-765G > C COX-2 polymorphism may be a susceptibility marker for gastric adenocarcinoma in patients with atrophy or intestinal metaplasia

AIM: To investigate the relationship between the -765G > C COX-2 polymorphism and the development of different gastric lesions: atrophy or intestinal metaplasia and gastric adenocarcinoma. METHODS: A cross-sectional study was performed involving 320 Portuguese individuals (210 without evidence of neoplastic disease, 73 patients with gastric adenocarcinomas and 37 with atrophy or intestinal metaplasia) using a PCR-RFLP method. RESULTS: -765C allele was overrepresented in the patients with gastric adenocarcinoma (51%) when compared either with the control group (38%) or patients with atrophy or intestinal metaplasia (27%). Callele was found to be very common in our population (0.22), and a multivariate logistic regression analysis revealed nearly 3-fold increased risk for the progression to gastric adenocarcinoma in patients with atrophy or intestinal metaplasia carrying the -765C allele (OR = 2.67, 95% CI = 1.03-6.93; P = 0.04).considered as another susceptibility marker for gastric adenocarcinoma development in patients with atrophy or intestinal metaplasia.

Clinical and pathological characterization of epstein-barr virus-associated gastric carcinomas in portugal

AIM To determine the prevalence of epstein-barr virus(eb V)-associated gastric carcinomas in the North Region of Portugal and to study its clinicopathological characteristics. METHODS We have performed a retrospective study including a total of 179 consecutive patients with gastric cancer(GC) submitted to gastrectomy during 2011 at the Portuguese Oncology Institute of Porto. Clinical and pathological data was collected from individual clinical records and inserted on a database with unique codification. Tumour tissues were collected from the institutional tumour bank. eb V was detected by in situ hybridization for the detection of eb V-encoded small RNAs(ebe Rs) and eb V latent proteins(LMP1 and LMP2 A) were detected by immunohistochemistry.RESULTS The analysis showed that eb V-associated gastric carcinomas(eb Va GC) represents 8.4%(15/179) of all GC cases, with a significant differential distribution among histological types(P < 0.001): 100%(3/3) of medullary carcinomas, 100%(1/1) of adenosquamous carcinoma, 8.7%(8/92) of tubular adenocarcinomas, 8.0%(2/25) of mixed carcinomas and 2%(1/51) in poorly cohesive carcinomas. The analysis revealed a higher predominance of eb Va GC in the upper third and middle(cardia, fundus and body) of the stomach(P = 0.041), a significant lower number of regional lymph nodes invasion(P = 0.025) and a tendency for better prognosis(P = 0.222). eb V latent protein expression revealed that all eb Va GC cases were LMP1-negative, nevertheless 6 cases(40%) expressed LPM2 A, which reveals that these cases show a distinct eb V-Latency profile(latency II-like).CONCLUSION eb Va GC represents 8.4% of all GC in the North Region of Portugal. The eb V-infected patients have specific clinic-pathological features that should be further explored to develop new strategies of management and treatment.

Gastric cancer in a Caucasian population: Role of pepsinogen C genetic variants

瞄准：在胃蛋白酶原 C (PGC ) 基因学习插入 / 删除多型性的角色，为胃粘膜的终端区别的一个有效标记，在到胃的损害的开发的危险性。方法：没有肿瘤的疾病的证据，学习与已知的胃的损害的 99 件样品和 127 件样品被执行。PCR 被采用， 6 多态的等位基因被放大：等位基因 1 (510 bp ) ，等位基因 2 (480 bp ) ，等位基因 3/4 (450/460 bp ) ，等位基因 5 (400 bp ) 并且等位基因 6 (310 bp ) 。结果：我们的结果表明等位基因 6 搬运人似乎对任何胃的损害的发展有保护(或 = 0.34；P【0.001 ) ，与象萎缩或肠的组织变形那样的胃的腺癌联系的 non-dysplastic 损害(或 = 0.28；P【0.001 ) 或侵略 GC (或 = 0.39；P = 0.004 ) 。结论：我们的学习表明等位基因 6 搬运人地位在胃的损害的发展有一个保护的角色，可能由于它有 PGC 的更高的表示的协会。而且，在控制组的等位基因 6 搬运人的频率比在亚洲人口获得了高是远的，它可能代表在白种人和亚洲人口之间的基因差距。

Epstein-Barr virus is associated with gastric carcinoma: The question is what is the significance?

AIM: To examine the possible role of the Epstein- Barr Virus (EBV) in the development of gastric adenocarcinoma (GC). It is unclear whether EBV is involved in GC development or is a consequence of gastric inflammation secondary to immunosuppressive treatments. METHODS: A systematic review was carried out of all published observational studies on the temporal association between EBV and GC, with a view to determine a causal relationship. RESULTS: The present study showed that the worldwide crude prevalence of EBV in gastric adenocarcinoma was 8.29%. The prevalence varied from 7.08% for intestinal type and 9.82% for diffuse type of GC. It was observed that Western and Central Asian countries had a significantly higher frequency of EBV positive cases compared to South-Eastern countries. America had the highest EBV-GC prevalence whereas Europe had the lowest. CONCLUSION: The present review has demonstrated a high prevalence of EBV in gastric adenocarcinoma. However, studies designed to assess a temporal relationship and histological association using sensitive techniques should be carried out to establish the role of EBV in GC carcinogenesis.

Prevalence of adenovirus and rotavirus infection in immunocompromised patients with acute gastroenteritis in Portugal

AIM: To characterize the prevalence of rotavirus(RV) and adenovirus(Ad V) infections in immunocompromised patients with acute gastroenteritis. METHODS: The presence of RV and Ad V(serotypes 40 and 41) was evaluated in 509 stool samples obtained between January 2009 and December 2010 from 200 immunocompromised patients(83 females and 117 males; median age 21 years old, range 0-72. The diagnosis of infection was performed as a routine procedure and the presence of RV and Ad V(serotypes 40 and 41) was determined by immunochromatography using the RIDA&#174; Quick Rota-Adeno-Kombi kit(r-Biopharm, Darmstadt, Germany). The data analysis and description of seasonal frequencies were performed using computer software IBM&#174; SPSS&#174;(Statistical Package for Social Sciences) Statistics version 20.0 for Mac. The frequencies of infection were compared into different age and gender groups by χ2 test.RESULTS: The study revealed 12.4% Ad V positive samples and 0.8% RV positive samples, which correspond to a prevalence of 6.5% and 1.5%, respectively. Ad V was more frequent between October 2009 and April 2010, while RV was identified in April 2010 and July 2010. The stool analysis revealed that from the 509 samples, 63(12.4%) were positive for Ad V and 4(0.8%) positive for RV, which by resuming the informationof each patient, lead to an overall prevalence of Ad V and RV of 6.5%(13/200 patients) and 1.5%(3/200 patients), respectively. The stratification of the analysis regarding age groups showed a tendency to an increased prevalence of infection in paediatric patients between 0-10 years old. Considering the seasonal distribution of these infections, our study revealed that Ad V infection was more frequent between October 2009 and April 2010, while RV infection was characterized by two distinct peaks(April 2010 and July 2010). CONCLUSION: The overall prevalence of Ad V and RV infection in immunocompromised patients with acute gastroenteritis was 8% and Ad V was the most prevalent agent.

Laparoscopic Gastrectomy after the Age of Eighty:Still a Good Choice?

Main Goals: Evaluation and comparison of short-term results of totally laparoscopic gastrectomy performed for gastric carcinoma in two groups of patients: older and younger than eighty years. Material and Methods: From 1st January 2011 to 31st October 2012, we have treated 110 patients for gastric carcinoma. 79 patients were submitted to radical gastric resection (the remainder 31 patients either presented with cardia carcinoma or were submitted to palliative treatment). In 33 cases we performed a laparoscopic gastrectomy while in the remainder 46 cases, the open approach was used. The 33 patients operated by a laparoscopic approach were the subject of this study. They were divided in two groups: Group A—patients eighty years old or older (10 cases) and Group B—patients younger than 80 years (23 cases). We evaluated and compared the short-term outcomes of both groups. Results: In all 33 cases, a gastrectomy was performed using a totally laparoscopic approach. There was no need to convert into open surgery. No patient needed to stay in the Intensive Care Unit. One patient needed a night stay in the Post Anesthetic Care Unit, due to subcutaneous emphysema (which resolved within 24 hours). There was a fatality in Group B, due to hepatic failure. The median of the operating time was 224 minutes in Group B and 199 minutes in Group A. The difference was non-significant (pvalue > 0.05). Group A patients were discharged in 6 to 10 days while those in Group B were discharged in 6 to 9 days. Conclusion: The results in this series suggest that totally laparoscopic gastrectomy is effective and safe in patients eighty years old and older, with low morbidity and mortality and short hospital stay. It compares favourably with the results of the same technique applied to younger patients. We suggest that laparoscopic approach to gastrectomy can be used in older patients, allowing them to benefit from the advantages of minimally invasive surgery.