MicroRNA Expression in Selected Carcinomas of the Gastrointestinal Tract

MicroRNAs (miRNAs) comprise a recently discovered class of small, 18–25 nucleotide, noncoding RNA sequences that regulate gene expression at the posttranscriptional level by binding to and inhibiting the translation of target messenger RNAs (mRNAs). Characteristic patterns of miRNA expression have been described in several malignancies of the gastrointestinal tract, and numerous investigators have demonstrated interactions between specific miRNA species and target oncogenes or tumor-suppressor genes. It is clear that miRNAs play an important role in regulating expression of a number of genes involved in gastrointestinal carcinogenesis, and, thus, these molecules may represent either diagnostic markers of, or therapeutic targets for, some types of malignancy. This paper summarizes the literature regarding miRNA expression in carcinomas of the colon, pancreas, and liver and discusses some of the mechanisms by which these molecules participate in gastrointestinal oncogenesis

Zasady pobierania wycinków błony śluzowej w chorobach zapalnych przewodu pokarmowego

Endoskopia z oceną mikroskopową materiału biopsyjnego są ważnymi elementami w diagnostyce i leczeniu chorych z dolegliwościami ze strony przewodu pokarmowego. Wiele częstych chorób zapalnych, na przykład eozynofilowe zapalenie przełyku, przełyk Barretta, zakażenie Helicobacter pylori, choroba trzewna, kolagenowe oraz limfocytarne zapalenie jelita grubego, a także nieswoiste choroby zapalne jelit mogą mieć postać nieciągłą, wieloogniskową i dlatego w niektórych przypadkach, aby uzyskać miarodajny materiał, konieczne jest pobranie licznych wycinków z błony śluzowej. Zarówno klinicyści, jak i patomorfolodzy dążą do ustalenia optymalnej liczby wycinków, które należy pobrać i zbadać, aby rozpoznać lub wykluczyć te choroby, jednak praktyka w tym względzie różni się istotnie, szczególnie gdy endoskopowy obraz śluzówki jest prawidłowy lub wykazuje jedynie minimalne zmiany. Wymagana liczba wycinków jest ściśle określona w wytycznych jedynie w przypadku niektórych schorzeń, na przykład przełyku Barretta i przewlekłego zapalenia żołądka. Celem tego przeglądu jest omówienie dostępnej literatury na temat zasad pobierania materiału biopsyjnego do badań histopatologicznych podczas endoskopii przewodu pokarmowego. Gastroenterologia Kliniczna 2009, tom 1, nr 1, 30-4

FibroSURE as a noninvasive marker of liver fibrosis and inflammation in chronic hepatitis B

BACKGROUND: Noninvasive markers of liver fibrosis have not been extensively studied in patients with chronic hepatitis B virus (HBV) infection. Our aim was to evaluate the capacity of FibroSURE, one of the two noninvasive fibrosis indices commercially available in the United States, to identify HBV infected patients with moderate to severe fibrosis. METHODS: Forty-five patients who underwent liver biopsy at a single tertiary care center were prospectively enrolled and had FibroSURE performed within an average interval of 11 days of the biopsy. RESULTS: Of the 45 patients, 40% were Asian, 40% were African American, and 13% were Caucasian; 27% were co-infected with HIV and 67% had no or mild fibrosis. We found FibroSURE to have moderate capacity to discriminate between patients with moderate to high fibrosis and those with no to mild fibrosis (area under receiver operating characteristic [AUROC] curve = 0.77; 95% confidence interval [CI] [0.61, 0.92]). When we combined the fibrosis score determined by FibroSURE with aspartate aminotransferase (AST) measurements and HIV co-infection status, the discriminatory ability significantly improved reaching an AUROC of 0.90 (95% CI [0.80, 1.00]). FibroSURE also had a good ability to differentiate patients with no or mild from those with moderate to high inflammation (AUROC = 0.83; 95% CI [0.71, 0.95]). CONCLUSIONS: FibroSURE in combination with AST levels has an excellent capacity to identify moderate to high fibrosis stages in chronic HBV-infected patients. These data suggest that FibroSURE may be a useful substitute for liver biopsy in chronic HBV infection

The microscopic anatomy of the esophagus including the individual layers, specialized tissues, and unique components and their responses to injury

The esophagus, a straight tube that connects the pharynx to the stomach, has the complex architecture common to the rest of the gastrointestinal tract with special differences that relate to its function as a conduit of ingested substances. For instance, it has submucosal glands that are unique and have a specific protective function. It has a squamous lining that exists nowhere else in the gut except the anus and it has a different submucosal nerve plexus when compared to the stomach and intestines. All of the layers of the esophageal wall and the specialized structures including blood and lymphatic vessels and nerves have specific responses to injury. The esophagus also has unique features such as patches of gastric mucosa called inlet patches at the very proximal part and it has a special sphincter mechanism at the most distal aspect. This review covers the normal microscopic anatomy of the esophagus and the patterns of reaction to stress and injury of each layer and each special structure.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147079/1/nyas13705_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/147079/2/nyas13705.pd

Isolated Splenic Metastasis from Rectal Carcinoma: A Rare Occurrence

The presence of isolated splenic metastasis in rectal carcinoma is uncommon and usually presents as an asymptomatic mass, noted incidentally on imaging. Splenectomy is usually performed with the goal of curing metastatic disease. It is unclear if adjuvant chemotherapy affords any benefit, and the prognosis is unknown. The case of a young woman is reported, in whom an isolated metastatic lesion in the spleen was discovered 9 months after adjuvant chemotherapy for stage III rectal adenocarcinoma. The patient has remained disease-free for nearly 5 years following splenectomy and chemotherapy. To our knowledge, this is the fourth reported case in the English literature of an isolated splenic metastatic lesion from rectal cancer. We discuss the unique presentation, the importance of post-treatment surveillance, and the implementation of multi-modality treatment strategies in this young patient