Different Sites Of Gastrointestinal Tract Research Articles

A Retrospective and Single Centric Histopathological Study of Gastrointestinal Tumors from 2011 to 2015

Background: This study was carried out to evaluate and to correlate the various histopathologic types of tumors at different sites of gastrointestinal tract in relation to age and sex of the patients. Materials and Methods: A cross-sectional histopathological study of gastrointestinal tumors of 117 cases was carried out retrospectively; on biopsies and surgical specimens received from department of Surgery of a teaching institute, from January-2011 to December-2015. Specimens were sent in 10% formalin, ten times that of the specimen’s volume; and kept for 24 hours in 10% formalin for proper fixation, subsequently dehydration, clearing, embedding in paraffin wax were carried out. Blocks were made, sections of 3-4µm thicknesses were cut and stained with Harris Haematoxylin and Eosin stain and observed microscopically. Results: From the total 117 cases of gastrointestinal tumors: 72 were males and 45 were females with peak occurrence in sixth decade and anatomical distribution was in esophagus 50(42.74%), stomach 11(9.40%), small intestine 09(7.69%), appendix 00(0%), colon and rectum 40(34.19%), anal canal 07(5.98%) with histological types- epithelial 95(81.20%), mesenchymal 09(7.69%), lymphoma 03(2.57%), poorly differentiated carcinoma 07(5.98%), metastatic 02(1.71%) and others 01(0.85%). Conclusion: Gastrointestinal tumors show a wide variation in the morphology. So, histopathological examination is must for the diagnosis and typing of these tumors. The peak age distribution was in the sixth decade. Male to female ratio was 1.6:1. The occurrence of gastrointestinal tumors was highest in the esophagus accounted for 42.74% of all cases. Most common type of malignancy was adenocarcinoma.

GIST: advances in tyrosine kinase inhibitors enhance laparoscopic resection even in advanced disease

Gastrointestinal stromal tumors (GIST) represent a model for targeted cancer therapy and also a prime paradigm of how laparoscopic GIST surgical resection and adjuvant treatment with tyrosine kinase inhibitors (TKIs) can result in excellent short-term and long-term outcomes of these patients. The relatively simple concept of GIST development and progress by activating mutations in only two genes, either the KIT or platelet-derived growth factor A (PDGFRA) gene, and the high pathological and clinical response to tyrosine kinase inhibitors (TKIs) [1]. By contrast, multiple genes are involved in highly complex biological processes underlying tumorigenesis and metastasis for major cancer types [2]. The potential for long-term survival or even cure of GIST patients with resectable tumors treated with surgery and adjuvant targeted treatment raises the question for improving quality-of-life (QOL) of these patients through laparoscopic surgery. This question of feasibility, safety, and efficacy of laparoscopic surgery for GIST treatment is highlighted by De Vogelaere et al. [3] in the August issue of Surgical Endoscopy. The authors report on 31 consecutive patients presenting with a primary gastric GIST without metastases. The most common symptoms were melena, anemia, and abdominal pain, and in one patient a laparoscopic approach for a GIST with acute bleeding was performed. In all 31 patients, a successful laparoscopic resection was performed. Most patients (n = 26) had a tumor larger than 2 cm in size. The duration of operation (60 vs. 103 min) and duration of hospital stay (6 vs. 8 days) were lower when tumor size was less than 2 cm compared with larger tumors. Postoperative hemorrhage was occurred in only one patient. After a median follow-up of 52 months, there were no recurrences or metastases. The authors conclude that laparoscopic resection is safe and effective in treating gastric GISTs, even for tumors larger than 2 cm. Given that GIST is uncommon, this is a large series with excellent short-term and oncological outcomes associated with laparoscopic surgical resection. The size of the tumor appears to have a modest impact in clinical treatment and outcomes, although the small number of patients (n = 5) with tumors less than 2 cm in size in this study does not allow for valid comparisons. Laparoscopic and robotic surgery for tumors located at different sites of gastrointestinal tract has evolved rapidly and become popular for the surgical treatment of resectable colon rectal and gastric cancer improving QOL of these patients [4–11]. The high responsiveness of GIST to small-molecules selective TKIs, such as imatinib [1], raises the question of laparoscopic surgery also in the treatment of locally advanced or metastatic GIST. In addition, advances in biomedical research exploring the molecular mechanisms responsible for imatinib resistance have led to the development of second generation inhibitors of mutated KIT/ PDGFRA tyrosine kinase, such as nilotinib [12]. The power of whole-exome sequencing (WES) to identify not only primary causal (driver) mutations in KIT and PDGFRA genes but also acquired (secondary) mutations in these genes involved in resistance to TKI reveals a new class of biomarkers to predict responsiveness or resistance for tailoring the best drug to individual patient with GIST. Taking lessons from this simplified two-gene model of GIST, we may improve the design of future cancer genome-based studies to evaluate much more complex molecular mechanisms of resistance to targeted drugs for common cancer types, such as colorectal cancer, C. Hottenrott (&) Chirurgische Klinik, St. Elisabethenkrankenhaus, Ginnheimer Strase 3, 60487 Frankfurt, Germany e-mail: info@gastricbreastcancer.com

Dietary carbohydrates with different rates of fermentation affect fermentation end-product profiles in different sites of gastro-intestinal tract of weaning piglet

AbstractAnin vivoexperiment was conducted to examine changes in fermentation end-products in the gastro-intestinal tract (GIT) of weaning piglets by the inclusion of fermentable carbohydrates in the diet. The experiment was repeated in three replicates of 36 piglets. Piglets were raised free of antibiotics and creep feeding prior to weaning at 4 weeks of age. Each replicate was conducted over a period of 10 days. The piglets were offered one of two dietary treatments: control diet (CON), and fermentable carbohydrate enriched diet (CHO); and were subjected to one of the two fasting treatments (i) fasting for 2 days in the beginning of the experimental period and (ii) non-fasting. Piglets were slaughtered on the 1st, 4th and 10th day of each period. Digesta samples were collected from: first half of small intestine, second half of small intestine, caecum, and colon. The dry matter, volatile fatty acid (VFA) profile, and ammonia concentrations were analysed. Food intake, growth and food conversion ratio were also recorded. There were no differences in production performances such as growth and food conversion ratio (FCR) between the treatment groups. Concentrations of VFA were significantly higher, while ammonia concentration was significantly lower in the CHO group compared to the CON group in different fermentation sites within the GIT (P<0·001), and on different slaughtering days (P<0·05). Fasting had no effect on fermentation end-products. This study concludes that the addition of fermentable carbohydrates of varying fermentabilities stimulated carbohydrate fermentation, with reduction in protein fermentation along the different parts of GIT studied, in weaning piglets.