Gastric cancer is the fourth most frequent cancer and the second cause of cancer-related deaths worldwide. The early diagnosis of gastric cancer is fundamental in decreasing the mortality rates. It has been shown that MPV level is a sign of inflammation in hepatocellular carcinoma and pancreatic adenocarcinoma. The aim of this study is to examine whether MPV would be a useful inflammatory marker for differentiating gastric cancer patients from healthy controls. Thirty-one gastric cancer patients and 31 age-sexes matched healthy subjects included into the study. Patients with hypertension, hematological and renal disease, heart failure, chronic infection, hepatic disorder and other cancer were excluded from the study. MPV level was significantly higher in pre-operative gastric cancer patients compared to healthy subjects (8.31 fL vs. 7.85; p: 0.007). ROC analysis suggested 8.25 fL as the cut-off value for MPV (AUC: 0.717, sensitivity: 61%, specificity: 81%). Surgical tumor resection resulted in a significant decrease in MPV level (8.31 fL vs. 7.55 fL; p: 0.001). No significant difference was found in MPV level between the post-operative group and control subjects. We did not find statistically significant difference between MPV and TNM stages. In conclusion, changes in MPV values may be used as an easily available biomarker for monitoring the healthy patients for GC risk and may prompt physicians to make an early diagnosis of GC.
Incidence of the esophagus adenocarcinoma has been dramatically increasing in Western countries since the last decade. Gastroesophageal reflux disease and Barrett’s esophagus are risk factors for adenocarcinoma. Methylenetetrahydrofolate reductase (MTHFR) genes play a key role not only in folate metabolism but also in esophagus, stomach, pancreatic carcinoma, and acute leukemias. Studies have suggested that genetic polymorphisms of MTHFR (C677T) may clarify the causes and events involved in esophageal carcinogenesis. In this study, we evaluated MTHFR C677T and A1298C polymorphisms, and vitamin B12, folate, and plasma homocystein levels in patients with esophageal adenocarcinoma (EAC), Barrett’s esophagus (BE), chronic esophagitis, and healthy controls (n= 26, n= 14, n= 30, and n= 30, respectively). The mean age of patients in the EAC and BE groups was significantly higher compared with the control group (P < 0.001, P= 0.003, respectively). In all patient groups, serum folate levels were significantly lower than that of the control group (P < 0.01, P < 0.05, and P < 0.01, respectively). There was no statistically significant association between folate levels and MTHFR gene polymorphisms. No differences were found in terms of MTHFR gene polymorphisms, homocystein, and B12 levels among the groups. MTHFR gene polymorphisms and folate deficiency are not predictors of early esophageal carcinoma. However, further studies using larger series of patients are needed to evaluate the effect of genetic polymorphisms in the folate metabolic pathway and to clarify the role of folate deficiency and folate metabolism in the development of esophagus adenocarcinoma.
A 59-year-old man was admitted to our department with epigastric pain and nausea. The patient mentioned that he had swallowed heated mastic to treat constipation shortly before his symptoms developed. He had no history of any diseases. His vital signs were within normal limits. The physical examination findings were normal, and the results of laboratory tests were unremarkable.
A 63-year-old man was admitted to our clinic with a 2-month history of epigastric pain and dyspeptic complaints. He had no history of any disease and his vital signs were within normal limits. Physical examination revealed a palpable abdominal mass. Laboratory tests showed unremarkable findings. Upper gastrointestinal endoscopy revealed a crater-like ulcer, approximately 3 cm in diameter, in the anterior wall of the gastric body, and compression on the posterior wall of the stomach ([Fig. 1]). The esophagus and duodenum were unremarkable. Histopathological analysis of an endoscopic biopsy sample from the ulcer revealed malignant melanoma. Abdominal computed tomography showed a large, heterogeneous, cystic solid tumor 15 cm in diameter, compatible with gastrointestinal stromal tumor (GIST), originating from the posterior wall of the stomach ([Fig. 2]). Percutaneous biopsy was performed. A diagnosis of GIST was confirmed by histopathological findings. The patient was referred to the surgery and medical oncology departments.
Non-alcoholic fatty liver disease (NAFLD) is a clinical term that covers simple fatty liver (SFL) and non-alcoholic steatohepatitis (NASH), and high-sensitivity C-reactive protein (hs-CRP) is a marker of inflammation. The aim of the present study was to investigate the relationship between steatosis and hs-CRP in patients with ultrasonographically verified NAFLD.We examined 296 consecutive patients. NAFLD was detected by ultrasound (US). Patients with NAFLD who had an alanine aminotransferase (ALT) level of > 40 IU/mL were considered to have NASH and those with normal liver function test results were considered to have SFL. Patients who did not have NAFLD constituted the control group. The SFL, NASH and control groups were compared in terms of hs-CRP levels.Of 296 patients, 86 had normal hepatic US findings and 210 had hepatosteatosis. Hs-CRP levels were higher in patients with NAFLD as compared to the control group (0.68 mg/ dL vs. 0.34 mg/dL, respectively; P < 0.05). There was no significant difference between patients with SFL and NASH in terms of hs-CRP levels (P > 0.05). Logistic regression analysis revealed that hs-CRP was a strong predictor of NAFLD (odds ratio: 6.04; 95% confidence interval: 2.08-17.74).hs-CRP can be used as a non-invasive marker of NAFLD as it was found to be a strong predictor of NAFLD in this study.
Background and aim Mercury exposure is encountered most commonly in individuals with amalgam fillings. The toxic, bactericidal, and immunosuppressive effects of mercury are well known. Furthermore, multiple antibiotic resistance can be transferred, together with mercury resistance. The aim of this study was to investigate the frequency of Helicobacter pylori infection in dyspeptic patients with amalgam fillings and the effect of the amalgam fillings on H. pylori eradication rates in these patients. Patients and methods Four hundred and seventy-five patients who presented with dyspeptic complaints and underwent upper gastrointestinal endoscopy and gastric biopsy were included in this study. One hundred and sixty-nine (35.6%) patients were negative and 306 (64.4%) patients were positive for H. pylori. All of the participants underwent dental examinations in a blinded manner. The participants were divided into two groups on the basis of the presence of amalgam fillings. The H. pylori-positive patients were divided randomly into three subgroups: patients who received concomitant therapy (CT) (rabeprazole–amoxicillin–clarithromycin–metronidazole for 14 days; n=122); patients who received quadruple therapy (QT) (rabeprazole–tetracycline–metronidazole–colloidal bismuth subcitrate for 10 days; n=97); and patients who received levofloxacin-based therapy (LT) (rabeprazole–amoxicillin–levofloxacin for 10 days; n=87). Eradication success was detected by a urea breath test 6 weeks after the end of treatment. Results The frequency of H. pylori infection was significantly lower in the filling group compared with the nonfilling group (53.7 and 78.8%, respectively; P<0.001). The eradication rates in the CT, QT, and LT groups were 65.5, 67.0, and 58.6%, respectively, in the intention-to-treat (ITT) analysis and 69.6, 70.7, and 62.2%, respectively, in the per-protocol (PP) analysis. In all of the H. pylori-positive patients and separately in the CT and LT groups, the eradication rates were significantly lower in the filling group compared with the nonfilling group. However, in the QT group, there was no significant difference between the patients with and without fillings (P=0.001, 0.003, 0.012, 0.14, respectively). Logistic regression analysis showed that the absence of amalgam filling exerts independent effects on the increased frequency of H. pylori infection and increased rate of H. pylori eradication. Conclusion This is the first study to show a lower frequency of H. pylori colonization in patients with amalgam fillings than without and that H. pylori eradication rates are lower in patients with amalgam fillings compared to those without.
