Is there an association between Helicobacter pylori in the inlet patch and globus sensation?

AIM:To determine the association between Helicobacter pylori(H.pylori)and globus sensation(GS)in the patients with cervical inlet patch. METHODS:Sixty-eight patients with esophageal inlet patches were identified from 6760 consecutive patients undergoing upper gastrointestinal endoscopy prospectively.In these 68 patients with cervical inlet patches, symptoms of globus sensation(lump in the throat), hoarseness,sore throat,frequent clearing of the throat,cough,dysphagia,odynophagia of at least 3 mo duration was questioned prior to endoscopy. RESULTS:Cervical heterotopic gastric mucosa(CHGM) was found in 68 of 6760 patients.The endoscopic prevalence of CHGM was determined to be 1%.H.pylori was identified in 16(23.5%)of 68 patients with inlet patch.53 patients were classified as CHGMⅡ.This group included 48 patients with globus sensation,4 patients with chronic cough and 1 patient with hoarseness.All the patients who were H.pylori(+)in cervical inlet patches had globus sensation.CONCLUSION:Often patients with CHGM have a long history of troublesome throat symptoms.We speculate that disturbances in globus sensation are like non-ulcer dyspepsia.

Relationship between indoleamine 2,3-dioxygenase activity and lymphatic invasion propensity of colorectal carcinoma

AIM: To evaluate whether serum and tumor indoleamine 2,3-dioxygenase activities can predict lymphatic invasion(LI) or lymph node metastasis in colorectal carcinoma.METHODS: The study group consisted of 44 colorectal carcinoma patients. The patients were re-grouped according to the presence or absence of LI and lymph node metastasis. Forty-three cancer-free subjects without any metabolic disturbances were included into the control group. Serum neopterin was measured by enzyme linked immunosorbent assay. Urinary neopterin and biopterin, serum tryptophan(Trp) and kynurenine(Kyn) concentrations of all patients were determined by high performance liquid chromatography. Kyn/Trp was calculated and its correlation with serum neopterin was determined to estimate the serum indoleamine 2,3-dioxygenase activity. Tissue sections from the studied tumors were re-examined histopathologicallyand were stained by immunohistochemistry with indoleamine-2,3-dioxygenase antibodies.RESULTS: Neither serum nor urinary neopterin was significantly different between the patient and control groups(both p > 0.05). However, colorectal carcinoma patients showed a significant positive correlation between the serum neopterin levels and Kyn/Trp(r = 0.450, p < 0.01). Urinary biopterin was significantly higher in cancer cases(p < 0.05). Serum Kyn/Trp was significantly higher in colorectal carcinoma patients(p < 0.01). Lymphatic invasion was present in 23 of 44 patients, of which only 12 patients had lymph node metastasis. Eleven patients with LI had no lymph node metastasis. Indoleamine-2,3-dioxygenase intensity score was significantly higher in LI positive cancer group(44.56% ± 6.11%) than negative colorectal cancer patients(24.04% ± 6.90%),(p < 0.05). Indoleamine 2,3-dioxygenase expression correlated both with the presence of LI and lymph node metastasis(p < 0.01 and p < 0.05, respectively). A significant difference between the accuracy of diagnosis by using either total indoleamine-2,3-dioxygenase immunostaining score or of lymph node metastasis was found during the evaluation of cancer patients.CONCLUSION: Indoleamine-2,3-dioxygenase expression may predict the presence of unrecognized LI and lymph node metastasis and may be included in the histopathological evaluation of colorectal carcinoma cases.