Research Center in Gastroenterology and Hepatology

Craiova, Romania

Research Center in Gastroenterology and Hepatology

Craiova, Romania
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Ignee A.,Caritas Krankenhaus | Jenssen C.,Krankenhaus Markisch Oderland | Hocke M.,Klinikum Meiningen | Dong Y.,Fudan University | And 7 more authors.
Endoscopic Ultrasound | Year: 2017

Background and Objectives: Gastrointestinal stromal tumors (GISTs) represent the largest group of subepithelial tumors (SET) of the upper gastrointestinal (GI) tract. They may show malignant behavior, in contrast to other SET. Endoscopic ultrasound (EUS) is frequently used to characterize SET. With the introduction of contrast-enhanced ultrasound (CEUS) into EUS (CE-EUS), distinct enhancement patterns can be detected. In the presented study, the characteristic features of CE-EUS in GIST are analyzed and compared with those of other SET. Materials and Methods: Consecutive patients from four centers with SET of the upper and middle GI tract were included and received endoscopic or transcutaneous CEUS. The results were compared with EUS-guided tissue acquisition, forceps biopsy, or surgical resection. Results: Forty-two out of 62 (68%) patients had SET of the stomach, 17/62 (27%) of the small intestine, 2/62 (3%) of the esophagus, and 1/62 (2%) extraintestinal. Eighty-one percent underwent surgery. Leiomyoma was found in 5/62 (8%) and GIST in 57/62 patients (92%). Thirty-nine out of 57 (68%) patients had GIST lesions in the stomach, 17/57 (30%) had GIST of the small intestine, and 1/57 (2%) patients had extraintestinal GISTs. GIST size was 62.6 ± 42.1 (16-200) mm. Hyperenhancement had a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 98%, 100%, 100%, 93%, and 98% for the diagnosis of GIST. Fifty out of 57 patients with GIST (88%) showed avascular areas in the center of the lesions. Conclusion: CE-EUS and CEUS show hyperenhancement and avascular areas in a high percentage of GIST but not in leiomyoma. Thus, GIST and leiomyoma can be discriminated accurately. © 2017 SPRING MEDIA PUBLISHING CO. LTD.


Burada F.,University of Medicine and Pharmacy of Craiova | Burada F.,Research Center in Gastroenterology and Hepatology | Angelescu C.,University of Medicine and Pharmacy of Craiova | Angelescu C.,Research Center in Gastroenterology and Hepatology | And 10 more authors.
Advances in Clinical and Experimental Medicine | Year: 2011

Background. Gastric cancer is the second leading cause of cancer death in both sexes worldwide and the prognosis of this malignancy remains very poor. Objectives, Material and Methods. This study assesses the association between interleukin 1β gene (IL-1B) and interleukin 1 receptor antagonist gene (IL-1RN) polymorphisms and gastric cancer susceptibility in the Romanian population. The authors investigated IL-1B -31T > C, IL-1B +3954C > T and IL1-RN +2018T > C polymorphisms in 103 subjects diagnosed with gastric cancer and 244 healthy controls. These polymorphisms were genotyped by allelic discrimination TaqMan PCR. Results. In all gastric cancer cases, a significant association with an increased risk of gastric cancer was only observed for the IL1-RN +2018T > C polymorphism (OR 2.52, 95% CI: 1.06-6.01). A stratified analysis showed that IL1-RN +2018T > C was associated with an increased risk of gastric non-cardia adenocarcinoma (OR 2.77, 95% CI: 1.10-6.99) and intestinal type (OR 3.08, 95% CI: 1.17-8.11). The authors found no significant differences between gastric cancer cases and controls for IL1-B -31CC (OR 0.77, 95% CI: 0.32-1.84) and IL1-B +3954TT (OR 0.77, 95% CI;0.32-1.85) genotypes polymorphisms. Conclusions. The results presented do not support the hypothesis that the IL-1B -31T > C and IL-1B +3954C > > T polymorphisms determine differences in gastric cancer risk among different individuals, but the IL1-RN +2018T > C polymorphism could contribute to gastric cancer risk in the Romanian population. © Copyright by Wroclaw Medical University.


Angelescu R.,Research Center in Gastroenterology and Hepatology | Burada F.,Research Center in Gastroenterology and Hepatology | Burada F.,University of Medicine and Pharmacy of Craiova | Angelescu C.,Research Center in Gastroenterology and Hepatology | And 8 more authors.
Endoscopic Ultrasound | Year: 2013

Objective: Angiogenesis is a crucial event for pancreatic carcinogenesis, and it also plays an important role in chronic pancreatitis. The aim of our study was to evaluate the mRNA expression of vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) in chronic inflammatory or malignant pancreatic pathology in order to elucidate the differences in expression patterns and potential clinical implications. Methods: Thirty-five patients who had undergone endoscopic ultrasonography followed by endoscipic ultrasound-guided fine needle aspiration (EUS-FNA) of focal pancreatic masses were included in the study. VEGF and EGFR mRNA expression levels in the samples collected by EUS-FNA were analyzed using quantitative real-time polymerase chain reaction (PCR). Results: VEGF expression was detected in all chronic pancreatitis and adenocarcinoma samples and in only 62.5% of pancreatic neuroendocrine tumors. EGFR expression was detected in only 40% of the chronic pancreatitis cases, 76.9% of adenocarcinomas and in 50% of pancreatic neuroendocrine tumors. Both VEGF and EGFR mRNA levels were significantly higher in pancreatic ductal adenocarcinoma than those in normal tissue. VEGF expression inversely correlated with pancreatic ductal adenocarcinoma size, while EGFR expression was related to local invasiveness of adenocarcinoma. Conclusion: Both VEGF and EGFR mRNA expression in EUS-FNA samples may be used as a diagnostic marker associated with invasiveness in patients with pancreatic adenocarcinoma.


PubMed | University of Medicine and Pharmacy of Craiova and Research Center in Gastroenterology and Hepatology
Type: Journal Article | Journal: Endoscopic ultrasound | Year: 2014

Angiogenesis is a crucial event for pancreatic carcinogenesis, and it also plays an important role in chronic pancreatitis. The aim of our study was to evaluate the mRNA expression of vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) in chronic inflammatory or malignant pancreatic pathology in order to elucidate the differences in expression patterns and potential clinical implications.Thirty-five patients who had undergone endoscopic ultrasonography followed by endoscipic ultrasound-guided fine needle aspiration (EUS-FNA) of focal pancreatic masses were included in the study. VEGF and EGFR mRNA expression levels in the samples collected by EUS-FNA were analyzed using quantitative real-time polymerase chain reaction (PCR).VEGF expression was detected in all chronic pancreatitis and adenocarcinoma samples and in only 62.5% of pancreatic neuroendocrine tumors. EGFR expression was detected in only 40% of the chronic pancreatitis cases, 76.9% of adenocarcinomas and in 50% of pancreatic neuroendocrine tumors. Both VEGF and EGFR mRNA levels were significantly higher in pancreatic ductal adenocarcinoma than those in normal tissue. VEGF expression inversely correlated with pancreatic ductal adenocarcinoma size, while EGFR expression was related to local invasiveness of adenocarcinoma.Both VEGF and EGFR mRNA expression in EUS-FNA samples may be used as a diagnostic marker associated with invasiveness in patients with pancreatic adenocarcinoma.


PubMed | Research Center in Gastroenterology and Hepatology
Type: Journal Article | Journal: Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie | Year: 2011

Hepatic stellate cells (HSC) are key-players in the pathogenesis of liver fibrosis, inducing collagen deposition and abnormal extracellular matrix remodeling.The purpose of this study was to identify the stellate cells using immunohistochemical techniques and to establish if there is a correlation between the expression of stellate cells and the clinical and histological parameters in patients with chronic viral hepatitis C.The studied group included 30 patients with chronic viral hepatitis C genotype 1, in whom a liver biopsy was performed previous to the antiviral treatment. After the histological analyze, the biopsy was stained with an anti-SMA antibody (Dako, Carpinteria, CA). The amount of positive stained area was determined using an arbitrary semiquantitative score from 1 to 4.Our observations suggest that there is a strong correlation between the stellate cells activity, evaluated using a semiquantitative score, and the stage of liver fibrosis (rs=0.76, p<0.001). Also, our study revealed a direct correlation, but less intense, with the necro-inflammatory activity (rs=0.39, p=0.03), the steatosis degree (rs=0.428, p=0.01) and the value of alanine aminotransferase (rs=0.4, p=0.03). The age and the viremia level were not correlated with the activity of the stellate cells.This study suggests that the transition of stellate cells from inactivated state to the state of highly fibrogenic cell is influenced mainly by the histological liver modifications (necroinflammatory activity and steatosis) and less by clinical parameters (age, sex) or the viremia level.

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