Zhou Wx

Fluorescence In Situ Hybridization with the UroVysion Kit for the Detection of Biliary Cancer in Chinese Patients

BACKGROUND Conventional biliary brush via ERCP has low clinical detection for biliary malignancy. Therefore, new approaches are needed to facilitate diagnosis. We therefore explored the application of fluorescent in situ hybrization (FISH) using a UroVysion kit for the detection of malignancy in the bile duct. METHODS Genetic alterations of target chromosomes such as aneuploidy in Chinese biliary cancer cell lines and tissues were measured using a UroVysion kit. The diagnostic value of the FISH assay was assessed by probing 27 brush samples of biliary cytology and control routine cytology (RC) samples. The gold standard was established by the pathology or clinical outcomes at the 12-month follow-up. RESULTS Aneuploidy is commonly found in cell lines and tissues of biliary cancers, but not in normal cells or tissues. Here we probed for aneuploidy in clinical biliary brush specimens obtained by ERCP using FISH and a UroVysion kit. The sensitivity, specificity, and positive and negative predictive values for biliary malignancy were found to be 50%, 100%, 100% and 31.3%, respectively. The sensitivity, specificity, and positive and negative predictive values by RC were found to be 22.7%, 100%, 100% and 22.7%, respectively. In combination with RC, FISH increased the diagnostic sensitivity to 63.6% although this difference was not found to be statistically significant. CONCLUSIONS Aneuploidy is frequently present in bile duct carcinomas. Here we found that the FISH assay is useful for the detection of Chinese biliary cancers.

Clinical Analysis of 15 Cases of Liver Nodular Regenerative Hyperplasia

Nodular regenerative hyperplasia (NRH) of liver may be one of the leading causes of non-cirrhotic intrahepatic portal hypertension (NCIPH), although the exact relationship is currently unknown. Diagnosis of NRH is relatively difficult and involves surgical pathology, and thus it is necessary to improve the preoperative recognition of NRH. Here, we analyze 15 cases of NRH to better understand this disease. All the liver specimens were microscopically examined by hematoxylin-eosin staining and reticulin and Masson trichrome staining. Diagnoses of NRH were confirmed by pathological examination. Clinically, NRH presents as diffused liver lesions with mildly increased liver enzymes. Portal hypertension is the most common clinical manifestation presenting prominently as splenomegaly, hypersplenism, and esophageal varices bleeding. NRH is often associated with autoimmune or collagen vascular diseases, and such patients often present with a variety of positive autoantibodies and increased erythrocyte sedimentation rate (ESR), Ig and γ %. Pathological examination of the liver showed diffuse small regenerative nodules without fibrous septa and obstructive portal venopathy. For those patients with portal hypertension of unknown cause and preserved liver function, especially, those combined with autoimmune diseases, NRH should be considered.

Sa1181 Abnormalities of Colonic Motilities Play a Crucial Role in Symptom Onset for Irritable Bowel Syndrome With Diarrhea

volunteers (HV) and 12 IBS patients and responses to exogenously applied capsaicin (0.1, 1 and 10 nM) and histamine (1, 10 and 100 μM) were monitored using calcium (Ca2+)imaging. In addition, the effect of 10 μM histamine pre-incubation on the capsaicin response was studied in HV. In parallel, murine dorsal root ganglia (DRG) were isolated to study the calcium response to capsaicin (10 250 nM) in the presence of histamine or after overnight incubation with mucosal biopsy supernatant from HV and IBS patients. Pyrilamine (1 μM) was used as H1R antagonist. Results: Application of histamine and capsaicin evoked significantly higher peak amplitudes in submucosal neurons from IBS patients compared to HV (Table 1). Pretreatment with histamine significantly increased the peak amplitudes in response to capsaicin in submucosal neurons from HV (Table 1). This sensitization of TRPV1 by histamine was confirmed in mouse DRG neurons, an effect that was prevented by preincubation with pyrilamine (Table 2). In parallel studies, overnight incubation with HV supernatant spiked with 10 μM histamine significantly increased the response to capsaicin compared to control HV supernatant. Similarly, overnight exposure of DRG neurons to IBS supernatant significantly increased the capsaicin response, an effect that was reduced by pyrilamine (Table 2). Conclusion: We showed that submucosal neurons of IBS patients are more intensely activated by capsaicin than those of HV. This effect can be mimicked by preincubation with histamine in both human submucosal neurons and mouse DRG neurons. Furthermore, incubation of mouse DRG neurons with IBS supernatant also increases the response to TRPV1, an effect that is blocked by the H1R antagonist pyrilamine. Based on these data, we conclude that histamine sensitizes TRPV1 on sensory neurons, most likely contributing to increased visceral pain perception in IBS. Moreover, we hypothesize that the therapeutic effect of the H1R antagonist ebastine in IBS patients can at least partly be explained by interference with this pathway. Table 1 Submucosal neuronal activation in rectal biopsies (% response)