Neoplastic Changes Research Articles

Expression of NRP-1 and NRP-2 in Endometrial Cancer.

Background: Neuropilins (NRPs) participate in many processes related to cancer development such as angiogenesis, lymphangiogenesis and metastasis. Although endometrial cancer is one of the most common gynecological cancers, it has not been studied in terms of NRPs expression.Objective: The aim of this study was to investigate the potential utility of NRPs as important factors in the diagnosis and treatment of endometrial cancer.Methods: Our study consisted of 45 women diagnosed with endometrial cancer at the following degrees of histological differentiation: G1, 17; G2, 15; G3, 13 cases. The control group included 15 women without neoplastic changes. The immunohistochemical reactions were evaluated using light microscopy.Results: We did not detect the expression of NRP-1 and NRP-2 in the control group. NRP-1 expression was found exclusively in cancer cells. It was higher in G2 and G3 and reached about 190% of G1. NRP-2 expression was observed in the endothelium and was similar across all three cancer grades. In cancer cells, NRP-2 expression increased with the degree of histological differentiation.Conclusion: NRP1 and NRP2 are candidates for complementary diagnostic molecular markers and promising new targets for molecular, personalized anticancer therapies.

Потенциал малигнизации кистозных неоплазий поджелудочной железы

Cystic neoplasms of the pancreas is a group of neoplastic changes in the epithelium of the ducts or parenchyma, which are the difficult diagnostic problems of modern medicine. With the improvement of diagnostic methods, the frequency of detection of incident cysts has increased. The article discusses the differential diagnostic characters, morphological features, and the potential for malignancy of pancreatic cystic neoplasms.

Allyl-isothiocyanate ameliorates the pre-neoplastic changes induced by the fern Dryopteris nigropalaceae on experimental feeding in Guinea pigs

Enzootic bovine haematuria, caused by long-term ingestion of ferns, is a chronic disease of hill cattle characterized by neoplastic lesions in the urinary bladder. Objectives of this study were to investigate the toxicity potential of long-term feeding of the fern Dryopteris nigropalaceae and effect of allyl isothiocyanate (AITC) to ameliorate fern toxicity and the associated pathological changes. The LC-MS analysis of the fern showed presence of ptaquiloside (4.5 ± 1.0 μg/g) and pterosin B (39 ± 9.1 μg/g). Groups of animals were fed dried fern powder at the dose of 20% w/w in normal feed and treated with and without AITC at graded doses. Long term feeding of fern induced inflammatory and pre-neoplastic lesions in urinary bladder. The important lesions included cystitis, squamous metaplasia and high-grade dysplasia. Urothelium showed positive immunoreactions for nuclear expression of H-ras and p53. However, no mutation suggestive of neoplastic change was observed on partial mRNA sequences analyses of exon 2 of H-ras and 5 or 7&8 of p53 genes. Strikingly, AITC showed dose-dependent amelioration of pre-neoplastic changes in fern-fed animals. In conclusion, AITC is shown to limit pre-neoplastic changes caused by D. nigropalaceae feeding in guinea pigs.

Artificial intelligence and upper gastrointestinal endoscopy: Current status and future perspective.

With recent breakthroughs in artificial intelligence, computer-aided diagnosis (CAD) for upper gastrointestinal endoscopy is gaining increasing attention. Main research focuses in this field include automated identification of dysplasia in Barrett's esophagus and detection of early gastric cancers. By helping endoscopists avoid missing and mischaracterizing neoplastic change in both the esophagus and the stomach, these technologies potentially contribute to solving current limitations of gastroscopy. Currently, optical diagnosis of early-stage dysplasia related to Barrett's esophagus can be precisely achieved only by endoscopists proficient in advanced endoscopic imaging, and the false-negative rate for detecting gastric cancer is approximately 10%. Ideally, these novel technologies should work during real-time gastroscopy to provide on-site decision support for endoscopists regardless of their skill; however, previous studies of these topics remain exvivo and experimental in design. Therefore, the feasibility, effectiveness, and safety of CAD for upper gastrointestinal endoscopy in clinical practice remain unknown, although a considerable number of pilot studies have been conducted by both engineers and medical doctors with excellent results. This review summarizes current publications relating to CAD for upper gastrointestinal endoscopy from the perspective of endoscopists and aims to indicate what is required for future research and implementation in clinical practice.

Validation of whole-body radiographs for examining uterine disorders in sexually intact female rabbits.

The present study evaluated whole-body radiographs of female rabbits regarding uterine disorders. Based on radiographs of 143 rabbits, visibility, size, shape and density of the uterus, nutritional status of the animal and possible metastasis in other organs were examined. A suspected diagnosis was deduced. The radiological findings were compared with the results of the histopathological examination. Especially the nutritional status was important regarding the visibility of the genital tract. In 99 of the 130 visible uteri (76.2 %), a pathological alteration was detected. Thereof, endometrial hyperplasia was most frequently seen (63.6 %), followed by neoplasia (altogether 42.4 %, 39.4 % of these with adenocarcinoma), endometritis (35.4 %) and other diseases (18.2 %). Forty-six rabbits showed only one disease, 42 rabbits had two, 10 rabbits three and one rabbit four different diseases. Among 13 of the 143 uteri that were not visible in the radiograph four were altered pathologically. In 31 of the 130 rabbits with a visible uterine region (21.7 %) the uterus was unaltered. Visualising the uterus proved impossible in two of four skinny rabbits (2.8 %), whereas in all 39 obese rabbits the uterus was visible. Only in one of the four skinny rabbits was the uterus without pathological findings and six of the 39 obese rabbits showed no pathological alteration, visibility notwithstanding. Calcification indicated a tumourous occurrence in 23 of 53 cases. Except for one rabbit, the mineralised neoplasia was an adenocarcinoma (n = 22). Five animals with calcification in the uterine region showed no abnormalities. Of these, the calcification of four animals was no longer existent in the radiograph after ovariohysterectomy. Neoplastic changes in the uterus did not always show calcification. In 20 of the 44 patients with uterine neoplasia no calcification was seen. Changes in uterine size occurred in 118 of the 143 rabbits (82.5 %) and alteration of the uterine shape in 109 of the 143 rabbits (67.1 %). Thus, the above presented parameters - especially size, shape and mineralisation - are very important regarding uterine diseases.

Expression Profile of Endoglin in Different Grades of Endometrial Cancer.

Endoglin is a marker of active, proliferating endothelial cells of blood vessels. In many cancers, it is present in both peripheral vessels and vessels located inside the tumor. Endoglin is more specific and sensitive compared to other tumor angiogenesis markers. It is suggested that endoglin can be considered a reliable marker of disease outcome. The aim of the study was to assess the expression of endoglin and to determine its potential usefulness as a complementary molecular marker of endometrial cancer. The study included 60 women who underwent hysterectomy: 45 with endometrioid endometrial cancer (study group) and 15 without neoplastic changes (control group). The study group was further divided according to the degree of histological differentiation: G1, 17; G2, 15; and G3, 13. The expression of endoglin was determined immunohistochemically with mouse anti-Endoglin monoclonal antibody. The obtained reactions were evaluated using light microscopy. Analysis of endoglin expression in endothelium showed that it reached 145% of the control. In G2, we observed that the endoglin level decreased and was similar to the control, while in G3 it increased and was even higher than in G1. In cancer cells, endoglin expression increased with the grade of endometrial cancer. Endoglin can be considered a valuable complementary molecular marker, allowing to visualize the advancement of the cancer process, including endometrial cancer.

Analysis of Skin Marks Through the Use of Intelligent Things

Melanoma is one of the more frequently encountered cancers, which quite often depends on exposure to ultraviolet radiation occurring in solar radiation. Of course, an additional factor is individual immunity and genetics. It is important to discover the possible spread of the cancer, which in this case depends on the observation of the skin, and above all the marks. The quickest possible detection of neoplastic changes can result in a chance to prolong life. In the era of mobility, where everyone has a camera built into the phone and access to the Internet, it is possible to analyze signs by an application that would analyze the skin. In the case of detected exceptions, the application would exchange information with a publicly available database and consult with a dermatologist about the possible need for urgent hispatological examination. In this paper, we propose a model of such a system based on intelligent things along with a detailed description of individual components. As a classification component, a convolutional classifier was proposed, which accepts not only image data, but also numerical one. The analysis of the proposed solution has been tested and discussed due to numerous advantages and disadvantages of such a solution nowadays.

Does Radiofrequency Ablation Induce Neoplastic Changes in Benign Thyroid Nodules: A Preliminary Study.

BackgroundTo evaluate the clinical feasibility of radiofrequency ablation (RFA) of benign thyroid nodules along with cytomorphological alteration, and any malignant transformation through biopsy.MethodsThe data were retrospectively collected between April 2008 and June 2013 and core needle biopsy (CNB) was performed on 16 benign thyroid nodules previously treated using RFA. The parameters of the patients were compared, between the time of enrollment and the last follow-up examination, using linear mixed model statistical analysis.ResultsNo atypical cells or neoplastic transformation were detected in the undertreated peripheral portion of treated benign nodules on the CNB specimen. RFA altered neither the thyroid capsule nor the thyroid tissue adjacent to the treated area. On histopathological examinations, we observed 81.2% acellular hyalinization, which was the most common finding. After a mean follow-up period of over 5 years, the mean volume of thyroid nodule had decreased to 6.4±4.2 mL, with a reduction rate of 81.3%±5.8% (P<0.0001).ConclusionRFA is a technically feasible treatment method for benign thyroid nodules, with no carcinogenic effect or tissue damage of the normal thyroid tissue adjacent to the RFA-treated zone.

Tubal choriocarcinoma presenting as an ectopic pregnancy

Choriocarcinoma, a subtype of gestational trophoblastic disease, is a rare and aggressive neoplasm. It occurs due to neoplastic changes in the chorionic villi epithelium. Primary fallopian tube choriocarcinoma is extremely rare and commonly mistaken as ectopic pregnancy. We present a case of a 37-year-old female who presented with complaints of prolonged spotting per vaginum following an induced abortion. Ultrasound was suggestive of the right tubal ectopic pregnancy, and beta-human chorionic gonadotropin (BHCG) levels were remarkably high. The patient was taken for laparoscopy suspecting tubal ectopic pregnancy and right salpingectomy was done. Histopathology was suggestive choriocarcinoma of fallopian tube. Contrast enhanced CT scan of brain MRI pelvis, and chest X-ray showed no evidence of metastasis. Hence, the patient was managed with single-agent chemotherapy with injection methotrexate with leucovorin. The case highlights the importance of histopathological examination of tubal specimen in all patients presenting with tubal ectopic pregnancy and also the need to suspect a tubal choriocarcinoma in any patient presenting as ectopic pregnancy with high BHCG levels.

A Correlation between Histochemical Patterns of Connective Tissue Fibers and AgNORs in Breast Lesions

Background: The precise histopathologic diagnosis of a breast lesion is the first step towards the most appropriate inclusive patient’s management. The aim of this study was to evaluate the correlation between histochemical patterns of connective tissue fibers and NORs in breast lesions. Methodology: Patients with breast cancer (n = 25) were ascertained as the case group, and those with benign breast lesions were ascertained as a control group (n = 25). Histochemical evaluations of elastic fibers, reticular fibers and mean AgNORs count were performed for all study subjects. Results: Elastic fibers intensity was brought into being lessening in benign lesions and upturns in the direction of malignant lesions. The intensity of elastic fibers was found to intensify with rises of neoplastic changes in breast cancer and this was found to be statistically significant P < 0.001. Mean AgNORs counts displayed increased clusters among malignant cases equated to benign ones. Mean AgNORs count significantly increased with neoplastic proliferation P < 0.005. Conclusion: Demonstration of connective tissue fibers (particularly elastic fibers) can strength the diagnostic evidence for conventional histopathology diagnosis. Mean AgNORs count can merge as an important quantitative marker in breast cancer diagnosis.

РАЗВИТИЕ РАКА ЖЕЛУДКА НА ФОНЕ ИНОРОДНОГО ТЕЛА

Gastric cancer is one of the most frequently encountered malignant human tumors. Cancer usually occurs, as a rule, on the background of chronic inflammatory diseases of the stomach, and it is now found that in an absolutely healthy stomach, neoplastic changes are impossible. They preceded the pre-cancerous condition that takes place with chronic anacid gastritis, callous gastric ulcer, and gastric polyps. The average, from pre-cancerous condition to cancer is from 10 to 20 years. The development of gastric cancer on the background of the foreign body is an extremely rare phenomenon. Possible causes of this transformation are the long-term presence of foreign body with the development of a circular neoplastic shaft around it. The article presents the result of surgical treatment of a patient with stomach cancer that developed on the background of a foreign body. Keywords: Gastric cancer, foreign body, diagnosis, surgical tactics, prognosis.

Histopathology re-examination of the NTP toxicity/carcinogenicity studies of tert-butyl alcohol to identify renal tumor and toxicity modes of action

Tert-butyl alcohol (TBA) targets the rat kidney following repeated exposures, including renal tubule tumors. The mode of action (MOA) of these tumors, concluded by a pathology working group, involves both alpha2u-globulin nephropathy (α2u-gN) and exacerbated chronic progressive nephropathy (CPN), but has been disputed and an undefined MOA proposed. This study further reviews the histology slides of male and female rat kidneys from the NTP drinking water 13-week toxicity and 2-year carcinogenicity studies, including the 15-month interim sacrifice group. The papillary epithelial lining alteration formerly referred to as “transitional cell hyperplasia” develops as part of advanced CPN and does not represent a separate toxicity. No changes were observed in the kidney pelvis urothelium. The only alterations in subchronic male rats involved α2u-gN and CPN, without test article-related alterations in females. Focused examination of areas of parenchyma unaffected by CPN in TBA-treated male and female rats of the chronic studies revealed no renal tubule abnormalities other than from the effects of α2u-gN and CPN. Unrelated to toxicity were spontaneous amphophilic or vacuolar tubule proliferative lesions. All observed TBA-associated non-neoplastic and neoplastic histopathological changes in the kidney can be explained by α2u-gN or enhanced CPN, neither of which are relevant to humans.

Phytol ameliorated benzo(a)pyrene induced lung carcinogenesis in Swiss albino mice via inhibition of oxidative stress and apoptosis.

In the present study, the modulatory effect of phytol against benzo(a)pyrene [B(a)P] induced lung carcinogenesis was investigated in Swiss albino mice. During the experimental period, phytol treatment showed no adverse toxic effect and mortality to the experimental animals. Lung tumor was observed in B(a)P treated group and also in animals post-treated with low concentration (50 mg/kg) of phytol. No neoplastic changes were observed in the lung tissue of the animals treated with the maximum dose of phytol (100 mg/kg). An elevated level of antioxidant enzymes combined with macromolecular damage (lipid peroxidation, protein carbonyl content) was observed upon B(a)P treatment whereas, phytol restored the level of antioxidant enzymes which were comparable to the vehicle control group. Moreover, administration of B(a)P induced apoptosis, as observed by the highest expression of Bax, caspase-3, and caspase-9 proteins in lung tissue of B(a)P alone treated animals. However, phytol treatment reduced the expression of Bax, caspase-3, and caspase-9 protein and maintained the constant expression of anti-apoptotic protein Bcl-2. These observations positively reveal that phytol regulates the antioxidant enzymes and thereby protects the cells against B(a)P induced carcinogenesis without showing any adverse toxic effect to the animals.

The impact of obesity and bariatric surgery on circulating and tissue biomarkers of endometrial cancer risk.

Obesity is the strongest risk factor for endometrial cancer (EC). To inform targeted screening and prevention strategies, we assessed the impact of obesity and subsequent bariatric surgery‐induced weight loss on endometrial morphology and molecular pathways implicated in endometrial carcinogenesis. Blood and endometrial tissue were obtained from women with class III–IV obesity (body mass index ≥40 and ≥50 kg/m2, respectively) immediately prior to gastric bypass or sleeve gastrectomy, and at two and 12 months’ follow up. The endometrium underwent pathological examination and immunohistochemistry was used to quantify proliferation (Ki‐67), oncogenic signaling (PTEN, pAKT, pERK) and hormone receptor (ER, PR) expression status. Circulating biomarkers of insulin resistance, reproductive function and inflammation were also measured at each time point. Seventy‐two women underwent bariatric surgery. At 12 months, the mean change in total and excess body weight was −32.7 and −62.8%, respectively. Baseline endometrial biopsies revealed neoplastic change in 10 women (14%): four had EC, six had atypical hyperplasia (AH). After bariatric surgery, most cases of AH resolved (5/6) without intervention (3/6) or with intrauterine progestin (2/6). Biomarkers of endometrial proliferation (Ki‐67), oncogenic signaling (pAKT) and hormone receptor status (ER, PR) were significantly reduced, with restoration of glandular PTEN expression, at 2 and 12 months. There were reductions in circulating biomarkers of insulin resistance (HbA1c, HOMA‐IR) and inflammation (hsCRP, IL‐6), and increases in reproductive biomarkers (LH, FSH, SHBG). We found an unexpectedly high prevalence of occult neoplastic changes in the endometrium of women undergoing bariatric surgery. Their spontaneous reversal and accompanying down‐regulation of PI3K‐AKT–mTOR signaling with weight loss may have implications for screening, prevention and treatment of this disease.

Posttransplant Characterization of Long-term Functional hESC-Derived Pancreatic Endoderm Grafts.

The paucity of human donors limits broadened application of β-cell replacement therapy. Insulin-producing cells derived from human embryonic stem cells (hESCs) have recently been investigated clinically as a feasible surrogate to primary tissue. Herein, we examine the long-term efficacy of hESC-derived pancreatic endoderm cells (PECs) to maintain normoglycemia posttransplant and characterize the phenotype of the PEC grafts. Mice with chemically induced diabetes were transplanted with PECs into the subcutaneous device-less site. Transplant function was assessed through nonfasting blood glucose measurements, intraperitoneal glucose tolerance testing (IPGTT), and human C-peptide secretion for 517 days. Explanted grafts were assessed for ex vivo function and immunohistochemically. All PEC recipients (n = 8) maintained normoglycemia until graft retrieval. IPGTTs at 365 and 517 days posttransplant did not differ (P > 0.05), however, both demonstrated superior glucose clearance compared with nondiabetic and transplant controls (P < 0.001). Serum C-peptide levels demonstrated significant glucose responsiveness (fasted vs. stimulated) (P < 0.01). Small intragraft cysts were palpable in all mice, which resolved but recurred after aspiration. Cysts showed monomorphic neuroendocrine proliferation and lined by ductal epithelium. Explanted grafts demonstrated similar insulin secretory capacity as human islets and stained positively for endocrine cells. Our results demonstrate the ability of PECs to differentiate in vivo and restore glycemic control while confirming minimal proliferation and absence of neoplastic change within the grafts during the time evaluated.

Differential Diagnosis of Pancreatic Cyst Tumors

Pancreatic cystic neoplasm is a group of neoplastic changes in the epithelium of the ducts or parenchyma of the pancreas. This is a complex diagnostic problem of modern medicine. With the improvement of diagnostic methods for pancreatic pathology, the frequency of detection of incidental pancreatic cysts has been increased. Some cystic lesions neoplasms are recognized as precursor of pancreatic adenocarcinoma and requires early surgical treatment, or close observation. The article discusses the issues of classification, the malignant potential and the differential diagnosis of pancreatic cysts.

Pathological Findings in the Adrenal Glands of 80 Dogs

Background: The adrenal glands development important endocrine functions and can be affected by primary or secondary diseases. These adrenal gland pathologies may induce clinical syndromes resulting from abnormalities in the production and secretion of hormones. Data about pathological changes in dogs are scarce. Therefore, the aim of the present study was to identify and evaluate the histopathological and epidemiological features of adrenal changes in dogs submitted to necropsy examination from 2005 to 2016 in a Veterinary Teaching Hospital, Londrina, Paraná, Brazil.Material, Methods &amp; Results: During this period, 80 animals presented alterations of adrenal gland, representing 5.5% of all necropsied dogs. The pure breed dogs representing 58.6% and mixed breed 41.4%; 53.4% were female and 46.6% were male. The non-neoplastic adrenal lesions were more frequently (57.5%) compared to the neoplastic changes (42.5%). Most of the adrenal glands lesions occurred in older dogs (60%), following by the middle aged (31.25%) and young dogs (8.75%). The main non-neoplastic lesions observed in the adrenal glands were of hyperplastic (69.5%) and circulatory (26%) origin, among the earlier, 68.8% were diffuse hyperplasia and 31.2% nodular hyperplasia. The nodular hyperplasia was classified as micronodular multifocal in 40% of the glands with nodular hyperplasia, macronodular multifocal in 30%, micronodular diffuse in 20%, and micronodular focal in 10%. The neoplasms observed were adrenocortical adenoma (ACA) in 44.1%, pheochromocytomas in 23.5% and adrenocortical carcinomas (ACC) in 11.7% of the dogs with adrenal tumors. Metastasis from other primary tumors were observed in 20.6%.Discussion: The data in veterinary literature about the frequency of changes in adrenal gland of dogs are scarce and focus features of diagnosis by ultrasound examination. Most of the adrenal changes observed in the present study were incidental findings observed during the necropsy examination and no specific clinical signs were observed. Non-neoplastic adrenal lesions, mainly of hyperplastic origin, were more frequently observed compared to the neoplastic changes. Differing from previous studies, the diffuse hyperplasia was the most common non neoplastic finding in the adrenal glands. Considering the subclassification of nodular hyperplasia, the multifocal micronodular and macronodular multifocal pattern were the most frequent. In veterinary literature, there are no data about frequency of nodular hyperplastic subtypes. However, in humans the subclassification of nodular hyperplasia is associated to development of endocrine disorders. Previous studies reported lower incidence of neoplastic changes in adrenal gland of dogs compared to the present results. The adrenocortical adenoma was the most common primary tumor, followed by the adrenocortical carcinoma, pheochromocytoma and adrenocortical carcinoma. Congestion and hemorrhage were common findings observed in the adrenal gland primary tumors. On the other hand, necrosis and inflammatory infiltrate were observed only in the adrenocortical carcinomas. These histopathological features may be used as tool in the differential diagnosis between well differentiated adrenocortical carcinoma and adenoma. The histopathological examination was fundamental to differential and definitive diagnosis of all canine adrenal gland disorders observed.

Asymptomatic Gastric Heterotopia in the Rectum? A Rare Finding with Unclear Malignant Risk

Introduction Gastric heterotopia (GHT) is the presence of normal gastric mucosa in extra-gastric regions in the gastrointestinal tract (GIT). The most common locations are the esophagus, duodenum, and Meckel's diverticulum, but rarely it may occur in the rectum resulting in symptoms and unclear long-term risk. Detailed Case Description We describe a case of a 27 year old, healthy woman, with a long-standing history of loose stools, up to 8 bowel movements per day, and bloating. After diagnostic workup including lactose-breath test, celiac screen, microbiologic, and endocrinologic work up as well as colonoscopy for microscopic colitis; the presumptive diagnosis was irritable bowel syndrome (IBS) - diarrhea subtype. Her colonoscopy revealed normal biopsies of the cecum, transverse colon; however, the rectum contained a well demarcated, erythematous region of approximately 1 inch diameter, adjacent to a prominent fold and resembling a flat polyp. Pathologic biopsy of the folds identified benign gastric mucosa and benign large intestinal mucosa respectively. The diagnosis of rectal GHT was made based on the presence of gastric oxyntic mucosa with chief, parietal, and foveolar cells. Hpylori was not seen. The patient's IBS was treated with diet and lifestyle intervention. Loperamide was used to reduce stool frequency. Repeat sigmoidoscopy 2 years later confirmed stable GHT in rectum. The patient responded well to a reduced gluten diet, and had resolution of her longstanding IBS. She remains stable 8 years after diagnosis with no active IBS symptoms, and no clinical concerns about her GHT. Discussion GHT distal to the foregut is believed to be caused by pluripotent stem cells abnormally differentiating into gastric mucosa. Common symptoms of GHT include abdominal pain and gastrointestinal bleeding but many cases are asymptomatic. A literature review demonstrates higher prevalence in males with a younger median age at diagnosis. Complications are more common in the pediatric population, while risk of malignant transformation is higher in adults. Treatment is with H2-receptor antagonists or proton-pump inhibitors for bleeding, or complete excision for refractory symptoms. Few cases of neoplastic changes are reported in the literature but further observation is needed to appreciate the risk and benefit of pre-emptive excision by surgery or endoscopic submucosal dissection.1614 Figure 1. Heterotopic gastric tissue in rectum

The role of the CagA gene in the occurrence of the inflammatory response of the gastric mucosa in patients with chronic Helicobacter pylori-associated gastritis

Currently, Helicobacter pylori infection (H. pylori) is recognized as one of the most important risk factors for gastrocarcinogenesis. It is known that this infection does not directly cause neoplastic changes in the gastric mucosa, and this is due to a number of consecutive events due to the long persistence of the pathogen in the human body. The initial stage of this cascade, of course, is the inflammatory response, due to the body’s ability to adapt to extraneous infection, which is the inevitable result of the interaction of H. pylori with cells of the gastric epithelium. This direct damaging effect is enhanced by the production of vacuolating cytotoxin and the release of products of the cytotoxin-associated CagA gene, which, at a pathomorphological level, is manifested by inflammatory infiltration of the gastric mucosa (GM) to some extent. On the relationship between the degree of contamination and the activity of the inflammation of the GM in people infected with the CagA strain, today there are different, often conflicting opinions, which is why in this work we set the goal of establishing the relationship between the nature of the inflammatory response and the presence of the CagA gene in H. pylori- infected patients. The purpose of the study is to determinate the relationship between the nature of the inflammatory response and the genetic features of the H. pylori strain (CagA genotype).We examined 365 patients, among whom 40 people were included in the control group (18 women and 22 men, whose average age was 45,33±15,46 and 42,82±12,31, respectively) without any gastroenterological pathology in the anamnesis , patients with chronic non-atrophic gastritis (188 people) and chronic atrophic gastritis (137 people). A close relationship was established between the presence of the CagA gene, activity and the degree of contamination for chronic non-atrophic gastritis: for a low degree of contamination, Fisher’s exact test was = 0.002, p&lt;0.05, for a moderate degree - 0.012, p&lt;0.05, for a high degree - 0,012, p&lt;0.05. Accordingly, in chronic atrophic gastritis: for a low degree of contamination Fisher’s exact test = 0.011, p&lt;0.05, for a moderate degree - 0.003, p&lt;0.05, for a high degree - 0.001, p&lt;0.05. There is also a close relationship between the degree of contamination and the activity of chronic gastritis: in patients with a high degree of contamination, CG activity was determined, as a rule, for stage 2-3. In our study, the inflammatory response depended on the presence or absence of the H. pylori strain in the patient, which contains the CagA genotype, which, in our opinion, plays a key role in triggering a cascade of inflammatory changes in the GM and progression of chronic gastritis.

Eco-Pap: The Ecological Modification of Papanicolaou Stain for Sustainable Cervical Cancer Diagnosis

Cervical cancer is the second most frequent cancer in women worldwide, and it is the disease that causes more disability-adjusted life years. Since the introduction of the Papanicolaou test (Pap test) in the 1940s, it has been demonstrated to have a high-yield diagnosis of cervical preneoplastic and neoplastic changes in women worldwide. The Pap test has been subjected to many modifications since the time of its inception to date. However, there is the paucity of data about the environmental impact generated by the use of its toxic-carcinogenic reagents such as hydrochloric acid, ammonia, mercury oxide, and, principally, xylene used for cellular clearing. The aim of this study was to validate the ecologically friendly modification of the Papanicolaou stain (Eco-Pap) for the diagnosis of cervical cancer. A prospective research was performed at the Hospital Nacional Docente Madre-Niño “San Bartolomé” in Lima, Peru, since 2015. Reagent handling strategies were divided into three phases: we used Harris’s progressive hematoxylin (for nuclear staining), a polychromatic solution (a mix of EA-36/O-G to suppress the use of many alcohol baths), and direct mounting (with Entellan solution). The cellular details were analyzed by the Quality Index Staining, an external QC, and under the requirements of Bethesda System 2014. We have evaluated a total of 72,901 cervical smears stained with Eco-Pap. The validation of Eco-Pap against the conventional Pap stain was optimal (κ = 0.89; 95% CI, 0.87% to 0.92%), showing a sensibility and specificity of 88.3% (95% CI, 85.1% to 90.0%) and 98.7% (95% CI, 98% to 99.2%), respectively (P < .05). Eco-Pap reduced dramatically the environmental pollution caused by 72 L of xylene, hydrochloric acid, and ammonia (6 L each) and mercury oxide (1.5 g). The Eco-Pap is an innovative and efficient staining method, reducing the use of toxic reagents with carcinogenic potential during cervical cancer screening by exfoliative cytology.