Results of delayed treatment of patients with malignant tumors of the lymphatic system]

The causes, with considerably influence the advancement of cancer process have been investigated in patients with lymphatic system tumours admitted to the Department of Chemotherapy at the Center of Oncology in Cracow. It has been revealed, that the delay in the treatment was mainly due to false first diagnosis as well as the negligence of the symptoms by the patients themselves and also to consulting medically unrecognized "healers" before undertaking proper, specialized treatment. It has been observed, that more than every fourth patient took advice of "non-doctors", i.e. bioenergy-therapists, incompetent healers, herbalists and so forth. These factors by influencing further delay in the treatment, diminish its chances.     

Analysis of the polymorphism of haptoglobins in Sardinia

The present study reports an analysis of the distribution of Hp polymorphism in Sardinia carried out on a sample of 871 individuals. The samples are examined according to the division by provinces and by historical-geographical regions. In both cases the phenotype Hp 2-1 has high frequency and a North-South trend. The Hp^*1 is the most common gene in every part of Sardinia. In general the distribution of Hp in Sardinia is not significantly heterogeneous in our sample, although presenting a discreet variability. The synthesis of our data and of the data available in literature shows some historical-geographicalareas, especially in the central north of the island, with particularly high Hp^*1 frequency (Baronie Siniscola and Orosei, Barbagie Ollorai and Belvì and Planargia; Sarrabus in the South). Similar high values of Hp^*1 have been highlighted in some groups of population in the Mediterranean basin, characterized by a certain geographical and/or cultural isolation.     

Microanatomy of the intestinal lymphatic system

The intestinal lymphatic system comprises two noncommunicating lymphatic networks: one containing the lacteals draining the villi and the connecting submucosal lymphatic network and one containing the lymphatics that drain the intestine muscular layer. These systems deliver lymph into a common network of collecting lymphatics originating near the mesenteric border. The intestinal lymphatic system serves vital functions in the regulation of tissue fluid homeostasis, immune surveillance, and the transport of nutrients; conversely, this system is affected by, and directly contributes to, disease processes within the intestine. Recent discoveries of specific lymphatic markers, factors promoting lymphangiogenesis, and factors selectively affecting the development of intestinal lymphatics, hold promise for unlocking the role of lymphatics in the pathogenesis of diseases affecting the intestine and for intestinal lymphatic selective therapies. Vital to progress in understanding how the intestinal lymphatic system functions is the integration of recent advances identifying molecular pathways for lymphatic growth and remodeling with advanced imaging modalities to observe lymphatic function and dysfunction in vivo.     

The clinical importance of micrometastases within the lymphatic system in patients after total gastrectomy

Background

In spite of radical gastrectomy with resection of the lymphatic system, where no metastases are found during histopathological examination, about 30% of patients have relapse of the neoplastic process. This situation may be caused by micrometastases or isolated neoplastic cells in the lymphatic system which were not identified during a standard histopathological examination.

Aim

The aim of the study was to evaluate the clinical importance of micrometastases within the lymphatic system in patients with gastric cancer.

Materials and methods

A group of 20 patients treated for gastric cancer were subjected to retrospective analysis. Of all the patients who underwent surgery, a group with tumours classified as T1 or T2 was selected. No metastases within the lymphatic system were found in the standard evaluation – N0 mark. Paraffin-embedded blocks of lymph nodes were cut and new specimens were made, which were then stained again by means of immunohistochemistry. Antibodies against cytokeratin AE1/AE3 were used.

Results

A total of 319 lymph nodes were assessed in 20 patients in an H + E examination. After the immunohistochemical examination, micrometastases within the lymphatic system were found in 4 (20%) patients and isolated neoplastic cells in other 4 (20%) patients.

Conclusion

On the basis of numerous publications and our own material, we think that the presence of micrometastases may be related to a worse prognosis. The clinical importance of micrometastases within the lymphatic system in patients after total gastrectomy.     

Visualizing function in the tumor-associated lymphatic system

The recent surge of interest in the lymphatic system can be attributed to two factors: the discovery of cytokines that induce the growth of new lymphatic capillaries and the identification of lymphatic endothelial-specific markers. In contrast to the above, there is a paucity of techniques for studying lymphatic function in vivo. This article reviews imaging and other techniques that allow the assessment of lymphatic function, particularly in the tumor microenvironment, and proposes novel solutions for probing the same in vivo.