Łukasz Wicherek

The evaluation of metallothionein expression in nasal polyps with respect to immune cell presence and activity

BackgroundThe expression of metallothionein (MT) is involved in acquiring resistance to immune-mediated apoptosis; it is also a negative regulator of the immune response. Nasal polyps are typified by a resistance to immune-mediated apoptosis as well as by excessive immune cell infiltration. RCAS1 (receptor-binding cancer antigen expressed on SiSo cells) is a membrane protein capable of inducing the apoptosis of CTLs and NK cells. The aim of the present study has been to explore the expression of metallothionein with respect to immune cell presence and immune cell activity. In our study, we identified immune cells using CD4 and CD68 antigen expression and evaluated their activity using CD25 antigen expression. We then analyzed metallothionein, RCAS1, CD25, CD4, and CD68 in a sampling of 50 nasal polyps using the immunohistochemistry method. We were able to divide the nasal polyps into three main groups according to their predominant immune cell infiltration: eosinophilic nasal polyps (21 cases), lymphocytic nasal polyps (17 cases), and neutrophilic nasal polyps (12 cases).ResultsIn the present study, statistically significant differences between the MT expression in the epithelium and that in the stroma of the nasal polyps along with the accompanying alterations in activation markers on immune cells were found and the number of macrophages in both the eosinophilic and the lymphocytic nasal polyps was assessed. RCAS1-expressing macrophages were found only in the eosinophilic nasal polyps.ConclusionMT expression seems to favor the survival of nasal polyp epithelial cells in the adjacent area of increasingly cytotoxic immune activity. RCAS1-expressing macrophages seem to participate in creating the immune suppressive microenvironment and so help to sustain local inflammation.

The analysis of the level of Treg lymphocytes in the blood of patients with endometrial cancer before and after the surgery — preliminary study

Introduction. The progression of cancer is a complex process involving host-tumour interactions taking place in cancer and in the cancer microenvironment. The tumour remodels the microenvironment into the suppressive profile by various mechanisms. One of the most important elements of this mechanism is the inducing of the infiltration of Treg lymphocytes into cancer and its microenvironment. The aim of the present study was to evaluate the alterations of the Treg cell population in the peripheral blood of patients before and after the surgical treatment for endometrial cancer. Material and methods. For the present study 24 patients with endometrial cancer were recruited. All the patients were treated surgically. The peripheral blood samples were collected from the endometrial cancer patients before operation and three days after the surgical procedure and evaluated using flow cytometry method. Results. CD25+ CD4+ FOXP3+ T cells were found in all the examined peripheral blood samples derived from the endometrial cancer patients in the days before and following applied surgery. We observed differences before and after the applied surgical procedure in patients treated for uterine cancer. The highest number of Treg cells in the peripheral blood was demonstrated before the surgical procedure; it diminished statistically significantly following the surgery. Conclusions. The decrease of the percentage of Treg cells in blood sera in patients following radical surgical treatment might be useful in measuring the radicalism of the treatment. The monitoring of the level of selective immune system suppression related to Treg cell blood serum levels during cancer therapy might support a decision to supplement the standard therapy with immunotherapy or to increase the degree of radicalism of the applied therapy.

The long-term outcomes in perimenopausal patients treated for cervical cancer

Introduction. In the coming decades, the population of adults 65 years of age and older will increase significantly. Younger patients between 30 and 40 years of age, who are diagnosed with cervical cancer, have a better prognosis than the older group. The second peak of incidence, involving patients between 60 and 70 years of age, correlates with a poorer prognosis. Material and methods. In our study, we included 360 patients between 40 and 60 years old operated on due to cervical cancer followed by radiochemotherapy. We divided these patients into two groups according to age. The first group was composed of premenopausal patients (aged between 40 and 50 years) and the second of postmenopausal patients (aged between 50 and 60 years), and long-term outcomes (overall survival rates OS) were analysed in both groups of patients. Results. We observed statistically significant differences in the long-term outcomes between the subgroups of patients treated surgically for cervical cancer, and it was better in the premenopausal group of patients. No statistically significant relationship between these two groups of patients as far as clinical features was observed. Conclusion. We found that postmenopausal patients may actually benefit more from having radical surgery. Proving this supports the case for distinguishing geriatric oncology from gynaecological oncology.

The quality of life and the occurrence of dysphagia in patients with head and neck cancer following combined oncological treatment

Introduction. The localisation of head and neck carcinomas influences the functions of speech, breathing, and swallowing, which, in turn, directly affect the patient’s quality of life. The poor prognosis associated with tumours of this type indicates that aggressive combined therapy protocols, including surgery, chemotherapy, and radiotherapy, should be implemented. Such treatments commonly cause acute toxicity and short- and long-term swallowing complications. Therefore, even though they can contribute significantly to survivorship, these treatments reduce the quality of life. The aim of this study was to analyse the influence of applied combined oncological treatments on the occurrence of dysphagia in patients with head and neck cancer and on their quality of life. Methods. A group of 135 patients with head and neck carcinomas treated with combined protocol (surgery, chemotherapy, and radiotherapy) in the Lukaszczyk Oncological Centre in Bydgoszcz between 2010 and 2014 was analysed. The quality of life and subjective evaluation of the swallowing function was assessed using the MDADI ( M.D. Anderson Dysphagia Inventory ). Results. A statistically significantly worse subjective evaluation of the quality of life was observed in the patients with dysphagia, who had undergone surgery with radiotherapy, compared to those who had not had surgery (p = 0.03). A statistically significantly worse subjective quality of life evaluation was found in patients who had the most locally advanced tumours (T4) (p = 0.04) as well as the highest stages of the disease (S3 and S4) (p = 0.04). A statistically significantly worse subjective quality of life with dysphagia was also seen in patients who had chemoradiotherapy in comparison to those who had radiotherapy alone (p = 0.01). A statistically significantly worse subjective quality of life with dysphagia was observed in the patients whose tumours were localised in the oral part of the pharynx and larynx compared to those patients with other tumour localisations (p = 0.02). A statistically significantly worse subjective quality of life with dysphagia was identified in the patients who had a higher dose of radiation (exceeding 45 Gy) in the upper oesophageal sphincter compared to those patients who had a lower dose (below 45 Gy) in the UES (p = 0.01). Conclusions. In patients with dysphagia, surgical treatment negatively impacts their subjective quality of life. Moreover, the pattern of radiation therapy affects the quality of life in patients with dysphagia. A radiation therapy plan that spares the upper oesophageal sphincter by using a dose of less than 45 Gy may prevent dysphagia. Dysphagia is also associated with tumour localization, tumour stage, and local advancement of the disease.

Recommendations of the Polish Gynecological Oncology Society for the diagnosis andtreatment of endometrial cancer

© Medical Communications Sp. z o.o. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (CC BY-NC-ND). Reproduction is permitted for personal, educational, non-commercial use, provided that the original article is in whole, unmodified, and properly cited. Zalecenia Polskiego Towarzystwa Ginekologii Onkologicznej dotyczące diagnostyki i leczenia raka szyjki macicy Recommendations of the Polish Gynecological Oncology Society for the diagnosis and treatment of cervical cancer

Endometriosis-associated ovarian carcinoma site in particular structures of the abdominal cavity and the pelvis

Aim: The aim of the study was to determine the frequency of the malignant endometrioma transformation in the structures of the...

Leczenie chirurgiczne zaawansowanego raka szyjki macicy a wytrzewienie – przeglad literatury

1 Department of Gynecology and Obstetrics, Essen, Germany. Kierownik: prof. med. Rainer Kimmig 2 Oddział Kliniczny Ginekologii Onkologicznej, Centrum Onkologii im. prof. Franciszka Łukaszczyka w Bydgoszczy. Kierownik Oddziału: prof. dr hab. n. med. Łukasz Wicherek 3 Klinika Chirurgii Onkologicznej i Urologii, Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie, Oddział w Krakowie. Kierownik Kliniki: prof. dr hab. n. med. Jerzy Mituś 4 Oddział Kliniczny Urologii Onkologicznej, Centrum Onkologii im. prof. Franciszka Łukaszczyka w Bydgoszczy. Kierownik Oddziału: dr n. med. Jerzy Siekiera 5 Zakład Mikrobiologii, Centrum Onkologii im. prof. Franciszka Łukaszczyka w Bydgoszczy. Kierownik Zakładu: dr n. med. Maria Szymankiewicz 6 Klinika Ginekologii Onkologicznej, Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie w Warszawie. Kierownik Kliniki: prof. dr hab. n. med. Beata Śpiewankiewicz 7 Klinika Ginekologii Onkologicznej, Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie, Oddział w Krakowie. Kierownik Kliniki: prof. dr hab. n. med. Krzysztof Urbański 8 Katedra i Klinika Ginekologii Onkologicznej i Pielęgniarstwa Ginekologicznego, Collegium Medicum UMK w Bydgoszczy. Kierownik Katedry i Kliniki: prof. dr hab. n. med. Łukasz Wicherek Adres do korespondencji: Prof. dr hab. n. med. Łukasz Wicherek, Oddział Kliniczny Ginekologii i Onkologii, Centrum Onkologii im. prof. Franciszka Łukaszczyka, ul. Romanowskiej 2, 85-796 Bydgoszcz, tel.: +48 52 374 33 99, +48 52 374 38 74, e-mail: mowicher@cyf-kr.edu.pl Podziękowanie Chcielibyśmy podziękować Dr. Zbigniewowi Pawłowiczowi i Prof. Jerzemu Stelmachowowi za okazaną pomoc, słowa wsparcia i zdolność przewidywania kierunków rozwoju medycyny. Zdjęcia przedstawione w manuskrypcie zostały wykonane podczas zabiegów wytrzewienia przeprowadzanych na Oddziale Klinicznym Ginekologii Onkologicznej, Centrum Onkologii w Bydgoszczy – za pomoc w ich wykonaniu dziękujemy Dr. Wojciechowi Polonceuszowi i Dr. Naserowi Alahmad Alali.