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Effects of endoscopic sphincterotomy on biliary epithelium:A case-control study

World Journal of Gastroenterology 2012年第8期18卷 794-799页

作者： John Kalaitzis Antonios Vezakis George Fragulidis Irene Anagnostopoulou Spyros Rizos efstathios papalambros Andreas Polydorou First Department of Surgery Tzaneio General Hospital of Piraeus Second Department of Surgery and Endoscopic Unit National and Kapodistrian University of Athens Medical School Aretaieion Hospital Department of Cytology Tzaneio General Hospital of Piraeus First Department of Surgery National and Kapodistrian University of Athens Medical School Laiko General Hospital

AIM: To study the long-term effects of endoscopic sphincterotomy on biliary epithelium. METHODS: This is a prospective case-control study. A total of 25 patients with a median age of 71 years (range 49-89 years) and prior endoscopic sphincterotomy (ES) for benign disease formed the fi rst group. The median time from ES was 42 mo (range 8-144 mo). Another 25 patients with a median age of 76 years (range 44-94 mo) and similar characteristics who underwent current endoscopic retrograde cholangio-pancreatography (ERCP) and ES for benign disease formed the second group (control group). Brush cytology of the biliary tree with p53 immunocytology was performed in all patients of both groups. ERCPs and recruitment were conducted at the Endoscopic Unit of Aretaieion University Hospital and Tzaneio Hospital, Athens, from October 2006 to June 2010. RESULTS: No cases were positive or suspicious for malignancy. Epithelial atypia was higher in the first group (32% vs 8% in the second group, P = 0.034). Acute cholangitis and previous biliary operation rates were also higher in the fi rst group (acute cholangitis, 60% vs 24% in the second group, P = 0.01; previous biliary operation, 76% vs 24% in the second group, P = 0.001). Subgroup analysis showed that previous ES was the main causal factor for atypia, which was not related to the time interval from the ES (P = 0.407). Two patients (8%) with atypia in the fi rst group were p53-positive. CONCLUSION: ES causes biliary epithelial atypia that represents mostly reactive/proliferative rather than premalignant changes. The role of p53 immunoreactivity in biliary atypia needs to be further studied.

关键词： Endoscopic sphincterotomy Brush cytolo-gy Atypia Cholangiocarcinoma p53 immunocytology

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Association between polymorphisms in the Toll-like receptor 4,CD14,and CARD15/NOD2and inflammatory bowel disease in the Greek population

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World Journal of Gastroenterology 2005年第5期11卷 681-685页

作者： Maria Gazouli Gerassimos Mantzaris Athanassios Kotsinas Panayotis Zacharatos efstathios papalambros Athanassios Archimandritis John Ikonomopoulos Vassilis G Gorgoulis Department of Histology-Embryology School of Medicine University of Athens11527 AthensGreece Department of Gastroenterology "Evagelismos" Hospital 11521 AthensGreece First Department of Surgery Laikon Hospital School of MedicineUniversity of Athens11527 AthensGreece Department of Pathophysiology Gastroenterology Section School of MedicineUniversity of Athens"Hippocration" Hospital11527 AthensGreece Agricultural University of Athens Department of Anatomy-Physiology Faculty of Animal Science11855 AthensGreece

AIM: Crohn's disease(CD)and ulcerative colitis(UC)are multifactorial diseases with a significant genetic *** from CARD15/NOD2 gene, evidence is accumulating that molecules related to the innate immune response such as CD14 or Toll-like receptor 4 (TLR4), are involved in their pathogenesis. In further exploring the genetic background of these diseases, we investigated the variations in the CARD15/NOD2 gene (Arg702Trp,Gly908Arg and Leu1007fsinsC), and polymorphisms in the TLR4 gene (Asp299Gly and Thr399Ile) as well as in the promoter of the CD14 gene (T/C at position -159) in Greek patients with CD and ***: DNA was obtained from 120 patients with CD,85 with UC and 100 healthy individuals. Genotyping was performed by allele specific PCR or by PCR-RFLP ***: The 299Gly allele frequency of the TLR4 gene and the T allele and TT genotype frequendes of the CD14 promoter were significantly higher in CD patients only compared to healthy individuals (P = 0.026＜0.05; P = 0.0048＜0.01 and P= 0.047＜0.05 respectively). Concerning the NOD2/CARD15mutations the overall presence in CD patients was significantly higher than that in UC patients or in ***, 51.67% of the CD patients were carriers of a TLR4 and/or CD14 polymorphic allele and at least one variant of the NOD2/CARD15, compared to 27% of the UC patients. It should be pointed out that both frequencies significantly increased as compared with the 10% frequency of multiple carriers found in healthy controls. A possible interaction of the NOD2/CARD15 with TLR4 and especially CD14, increased the risk of developing inflammatory bowel disease (IBD).CONCLUSION: Our results indicate that co-existence of a mutation in either the TLR4 or CD14 gene, and in NOD2/CARD15is associated with an increased susceptibility to developing CD compared to UC, and to developing either CD or UC compared to healthy individuals.

关键词： Inflammatory bowel disease CARD15/NOD2 gene Toll-like receptor 4 CD14 Antigen

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