Historia natural de los linfomas gástricos primarios. Utilidad de la ecoendoscopia y la tomografía computerizada

104 p.Introducción: el linfoma gástrico primario (LGP) es una patología poco frecuente. Los tipos de LGP más habituales son el linfoma MALT y el DLBCL, ambos de estirpe celular B. El diagnóstico de los LGP ha sido estudiado ampliamente y actualmente parece claro el papel de la gastroscopia con biopsias, pero no está tan claro el rol que juegan tanto en la ultrasonografía endoscópica (USE) como la tomografía computerizada (TC), aunque parece que el USE ha demostrado ser superior a la TC para la estadificación. No obstante, la utilidad del USE en el seguimiento del linfoma gástrico primario parece ser controvertido.Objetivos: analizar las características de los linfomas gástricos primarios. histopatólógicas, el tratamiento, la evolución y supervivencia así como el papel de las pruebas diagnósticas, especialmente de la USE en el seguimiento en una serie de pacientes diagnósticados de LGP.Metodología: estudio observacional, analítico y de corte transversal, en pacientes con diagnóstico histológico de linfoma gástrico que fueron atendidos en el Hospital Donostia (Guipúzcoa) desde 1991 hasta el año 2018.Resultados: se estudiaron 57 pacientes de entre 28 y 78 años con diagnóstico de LG. La mayoría de los pacientes eran hombres (57.9%). El tiempo medio de seguimiento fue de 88 meses. El tipo de linfoma más frecuente fue elMALT (61.4%). La mayoría de los pacientes se encontraba en estadio I (52.6%). El 59.6% de los pacientes presentó diagnóstico positivo para HP. Los sujetos con tipo de linfoma MALT presentaron prueba positiva de HP en mayor proporción (47,3%). En 33 pacientes se realizó USE al diagnóstico siendo normal en un 15% de los casos (5 de 33 pacientes), mientras que la TC se realizó en 53 pacientes siendo normal en 15 (28%). La TC detecto recidiva en el 71% de los casos y la USE en el 75% . La supervivencia al año, 5 año y 10 años fue de 96.5%, 88.7% y 64.4%, respectivamente. La mayoría de los pacientes incluidos en este estudio no presentó recidiva (77.2%). Durante el seguimiento fallecieron 14 (24.5%) pacientes, 7 (12.3%) debido al linfoma.Conclusiones: el pronóstico del LGP es bueno con una mortalidad baja. Los tratamientos son muy heterogéneos. Las biopsias gástricas son el procedimiento de elección para la detección de recidivas. La TC y la USE no son precisas para la detección de recidivas

Evaluation of alpha 1-antitrypsin and the levels of mRNA expression of matrix metalloproteinase 7, urokinase type plasminogen activator receptor and COX-2 for the diagnosis of colorectal cancer

Background Colorectal cancer (CRC) is the second most common cause of death from cancer in both men and women in the majority of developed countries. Molecular tests of blood could potentially provide this ideal screening tool. Aim Our objective was to assess the usefulness of serum markers and mRNA expression levels in the diagnosis of CRC. Methods In a prospective study, we measured mRNA expression levels of 13 markers (carbonic anhydrase, guanylyl cyclase C, plasminogen activator inhibitor, matrix metalloproteinase 7 (MMP7), urokinase-type plasminogen activator receptor (uPAR), urokinase-type plasminogen activator, survivin, tetranectin, vascular endothelial growth factor (VEGF), cytokeratin 20, thymidylate synthase, cyclooxygenase 2 (COX-2), and CD44) and three proteins in serum (alpha 1 antitrypsin, carcinoembryonic antigen (CEA) and activated C3 in 42 patients with CRC and 33 with normal colonoscopy results. Results Alpha 1-antitrypsin was the serum marker that was most useful for CRC diagnosis (1.79±0.25 in the CRC group vs 1.27±0.25 in the control group, P<0.0005). The area under the ROC curve for alpha 1-antitrypsin was 0.88 (0.79-0.96). The mRNA expression levels of five markers were statistically different between CRC cases and controls: those for which the ROC area was over 75% were MMP7 (0.81) and tetranectin (0.80), COX-2 (0.78), uPAR (0.78) and carbonic anhydrase (0.77). The markers which identified early stage CRC (Stages I and II) were alpha 1-antitrypsin, uPAR, COX-2 and MMP7. Conclusions Serum alpha 1-antitrypsin and the levels of mRNA expression of MMP7, COX-2 and uPAR have good diagnostic accuracy for CRC, even in the early stages

Evaluation of Alpha 1-Antitrypsin and the Levels of mRNA Expression of Matrix Metalloproteinase 7, Urokinase Type Plasminogen Activator Receptor and COX-2 for the Diagnosis of Colorectal Cancer

8 p.Background: Colorectal cancer (CRC) is the second most common cause of death from cancer in both men and women in the majority of developed countries. Molecular tests of blood could potentially provide this ideal screening tool. -- Aim: Our objective was to assess the usefulness of serum markers and mRNA expression levels in the diagnosis of CRC. -- Methods: In a prospective study, we measured mRNA expression levels of 13 markers (carbonic anhydrase, guanylyl cyclase C, plasminogen activator inhibitor, matrix metalloproteinase 7 (MMP7), urokinase-type plasminogen activator receptor (uPAR), urokinase-type plasminogen activator, survivin, tetranectin, vascular endothelial growth factor (VEGF), cytokeratin 20, thymidylate synthase, cyclooxygenase 2 (COX-2), and CD44) and three proteins in serum (alpha 1 antitrypsin, carcinoembryonic antigen (CEA) and activated C3 in 42 patients with CRC and 33 with normal colonoscopy results. -- Results: Alpha 1-antitrypsin was the serum marker that was most useful for CRC diagnosis (1.79 +/- 0.25 in the CRC group vs 1.27 +/- 0.25 in the control group, P < 0.0005). The area under the ROC curve for alpha 1-antitrypsin was 0.88 (0.79-0.96). The mRNA expression levels of five markers were statistically different between CRC cases and controls: those for which the ROC area was over 75% were MMP7 (0.81) and tetranectin (0.80), COX-2 (0.78), uPAR (0.78) and carbonic anhydrase (0.77). The markers which identified early stage CRC (Stages I and II) were alpha 1-antitrypsin, uPAR, COX-2 and MMP7. -- Conclusions: Serum alpha 1-antitrypsin and the levels of mRNA expression of MMP7, COX-2 and uPAR have good diagnostic accuracy for CRC, even in the early stages.Centro de Investigación Biomédica en Enfermedades Hepáticas y Digestivas (CIBERehd) is funded by the Instituto de Salud Carlos III. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Evaluation of Alpha 1-Antitrypsin and the Levels of mRNA Expression of Matrix Metalloproteinase 7, Urokinase Type Plasminogen Activator Receptor and COX-2 for the Diagnosis of Colorectal Cancer

<div><h3>Background</h3><p>Colorectal cancer (CRC) is the second most common cause of death from cancer in both men and women in the majority of developed countries. Molecular tests of blood could potentially provide this ideal screening tool.</p> <h3>Aim</h3><p>Our objective was to assess the usefulness of serum markers and mRNA expression levels in the diagnosis of CRC.</p> <h3>Methods</h3><p>In a prospective study, we measured mRNA expression levels of 13 markers (carbonic anhydrase, guanylyl cyclase C, plasminogen activator inhibitor, matrix metalloproteinase 7 (MMP7), urokinase-type plasminogen activator receptor (uPAR), urokinase-type plasminogen activator, survivin, tetranectin, vascular endothelial growth factor (VEGF), cytokeratin 20, thymidylate synthase, cyclooxygenase 2 (COX-2), and CD44) and three proteins in serum (alpha 1 antitrypsin, carcinoembryonic antigen (CEA) and activated C3 in 42 patients with CRC and 33 with normal colonoscopy results.</p> <h3>Results</h3><p>Alpha 1-antitrypsin was the serum marker that was most useful for CRC diagnosis (1.79±0.25 in the CRC group vs 1.27±0.25 in the control group, P<0.0005). The area under the ROC curve for alpha 1-antitrypsin was 0.88 (0.79–0.96). The mRNA expression levels of five markers were statistically different between CRC cases and controls: those for which the ROC area was over 75% were MMP7 (0.81) and tetranectin (0.80), COX-2 (0.78), uPAR (0.78) and carbonic anhydrase (0.77). The markers which identified early stage CRC (Stages I and II) were alpha 1-antitrypsin, uPAR, COX-2 and MMP7.</p> <h3>Conclusions</h3><p>Serum alpha 1-antitrypsin and the levels of mRNA expression of MMP7, COX-2 and uPAR have good diagnostic accuracy for CRC, even in the early stages.</p> </div

ROC curves comparing carcinoembrionic antigen (CEA) in serum and MMP7 RNA expression.

<p>The areas under ROC curve for CEA and matrix metalloproteinase 7 (MMP7) were 0.84 and 0.81, respectively.</p

Oligonucleotide primer sequences generated used for the detection of mRNA for CRC markers.

<p>Oligonucleotide primer sequences generated used for the detection of mRNA for CRC markers.</p

The levels of mRNA expression in blood of the proteins analysed and the statistical significance of differences in the values between patients with CRC and controls.

<p>SD; standard deviation PAI; plasminogen activator inhibitor MMP7;matrix metalloproteinase 7 uPAR; urokinase-type plasminogen activator receptor uPA;urokinase-type plasminogen activator VEGF; vascular endothelial growth factor COX-2; cyclooxygenase 2.</p

The levels of mRNA expression of the proteins analysed and the statistical significance of differences in the values between cancer tissue and healthy tissue in patients with CRC.

<p>SD; standard deviation PAI; plasminogen activator inhibitor MMP7;matrix metalloproteinase 7 uPAR; urokinase-type plasminogen activator receptor uPA;urokinase-type plasminogen activator VEGF; vascular endothelial growth factor COX-2; cyclooxygenase 2.</p