Beáta Hemmelová

HOTAIR long non-coding RNA is a negative prognostic factor not only in primary tumors, but also in the blood of colorectal cancer patients

Colorectal cancer (CRC) is one of the main causes of death of neoplasia. Demand for predictive and prognostic markers to reverse this trend is increasing. Long non-coding RNA HOTAIR (Homeobox Transcript Antisense Intergenic RNA) overexpression in tumors was previously associated with poor prognosis and higher mortality in different carcinomas. We analyzed HOTAIR expression levels in tumor and blood of incident sporadic CRC patients in relation to their overall survival with the aim to evaluate surrogate prognostic marker for CRC. Tissue donor group consisted of 73 CRC patients sampled for tumor and normal tissue. Blood donor group was represented by 84 CRC patients compared with 40 healthy controls. Patients were characterized for tumor-node-metastasis stage, tumor grade, microsatellite instability and tumor penetration by stromal cells. HOTAIR levels were assessed by real-time quantitative PCR. CRC patients had higher HOTAIR expression in blood than healthy controls (P = 0.0001), whereas there was no difference in HOTAIR levels between tumor and adjacent mucosa of CRC patients. HOTAIR levels positively correlated between blood and tumor (R = 0.43, P = 0.03). High HOTAIR levels in tumors were associated with higher mortality of patients [Coxs proportional hazard, hazard ratio = 4.4, 95% confidence interval: 1.0-19.2, P = 0.046]. The hazard ratio was even higher when blood HOTAIR levels were taken into account (hazard ratio = 5.9, 95% confidence interval: 1.3-26.1, P = 0.019). Upregulated HOTAIR relative expression in primary tumors and in blood of CRC patients is associated with unfavorable prognosis. Our data suggest that HOTAIR blood levels may serve as potential surrogate prognostic marker in sporadic CRC.

Crohn disease and pregnancy: a case report of an acute abdomen

We present a 29-year-old patient with Crohn disease diagnosed in 2009 who underwent right side hemicolectomy in January 2014 (because of a stenosis of caecum and ascending colon). Side to side anastomosis was performed. The control colonoscopy did not show signs of CD recurrence, there were only three aphthous lesions near the base of the colon. Rutgeerts score was i1, so the step-up therapy was not indicated. After the procedure, the patient remained in remission on a conservative treatment using azathioprine. The patient is a non-smoker since 2010, before that she used to smoke five cigarettes per day and before conception she used per oral contraception for 8 years until August 2014. Because of the remission of CD and after a consensus with a gastroenterologist, the first pregnancy was planned. During the pregnancy, the medication remained on azathioprine.