demonstrated that oxLDL and o-LAB were not satisfactory risk markers of CRC. Although significant relation between o-LAB level and CRC is observed, it may be rather the result of individual differences in the host immune responses against cancer

The concurrent impact of mild cognitive impairment and frailty syndrome in heart failure

Pathological processes associated with ageing increase the risk of cognitive deficits and dementia. Frailty syndrome, also known as weakness or reserve depletion syndrome, may significantly accelerate these pathological processes in the elderly population. Frailty syndrome is characterized by decreased physiological function and neuropsychiatric symptoms, including cognitive decline and depressive states. In people with cardiovascular disease, the risk of frailty is 3 times higher. Frailty syndrome is particularly prevalent in severe heart failure, which increases the risk of mortality, increases hospital readmission, and reduces patients’ quality of life. In addition, co-occurrence of cognitive impairment and frailty syndrome significantly increases the risk of dementia and other adverse outcomes, including mortality, in the heart failure population

Survival analysis of patients with acute coronary syndrome receiving comprehensive coordinated care after myocardial infarction (KOS-Zawał)

Background: This study aimed to analyze survival rates among patients with acute coronary syndrome (ACS) covered and not covered by the National Comprehensive Care after Myocardial Infarction (KOS-Zawał) program.Methods: A total of 179 972 patients after myocardial infarction (MI) were enrolled in KOS-Zawał program between October 2017 and March 2020 and were included in the comparative analysis with survival analysis. A group of 24 496 (13.61%) patients received KOS-Zawał services, while a group of 155 476 (86.39%) were not covered by the KOS-Zawał program. The time points for observation of the incidence of death were set at 30, 180, and 365 days from the end of the first hospitalization.Results: There was a lower incidence of death in favor of the KOS-Zawał group relative to the non-KOS-Zawał group both in hospital and at 30, 180, and 365 days after the end of hospitalization, respectively: 0.19% vs. 6.55%; 0.80% vs. 8.39%; 2.92% vs. 10.74%; and 6.35% vs. 13.40%. Survival analysis revealed a statistically significantly lower (P <0.0001) probability of death in the KOS-Zawał group compared with the non-KOS-Zawał group. Also, logistic regression analysis confirmed that patients in the KOS-Zawał group had a significantly lower risk of death than those in the non-KOS-Zawał group (odds ratio, 0.710; 95% confidence interval, 0.554–0.908; P = 0.007).Conclusions: The KOS-Zawał comprehensive care program reduces the risk of death in the first year after MI by 29%. There are indications of a biased interpretation of the data due to the initial better clinical status of post-MI patients covered by the KOS-Zawał program

Evaluation of Apelin and Apelin Receptor Level in the Primary Tumor and Serum of Colorectal Cancer Patients

Colorectal cancer is the second deadliest tumor, which has a positive correlation with obesity which led to increasing interest in the relationship between adipokines and cancer progression. Apelin is a secreted peptide involved in regulation of tumor progression and invasiveness. In this study, we examined apelin and apelin receptor expression level in colorectal cancer. Apelin, and its receptor mRNA, and protein expression levels were measured in tumor tissue of 56 surgically treated colorectal adenocarcinoma (CRC) patients. We also analyzed apelin and apelin receptor protein levels in sera of 56 CRC patients and 27 healthy controls. The mRNA and protein level of this peptide and its receptor was higher in tumors than that in control tissue. Serum levels of apelin and apelin receptor were increased in CRC patients in comparison to controls. The concentration of serum apelin level significantly increased in individuals with lymph node and distant metastasis. Obtained results suggest that apelin could be an important factor in progression of colorectal carcinoma

Cancer screening activity results in overdiagnosis and overtreatment of papillary thyroid cancer: A 10-year experience at a single institution.

BackgroundIt is estimated that one of the potential cause of the increasing prevalence of thyroid cancer (TC) is the easier and widespread access to diagnostic tools. If an individual evaluates the thyroid gland due to a mentioned mechanism without considering TC risk factors or symptoms, we can describe this phenomenon as cancer screening activity (CSA).Aim of the studyWe 1) estimated what types of TC were diagnosed due to CSA, 2) analyzed what clinicopathological features were characteristic of TCs diagnosed by CSA, 3) determined if these features were characteristic of indolent cases, and finally we 4) assessed whether CSA could have resulted in the increasing incidence of potentially indolent papillary thyroid cancer (PTC).Materials and methodsA retrospective review of 4,701 medical records of patients admitted and surgically treated at one surgical center between 2008 and 2017 was performed. Among the enrolled patients, 569 (12.1%) had thyroid malignancy, and 514 (10.9%) were diagnosed with PTC. We divided these patients into two groups: 1) patients in whom TC diagnostics were performed without considering any TC risk factors or symptoms (CSA-yes) and 2) those in whom TC was diagnosed due to TC risk factors or symptoms (CSA-no). We then compared the clinicopathological features of these two groups.ResultsThe most common type of TC diagnosed in the CSA-group was PTC (p = 0.024). CSA-yes patients showed a significantly lower degree of Tumor-Node-Metastasis (TNM) staging and demonstrated a significantly lower rate of multifocality, but not of bilaterality (pConclusionsThe use of CSA results in the diagnosis of indolent cases of PTC and may be one of the potential causes of overdiagnosis and overtreatment of this malignancy

Obesity and Overweight Are Associated with Minimal Extrathyroidal Extension, Multifocality and Bilaterality of Papillary Thyroid Cancer

Epidemiological studies have shown a strong association between high body mass index (BMI) and papillary thyroid cancer (PTC). We assessed the clinical and histopathological features of PTC in patients with a higher BMI and compared them to analogous parameters in PTC patients with a normal BMI. We retrospectively analyzed 5021 medical records of patients admitted and surgically treated for thyroid tumors in one center between 2008 and 2018. Finally, we extracted data from 523 adult patients with PTC and stratified patients into two groups according to BMI: Group 1 with BMI 2 and Group 2 with BMI ≥ 25 kg/m2. Data stratification was performed to estimate the association of overweight and obesity with clinical and histopathological features of PTC in both univariable and multivariable binary logistic regression analyses. Overall, compared to patients with a normal BMI, overweight and obese patients had a greater risk of minimal extrathyroidal extension (minimal ETE), multifocality and bilaterality of PTC (p p = 0.894). Obesity and overweight were significantly associated with higher aggressiveness of PTC. When considering various management options for PTC patients, these findings regarding overweight and obesity should be taken into consideration during the decision-making process

Local and Systemic IL-7 Concentration in Gastrointestinal-Tract Cancers

Background and objectives: Interleukin-7 (IL-7) is exploited in cancer immunotherapies although its status in solid tumors is largely unknown. We aimed to determine its systemic and local concentrations in esophageal (EC), gastric (GC), and colorectal (CRC) cancers. Materials and Methods: IL-7 was immunoenzymatically measured in paired surgical specimens of tumors and tumor-adjacent tissue (n = 48), and in the sera of 170 individuals (54 controls and 116 cancer patients). Results: IL-7 was higher in tumors as compared to noncancerous tissue in all cancers (mean difference: 29.5 pg/g). The expression ratio (tumor to normal) was 4.4-fold in GC, 2.2-fold in EC, and 1.7-fold in CRC. However, when absolute concentrations were compared, the highest IL-7 concentrations were in CRC, both when tumor and noncancerous tissue were analyzed. In CRC tumors, IL-7 was 2 and 1.5 times higher than in EC and GC tumors. In noncancerous CRC tissue, IL-7 was 2.3- and 2.8-fold higher than in EC and GC. IL-7 overexpression was more pronounced in Stage 3/4 and N1 cancers as a result of decreased cytokine expression in noncancerous tissue. Tumor location was a key factor in determining both local and systemic IL-7 concentrations. Serum IL-7 in CRC and EC was higher than in controls, GC, and patients with adenocarcinoma of gastric cardia (CC), but no significant correlation with the disease advancement could be observed. Conclusions: IL-7 protein is overexpressed in EC, GC, and CRC, but concentrations differ both in tumor and tumor-adjacent tissue with respect to tumor location. More advanced cancers have lower IL-7 concentrations in the immediate environment of the tumor. At the systemic level, IL-7 is elevated in CRC and EC, but not CC or GC. IL-7 dependence on the location of the primary tumor should be taken into account in future IL-7-based immunotherapies. Functional studies explaining a role of IL-7 in gastrointestinal cancers are needed