AIM: To study an assessment of the number of enterochromaffin cells and expression of hydroxyindole-Omethyltransferase in colonic mucosa and urine excretion of 6-sulfatoxymelatonin in patients with ulcerative colitis....AIM: To study an assessment of the number of enterochromaffin cells and expression of hydroxyindole-Omethyltransferase in colonic mucosa and urine excretion of 6-sulfatoxymelatonin in patients with ulcerative colitis. METHODS: The study included 30 healthy subjects (groupⅠ-C), 30 patients with ulcerative proctitis [group Ⅱ-ulcerative proctitis (UP)] and 30 patients with ulcerative colitis [group Ⅲ-ulcerative colitis (UC)] in acute phases of these diseases. The number of enterochromaffin cells (EC) was estimated in rectal and colonic mucosa. Bioptates were assembled from many different parts of the large intestine. Immunorective cells collected from various parts of the colon were counted according to the Eurovision DAKO (Dako A/S, Copenhagen, Denmark) System in the range of 10 fields in each bioptate at × 200 magnification. The level of mRNA expression of hydroxyindole-O-methyltransferase (HIOMT) in colonic mucosa was estimated with RT-PCR. Urine 6-sulfatoxymelatonin (6-HMS) excretion was determined immunoenzymatically using an IBL (IBL International GmbH, Hamburg, Germany) kit (RE 54031). RESULTS: The number of EC cells in healthy subjects (C) was 132.40 ± 31.26. In patients of group Ⅱ (UP) and group Ⅲ (UC) the number of these cells was higher 225.40 ± 37.35 (P < 0.001) and 225.24 ± 40.50 (P < 0.001) respectively. Similar differences were related to HIOMT expression, which was 1.04 ± 0.36 in group C, 1.56 ± 0.56 (P < 0.01) in group UP and 2.00 ± 0.35 (P < 0.001) in group UC. Twenty-four hour 6-HMS urinary excretion was as follows: C 16.32 ± 4.95 μg/24 h, UP 26.30 ± 7.29 μg/24 h (P < 0.01), UC 42.30 ± 12.56 μg/24h (P < 0.001). A correlation between number of EC cells and 6-HMS excretion was noted in all groups: r = 0.766 in patients with UP, r = 0.703 with UC and r = 0.8551 in the control group; the correlation between the results is statistically significant. CONCLUSION: In the acute phases of both UP and UC, proliferation of EC cells and high expression of HIOMT and urine excretion of 6-HMS is noted. These changes may represent a beneficial response in the anti-inflammatory and defense mechanism.展开更多
In a series of 130 cases of adenocarcinomas of the large intestine, enterochromaffin (EC) cells were detected in 54 cases (41.3%) by limmunocytochemistry with anti-chromogranin monoclonal antibody. Among the 54 cases,...In a series of 130 cases of adenocarcinomas of the large intestine, enterochromaffin (EC) cells were detected in 54 cases (41.3%) by limmunocytochemistry with anti-chromogranin monoclonal antibody. Among the 54 cases, 30 were found positive for serotonin, 14 for somatostatin, 11 for glucagon, 5 for pancreatic polypeptide, and only one for gastrin. The cases with EC cell (++) or polypeptide positive cells exhibited higher grade of differentiation, earlier stage of tumor extension and higher survival rate than those without EC cells. A significant difference of the EC cell population pattern among different histological grades of the tumors and non-neoplastic mucosa was found. The proportion of hormone, especially polypeptied positive cells was the highest in the mucosa and lowest in the moderately or poorly-differentiated carcinomas. The incidence, methodology and clinicopathological significance of EC cells found in the tumors are discussed.展开更多
AIM: To investigate if there are changes in serotonin (5-HT) levels, enterochromaffin (EC) cells and mast cells in small intestinal mucosa of patients with irritable bowel syndrome (IBS). METHODS: Diarrhea-predominant...AIM: To investigate if there are changes in serotonin (5-HT) levels, enterochromaffin (EC) cells and mast cells in small intestinal mucosa of patients with irritable bowel syndrome (IBS). METHODS: Diarrhea-predominant (IBS-D, n = 20), or constipation-predominant (IBS-C, n = 18) IBS patients and healthy controls (n = 20) underwent colonoscopy and peroral small intestinal endoscopy, and mucosal samples were obtained at the descending part of the duodenum, proximal end of jejunum and terminal ileum. High-performance liquid chromatography- electrochemistry and immunohistochemical methods were used to detect 5-HT content, EC cells and mast cells. RESULTS: (1) There were no differences in the number and distribution of EC cells between IBS patients and the normal group. (2) The mucosal 5-HT contents at the duodenum, jejunum and ileum in IBS-C patients were 182 ± 90, 122 ± 54, 61 ± 35 ng/mg protein, respectively, which were all lower than those in the normal group (256 ± 84, 188 ± 91, and 93 ± 45 ng/ mg protein, respectively), with a significant difference at the jejunum (P < 0.05). There were no differences in the small intestinal mucosal 5-HT contents between IBS-D patients and the normal group. The mucosal 5-HT contents at the duodenum were significantly higher than those at the ileum in the three groups (P < 0.001). (3) The numbers of mast cells in patients with IBS-C and IBS-D at the ileum were 38.7 ± 9.4 and 35.8 ± 5.5/highpower field (hpf), respectively, which were significantly more than that in the normal group (29.8 ± 4.4/hpf) (P < 0.001). There was no significant difference in the numbers of mast cells at the other two parts between IBS patients and the normal group. The numbers of mast cells in IBS-C, IBS-D, and normal groups were all significantly higher at the ileum (38.7 ± 9.4, 35.8 ± 5.5, 29.8 ± 4.4/hpf, respectively) than at the duodenum (19.6 ± 4.7, 18.5 ± 6.3, 19.2 ± 3.3/hpf, respectively, P < 0.001). CONCLUSION: The changes in the 5-HT signaling pathway at the jejunum of IBS-C patients and the increase in mast cells in patients with IBS at the terminal ileum may offer evidence to explain the pathogenesis of IBS.展开更多
AIM To evaluate the long-term safety ofomeprazole in patients of gastroesophagealreflux disease resistant to treatment with H2receptor antagonist.METHODS We prospectively followed 33patients on omeprazole therapy for ...AIM To evaluate the long-term safety ofomeprazole in patients of gastroesophagealreflux disease resistant to treatment with H2receptor antagonist.METHODS We prospectively followed 33patients on omeprazole therapy for severeerosive esophagitis for 5-8 years,with periodicgastrin levels,H.pylori infection,gastricbiopsies for incidence of ECL cell hyperplasia,carcinoids,gastric atrophy and neoplasia.Atotal 185 patient follow-up years and 137 gastricbiopsies were done.RESULTS Among the 33 patients,36% reachedtheir peak gastrin levels in an average of 8months to one year,then drifted Down slowlyover 1-2 year period to just above their baselinelevel,24% of the patients had a peak gastrinlevel above 400ng·L^1 and one patient had apeak level above 1000 ng·L^1.One patient had amild ECL cell hyperplasia which was self limitingand did not show any dysplastic changes.Eighteen percent of patients were positive forH.pylori infection.The gastric biopsies did notshow gastric atrophy,intestinal metaplasia orneoplastic changes.CONCLUSION In a series of 33 patients followed for 5 - 8 years on omeprazole therapy for severe reflux esophagitis, we did not observe any evidence of significant ECL cell hyperplasia, gastric atrophy, intestinal metaplasia, dysplasia or neoplastic changes.展开更多
Gastric carcinoids(GCs) are classified as: type Ⅰ,related to hypergastrinemia due to chronic atrophic gastritis(CAG), type Ⅱ, associated with Zollinger-Ellison syndrome in multiple endocrine neoplasia type 1, and ty...Gastric carcinoids(GCs) are classified as: type Ⅰ,related to hypergastrinemia due to chronic atrophic gastritis(CAG), type Ⅱ, associated with Zollinger-Ellison syndrome in multiple endocrine neoplasia type 1, and type Ⅲ, which is normogastrinemic. The management of type-Ⅰ gastric carcinoids(GC1s) is still debated,because of their relatively benign course. According to the European Neuroendocrine Tumor Society guidelines endoscopic resection is indicated whenever possible;however, it is not often feasible because of the presence of a multifocal disease, large lesions, submucosal invasion or, rarely, lymph node involvement. Therefore,somatostatin analogs(SSAs) have been proposed as treatment for GC1 s in view of their antisecretive,antiproliferative and antiangiogenic effects. However,in view of the high cost of this therapy, its possible side effects and the relatively benign course of the disease,SSAs should be reserved to specific subsets of "high risk patients", i.e., those patients with multifocal or recurrent GCs. Indeed, it is reasonable that, after the development of a gastric neuroendocrine neoplasm in patients with a chronic predisposing condition(such as CAG), other enterochromaffin-like cells can undergo neoplastic proliferation, being chronically stimulated by hypergastrinemia. Therefore, definite indications to SSAs treatment should be established in order to avoid the undertreatment or overtreatment of GCs.展开更多
基金Supported by The Ministry of Science and High Education of Poland,No.NN4024221/38
文摘AIM: To study an assessment of the number of enterochromaffin cells and expression of hydroxyindole-Omethyltransferase in colonic mucosa and urine excretion of 6-sulfatoxymelatonin in patients with ulcerative colitis. METHODS: The study included 30 healthy subjects (groupⅠ-C), 30 patients with ulcerative proctitis [group Ⅱ-ulcerative proctitis (UP)] and 30 patients with ulcerative colitis [group Ⅲ-ulcerative colitis (UC)] in acute phases of these diseases. The number of enterochromaffin cells (EC) was estimated in rectal and colonic mucosa. Bioptates were assembled from many different parts of the large intestine. Immunorective cells collected from various parts of the colon were counted according to the Eurovision DAKO (Dako A/S, Copenhagen, Denmark) System in the range of 10 fields in each bioptate at × 200 magnification. The level of mRNA expression of hydroxyindole-O-methyltransferase (HIOMT) in colonic mucosa was estimated with RT-PCR. Urine 6-sulfatoxymelatonin (6-HMS) excretion was determined immunoenzymatically using an IBL (IBL International GmbH, Hamburg, Germany) kit (RE 54031). RESULTS: The number of EC cells in healthy subjects (C) was 132.40 ± 31.26. In patients of group Ⅱ (UP) and group Ⅲ (UC) the number of these cells was higher 225.40 ± 37.35 (P < 0.001) and 225.24 ± 40.50 (P < 0.001) respectively. Similar differences were related to HIOMT expression, which was 1.04 ± 0.36 in group C, 1.56 ± 0.56 (P < 0.01) in group UP and 2.00 ± 0.35 (P < 0.001) in group UC. Twenty-four hour 6-HMS urinary excretion was as follows: C 16.32 ± 4.95 μg/24 h, UP 26.30 ± 7.29 μg/24 h (P < 0.01), UC 42.30 ± 12.56 μg/24h (P < 0.001). A correlation between number of EC cells and 6-HMS excretion was noted in all groups: r = 0.766 in patients with UP, r = 0.703 with UC and r = 0.8551 in the control group; the correlation between the results is statistically significant. CONCLUSION: In the acute phases of both UP and UC, proliferation of EC cells and high expression of HIOMT and urine excretion of 6-HMS is noted. These changes may represent a beneficial response in the anti-inflammatory and defense mechanism.
文摘In a series of 130 cases of adenocarcinomas of the large intestine, enterochromaffin (EC) cells were detected in 54 cases (41.3%) by limmunocytochemistry with anti-chromogranin monoclonal antibody. Among the 54 cases, 30 were found positive for serotonin, 14 for somatostatin, 11 for glucagon, 5 for pancreatic polypeptide, and only one for gastrin. The cases with EC cell (++) or polypeptide positive cells exhibited higher grade of differentiation, earlier stage of tumor extension and higher survival rate than those without EC cells. A significant difference of the EC cell population pattern among different histological grades of the tumors and non-neoplastic mucosa was found. The proportion of hormone, especially polypeptied positive cells was the highest in the mucosa and lowest in the moderately or poorly-differentiated carcinomas. The incidence, methodology and clinicopathological significance of EC cells found in the tumors are discussed.
基金Supported by the Key Clinical Project (2004) from the National Ministry of Health, No. 2004-56
文摘AIM: To investigate if there are changes in serotonin (5-HT) levels, enterochromaffin (EC) cells and mast cells in small intestinal mucosa of patients with irritable bowel syndrome (IBS). METHODS: Diarrhea-predominant (IBS-D, n = 20), or constipation-predominant (IBS-C, n = 18) IBS patients and healthy controls (n = 20) underwent colonoscopy and peroral small intestinal endoscopy, and mucosal samples were obtained at the descending part of the duodenum, proximal end of jejunum and terminal ileum. High-performance liquid chromatography- electrochemistry and immunohistochemical methods were used to detect 5-HT content, EC cells and mast cells. RESULTS: (1) There were no differences in the number and distribution of EC cells between IBS patients and the normal group. (2) The mucosal 5-HT contents at the duodenum, jejunum and ileum in IBS-C patients were 182 ± 90, 122 ± 54, 61 ± 35 ng/mg protein, respectively, which were all lower than those in the normal group (256 ± 84, 188 ± 91, and 93 ± 45 ng/ mg protein, respectively), with a significant difference at the jejunum (P < 0.05). There were no differences in the small intestinal mucosal 5-HT contents between IBS-D patients and the normal group. The mucosal 5-HT contents at the duodenum were significantly higher than those at the ileum in the three groups (P < 0.001). (3) The numbers of mast cells in patients with IBS-C and IBS-D at the ileum were 38.7 ± 9.4 and 35.8 ± 5.5/highpower field (hpf), respectively, which were significantly more than that in the normal group (29.8 ± 4.4/hpf) (P < 0.001). There was no significant difference in the numbers of mast cells at the other two parts between IBS patients and the normal group. The numbers of mast cells in IBS-C, IBS-D, and normal groups were all significantly higher at the ileum (38.7 ± 9.4, 35.8 ± 5.5, 29.8 ± 4.4/hpf, respectively) than at the duodenum (19.6 ± 4.7, 18.5 ± 6.3, 19.2 ± 3.3/hpf, respectively, P < 0.001). CONCLUSION: The changes in the 5-HT signaling pathway at the jejunum of IBS-C patients and the increase in mast cells in patients with IBS at the terminal ileum may offer evidence to explain the pathogenesis of IBS.
文摘AIM To evaluate the long-term safety ofomeprazole in patients of gastroesophagealreflux disease resistant to treatment with H2receptor antagonist.METHODS We prospectively followed 33patients on omeprazole therapy for severeerosive esophagitis for 5-8 years,with periodicgastrin levels,H.pylori infection,gastricbiopsies for incidence of ECL cell hyperplasia,carcinoids,gastric atrophy and neoplasia.Atotal 185 patient follow-up years and 137 gastricbiopsies were done.RESULTS Among the 33 patients,36% reachedtheir peak gastrin levels in an average of 8months to one year,then drifted Down slowlyover 1-2 year period to just above their baselinelevel,24% of the patients had a peak gastrinlevel above 400ng·L^1 and one patient had apeak level above 1000 ng·L^1.One patient had amild ECL cell hyperplasia which was self limitingand did not show any dysplastic changes.Eighteen percent of patients were positive forH.pylori infection.The gastric biopsies did notshow gastric atrophy,intestinal metaplasia orneoplastic changes.CONCLUSION In a series of 33 patients followed for 5 - 8 years on omeprazole therapy for severe reflux esophagitis, we did not observe any evidence of significant ECL cell hyperplasia, gastric atrophy, intestinal metaplasia, dysplasia or neoplastic changes.
文摘Gastric carcinoids(GCs) are classified as: type Ⅰ,related to hypergastrinemia due to chronic atrophic gastritis(CAG), type Ⅱ, associated with Zollinger-Ellison syndrome in multiple endocrine neoplasia type 1, and type Ⅲ, which is normogastrinemic. The management of type-Ⅰ gastric carcinoids(GC1s) is still debated,because of their relatively benign course. According to the European Neuroendocrine Tumor Society guidelines endoscopic resection is indicated whenever possible;however, it is not often feasible because of the presence of a multifocal disease, large lesions, submucosal invasion or, rarely, lymph node involvement. Therefore,somatostatin analogs(SSAs) have been proposed as treatment for GC1 s in view of their antisecretive,antiproliferative and antiangiogenic effects. However,in view of the high cost of this therapy, its possible side effects and the relatively benign course of the disease,SSAs should be reserved to specific subsets of "high risk patients", i.e., those patients with multifocal or recurrent GCs. Indeed, it is reasonable that, after the development of a gastric neuroendocrine neoplasm in patients with a chronic predisposing condition(such as CAG), other enterochromaffin-like cells can undergo neoplastic proliferation, being chronically stimulated by hypergastrinemia. Therefore, definite indications to SSAs treatment should be established in order to avoid the undertreatment or overtreatment of GCs.
