Human papillomavirus does not have a causal role in colorectal carcinogenesis

AIM: To investigate the presence of human papillomavirus(HPV) DNA along with the integration,the quantification and the expression of the HPV16 in colorectal cancers.METHODS: A prospective series of colorectal tumors were genotyped for HPV DNA.The clinical and pathological variables of the HPV-positive tumors were compared to those of HPV-negative samples.The integration status of HPV16 was evaluated by calculating E2/E6 ng ratios.HPV16-positive tumors were also evaluated for(1) E2,E4,E5,E6 and E7 viral gene ng quantification;(2) relative quantification compared to W12 cells; and(3) viral E2,E4,E5,E6 and E7 mR NA transcripts by real-time polymerase chain reaction.RESULTS: HPV infection was detected in 16.9% of all tumors examined,and HPV16 was the most frequent type detected(63.6% of positive tissues).Notably,the clinical and pathological features of HPV-positive colorectal cancers were not significantly different than those of HPV-negative cancers(χ2 and t-test for all clinical and pathological features of HPV-positive vs HPV-negative colorectal cancers: p ns).HPV16 DNA was present exclusively in episomal form,and the HPV16 E2,E4,E5,E6 and E7 genes were detected in tracenanogram quantities.Furthermore,the HPV16 genes ranged from 10-3 to 10-9 compared to W12 cells at an episomal stage.Although the extractions were validated by housekeeping gene expression,all the HPV16 positive tissues were transcriptionally inactive for the E2,E4,E5,E6 and E7 mR NAs.CONCLUSION: Based on our results,HPV is unlikely involved in colorectal carcinogenesis.

Synchronous gastric adenocarcinoma and pancreatic ductal adenocarcinoma

BACKGROUND:The association between gastric and pancreatic carcinoma is a relatively rare condition.In gastric carcinoma patients,the prevalence of second tumors varies 2.8% to 6.8% according to the reported statistics.Gastric cancer associated with pancreatic cancer is uncommon.METHODS:We report a case of a 73-year-old patient hospitalized for vomiting and weight loss.Esophagogastroduodenoscopy demonstrated an ulcerative lesion of the gastric antrum.Computed tomography and magnetic resonance showed a gastric thickening in the antral and pyloric portion and a nodular mass (3×1.7 cm) in the uncinate portion of the pancreas.RESULTS:The patient underwent pancreaticoduoden-ectomy according to Whipple regional type Ⅰ Fortner.Histological examination of the specimen demonstrated a moderately differentiated adenocarcinoma of the stomach and a poorly differentiated ductal adenocarcinoma of the pancreas.CONCLUSIONS:Long survival is rare in patients with associated gastric and pancreatic cancer.Surgical resection remains the only potentially curative treatment.

Is proliferative colonic disease presentation changing?

AIM:To compare the site,age and gender of cases of colorectal cancer(CRC) and polyps in a single referral center in Rome,Italy,during two periods.METHODS:CRC data were collected from surgery/pathology registers,and polyp data from colonoscopy reports.Patients who met the criteria for familial adenomatous polyposis,hereditary non-polyposis colorectal cancer syndrome or inflammatory bowel disease were excluded from the study.Overlap of patients between the two groups(cancers and polyps) was carefully avoided.Theχ 2 statistical test and a regression analysis were performed.RESULTS:Data from a total of 768 patients(352 and 416 patients,respectively,in periods A and B) who underwent surgery for cancer were collected.During the same time periods,a total of 1693 polyps were analyzed from 978 patients with complete colonoscopies(428 polyps from 273 patients during period A and 1265 polyps from 705 patients during period B).A proximal shift in cancer occurred during the latter years for both sexes,but particularly in males.Proximal cancer increased > 3-fold in period B compared to period A in males [odds ratio(OR) 3.31,95%CI:2.00-5.47;P < 0.0001).A similar proximal shift was observed for polyps,particularly in males(OR 1.87,95%CI:1.23-2.87;P < 0.0038),but also in females(OR 1.62,95%CI:0.96-2.73;P < 0.07).CONCLUSION:The prevalence of proximal proliferative colonic lesions seems to have increased over the last decade,particularly in males.

Is colonoscopy sufficient for colorectal cancer surveillance in all HNPCC patients?

有有在 hMSH2 的一个变化的结肠癌衬里的世袭 non-polyposis 的 34 岁的男性被报导。尽管有常规 colonoscopic 后续，他得了包含额外的钠区域的盲肠的癌症。由于亚 occlusive 症状，病人被提交推进结肠镜检查，然而没有瘤形成的清楚的证据。计算断层摄影术 CT 扫描此后执行了的多平面的重建揭示了的薄片透壁集中在在盲肠的阀门附近局部性的尺寸的 2.5 厘米。讨论在右边的结肠癌的很高的风险在病人的后续象对进一步的调查的需要一样在 colonoscopic 考试的可靠性上被做，例如世袭 non-polyposis 结肠癌影响的男 hMSH2 搬运人。

Liver biopsy:analysis of results of two specialist teams

AIM:To analyze the safety and the adequacy of a sample of liver biopsies(LB)obtained by gastroenterologist(G)and interventional radiologist(IR)teams.METHODS:Medical records of consecutive patients evaluated at our GI unit from 01/01/2004 to31/12/2010 for whom LB was considered necessary to diagnose and/or stage liver disease,both in the setting of day hospital and regular admission(RA) care,were retrieved and the data entered in a database.Patients were divided into two groups:one undergoing an ultrasonography(US)-assisted procedure by the G team and one undergoing US-guided biopsy by the IR team.For the first group,an intercostal approach(US-assisted) and a Menghini modified type needle 16 G(length 90 mm) were used.The IR team used a subcostal approach(US-guided) and a semiautomatic modified Menghini type needle 18 G(length 150 mm).All the biopsies were evaluated for appropriateness according to the current guidelines.The number of portal tracts present in each biopsy was assessed by a revision performed by a single pathologist unaware of the previous pathology report.Clinical,laboratory and demographic patient characteristics,the adverse events rate and the diagnostic adequacy of LB were analyzed.RESULTS:During the study period,226 patients,126 males(56%) and 100 females(44%),underwent LB:167(74%) were carried out by the G team,whereas 59(26%) by the IR team.LB was mostly performed in a day hospital setting by the G team,while IR completed more procedures on inpatients(P < 0.0001).The groups did not differ in median age,body mass index(BMI),presence of comorbidities and coagulation parameters.Complications occurred in 26 patients(16 G team vs 10 IR team,P = 0.15).Most gross samples obtained were considered suitable for basal histological evaluation,with no difference among the two teams(96.4% G team vs 91.5% IR,P = 0.16).However,the samples obtained by the G team had a higher mean number of portal tracts(G team 9.5 ± 4.8; range 1-29 vs IR team 7.8 ± 4.1; range 1-20)(P = 0.0192) and a longer mean length(G team 22 mm ± 8.8 vs IR team 15 ± 6.5 mm)(P = 0.0001).CONCLUSION:LB can be performed with similar outcomes both by G and IR.Use of larger dimension needles allows obtaining better samples,with a similar rate of adverse events.