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Human cytomegalovirus and Epstein-Barr virus infection in inflammatory bowel disease:Need for mucosal viral load measurement

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World Journal of Gastroenterology 2015年第6期21卷 1915-1926页

作者： Rachele Ciccocioppo Francesca Racca Stefania Paolucci Giulia Campanini Lodovica Pozzi Elena Betti Roberta Riboni Alessandro Vanoli Fausto Baldanti Gino Roberto Corazza Centre for the Study and Cure of inflammatory Bowel disease Clinica Medica I IRCCS San Matteo Hospital Foundation University of Pavia SS Virologia Molecolare - SC Virologia e microbiologia Fondazione IRCCS Policlinico San Matteo Servizio di Endoscopia digestiva Fondazione IRCCS Policlinico San Matteo Servizio di anatomia patologica Fondazione iRCCS Policlinico San Matteo

AiM:To evaluate the best diagnostic technique and risk factors of the human Cytomegalovirus(HCMV)and Epstein-Barr virus(EBV)infection in inflammatory bowel disease(iBd).METHOdS:A cohort of 40 iBd patients(17 refractory)and 40 controls underwent peripheral blood and endoscopic colonic mucosal sample *** infection was assessed by quantitative real-time polymerase chain reaction and immunohistochemistry,and correlations with clinical and endoscopic indexes of activity,and risk factors were ***:All refractory patients carried detectable levels of HCMV and/or EBV mucosal load as comparedto 13/23(56.5%)non-refractory and 13/40(32.5%)*** median dNA value was significantly higher in refractory(HCMV 286 and EBV 5.440 copies/105cells)than in non-refractory(HCMV 0 and EBV 6copies/105 cells;PdiBd patients and controls(HCMV and EBV 0 copies/105 cells;Pients showed dNA peak values≥103 copies/105 cells in diseased mucosa in comparison to non-diseased mucosa(Pdile non-refractory patients and controls invariably displayed levels below this threshold,thus allowing us to differentiate viral colitis from mucosal ***,the mucosal load positively correlated with the values found in the peripheral blood,whilst no correlation with the number of positive cells at immunohistochemistry was *** use was identified as a significant risk factor for both HCMV(P=0.018)and EBV(P=0.002)***,a course of specific antiviral therapy with ganciclovir was successful in all refractory patients with HCMV colitis,whilst refractory patients with EBV colitis did not show any improvement despite steroid tapering and discontinuation of the other ***:Viral colitis appeared to contribute to mucosal lesions in refractory iBd,and its correct diagnosis and management require quantitative real-time polymerase chain reaction assay of mucosal specime

关键词： inflammatory bowel disease quantitative real-time

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Expression of HER2 and bradykinin B_1 receptors in precursor lesions of gallbladder carcinoma

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World Journal of Gastroenterology 2012年第11期18卷 1208-1215页

作者： Cesar Toledo Carola E Matus Ximena Barraza Pamela Arroyo Pamela Ehrenfeld Carlos d Figueroa Kanti d Bhoola Maeva del Pozo Maria T Poblete Laboratorio de Patologia Celular Instituto de AnatomiaHistologia y PatologiaUniversidad Austral de ChileValdivia Box 567Chile Servicio de anatomia patologica Hospital Base Lung Institute of Western AustraliaCentre for Asthma and Allergy Research InstituteUniversity of Western Australia

AiM： To determine the expression of HER2 and bradykinin B1 receptors （B1R） in the two pathogenic models of gallbladder cancer： the metaplasia dysplasia carcino ma and the adenoma carcinoma pathways.METHOdS： Receptor proteins were visualized by immunohistochemistry on 5-μm sections of paraffin-embedded tissue. Expression of both receptors was studied in biopsy samples from 92 patients （6 males and 86 females; age ranging from 28 to 86 years, mean 56 years）. High HER2 expression in specimens was additionally investigated by fluorescence in situ hybridization. Cell proliferation in each sample was assessed by using the Ki-67 proliferation marker.RESULTS： HER2 receptor protein was absent in adenomas and in normal gallbladder epithelium. On the contrary, there was intense staining for HER2 on the basolateral membrane of epithelial cells of intestinal metaplasia （22/24; 91.7%） and carcinoma in situ （9/10; 90%）, the lesions that displayed a significantly high proliferation index. Protein up-regulation of HER2 in the epithelium with metaplasia or carcinoma in s/tu was not accompanied by HER2 gene amplification. A similar result was observed in invasive carcinomas （0/12）. The B1R distribution pattern mirrored that of HER2 except that B1R was additionally observed in the adenomas. The B1R appeared either as cytoplasmic dots or labeling on the apical cell membrane of the cells composing the epithelia with intestinal metaplasia （24/24; 100%） and carcinoma in situ （10/10; 100%） and in the epithelial cells of adenomas. in contrast, both HER2 （4/12; 33%） and B1R （1/12; 8.3%） showed a low expression in inva- sive gallbladder carcinomas.CONCLUSiON： The up-regulation of HER2 and B1R in precursor lesions of gallbladder carcinoma suggests cross-talk between these two receptors that may be of importance in the modulation of cell proliferation in gallbladder carcinogenesis,

关键词： Bradykinin Bi receptor HER2 Gallbladderadenoma Gallbladder dysplasia intestinal metaplasia Gallbladder cancer

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Complete pancreatic heterotopia of gallbladder with hypertrophic duct simulating an adenomyoma

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World Journal of Gastroenterology 2006年第11期12卷 1786-1787页

作者： Luca Pilloni Alessandro Cois Alessandro Uccheddu Rossano Ambu Pierpaolo Coni Gavino Faa istituto di anatomia patologica dipartimento di Citomorfologia Universita degli Studi di CagliariItaly Semeiotica Chirurgica dipartimento Chirurgico Materno infantile e di Scienze delle immagini Università degli Studi di CagliariItaly istituto di anatomia patologica dipartimento di Citomorfologia Università degli Studi di CagliariItaly

The gallbladder is an unusual location of pancreatic heterotopia, defined as the presence of pancreatic tissue lacking anatomical and vascular continuity with the main body of the gland. A 28-year-old man presented with anorexia, nausea and pain in the right upper abdomen. On physical examination, the abdomen was tender to palpation and Murphy sign was positive. The patient underwent a cholecystecomy. This case, in our opinion, is very interesting since it permits to consider a controversial issue in the pathology of the gallbladder. The histological appearance of ductal structure in pancreatic heterotopia resembles the histological picture of both Aschoff-Rokitansky （AR） sinuses and adenomyomas. This finding suggests that these lesions are linked by a common histogenetic origin. We suggest that the finding of an adenomyoma in the gallbladder should prompt an extensive sampling of the organ in order to verify the coexistence of pancreatic rests.

关键词： Pancreatic heterotopia Gallbladder Hypertrophic duct Adenomyoma Aschoff-Rokitansky sinuses

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Anti-tumor necrosis factor α therapy associates to type 17 helper T lymphocytes immunological shift and significant microbial changes in dextran sodium sulphate colitis

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World Journal of Gastroenterology 2019年第12期25卷 1465-1477页

作者： Valentina Petito Cristina Graziani Loris R Lopetuso Marco Fossati Alessandra Battaglia Vincenzo Arena domenico Scannone Gianluca Quaranta Andrea Quagliariello Federica del Chierico Lorenza Putignani Luca Masucci Maurizio Sanguinetti Alessandro Sgambato Antonio Gasbarrini Franco Scaldaferri istituto di Patologia Speciale Medica Università Cattolica del Sacro Cuore UOC di Medicina interna e Gastroenterologia Area di Gastroenterologia e Oncologia Medica Dipartimento di Scienze Gastroenterologiche Endocrino-Metaboliche e Nefro-Urologiche Fondazione Policlinico Universitario "A. Gemelli" IRCCS dipartimento delle Scienze della Salute della donna e del Bambino Fondazione Policlinico Universitario "A. Gemelli" IRCCS istituto di Clinica Ostetrica e Ginecologica Università Cattolica del Sacro Cuore U.O.S.A. Gineco-Patologia e Patologia Mammaria Fondazione Policlinico Universitario "A. Gemelli" IRCCS istituto di anatomia patologica Università Cattolica del Sacro Cuore dipartimento di anatomia patologica e istologia Fondazione Policlinico Universitario "A. Gemelli" IRCCS dipartimento di microbiologia Fondazione Policlinico Universitario "A. Gemelli" IRCCS istituto di microbiologia Università Cattolica del Sacro Cuore Unità di Microbioma Umano Ospedale Pediatrico Bambino Gesù IRCCS Unità di Parassitologia Ospedale Pediatrico Bambino Gesù IRCCS istituto di Patologia Generale Università Cattolica del Sacro Cuore

BACKGROUNd Anti-tumor necrosis factor α(TNFα) represents the best therapeutic option to induce mucosal healing and clinical remission in patients with moderate-severe ulcerative colitis. On the other side gut microbiota plays a crucial role in pathogenesis of ulcerative colitis but few information exists on how microbiota changes following anti-TNFα therapy and on microbiota role in mucosal *** To elucidate whether gut microbiota and immune system changes appear following anti TNFα therapy during dextran sulfate sodium(dSS) *** Eighty C57 BL/6 mice were divided into four groups: "No dSS", "No dSS + antiTNFα", "dSS" and "dSS + anti-TNFα". "dSS" and "dSS + anti-TNFα" were treated for 5 d with 3% dSS. At day 3, mice whithin "No dSS+anti-TNFα" and"dSS+anti-TNFα" group received 5 mg/kg of an anti-TNFα agent. Forty mice were sacrificed at day 5, forty at day 12, after one week of recovery post dSS. The severity of colitis was assessed by a clinical score(disease Activity index), colon length and histology. Bacteria such as Bacteroides, Clostridiaceae, Enterococcaceae and Fecalibacterium prausnitzii(F. prausnitzii) were evaluated by quantitative *** 1 helper T lymphocytes(Th1), type 17 helper T lymphocytes(Th17) and Cd4+ regulatory T lymphocytes(Treg) distributions in the mesenteric lymph node(MLN) were studied by flow *** Bacteria associated with a healthy state(i.e., such as Bacteroides, Clostridiaceae and F. prausnitzii) decreased during colitis and increased in course of anti-TNFαtreatment. Conversely, microorganisms belonging to Enterococcaceae genera,which are linked to inflammatory processes, showed an opposite ***, in colitic mice treated with anti-TNFα microbial changes were associated with an initial increase(day 5 of the colitis) in Treg cells and a consequent decrease(day 12 post dSS) in Th1 and Th17 frequency cells. Healthy mice treated with anti-TNFα showed the same histological, microbial and immune featur

关键词： Gut microbiota dextran sodium sulphate colitis immune system T cells Mesenchymal lymphnode Tumor necrosis factor α

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Large gangliocytic paraganglioma of the duodenum:A rare entity

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World Journal of Gastrointestinal Surgery 2015年第8期7卷 170-173页

作者： Alejandra Gordillo Hernández Eduardo dominguez-Adame Lanuza Auxiliadora Cano Matias Rosario Perez Huertas Katherine Maria Gallardo Rodriguez Purificacion Gallinato Perez Fernando Oliva Mompean Servicio de Cirugia General Hospital Universitario Virgen de Macarena Jefe de Sección de Cirugia Laparoscopica Avanzada y Cirugía Bariatrica Hospital Universitario Virgen de Macarena Servicio de anatomia patologica Hospital Universitario Virgen de Macarena

Gangliocytic paragangliomas are rare tumors that almost exclusively occur within the second portion of the duodenum. Although these tumors generally have a benign clinical course, they have the potential to recur or metastasize to regional lymph nodes. The case report presented here describes a 57-year-old female patient with melena, progressive asthenia, anemia, and a mass in the second-third portion of the duodenum that was treated by local excision. The patient was diagnosed with a friable bleeding tumor. The histologic analysis showed that the tumor was a 4 cm gangliocytic paraganglioma without a malignant cell pattern. in the absence of local invasion or distant metastasis, endoscopic resection represents a feasible, curative therapy. Although endoscopic polypectomy is currently considered the treatment of choice, it is not recommended if the size of the tumor is > 3 cm and/or there is active or recent bleeding. Patients diagnosed with a gangliocytic paraganglioma should be closely followed-up for possible local recurrence.

关键词： duodenum Gangliocytic paraganglioma Ganglion cells

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Giardia lamblia infection in patients with irritable bowel syndrome and dyspepsia:A prospective study

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World Journal of Gastroenterology 2006年第12期12卷 1941-1944页

作者： Barbara Grazioli Giovanni Matera Costanza Laratta Giuseppina Schipani Giovanni Guarnieri Ester Spiniello Maria imeneo Andrea Amorosi Alfredo Focà Francesco Luzza dipartimento di Medicina Sperimentale e Clinica Cattedra di Gastroenterologia Università di Catanzaro 'Magma Graecia' Catanzaro Italy dipartimento di Scienze Mediche Istituto di Microbiologia Università di Catanzaro 'Magna Graecia' Catanzaro Italy dipartimento di Medicina Sperimentale e Clinica Cattedra di Anatomia Patologica Universith di Catanzaro 'Magna Graecia' Catanzaro Italy

AiM： To evaluate the prevalence of Giardia lamblia （G. lamblia） infection in patients with irritable bowel syndrome （iBS） and dyspepsia and to establish which is the most accurate test to diagnose the infection in this setting. METHOdS： One hundred and thirty-seven patients who consecutively attended the Outpatient Gastroenterology Clinic for the first time between January 2002 and decernber 2003 due to symptoms of iBS and/or dyspepsia were recruited. All patients underwent clinical evaluation, first-step haematology and chemistry tests, serologic assays for celiac disease, lactose-H2 breath test, abdominal ultrasonography, and esophagogastroduodenoscopy. Helicobacterpylon status was evaluated. in patients with symptoms of iBS older than 45 years, colonoscopy was also performed. in all patients, duodenal biopsies and stool samples were examined for trophozoites and cysts of G. lamblia by several methods. RESULTS： G. lamblia was identified in 9 patients. The following diagnoses were also made： iBS （100/137, 73%）, functional dyspepsia （62/137, 45%）, organic dyspepsia （33/137, 24%）, and lactose intolerance （75/137, 55%）. A significant association was found between giardiasis and H pylori infection （x^2= 6.632, OR= 12.4, Ci= 1.5-68.1）. There were no symptoms that reliably allowed the recognition of giardiasis. direct search of the parasite in duodenal biopsy and stool sample examinations gave concordant results in all cases while histological examination of duodenal biopsies displayed a low sensitivity （e.g., 22.2%）. CONCLUSiON： in this consecutive series, diagnosis of *** infection accounted for 6.5% of patients with iBS and dyspepsia. duodenal biopsies for diagnosis of giardiasis may be unnecessary if stool sample examination is performed.

关键词： dyspepsia Giardiasis H pylori irritablebowel syndrome

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intratumoral sampling variability in hepatocellular carcinoma: A case report

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World Journal of Gastroenterology 2007年第29期13卷 4019-4021页

作者： Giancarlo Senes daniela Fanni Alessandro Cois Alessandro Uccheddu Gavino Faa dipartimento di Citomorfologia Divisione di Anatomia Patologica University of Cagliari Cagliari Italy dipartimento Chirurgico Materno Infantile e di Scienze delle Immagini Clinica Chirurgica University of Cagliari Cagliari Italy

The differential diagnosis between hepatocellular carcinoma （HCC） and regenerative liver nodules and other primary liver tumors may be very difficult, particularly when performed on liver biopsies. difficulties in histological typing may be often minimized by immunohistochemistry. Among the numerous markers proposed, CK18, Hep Par1 and glypican 3 （GPC3） are considered the most useful in HCC diagnosis. Here we report a case of HCC in a 72-year-old male with HBV- related chronic liver disease, characterized by a marked morphological and immunohistochemical intratumoral variability. in this case, tumor grading ranged from areas extremely well differentiated, similar to regenerative nodule, to undifferentiated regions, with large atypical multinucleated cells. While almost all sub nodules were immunostained by Hep Par 1, immunoreactivity for glypican 3 and for Ckl8 was patchy, with negative tumor region adjacent to the highly immunoreactive areas. Our case stresses the relevance of sampling variability in the diagnosis of HCC, and indicates that caution should be taken in grading an HCC and in the interpretation of immunohistochemical stains when only small core biopsies from liver nodules are available.

关键词： Liver Hepatocellular carcinoma Sampling variability Hep Par 1 GPC3 differentiation

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Possible association between hepatitis C virus and malignancies different from hepatocellular carcinoma:A systematic review

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World Journal of Gastroenterology 2015年第45期21卷 12896-12953页

作者： Sirio Fiorino Letizia Bacchi-Reggiani dario de Biase Adele Fornelli Michele Masetti Andrea Tura Fabio Grizzi Matteo Zanello Laura Mastrangelo Raffaele Lombardi Giorgia Acquaviva Luca di Tommaso Arrigo Bondi Michela Visani Sergio Sabbatani Laura Pontoriero Carlo Fabbri Andrea Cuppini Annalisa Pession Elio Jovine Unità Operativa di Medicina interna Ospedale di Budrio dipartimento di Medicina Sperimentale Istituto di Cardiologia Policlinico S. Orsola-Malpighi Università degli Studi di Bologna dipartimento di Medicina Sperimentale Università di Bologna Unità Operativa Biologia Molecolare Anatomia Patologica Ospedale Bellaria Servizio di anatomia patologica Ospedale Maggiore Unità Operativa di Chirurgia A Ospedale Maggiore institute of Neuroscience National Research Council Humanitas Clinical and Research Center Rozzano dipartimento di Farmacia e Biotecnologie Università di Bologna istituto di Malattie infettive Policlinico S. Orsola-Malpighi Università degli Studi di Bologna Unità di Cura Materno-infantile Distretto Lametino U.O. Endoscopia Ospedale Maggiore

AiM: To summarize the current knowledge about the potential relationship between hepatitis C virus(HCV) infection and the risk of several extra-liver cancers. METHOdS: We performed a systematic review of the literature, according to the Preferred Reporting items for Systematic reviews and Meta-Analysis(PRiSMA) Statement. We extracted the pertinent articles, published in MEdLiNE and the Cochrane Library, using the following search terms: neoplasm/cancer/malignancy/tumor/carcinoma/adeno-carcinoma and non-Hodgkin lymphomas, kidney/renal-, cholangio-, pancreatic-, thyroid-, breast-,oral-, skin-, prostate-, lung-, colon-, stomach-, haematologic. Case series, case-series with control-group, case-control, cohort-studies as well as meta-analyses, written in English were collected. Some of the main characteristics of retrieved trials, which were designed to investigate the prevalence of HCV infection in each type of the above-mentioned human malignancies were summarised. A main table was defined and included a short description in the text for each of these tumours, whether at least five studies about a specific neoplasm, meeting inclusion criteria, were available in literature. According to these criteria, we created the following sections and the corresponding tables and we indicated the number of included or excluded articles, as well as of meta-analyses and reviews:(1) HCV and haematopoietic malignancies;(2) HCV and cholangiocarcinoma;(3) HCV and pancreatic cancer;(4) HCV and breast cancer;(5) HCV and kidney cancer;(6) HCV and skin or oral cancer; and(7) HCV and thyroid cancer. RESULTS: According to available data, a clear correlation between regions of HCV prevalence and risk of extra-liver cancers has emerged only for a very small group of types and histological subtypes of malignancies. in particular, HCV infection has been associated with:(1) a higher incidence of some B-cell Non-HodgkinLymphoma types, in countries, where an elevated prevalence of this pathogen is de

关键词： Neoplasm Cancer Hepatitis C virus Risk factors Ext

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Magnetic resonance imaging:A new tool for diagnosis of acute ischemic colitis?

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World Journal of Gastroenterology 2012年第13期18卷 1496-1501页

作者： Francesca iacobellis daniela Berritto Francesco Somma Carlo Cavaliere Marco Corona Santolo Cozzolino Franco Fulciniti Salvatore Cappabianca Antonio Rotondo Roberto Grassi institute of Radiology Second University of Naples80138 NaplesItaly Biotechnology Center A.O.R.N.Cardarelli80131 NaplesItaly S.S.d.di Citopatologia A.F.di Anatomia PatologicaIstituto Nazionale Tumori"Fondazione G.Pascale"80131 NaplesItaly

AiM： To define the evolution of ischemic lesions with 7T magnetic resonance imaging （7T-MRi） in an animal model of acute colonic ischemia. METHOdS： Adult Sprague-dawley rats were divided into two groups. Group i underwent inferior mesenteric artery （iMA） ligation followed by macroscopic observa- tions and histological analysis. in group H, 7T-MRi was performed before and after iMA ligation and followed by histological analysis. RESULTS： Morphological alterations started to develop 1 h after iMA ligation, when pale areas became evident in the splenic flexure mesentery and progressively wors-ened up to 8 h thereafter, when the mesentery was less pale, and the splenic flexure loop appeared very dark. The 7T-MRi results reflected these alterations, showing a hyperintense signal in both the intraperitoneal space and the colonic loop wall 1 h after iMA ligation; the lat- ter progressively increased to demonstrate a reduction in the colonic loop lumen at 6 h. Eight hours after iMA ligation, MRi showed a persistent colonic mural hyper- intensity associated with a reduction in peritoneal free fluid. The 7T-MRi findings were correlated with histolog- ical alterations, varying from an attenuated epithelium with glandular apex lesions at 1 h to coagulative necro- sis and loss of the surface epithelium detected 8 h after iMA ligation. CONCLUSiON： MRi may be used as a substitute for invasive procedures in diagnosing and grading acute ischemic colitis, allowing for the early identification of pathological findings.

关键词： ischemic colitis Animal models Sprague-dawley rats Magnetic resonance imaging Histopathology

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Repeated anastomotic recurrence of colorectal tumors: Genetic analysis of two cases

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World Journal of Gastroenterology 2011年第32期17卷 3752-3758页

作者： Renato Costi Cinzia Azzoni Federico Marchesi Lorena Bottarelli Vincenzo Violi Cesare Bordi dipartimento di Scienze Chirurgiche Università degli Studi di Parma 43100 Parma Italy département de Chirurgie digestive et Endocrinienne H pital Cochin Assistance Publique-H pitaux de Paris Université Paris Descartes 75679 Paris France dipartimento di Patologia e Medicina di Laboratorio Sezione di Anatomia ed Istologia Patologica Università degli Studi di Parma 43100 Parma Italy

AiM: To investigate genetics of two cases of colorectal tumor local recurrence and throw some light on the etiopathogenesis of anastomotic recurrence. METHOdS: Two cases are presented: a 65-year-old female receiving two colonic resections for primary anastomotic recurrences within 21 mo, and a 57-year-old female undergoing two local excisions of recurrent anastomotic adenomas within 26 mo. A loss of heterozygosity (LOH) study of 25 microsatellite markers and a mutational analysis of genes BRAF , K-RAS and APC were performed in samples of neoplastic and normal colonic mucosa collected over the years. RESULTS: A diffuse genetic instability was present in all samples, including neoplastic and normal colonic mucosa. Two different patterns of genetic alterations (LOH at 5q21 and 18p11.23 in the first case, and LOH at 1p34 and 3p14 in the second) were found to be associated with carcinogenesis over the years. A role for the genes MYC-L (mapping at 1p34) and FiHT (mapping at 3p14.2) is suggested, whereas a role for APC (mapping at 5q21) is not shown. CONCLUSiON: The study challenges the most credited intraluminal implantation and metachronous carcinogenesis theories, and suggests a persistent, patient-specific alteration as the trigger of colorectal cancer anastomotic recurrence.

关键词： Anastomotic recurrence Colorectal cancer Allelic loss Genetic alterations

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