Teresa Starzyńska

Publications of Teresa Starzyńska

• [Helicobacter pylori infection in pancreatic cancer].

  Authors: Alicja Gawin, Thomas Wex, Małgorzata Ławniczak, Peter Malfertheiner, Teresa Starzyńska

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 02/2012; 32(188):103-7.

  Despite some advances in the oncological managament, pancreatic cancer remains a clinical problem and has remained leading cause of cancer deaths. The association between Helicobacter pylori (H.Despite some advances in the oncological managament, pancreatic cancer remains a clinical problem and has remained leading cause of cancer deaths. The association between Helicobacter pylori (H. pylori) infection and pancreatic was suggested, but the issue remains of contentious. The aim of the study was to determine the relationship between H. pylori infection and pancreatic cancer development on a sample of Polish population. 139 patients with pancreatic cancer and 177 controls were included in the study. Seropositivity for H. pylori, including CagA protein were assessed by the enzyme-linked immunosorbent assay and Western blot, respectively. The frequency of H. pylori in pancreatic cancer patients and controls were compared adjusted for age, sex, cigarette smoking and a family history of cancer in the logistic regresion model. No significant differences between pancreatic cancer patients and controls were seen according to H. pylori seropositivity (87.1 vs 82.5%; OR = 1.27; CI95%: 0.64-2.61; p = 0.514) and CagA seropositivity (83.5 vs 84.9%; OR = 0.90; CI95%: 0.46-1.73; p = 0.744). The study didn't support previous observations of H. pylori infection as a plausible pathogenic risk factor for pancreatic cancer development. The high prevalence of infection in the control group may explain why the earlier reports of a positive association between H. pylori infection and pancreatic cancer could not be confirmed in the study.

• Endoscopic submucosal dissection for treatment of gastric subepithelial tumors (with video).

  Authors: Andrzej Białek, Anna Wiechowska-Kozłowska, Jan Pertkiewicz, Marcin Polkowski, Piotr Milkiewicz, Katarzyna Karpińska, Małgorzata Ławniczak, Teresa Starzyńska

  Gastrointestinal endoscopy. 02/2012; 75(2):276-86.

  Endoscopic submucosal dissection (ESD) is a well-accepted method for removing superficial mucosal tumors; however, there is limited data on the use of this method for removing subepithelialEndoscopic submucosal dissection (ESD) is a well-accepted method for removing superficial mucosal tumors; however, there is limited data on the use of this method for removing subepithelial tumors. To investigate the efficacy, safety, and outcome of ESD for gastric subepithelial tumors and determine factors related to treatment success. Retrospective analysis of a prospectively maintained database. Single tertiary academic center. From April 2007 to November 2010, 37 patients with gastric subepithelial tumors were treated with ESD. Macroscopically and microscopically complete en block resection rate (R0), complication rate, and endosonographic features predictive of R0 resection. The median tumor diameter was 25.0 mm, (range 10-60 mm, IQR 17-37). The overall rate of R0 resections was 81.1% (30/37, 95%CI: 61.8-90.2%), including 100% (15/15, 95%CI: 78.2-100.0%) of tumors from the submucosa and 68.2% (15/22, 95%CI: 45.1-86.1%) of tumors from the muscularis propria. Seventeen patients had a final diagnosis of gastrointestinal stromal tumor. The severe complication (perforation) rate was 5.4% (2/37, 95%CI: 0.0-9.5%). One patient required surgery; the other was treated conservatively. No recurrence was observed in patients with R0 resections at a median follow up of 21.0 months (IQR 11-35). Successful R0 resections were predicted by the observation of no, or only narrow, tumor connections with the underlying muscle layer during EUS (OR=35.0, 95%CI: 3.7-334.4, p=0.001). Single-center, retrospective analysis, short follow-up. ESD is an effective and relatively safe method for removing gastric subepithelial tumors. Endoscopic ultrasonography findings can predict complete tumor resections.

• Adipose Tissue as a Potential Source of Hematopoietic Stem/Progenitor Cells.

  Authors: Wojciech Błogowski, Mariusz Z Ratajczak, Ewelina Zyżniewska-Banaszak, Barbara Dołęgowska, Teresa Starzyńska

  Obesity (Silver Spring, Md.). 01/2012;

  It has been more than 30 years since adipose tissue (AT) has been recognized as a central modulator orchestrating sophisticated process termed "immunometabolism". Nonetheless, despite its uniqueIt has been more than 30 years since adipose tissue (AT) has been recognized as a central modulator orchestrating sophisticated process termed "immunometabolism". Nonetheless, despite its unique involvement in the regulation of immune and endocrine homeostasis, recent studies demonstrated that AT also contains significant number of hematopoietic stem/progenitor cells (HSPCs) that may be there "settling down" throughout life. In this article we will focus on presenting the current concepts regarding endocrine, immunological, and molecular mechanisms that may contribute to and regulate bone marrow (BM)-derived HSPCs homing into AT environment, as well as, highlight various structural and morphological similarities between BM and AT that might be involved in creating appropriate tissue niches for BM-derived HSPCs in AT. Finally, we will discuss how development of obesity or type 2 diabetes may influence balance of homing signals for HSPCs in AT environment.

• The CHEK 2 GENE mutations and the risk of Gastric cancer.

  Authors: Urszula Teodorczyk, Cezary Cybulski, Anna Jakubowska, Teresa Starzyńska, Małgorzata Lawniczak, Katarzyna Ferenc, Krzysztof Marlicz, Zbigniew Banaszkiewicz, Rafał Wiśniowski, Jan Lubiński

  Hereditary cancer in clinical practice. 01/2012; 10 Suppl 1:A10.

• [Irritable bowel syndrome--irritable bowel or irritable mind?].

  Authors: Wojciech Marlicz, Iwona Zawada, Teresa Starzyńska

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 01/2012; 32(187):64-9.

  Irritable bowel syndrome (IBS) is one of the most common disorders of gastrointestinal tract, affecting significant number of western population. The characteristic features are chronic and(or)Irritable bowel syndrome (IBS) is one of the most common disorders of gastrointestinal tract, affecting significant number of western population. The characteristic features are chronic and(or) recurrent abdominal pain and discomfort associated with changes in the bowel habit with or without bloating. According to Rome Criteria III there is an improved focus on the intestinal transit time which allows for better diagnosis and characterization of patients either with diarrhea, constipation predominant or mixed type IBS. Patients with IBS also frequently manifest various symptoms related to central nervous system (CNS) as depression or personality disorders. In this review we present current knowledge concerning etiopathogenesis of IBS with emphasis on the role of microbiota and describe promissing profilatic and treatment modalities with anti-biotics and probiotics capable to modulate microbiota and gut-brain axis. Most recent studies concerning clinical efficacy of antibiotic rifaximin and probiotic strain Lactobacillus plantarum 299v in symptom prevention (reduction) of this common gastrointestinal disorder are briefly described.

• Nodular regenerative liver hyperplasia as a complication of azathioprine-containing immunosuppressive treatment for Crohn's disease.

  Authors: Wojciech Błogowski, Wojciech Marlicz, Andrzej Smereczyński, Małgorzata Lawniczak, Agnieszka Lewosiuk, Teresa Starzyńska

  Immunopharmacology and immunotoxicology. 06/2011; 33(2):398-402.

  Nodular regenerative liver hyperplasia (NRH) is a very rare but potentially severe complication of thiopurine-containing immunosuppressive therapy for autoimmune disorders, organ transplantation,Nodular regenerative liver hyperplasia (NRH) is a very rare but potentially severe complication of thiopurine-containing immunosuppressive therapy for autoimmune disorders, organ transplantation, and/or oncological treatment. Here we report a case of a 40-year-old female patient with Crohn's disease and genetic hypercoagulability disorder-factor V Leiden, who in the course of azathioprine immunosuppressive treatment for inflammatory bowel disease developed NRH, which was clinically manifested by thrombocytopenia and delicate hepato-splenomegaly. Moreover, her endoscopic examination of upper gastrointestinal tract demonstrated esophageal varices. Genetic analysis revealed heterozygous genotype (*1/*3A) of thiopurine S-methyltransferase (TPMT), a key enzyme of thiopurines' metabolism, which results in lower activity of TPMT enzyme, thereby making our patient more susceptible to azathioprine-related hepato and myelotoxicity development. Treatment was started with the immediate cessation of azathioprine therapy, and administration of propranolol as primary prophylaxis for bleeding from esophageal varices. Currently (3 years after diagnosis) remission of Crohn's disease is achieved, however, progression of features of portal hypertension is observed. Propranolol administration is continued and the patient is constantly monitored in our Department. Our Case Study highlights the clinical difficulties and challenges associated with diagnosing of azathioprine-induced NRH, as well as, supports previous observations that hypercoagulability disorders and abnormal TPMT activity may contribute to NRH development.

• An unusual tumor of the cecum: the diagnosis to keep in mind!

  Authors: Wojciech M Marlicz, Andrzej Smereczyński, Teresa Starzyńska

  Gastroenterology. 02/2011; 140(4):e5-6.

• CDH1 gene mutations do not contribute in hereditary diffuse gastric cancer in Poland.

  Authors: Anna Jakubowska, Małgorzata Lawniczak, Beata Wojnarska, Cezary Cybulski, Tomasz Huzarski, Tomasz Byrski, Aleksandra Tołoczko-Grabarek, Katarzyna Jaworska, Katarzyna Durda, Teresa Starzyńska, Jan Lubiński

  Familial cancer. 12/2010; 9(4):605-8.

  Hereditary diffuse gastric cancer (HDGC) is a cancer susceptibility syndrome characterized by a high risk of diffuse stomach cancer and lobular breast cancer. HDGC is caused by germline mutations inHereditary diffuse gastric cancer (HDGC) is a cancer susceptibility syndrome characterized by a high risk of diffuse stomach cancer and lobular breast cancer. HDGC is caused by germline mutations in the CDH1 gene encoding the E-cadherin which is a member of the transmembrane glycoprotein family responsible for calcium-dependent, cell-to-cell adhesion and plays a fundamental role in the maintenance of cell differentiation and the normal architecture of epithelial tissues. Mutations in the CDH1 gene are detected in 30-46% of families that fulfil strong clinical criteria for HDGC and in about 11% of families fulfilling the modified criteria. In the present study, we investigated germline mutations in the CDH1 gene in Polish patients with HDGC. The entire coding sequence of CDH1 gene was analyzed by sequencing in 86 Polish cancer patients from families fulfilling the modified criteria of HDGC. We found several silent mutations including one common variant (c.2076T>C) present in 56 patients, and three rare variants (c.2253C>T, c.1896C>T, c.2634C>T) detected in 2 patients. In addition, we found four rare sequence variants of unknown significance localized in introns. We did not detect any deleterious mutations of the CDH1 gene. CDH1 gene mutations are not present in Polish families with HDGC defined by the modified clinical criteria. Further studies of families with HDGC matching the restrictive criteria for HDGC are needed.

• [Wilson's disease].

  Authors: Małgorzata Ławniczak, Joanna Raszeja-Wyszomirska, Teresa Starzyńska

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 08/2010; 29(170):125-7.

  Wilson's disease is caused by a P-type ATP-ase gene mutations with reduced biliary copper excretion and accumulation copper in the liver and other tissues. Clinical symptoms can be heterogeneous butWilson's disease is caused by a P-type ATP-ase gene mutations with reduced biliary copper excretion and accumulation copper in the liver and other tissues. Clinical symptoms can be heterogeneous but in many cases on the first stage the only abnormalities is elevation of aminotransferase activity. In some cases the first fatal symptom of disease is acute liver failure, therefore early diagnosis and treatment is essential. We present an actual recommendations for diagnosis and treatment of patients with Wilson's disease.

• [64-slice computer tomography for diagnostics of the small bowel: computer tomography enteroclysis].

  Authors: Błazej Richter, Anna Walecka, Ewa Gabrysz-Trybek, Wojciech Marlicz, Teresa Starzyńska, Michał Rać

  Annales Academiae Medicae Stetinensis. 01/2010; 56(1):28-35.

  Radiologic imaging of the small bowel is the method of choice because other methods are of limited availability. Computer tomography (CT) enteroclysis is the leading modern method for diagnosticRadiologic imaging of the small bowel is the method of choice because other methods are of limited availability. Computer tomography (CT) enteroclysis is the leading modern method for diagnostic imaging of the small intestine. It combines the advantages of conventional small bowel infusion with those of abdominal CT and can serve to disclose a wide range of small bowel pathologies. 101 patients underwent CT enteroclysis at the Department of Diagnostic Imaging and Interventional Radiology, Pomeranian Medical University in Szczecin. The procedure of CT enteroclysis is described starting from patient preparation and infusion technique to the scanning protocols. The results served to characterize the patients, establish indications and contraindications to CT enteroclysis, and reveal common errors of the method. Preliminary findings bring to light the considerable usefulness of CT enteroclysis. Other methods like ultrasound, MRI, conventional enteroclysis, or capsule endoscopy can be complementary in special cases.

• Is there any relationship between BRCA1 gene mutation and pancreatic cancer development?

  Authors: Małgorzata Lawniczak, Alicja Gawin, Andrzej Białek, Jan Lubiński, Teresa Starzyńska

  Polskie archiwum medycyny wewnȩtrznej. 12/2008; 118(11):645-9.

  INTRODUCTION: Pancreatic cancer belongs to carcinomas associated with poor prognosis and low survival rate. It has been highlighted that the cancer risk is linked to both environmental and geneticINTRODUCTION: Pancreatic cancer belongs to carcinomas associated with poor prognosis and low survival rate. It has been highlighted that the cancer risk is linked to both environmental and genetic factors. Available studies allow to estimate that genetic factors play a role in 5-10% of patients with pancreatic cancer. Beside other carcinomas, pancreatic cancer occurs in hereditary neoplastic syndromes associated with gene mutations, including CDKN2A, CHEK2, BRCA2. It has also been suggested that BRCA1 mutation is involved given the fact that BRCA1 mutation carriers are at increased risk for pancreatic cancer. However, a role of this mutation is not fully understood. OBJECTIVES: The purpose of the study was to assess the relationship between BRCA1 gene mutation and pancreatic cancer in Polish population. PATIENTS AND METHODS: 88 pancreatic cancer patients (56 males and 35 females) and 3784 carriers of BRCA1 mutation from 1637 families were enrolled in the study. Almost 65% of pancreatic cancer patients were cigarette smokers. Genotyping for constitutive BRCA1 gene mutation was performed in all patients with pancreatic cancer. ASA-PCR and PCR-RFLP methods were used to detect BRCA1 (5382insC, C61G, 4153delA) mutations. The frequency of pancreatic cancer in families of BRCA1 mutation carriers was evaluated. RESULTS: No carriers of BRCA1 mutation were identified in patients with pancreatic cancer. Only in 11 families (0.7%) with BRCA1 mutation carriers, pancreatic cancer was diagnosed. CONCLUSIONS: Our results suggest that there is no relationship between BRCA1 mutation and pancreatic cancer development in Polish population.

• [Recurrent variceal bleeding in a patient with portal and splenic vein thrombosis secondary to complex thrombophilia]

  Authors: Małgorzata Ławniczak, Joanna Raszeja-Wyszomirska, Wojciech Marlicz, Andrzej Białek, Anna Wiechowska-Kozłowska, Jerzy Lubikowski, Maciej Wójcicki, Teresa Starzyńska

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 09/2008; 25(146):150-2.

  Thrombophilia in adults is one of main causes of portal vein thrombosis. Esophageal and gastric varices, ascites and hypersplenism are well known complications of portal hypertension. There areThrombophilia in adults is one of main causes of portal vein thrombosis. Esophageal and gastric varices, ascites and hypersplenism are well known complications of portal hypertension. There are controversial issues on the management, especially anticoagulant therapy and surgical treatment of these patients. We present a 42-years old woman with a history of three acute coronary episodes suffering from recurrent variceal bleeding due to portal and splenic vein thrombosis in the course of myeloproliferative disorder and protein C deficiency. It was 10 months delay of diagnosis. She was successfully treated with medical and surgical treatment (esophageal stapler transection, cardial devascularization, and splenectomy). In the paper we discuss complexity of diagnosis and surgical treatment.

• [Endosonography and endoscopic submucosal dissection in rectal cancer--case report].

  Authors: Anna Wiechowska-Kozłowska, Andrzej Białek, Teresa Starzyńska

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 02/2008; 24(140):117-20.

  This paper presents a case report of a 61 year-old man who had diagnosed in colonoscopy rectal cancer of early stage. In endosonography (EUS) intramucosal lesion without enlargement of regional lymphThis paper presents a case report of a 61 year-old man who had diagnosed in colonoscopy rectal cancer of early stage. In endosonography (EUS) intramucosal lesion without enlargement of regional lymph nodes was demonstrated. The patient was qualified for endoscopic therapy by submucosal dissection (ESD). The treatment was performed without any complications. The histological findings confirmed an early stage of rectal cancer--This, according to TNM classification.

• [Endoscopic ultrasonography in the assessment and management of complications of liver cirrhosis].

  Authors: Anna Wiechowska-Kozłowska, Andrzej Białek, Teresa Starzyńska, Piotr Milkiewicz

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 02/2008; 24(140):134-9.

  Upper gastrointestinal endoscopy plays a major role in the diagnostic and treatment of the complications of portal hypertension in patients with liver cirrhosis. Endosonography (EUS), which combinesUpper gastrointestinal endoscopy plays a major role in the diagnostic and treatment of the complications of portal hypertension in patients with liver cirrhosis. Endosonography (EUS), which combines routine endoscopy and ultrasound examination has been so far infrequently used in these cohort of patients despite the fact that it offers much more detailed analysis of several features of portal hypertension, not detected with routine endoscopy. These include detection of so called "deep varices", assessment of the thickness of gastric wall, differentiation between thickened folds and varices or detection of subclinical amounts of ascitic fluid. In this paper we systematically review the current and potential future applications of EUS in the diagnostic and treatment of patients with liver cirrhosis.

• [Serum anti-p53 antibodies in gastric cancer patients]

  Authors: Małgorzata Lawniczak, Dariusz Bielicki, Violetta Sulzyc-Bielicka, Krzysztof Marlicz, Teresa Starzyńska

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 09/2007; 23(135):192-5.

  Mutation of the p53 gene belongs to the most common genetic alteration in human cancer. Prognostic significance of serum anti-p53 antibodies in patients with gastric cancer is still a matter ofMutation of the p53 gene belongs to the most common genetic alteration in human cancer. Prognostic significance of serum anti-p53 antibodies in patients with gastric cancer is still a matter of controversy. The aim of the study was to estimate the presence of anti-p53 antibodies in serum of gastric cancer patients and relationship between anti-p53 antibodies and chosen clinical and pathomorphological data age, sex, localization of cancer, histology, stage of disease, metastases to lymph nodes and the time of survival. MATERIAL AND METHOD: Serum samples from 71 patients with gastric cancer were analyzed by specific enzyme-linked immunosorbent assay (ELISA) to determine the presence of serum anti-p53 antibodies. The results were statistically compared with clinical and pathological features and postoperative survival. RESULTS: Anti-p53 antibodies were detected in 16 (23%) gastric cancer patients. The presence of p53 antibodies was connected with intestinal tumor type (p < 0.05) and older age (p = 0.0035). There were no association between anti-p53 antibodies, stage and the time of survival. CONCLUSION: These results suggest that in gastric cancer patients serum anti-p53 antibodies detected by ELISA are not predictor of prognosis.

• Molecular epidemiology of gastric cancer.

  Authors: Teresa Starzyńska

  Digestive diseases (Basel, Switzerland). 02/2007; 25(3):222-4.

  Molecular epidemiology refers to the incorporation of molecular techniques in epidemiological studies. There are different biomarkers in cancer research used for molecular epidemiology includingMolecular epidemiology refers to the incorporation of molecular techniques in epidemiological studies. There are different biomarkers in cancer research used for molecular epidemiology including markers of exposure, markers of dose, susceptibility, treatment response, prognosis, altered structure/function and cancer type. Selected markers, especially those of exposure and susceptibility, are described in an example of gastric cancer. Clinical significance of molecular epidemiology is discussed.

• Effect of CYP2C19*17 gene variant on Helicobacter pylori eradication in peptic ulcer patients.

  Authors: Mateusz Kurzawski, Barbara Gawrońska-Szklarz, Joanna Wrześniewska, Andrzej Siuda, Teresa Starzyńska, Marek Droździk

  European journal of clinical pharmacology. 10/2006; 62(10):877-80.

  OBJECTIVE: Eradication of Helicobacter pylori is an important treatment strategy in peptic ulcer patients. Current regimens of eradication consist of proton pump inhibitor (PPI) and two antibiotics.OBJECTIVE: Eradication of Helicobacter pylori is an important treatment strategy in peptic ulcer patients. Current regimens of eradication consist of proton pump inhibitor (PPI) and two antibiotics. The principal enzyme involved in PPIs metabolism is CYP2C19, which exhibits an interindividual variability of activity, mainly due to genetic polymorphism. Two alleles (CYP2C19*2 and CYP2C19*3), responsible for slow PPIs metabolism, were previously associated with higher efficacy of eradication. Recently, a novel CYP2C19 gene variant (CYP2C19*17), associated with faster metabolism of CYP2C19 substrates, was described. In the present study, a potential association between CYP2C19*17 allele and lower H. pylori eradication efficacy was tested in a group of peptic ulcer patients. METHODS: A total of 125 peptic ulcer patients, positive for H. pylori infection, were treated with triple therapy (pantoprazole+amoxicillin+metronidazole). Subsequently, the patients were divided into two groups (group 1 - success, and group 2 - failure of eradication after therapy) and genotyped for the presence of CYP2C19 variant alleles (*2, *3, and *17). RESULTS: Frequency of CYP2C19 alleles in two groups of patients were: 56.4 versus 65 (p=0.060) for *1, 15.4 versus 5.3 (p=0.015) for *2, and 28.2 versus 25.5 (p=0.663) for *17 allele, respectively. CYP2C19*3 was not detected in the evaluated population. No significant differences in frequency nor distribution of *17 allele were found between two groups of patients. CYP2C19*2 allele was associated with successful H. pylori eradication (p<0.02), *2 allele carriers were found to be over 4-times more prone to the treatment compared to *1/*1 homozygotes (OR=4.2, p=0.015). CONCLUSION: Our results suggest that, contrary to CYP2C19*2, CYP2C19*17 allele has no impact on efficacy of H. pylori eradication in peptic ulcer patients treated with pantoprazole.

• The association between the interleukin-1 polymorphisms and gastric cancer risk depends on the family history of gastric carcinoma in the study population.

  Authors: Teresa Starzyńska, Katarzyna Ferenc, Thomas Wex, Thilo Kähne, Jan Lubiński, Malgorzata Lawniczak, Krzysztof Marlicz, Peter Malfertheiner

  The American journal of gastroenterology. 03/2006; 101(2):248-54.

  OBJECTIVES: The association between interleukin-1 polymorphisms, H. pylori and increased gastric cancer risk remains controversial. AIMS: To compare the prevalence of these polymorphisms inOBJECTIVES: The association between interleukin-1 polymorphisms, H. pylori and increased gastric cancer risk remains controversial. AIMS: To compare the prevalence of these polymorphisms in individuals with two mutually exclusive diseases connected with infection, gastric cancer, and duodenal ulcer. METHODS: 121 gastric cancer and 119 duodenal ulcer patients. Genomic DNA was typed for polymorphisms at position -511, -31 in the interleukin-1beta gene (IL-1 beta) using primer extension and mass-spectrometry. Analysis of the variable number of tandem repeats in intron 2, in its receptor antagonist gene (IL-1RN) was performed by PCR and agarose gel electrophoresis. RESULTS: All subjects were successfully genotyped for the three gene loci. IL-1 beta-511 was found to be in reverse linkage disequilibrium with IL-1 beta-31. The differences between gastric cancer and duodenal ulcer patients concerned only heterozygous variant of IL-1beta and were related to family history of gastric cancer, tumor stage, histology, site. Thus, CT carriers were found to have a higher risk of sporadic [OR 2.21 (95% CI, 1.22-3.99)], early [OR 2.81 (95% CI, 1.14-6.93)], diffuse [OR 2.48, (95% CI 1.21-5.09)] or non-cardia gastric cancer [OR 1.88 (95% CI 1.06-3.33)]. Furthermore, CT genotype was significantly more prevalent in gastric cancer patients with negative than in those with a positive family history (p = 0.039). CONCLUSIONS: The association between the interleukin-1 polymorphisms and gastric cancer risk depends on the family history of gastric carcinoma in the study population. This phenomenon may be in part responsible for differences in results of interleukin-1 studies performed on populations with low and high gastric cancer prevalence.

• Effect of CYP2C19 and MDR1 polymorphisms on cure rate in patients with acid-related disorders with Helicobacter pylori infection.

  Authors: Barbara Gawrońska-Szklarz, Joanna Wrześniewska, Teresa Starzyńska, Andrzej Pawlik, Krzysztof Safranow, Katarzyna Ferenc, Marek Droździk

  European journal of clinical pharmacology. 07/2005; 61(5-6):375-9.

  A proton pump inhibitor (PPI) plus two antibiotics (amoxicillin and either clarithromycin or metronidazole) are recommended for treatment of acid-related disorders with Helicobacter pylori (H.A proton pump inhibitor (PPI) plus two antibiotics (amoxicillin and either clarithromycin or metronidazole) are recommended for treatment of acid-related disorders with Helicobacter pylori (H. pylori) infection. The aim of this pharmacogenetic study was to evaluate the efficacy of triple therapy with PPIs on eradication of H. pylori infection in relation to cytochrome P450 2C19 (CYP2C19) and P-glycoprotein (MDR1) gene polymorphisms. The retrospective study involved 70 Polish Caucasian patients with H. pylori infection, diagnosed and treated with one of the two different triple therapy regimens [omeprazole, amoxicillin, and clarithromycin (OAC) or pantoprazole, amoxicillin, and metronidazole (PAM)]. Using genomic DNA, CYP2C19 (*2 and *3) and C3435T MDR1 alleles were determined by means of polymerase chain reaction-restriction fragment length polymorphism assays. A significantly higher prevalence (P<0.05) of heterozygous extensive metabolizers (hetEM) with CYP2C19*1/*2 genotype (32.4% versus 8.3%) and homozygous with 3435TT MDR1 genotype (38.2% versus 13.9%) was found in patients cured after the first cycle of triple therapy than in patients with failure of eradication after the first cycle. CYP2C19*1/*2 and 3435TT MDR1 genotypes as well as PAM regimen of treatment were also predictive of successful eradication of H. pylori infection after the first cycle of triple therapy at univariate/multivariate logistic regression analysis. This pharmacogenetic study on the influence of different CYP2C19 and C3435T MDR1 genotypes on H. pylori eradication suggests that CYP2C19 and MDR1 polymorphisms may be independent predictable determinants of the efficacy of triple therapy including PPI. The PAM regimen of treatment seems to be more effective after the first cycle of the therapy than the OAC regimen.

• Nuclear pedigree criteria for the identification of individuals suspected to be at risk of an inherited predisposition to gastric cancer.

  Authors: Beata Gawdis-Wojnarska, Marek Brzosko, Jacek Fliciński, Krzysztof Marlicz, Teresa Starzyńska, Rodney J Scott, Jan Lubiński

  Hereditary cancer in clinical practice. 01/2004; 2(2):65-8.

  Gastric cancer is the second most frequently diagnosed malignancy worldwide and therefore represents a significant healthcare burden. Environmental and genetic factors are involved in the developmentGastric cancer is the second most frequently diagnosed malignancy worldwide and therefore represents a significant healthcare burden. Environmental and genetic factors are involved in the development of gastric cancer. To date only one clear genetic predisposition has been identified involving mutations in the E-cadherin gene. The disease phenotype in patients harbouring E-cadherin mutations appears to be specifically related to diffuse gastric cancer. Little is known genetically about the other forms of gastric cancer. Since there is a growing awareness about the necessity of early intervention criteria have been developed that aid the identification of hereditary forms of gastric cancer. The aim of the current study was to identify minimal inclusion criteria so that nuclear pedigree families can be provided with risk assessment and/or genetic testing.The results reveal that inclusion features described herein such as (a) gastric cancer diagnosed before 46 years of age; (b) two gastric cancers among first degree relatives diagnosed over the age of 50 are useful in identifying suspected hereditary gastric cancer patients.