Claudins-Promising Biomarkers for Selected Gastrointestinal (GI) Malignancies?

Despite recent() improvements in diagnostic ability() and treatment() strategies for patients() with neoplastic disease(), gastrointestinal (GI) cancers(), such() as colorectal, gastric, pancreatic, and oesophageal cancers(), are still common() malignancies and the leading() cause() of cancer() deaths worldwide(), with a high frequency of recurrence and metastasis as well as poor patient() prognosis. There is a link() between the secretion of proteolytic enzymes that degrade the extracellular matrix and the pathogenesis of GI tumours. Recent() findings have focused() on the potential() significance() of selected claudins (CLDNs) in the pathogenesis and prognosis of GI cancers(). Tight junctions (TJs) have been proven to play an important role() in maintaining cell() polarity and permeability. A number of authors have recently() revealed that TJ proteins, particularly() selected CLDNs, are related() to inflammation and the development() of various tumours, including GI malignancies. This review() presents general() characteristics and the involvement() of selected CLDNs in the progression() of GI malignancies, with a focus() on the potential() application() of these proteins in the diagnosis() and prognosis of colorectal cancer() (CRC), gastric cancer() (GC), pancreatic cancer() (PC), and oesophageal cancer() (EC). Our review() indicates that selected CLDNs, particularly() CLDN1, 2, 4, 7, and 18, play a significant() role() in the development() of GI tumours and in patient() prognosis. Furthermore, selected CLDNs may be of value() in the design() of therapeutic() strategies for the treatment() of recurrent tumours.

Subfertility as Overlapping of Nutritional, Endocrine, Immune, and Cardiometabolic Dysregulations-A Study Focused on Biochemical Endophenotypes of Subfertile Couples

Subfertility is a global health issue, and as many as 30% of cases are attributed to unexplained reasons. A hypercaloric, high-fat diet stimulates the expansion of pro-inflammatory gut microbiota with a consequent rise in circulating lipopolysaccharides. Adverse gut microbiota remodeling can exacerbate insulin resistance, while sex and thyroid hormones may influence the variability in gut microbiota. This cross-sectional study included 150 participants and was designed to determine a biochemical, nutritional-related pattern that may distinguish subfertile from fertile individuals and couples. A panel of 28 biomarkers was assessed. Four biochemical phenotypes of unexplained subfertility were found, including two metabolic and two immune, when assessed using binary logistic regression models. Two phenotypes were distinguished in women: cardio-metabolic with atherogenic dyslipidemia (LowHDL-cholesterol: OR = 10.9; p < 0.05) and autoimmune thyroid disorder (Highanti-thyroid-peroxidase: OR = 5.5; p < 0.05) and two in men: hepato-metabolic with elevated liver injury enzymes (HighHOMA-IR: OR = 6.1; p < 0.05) and immune type-2 response (HighIgE: OR = 6.4; p < 0.05). The chances of a couple's subfertility rose with the number of laboratory components of metabolic syndrome in the couple (OR = 1.7; p < 0.05) and if at least one partner had an elevated total IgE level (>100 kU/L) (OR = 6.5; p < 0.05). This study found that unexplained subfertility may be accompanied by mutually overlapping immune and metabolic dysregulations in individuals and couples. We propose one-time laboratory diagnostics taking into account the lipid profile, insulin resistance, anti-thyroid-peroxidase, and total IgE in both males and females with unexplained subfertility. This may allow for a one-time assessment of targeted medical and nutritional interventions and help optimize patients' health. The gut-organ axes related to subfertility are discussed in the context of the obtained results.

The Significance of CXCL1 and CXCR1 as Potential Biomarkers of Colorectal Cancer

The CXCL1/CXCR2 and CXCL8-CXCR1/CXCR2 axes are under intensive investigation as they appear to regulate the progression and invasion of colorectal cancer (CRC). Growing evidence demonstrates the elevated expression of these proteins in CRC. However, a majority of relevant studies have been performed on CRC tissues using immunohistochemical techniques. Our study is the first to evaluate the diagnostic significance of serum CXCL1 and CXCR1 levels in CRC patients in comparison to well-established tumor markers, such as the carcinoembryonic antigen (CEA), and markers of inflammation, such as C-reactive protein (CRP). Thus, the aim of our study was to assess whether circulating serum levels of CXCL1 and CXCR1 might be candidates for novel biomarkers in the diagnosis and progression of CRC. The study was performed on 76 subjects, including patients with CRC and healthy volunteers as a control group. Serum concentrations of CXCL1, CXCR1, and the classical tumor marker (CEA) were measured using immunoenzyme assays, while CRP levels were assessed with the immunoturbidimetric method. Serum CXCL1 levels were statistically significantly increased in CRC patients when compared to healthy subjects, and similar results were found for CEA and CRP levels. The percentage of elevated concentrations of CXCL1 and CXCR1 was higher than that of the classical tumor biomarker and increased in the combined measurement of these proteins with CEA. In addition, among all proteins tested, serum CXCL1 seems to be the best indicator in the differentiation between CRC patients with nodal involvement and patients without the presence of lymph node metastasis. Our preliminary results indicate the role of serum CXCL1 and CXCR1 in the diagnosis of CRC, particularly in the combined measurement with CEA.

The Comprehensive Analysis of Specific Proteins as Novel Biomarkers Involved in the Diagnosis and Progression of Gastric Cancer

Gastric cancer (GC) cases are predicted to rise by 2040 to approximately 1.8 million cases, while GC-caused deaths to 1.3 million yearly worldwide. To change this prognosis, there is a need to improve the diagnosis of GC patients because this deadly malignancy is usually detected at an advanced stage. Therefore, new biomarkers of early GC are sorely needed. In the present paper, we summarized and referred to a number of original pieces of research concerning the clinical significance of specific proteins as potential biomarkers for GC in comparison to well-established tumor markers for this malignancy. It has been proved that selected chemokines and their specific receptors, vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR), specific proteins such as interleukin 6 (IL-6) and C-reactive protein (CRP), matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs), a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS), as well as DNA- and RNA-based biomarkers, and c-MET (tyrosine-protein kinase Met) play a role in the pathogenesis of GC. Based on the recent scientific literature, our review indicates that presented specific proteins are potential biomarkers in the diagnosis and progression of GC as well as might be used as prognostic factors of GC patients' survival.

The caspase-8 and procaspase-3 expression in gastric cancer and non-cancer mucosa in relation to clinico-morphological factors and some apoptosis-associated proteins

PURPOSE

The aim of the study was to assess the expression of caspase-8 and procaspase-3 proteins in gastric cancer (GC) cells and non-cancerous mucosa in relation to clinical and morphological characteristics of the tumor, postoperative survival as well as other apoptosis-related proteins.

MATERIALS AND METHODS

The study included 91 ​GC patients. Expression of the proteins was assessed using immunohistochemical method.

RESULTS

Positive expression of procaspase-3 was found in all GC cells. A significant difference was found between high expression of this protein in cancer cells (70.3%) and non-cancerous mucosa (1.25%) (p ​≤ ​0.05). Caspase-8 expression was observed in 50.7% of GC cells and 46.7% of mucosa. Caspase-8 was more common in Lauren type II compared to Lauren type I cancer (p ​= ​0.009), while a statistically significant difference was reported between positive procaspase-3 expression and differentiation of GC (p ​= ​0.043) and Lauren's classification (p ​= ​0.028). We observed a significant positive correlation between the expression of caspase-8 and bcl-xl (p ​= ​0.030) as well as between the procaspase-3 and BID (p ​= ​0.026). Positive caspase-8 expression was associated with longer survival of GC patients (p ​≤ ​0.01).

CONCLUSIONS

Our findings indicate the potential role of the analyzed proteins in GC pathogenesis. Positive expression of caspase-8 is associated with longer survival and better patient prognosis.

Granzymes-Their Role in Colorectal Cancer

Colorectal cancer (CRC) is among the most common malignancies worldwide. CRC is considered a heterogeneous disease due to various clinical symptoms, biological behaviours, and a variety of mutations. A number of studies demonstrate that as many as 50% of CRC patients have distant metastases at the time of diagnosis. However, despite the fact that social and medical awareness of CRC has increased in recent years and screening programmes have expanded, there is still an urgent need to find new diagnostic tools for early detection of CRC. The effectiveness of the currently used classical tumour markers in CRC diagnostics is very limited. Therefore, new proteins that play an important role in the formation and progression of CRC are being sought. A number of recent studies show the potential significance of granzymes (GZMs) in carcinogenesis. These proteins are released by cytotoxic lymphocytes, which protect the body against viral infection as well specific signalling pathways that ultimately lead to cell death. Some studies suggest a link between GZMs, particularly the expression of Granzyme A, and inflammation. This paper summarises the role of GZMs in CRC pathogenesis through their involvement in the inflammatory process. Therefore, it seems that GZMs could become the focus of research into new CRC biomarkers.

A Disintegrin and Metalloproteinase (ADAM) Family-Novel Biomarkers of Selected Gastrointestinal (GI) Malignancies?

The global burden of gastrointestinal (GI) cancers is expected to increase. Therefore, it is vital that novel biomarkers useful for the early diagnosis of these malignancies are established. A growing body of data has linked secretion of proteolytic enzymes, such as metalloproteinases (MMPs), which destroy the extracellular matrix, to pathogenesis of GI tumours. A disintegrin and metalloproteinase (ADAM) proteins belong to the MMP family but have been proven to be unique due to both proteolytic and adhesive properties. Recent investigations have demonstrated that the expression of several ADAMs is upregulated in GI cancer cells. Thus, the objective of this review is to present current findings concerning the role of ADAMs in the pathogenesis of GI cancers, particularly their involvement in the development and progression of colorectal, pancreatic and gastric cancer. Furthermore, the prognostic significance of selected ADAMs in patients with GI tumours is also presented. It has been proven that ADAM8, 9, 10, 12, 15, 17 and 28 might stimulate the proliferation and invasion of GI malignancies and may be associated with unfavourable survival. In conclusion, this review confirms the role of selected ADAMs in the pathogenesis of the most common GI cancers and indicates their promising significance as potential prognostic biomarkers as well as therapeutic targets for GI malignancies. However, due to their non-specific nature, future research on ADAM biology should be performed to elucidate new strategies for the diagnosis of these common and deadly malignancies and treatment of patients with these diseases.

Sensitisation and allergic reactions to alpha-1,3-galactose in Podlasie, Poland, an area endemic for tick-borne infections

PURPOSE

Ticks transmit several pathogens and seem implicated in the production of specific IgE antibodies to alpha-1,3-galactose (α-gal sIgE). They cause delayed and immediate allergy to mammalian meat and medication including antivenoms, vaccines and monoclonal antibodies.

METHODS

We assessed the prevalence of α-gal sIgE in forest workers and healthy controls in the Podlasie voivodeship, north-eastern Poland; the relationship between α-gal sIgE and allergy to α-gal-containing products; the correlation between α-gal sIgE and anti-Borrelia burgdorferi and anti-tick-borne encephalitis virus (TBEV) antibodies; the relationship between α-gal sIgE and markers of infection with lesser-known pathogens transmitted by ticks such as Anaplasma phagocytophilum.

RESULTS

Production of α-gal sIgE was closely related to tick bites. The odds ratio for detectable α-gal sIgE was 9.31 times higher among people with a history of tick bites (OR 9.3; p < .05). There was no correlation with the history of TBE, Lyme disease or human granulocytic anaplasmosis. However, serum α-gal sIgE correlated with anti-TBEV IgM antibodies in CSF. There was a strong correlation between α-gal sIgE and total IgE and sIgE to pork and beef.

CONCLUSIONS

Our data support the link between I.ricinus ticks and the production of α-gal sIgE and confirm that the pathogens carried by ticks we examined for do not seem implicated in this immune response.

Serum CXCL8 and Its Specific Receptor (CXCR2) in Gastric Cancer

Gastric cancer (GC) is the second leading cause of cancer-related deaths worldwide. This malignancy is usually diagnosed at an advanced stage. Therefore, novel biomarkers useful in the early detection of GC are sorely needed. Some authors suggest the role of chemokines and their specific receptors in GC pathogenesis. The aim of the study was to investigate whether serum CXCL8 and its receptor (CXCR2) might be considered as potential candidates for biomarkers in the diagnosis and prognosis of GC. The study included 98 subjects: 64 GC patients and 34 healthy volunteers. CXCL8 and CXCR2 concentrations were assessed by the enzyme-linked immunosorbent assay (ELISA) method. Serum CXCL8 and CXCR2 concentrations were significantly higher in GC patients than in healthy controls, similar to the well-established tumor marker (CA19-9) and marker of inflammation (CRP). Diagnostic sensitivity of CXCL8 was the highest among all proteins tested and increased for the combined assessment with CA19-9. The area under the ROC curve for CXCL8 was higher than those for CXCR2 and classical tumor markers. Serum CXCL8 levels were indicated as a significant risk factor of GC occurrence. Our findings suggest that serum CXCL8 is a promising candidate for a biomarker in GC diagnosis and might be used as a significant predictor of GC risk.

A Disintegrin and Metalloproteinase (ADAM) Family: Their Significance in Malignant Tumors of the Central Nervous System (CNS)

Despite the considerable advances in diagnostic methods in medicine, central nervous system (CNS) tumors, particularly the most common ones-gliomas-remain incurable, with similar incidence rates and mortality. A growing body of literature has revealed that degradation of the extracellular matrix by matrix metalloproteinases (MMPs) might be involved in the pathogenesis of CNS tumors. However, the subfamily of MMPs, known as disintegrin and metalloproteinase (ADAM) proteins are unique due to both adhesive and proteolytic activities. The objective of our review is to present the role of ADAMs in CNS tumors, particularly their involvement in the development of malignant gliomas. Moreover, we focus on the diagnostic and prognostic significance of selected ADAMs in patients with these neoplasms. It has been proven that ADAM12, ADAMTS4 and 5 are implicated in the proliferation and invasion of glioma cells. In addition, ADAM8 and ADAM19 are correlated with the invasive activity of glioma cells and unfavorable survival, while ADAM9, -10 and -17 are associated with tumor grade and histological type of gliomas and can be used as prognostic factors. In conclusion, several ADAMs might serve as potential diagnostic and prognostic biomarkers as well as therapeutic targets for malignant CNS tumors. However, future research on ADAMs biology should be performed to elucidate new strategies for tumor diagnosis and treatment of patients with these malignancies.

The Clinical Utility of Serum CXCR-2 Assessment in Colorectal Cancer (CRC) Patients

BACKGROUND/AIM

The current study aimed to evaluate the clinical utility of the levels of the C-X-C-motif chemokine receptor-2 (CXCR-2) serum receptor in comparison to the carcinoembryonic antigen (CEA) tumor marker and - the C-reactive protein (CRP) inflammatory marker in the diagnosis and prognosis of colorectal cancer (CRC).

MATERIALS AND METHODS

Our study comprised 59 patients with CRC and 46 healthy subjects. Serum concentrations of the analyzed proteins were measured using enzyme-linked immunosorbent assay, chemiluminescent microparticle immunoassay and immunoturbidimetric methods.

RESULTS

Serum levels of CXCR-2 were lower, while those of CEA and CRP were significantly higher in CRC patients in comparison to the control group. The diagnostic sensitivity of CXCR-2 was higher than that of CEA, and increased when CXCR-2 analysis was combined with CEA or CRP.

CONCLUSION

According to our knowledge, this is the first study concerning the significance of CXCR2 as a CRC biomarker. Measurement of the serum levels of CXCR-2 may improve the diagnosis efficiency of CRC patients, especially in combination with the tumor marker CEA.

Chemokines-What Is Their Role in Colorectal Cancer?

Colorectal cancer (CRC) is one of the leading causes of cancer-related death. It is the second most frequently diagnosed malignancy in Europe and third worldwide. Colorectal malignancies diagnosed at an early stage offer a promising survival rate. However, advanced tumors often present distant metastases even after the complete resection of a primary tumor. Therefore, novel biomarkers of CRC are sorely needed in the diagnosis and prognosis of this common malignancy. A family of chemokines are composed of small, secreted proteins. They are best known for their ability to stimulate the migration of several cell types. Some investigations have indicated that chemokines are involved in cancer development, including CRC. This article presents current knowledge regarding chemokines and their specific receptors in CRC progression. Moreover, the prime aim of this review is to summarize the potential role of these proteins as biomarkers in the diagnosis and prognosis of CRC.

The Significance of CXCL1 and CXCL8 as Well as Their Specific Receptors in Colorectal Cancer

Every year, almost 2 million people develop colorectal cancer (CRC), which makes it the fourth most common malignancy worldwide. It is also estimated that approximately 48% of CRC patients will die from the disease. Thus, noninvasive and accurate methods for early detection and prevention of CRC are sorely needed. It is suggested that C-X-C motif ligand 1 (CXCL1) and C-X-C motif ligand 8 (CXCL8) as well as their cognate receptors can mediate tumor growth, proliferation, survival, neoangiogenesis and metastasis of malignant cells, including CRC. However, little is known about the clinical significance of these proteins as potential biomarkers for CRC. Therefore, in our review, we performed a comprehensive literature search using the PubMed database to identify original articles that investigated whether CXCL1 and CXCL8 and their receptors play a role in CRC pathogenesis. In summary, our review highlighted the potential significance of CXCL1/CXCR2 and CXCL8/CXCR1,-2 in the diagnosis and progression of CRC as well as indicated their potential therapeutic significance. However, given the non-specific nature of analyzed chemokines and a small number of studies concerning the assessment of blood concentration of these proteins in CRC patients, investigations need to be continued in the future before selected chemokines could be established as biomarkers for CRC.

Specific Receptors for the Chemokines CXCR2 and CXCR4 in Pancreatic Cancer

Background: The mortality rate of pancreatic cancer (PC) is equal to its incidence and the majority of PC patients die within a few months of diagnosis. Therefore, a search for new biomarkers useful in the diagnosis and prognosis of PC is ongoing. Objectives: The aim of our study was to compare the utility of CXCR2 and CXCR4 in the diagnosis and prediction of PC with classical tumor marker (carcinoembryonic antigen, CEA) and marker of inflammation–C-reactive protein (CRP). Patients and Methods: The study comprised 64 subjects — 32 PC patients and 32 healthy volunteers. Serum concentrations of tested proteins were analysed using immunological methods. Results: Serum CXCR2 and CXCR4 concentrations, similarly to those of CEA and CRP, were significantly elevated in PC patients compared to healthy controls. Moreover, concentrations of CXCR4 were significantly correlated with CXCR2 and CRP levels, while CRP concentrations were correlated with CXCR2 and CEA levels. The diagnostic sensitivity and the predictive value for negative (PV_−ve) results for CXCR4 were similar to those of CEA and higher than those of CXCR2 and CRP, while the area under the ROC curve (AUC) for CXCR4 was the highest among all tested proteins (CXCR2, CEA, CRP). Moreover, serum CXCR2 was found to be a significant predictor of PC risk. Conclusions: CXCR4 is a better candidate for a tumor marker than CXCR2 in the diagnosis of PC, while serum CXCR2 is a significant predictor of PC risk.

Clinical significance of fluid biomarkers in Alzheimer's Disease

The number of patients with Alzheimer's Disease (AD) and other types of dementia disorders has drastically increased over the last decades. AD is a complex progressive neurodegenerative disease affecting about 14 million patients in Europe and the United States. The hallmarks of this disease are neurotic plaques consist of the Amyloid-β peptide (Aβ) and neurofibrillary tangles (NFTs) formed of hyperphosphorylated Tau protein (pTau). Currently, four CSF biomarkers: Amyloid beta 42 (Aβ42), Aβ42/40 ratio, Tau protein, and Tau phosphorylated at threonine 181 (pTau181) have been indicated as core neurochemical AD biomarkers. However, the identification of additional fluid biomarkers, useful in the prognosis, risk stratification, and monitoring of drug response is sorely needed to better understand the complex heterogeneity of AD pathology as well as to improve diagnosis of patients with the disease. Several novel biomarkers have been extensively investigated, and their utility must be proved and eventually integrated into guidelines for use in clinical practice. This paper presents the research and development of CSF and blood biomarkers for AD as well as their potential clinical significance. Upper panel: Aβ peptides are released from transmembrane Amyloid Precursor Protein (APP) under physiological conditions (blue arrow). In AD, however, pathologic accumulation of Aβ monomers leads to their accumulation in plaques (red arrow). This is reflected in decreased concentration of Aβ1-42 and decreased Aβ42/40 concentration ratio in the CSF. Lower panel: Phosphorylated Tau molecules maintain axonal structures; hyperphosphorylation of Tau (red arrow) in AD leads to degeneration of axons, and release of pTau molecules, which then accumulate in neurofibrillary tangles. This process is reflected by increased concentrations of Tau and pTau in the CSF.

Biochemistry of infertility

Infertility affects approximately 186 million people worldwide and 8-12% of couples of reproductive age. Therefore, a comprehensive diagnostic evaluation of infertility is crucial to achieving improvements in targeted prevention and treatment outcomes. The aim of this review is to explore the biochemistry of infertility in order to properly diagnose and treat infertile couples. Recent studies indicate that routine measurement of biochemical parameters reflecting thyroid dysfunction, immunological disorders, autoimmune mechanisms, insulin resistance and malabsorption of selected micro- and macronutrients are required to assess infertility. Due to the complexity of this approach, algorithmic protocols that integrate these biochemical parameters in a dynamic test environment are necessary to provide a more comprehensive diagnostic assessment and more effective treatment strategy for infertile couples.

The significance of chemokine CXCL-8 in esophageal carcinoma

Chemokines are a group of small molecular weight proteins that are structurally related. These molecules play an important role in the growth, differentiation and activation of many types of cells [1, 2]. Chemokines are synthesized mostly by leukocytes and act through their cognate G-protein coupled receptors to cause a cellular response, such as migration, adhesion or chemotaxis [1, 3]. The chemokine family has been classified into four classes: CC, CXC, CX3C, and (X), based on the arrangement of N-terminal cysteine residues [4]. These small peptides may also be grouped into inflammatory, homeostatic or dual function chemokines. Inflammatory chemokines can be induced during an immune response, whereas homeostatic chemokines are involved in control of cell migration [5]. The chemokine receptors are seven-transmembrane receptors coupled to G-proteins, that consist of an N-terminus outside the cell surface, three extracellular and three intracellular loops as well as a C-terminus in the cytoplasm [6, 7].

Novel potential biomarkers for pancreatic cancer - A systematic review

BACKGROUND

It is estimated that in developed countries the incidence rate of pancreatic cancer (PC) will continue to rise and by 2020 will be the second most fatal cancer. The mortality of PC patients closely parallels the incidence rate, as this malignancy remains asymptomatic until it reaches an advanced stage of disease. Thus, novel biochemical markers that improve the management of PC patients are necessary. The aim of the work that follows is to investigate whether selected inflammatory mediators might be used in the diagnosis of PC, with the aim of improving the prognosis for PC patients.

METHODS

We performed a thorough search for literature pertaining to our investigation via the MEDLINE/PubMed database.

RESULTS

It has been proved that certain inflammatory mediators might be involved in tumor progression, such as growth, proliferation, migration and angiogenesis of tumor cells. In the present review, we summarized and referred to a number of original papers concerning the clinical significance of selected cytokines and specific inflammatory proteins such as C-reactive protein, as well as of various matrix metalloproteinases and their tissue inhibitors, as potential biomarkers for PC in comparison to well-established tumor markers for this malignancy.

CONCLUSION

Presented proteins might be potential biomarkers in the diagnosis and progression of PC.

The impact of laparoscopic adrenalectomy on renal function. Results of a prospective randomised clinical trial

INTRODUCTION

Laparoscopic adrenalectomy is the gold standard management of benign adrenal masses and isolated metastases to adrenal glands. Two techniques of endoscopic adrenalectomy: lateral transperitoneal approach (LTA) and posterior retroperitoneal approach (PRA) seem to be equally safe and effective. Recent studies suggest advantages of PRA over LTA in terms of lower intensity of postoperative pain, shorter hospital stay, faster recovery, and lower early morbidity. However, PRA involves high insufflation pressure of CO₂ within a limited retroperitoneal space. The aim of our study was to prospectively assess the effect of LTA versus PRA laparoscopic adrenalectomies on renal function.

MATERIAL AND METHODS

We randomly assigned patients referred for unilateral adrenalectomy to either LTA (n = 33) or PRA (n = 44). The inclusion criteria were: hormonal activity and/or tumour diameter > 4 cm and/or suspicion of metastasis to adrenal gland. The exclusion criteria comprised: tumours > 8 cm, results of imaging studies suggesting primary invasive malignancy, and refusal to undergo randomisation. The patients were prospectively followed for a minimum of six months. Serum creatinine, cystatin C, and urinary neutrophil gelatinase-associated lipocalin (NGAL) were measured preoperatively and at postoperative days: 1, 7, and 30.

RESULTS

We found increased concentrations of urinary NGAL at day 1 following laparoscopic adrenalectomy using PRA, as compared to LTA. Patients undergoing right-sided PRA had increased creatinine concentrations, as compared to left-sided PRA. Patients with aldosterone-producing adenoma had decreased preoperative eGFR as compared to subjects with non-functioning incidentaloma. NGAL increased significantly in this group postoperatively. All the disturbances normalised within one month postoperatively.

CONCLUSIONS

Renal function impairment after PRA may result from compression of inferior vena cava by high retroperitoneal pressure during right-sided adrenalectomy. Despite the transient character of the observed abnormalities, we suggest that patients with high risk of acute kidney injury may benefit from an alternative technique of adrenalectomy using LTA.

Comparison between clinical significance of serum CXCL-8 and classical tumor markers in oesophageal cancer (OC) patients

C-X-C motif chemokine 8 (CXCL-8), known as interleukin-8, is a pro-inflammatory cytokine which acts as a chemotactic factor, mainly for leukocytes. CXCL-8 is produced by malignant cells, and therefore it can stimulate the growth and progression of various neoplasms, including oesophageal cancer (OC). The aim of the current study was to measure serum concentrations of chemokine CXCL-8 in OC patients and establish whether this protein might be considered a potential candidate for a tumor marker in the diagnosis and progression of OC. The study included 50 OC subjects (32 patients with squamous cell carcinoma of oesophagus-OSCC, 18 patients with adenocarcinoma-OAC) and 26 healthy volunteers. Serum CXCL-8 concentrations were measured using immunoenzymatic assay (ELISA). CRP levels were determined by immunoturbidimetric method, while classical tumor marker levels were measured using chemiluminescent immunoassay. CXCL-8 concentrations were significantly higher in OC patients compared to healthy controls. We demonstrated significant differences between CXCL-8 concentrations and depth of tumor invasion (T factor) in OC patients and OSCC subgroup. In addition, CXCL-8 levels were found to correlate positively with T factor and CRP concentrations. The diagnostic sensitivity, negative predictive value and the area under ROC curve (AUC) of CXCL-8 were higher than those of classical tumor markers. Our findings suggest the potential usefulness of CXCL-8 in the diagnosis and progression of OC. However, due to the non-specific nature of this chemokine, further research is needed to clarify the usefulness of CXCL-8 as a tumor marker of OC.

Matrix metalloproteinase 2 (MMP-2) and its tissue inhibitor 2 (TIMP-2) in pancreatic cancer (PC)

Objectives

The incidence rate of pancreatic cancer (PC) is similar to mortality rate, thus searching specific tumor biomarkers of PC is sorely needed. Matrix metalloproteinase-2 (MMP-2) and the imbalance between MMP-2 and its tissue inhibitor (TIMP-2) play a critical role in tumor progression. We aim to assess the diagnostic and prognostic usefulness of serum MMP-2 and TIMP-2 as potential biomarkers in comparison to well-established tumor markers of PC (CA 19-9, carbohydrate antigen 19-9 and CEA, carcinoembryonic antigen).

Results

We indicated the significant differences between serum TIMP-2 concentrations in PC patients, CP individuals and control group. The diagnostic sensitivity of TIMP-2 was the highest among all proteins tested and increased up to 96% in combined measurement with MMP-2. The area under ROC curve (AUC) for TIMP-2 was larger than for MMP-2, but lower than for classical tumor markers.

Methods

Presented study comprised on 226 subjects, including 92 PC patients, 43 chronic pancreatitis (CP) patients and 91 healthy volunteers. The serum concentrations of these proteins were measured using immunological methods.

Conclusions

Presented findings suggest higher usefulness of TIMP-2 than MMP-2 as potential biomarker in the diagnosis of PC patients, however more studies on large population are needed to support our results.

The role of selected chemokines and their specific receptors in pancreatic cancer

Pancreatic carcinoma is a highly malignant disease associated with an extremely poor prognosis, which is caused by late presentation, aggressive invasion and metastases, as well as the detection of pancreatic carcinoma in its advanced stages. Thus, better understanding of the tumour biology of this malignancy is sorely needed to improve the clinical outcome. A great challenge for the medical practice is finding a new biomarker of pancreatic carcinoma that will be helpful in diagnosis, in prognosis and in making clinical decisions, including the assessment of patients' response to therapy. It is suggested that selected chemokines and their specific receptors play an important role in tumour progression, such as tumour growth, angiogenesis, proliferation and development of metastasis. In the present review, general characteristics of chemokines and their specific receptors as well as the significance of these molecules in tumour development are described. The crucial issue of this review is to summarise the importance of various chemokines and their specific receptors in pancreatic carcinoma. Understanding the role of chemokines in the pathogenesis of pancreatic carcinoma is extremely important since these proteins may be used as a potential tool in the diagnosis and prognosis of pancreatic carcinoma patients.

Serum chemokine CXCL8 as a better biomarker for diagnosis and prediction of pancreatic cancer than its specific receptor CXCR2, C-reactive protein, and classic tumor markers CA 19-9 and CEA

Introduction Novel biomarkers are critically needed to improve the management of patients with pancreatic cancer (PC). Objectives We aimed to evaluate the clinical usefulness of serum CXCL8 in relation to its specific receptor CXCR2 in the diagnosis and prediction of PC compared with classic tumor markers (carbohydrate antigen 19-9 [CA 19-9] and carcinoembryonic antigen [CEA]) and C-reactive protein (CRP). Patients and methods The study included 76 subjects: 42 patients with PC and 34 healthy volunteers. Serum protein levels were measured by immunological methods. Results Serum CXCL8 and CXCR2 concentrations were significantly higher in PC patients compared with healthy controls, similarly to classic tumor markers and CRP. CXCL8 levels were significantly elevated in patients with lymph node metastasis compared with individuals without nodal involvement. The diagnostic sensitivity, accuracy, negative predictive value, and areas under the receiver operating characteristic curves for CXCL8 were higher than those for CXCR2, CRP, CA 19-9, and CEA. Moreover, serum CXCL8 was the only significant predictor of PC risk. Conclusions Our findings indicate the significance of the CXCL8-CXCR2 axis in the pathogenesis of PC. Serum CXCL8 is emerging as the strongest candidate for a potential PC biomarker among all proteins tested.

Stem cell factor in the serum of patients with esophageal cancer in relation to its histological types

INTRODUCTION

Hematopoietic growth factors (HGFs), such as stem cell factor (SCF), may stimulate proliferation and differentiation of hematopoietic progenitor cells. Stem cell factor is also able to affect the growth of malignant tumors, including esophageal cancer (EC). The prognosis of EC patients' survival is still unfavorable. Thus, novel biomarkers are necessary to improve the diagnosis and prognosis of EC patients. The aim of this study was to determine the serum SCF concentrations in EC patients in relation to its histological types and compare these levels with the classical tumor marker - carcinoembryonic antigen (CEA).

MATERIAL AND METHODS

The study included 56 EC patients and 65 healthy controls. Serum SCF and CEA concentrations were measured using immunoenzyme assays. Moreover, diagnostic criteria of both proteins tested and the survival of EC patients were assessed.

RESULTS

The serum SCF concentrations were lower in EC patients compared to healthy controls, but the difference was not significant, whereas CEA levels were higher in EC patients than in healthy subjects. The serum SCF concentrations were significantly higher in patients with adenocarcinoma of the esophagus (AC) than in patients with esophageal squamous cell carcinoma (ESCC). Moreover, the diagnostic sensitivity of SCF (88%) was higher than for CEA (29%) and increased for combined analysis of SCF with CEA.

CONCLUSIONS

Our findings suggest the potential role of serum SCF in the diagnosis of EC patients, especially in combination with the classical tumor marker. However, due to the non-specific nature of SCF, this issue requires further investigations performed on a larger population of EC patients.

Serum concentrations of receptor for interleukin 8 in patients with esophageal cancer

INTRODUCTION A specific receptor for interleukin 8, known as C-X-C chemokine type‑2 receptor (CXCR‑2), is one of the 7‑transmembrane G‑protein‑coupled receptors. Its involvement in the development of numerous malignancies, including esophageal cancer (EC), has been suggested. OBJECTIVES The aim of this study was to assess the diagnostic and prognostic usefulness of serum CXCR‑2 level measurement in patients with EC, in comparison with C‑reactive protein (CRP) levels and classic tumor markers such as carcinoembryonic antigen (CEA) and squamous cell carcinoma antigen (SCC‑Ag).  PATIENTS AND METHODS The study included 72 individuals: 42 patients with EC and 30 healthy volunteers. Serum CXCR‑2 concentrations were measured by an immunoenzymatic assay. The levels of classic tumor markers were measured using the chemiluminescent method, and CRP levels were measured using the immunoturbidimetric method. RESULTS Serum CXCR‑2 concentrations were significantly higher in patients with EC than in the control group, similarly to CEA and CRP levels. Moreover, CXCR‑2 concentrations were significantly higher in patients with poorly differentiated EC (G3) compared with those with G2 tumors. The diagnostic sensitivity and accuracy, as well as the negative predictive value of the serum CXCR‑2 assay were higher than those observed for classic tumor markers and slightly lower than those observed for CRP levels. The highest diagnostic sensitivity was found for the combined analysis of CXCR‑2 and CRP. CONCLUSIONS Our results suggest the role of CXCR‑2 in the development of EC. Thus, further research is needed to clarify the significance of chemokines and their receptors as potential tumor markers of EC.

Matrix Metalloproteinases and Their Tissue Inhibitors in Comparison to Other Inflammatory Proteins in Gastric Cancer (GC)

Gastric cancer (GC) remains a major cause of cancer-related deaths worldwide. The lack of management strategies for the diagnosis of GC in patients gives rise to the challenging questions about the new tumor markers for GC. Developing malignant process may induce local and systemic inflammatory responses. Cancer-associated inflammation is characterized by the infiltration of immune cells. Thus, the inflammation-related proteins, such as cytokines, chemokines, and selected matrix metalloproteinases, may facilitate the growth, proliferation, and migration of tumor cells, including GC. Based on our previous findings, we assessed the significance of various inflammatory mediators as candidates for tumor markers of GC.

Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) in amyotrophic lateral sclerosis (ALS)

Matrix metalloproteinases (MMPs) are zinc-dependent endopeptidases, responsible for the integrity of the basement membrane (BM) via degradation of extracellular matrix and BM components. These enzymes are presented in central and peripheral nervous system. They are considered to be involved in the pathogenesis of several neurological diseases, including amyotrophic lateral sclerosis (ALS). ALS is a motor neuron disease, leading to muscle atrophy, paralysis and death within 3–5 years from diagnosis. Currently, there is no treatment that can substantially prolong life of ALS patients. Despite the fact that MMPs are not specific for ALS, there is also strong evidence that these enzymes are involved in the pathology of ALS. MMPs are able to exert direct neurotoxic effects, or may cause cell death by degrading matrix proteins. The objective of this paper is to provide an updated and comprehensive review concerning the role of MMPs and their tissue inhibitors (TIMPs) in the pathology of ALS with an emphasis on the significance of MMP-2 and MMP-9 as well as their tissue inhibitors as potential biomarkers of ALS. Numerous hypotheses have been proposed regarding the role of selected MMPs and TIMPs in ALS pathogenesis. Moreover, selective MMPs’ inhibitors might be potential targets for therapeutic strategies for patients with ALS. However, future investigations are necessary before some of those non-specific for ALS enzymes could finally be used as biomarkers of this disease.

Higher importance of interleukin 6 than classic tumor markers (carcinoembryonic antigen and squamous cell cancer antigen) in the diagnosis of esophageal cancer patients

It has been suggested that interleukin 6 (IL-6) plays a potential role in the growth and progression of tumors, including esophageal cancer (EC). The aim of the study was to compare clinical significance of serum IL-6 with classic tumor markers - carcinoembryonic antigen (CEA) and squamous cell cancer antigen (SCC-Ag) - in EC patients in relation to its histological types - squamous cell carcinoma of esophagus (ESCC) and adenocarcinoma (AD) of esophagus. The study included 53 EC patients and 90 healthy subjects. Serum IL-6 and CEA levels were determined using immunoenzyme assays, while SCC-Ag - chemiluminescent assay. The diagnostic criteria and prognostic values for markers were defined. The levels of all proteins tested in EC, ESCC, and AD were higher than in healthy subjects. The percentage of elevated results was substantially higher for IL-6 (86%) than for CEA (30%) and SCC-Ag (24%) in EC, similarly as in ESCC (87%, 23%, and 33%) and AD (87%, 39%, and 13%, respectively) patients. Concentrations of IL-6 depended on distant metastases and patients' survival in EC and were significantly higher in ESCC patients with more advanced tumor stage and nodal metastases. The IL-6 area under receiver operating characteristic curve (0.92) was larger than for CEA (0.84) and SCC-Ag (0.62) in EC, likewise in ESCC (0.92, 0.87, 0.77) and AD (0.91, 0.79, 0.57, respectively). Our findings indicate better usefulness of IL-6 than classic tumor markers in the diagnosis of EC, especially in patients with ESCC.

Cerebrospinal fluid leakage--reliable diagnostic methods

Prompt diagnosis and early treatment of cerebrospinal fluid (CSF) leakage minimizes the risk of severe complications. In patients presenting with clear fluid nasal discharge it is important to identify the nature of the rhinorrhea. The CSF leakage may occur as post-traumatic, iatrogenic, spontaneous or idiopathic rhinorrhea. The differential diagnosis of CSF rhinorrhea often presents a challenging problem. The confirmation of CSF rhinorrhea and localization of the leakage may be diagnosed by CT, MRI cisternography and MRI cisternography in combination with single photon emission tomography or radioisotopic imaging. Although these methods allow estimation of the CSF leakage with high accuracy, they are expensive and invasive procedures. Therefore, biochemical methods are still used in the differentiation. Although the most common diagnostic method for screening CSF leakage is glucose oxidase, its diagnostic sensitivity and specificity is generally unsatisfactory. False negative results may occur with bacterial contamination and false positive results are common in diabetic patients. Glucose detection is not recommended as a confirmatory test. As such, other biomarkers of the CSF leakage, such as beta-2-transferrin (beta-2 trf) and beta-trace protein (betaTP) are necessary to identify and confirm of this condition.