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This paper presents a case report of a 61 year-old man who had diagnosed in colonoscopy rectal cancer of early stage. In endosonography (EUS) intramucosal lesion without enlargement of regional lymph nodes was demonstrated. The patient was qualified for endoscopic therapy by submucosal dissection (ESD). The treatment was performed without any complications. The histological findings confirmed an early stage of rectal cancer--This, according to TNM classification.

The neuroendocrine tumors (NET) of the colon are rare with a rising incidence due to an increased number of diagnostic examination including screening colonoscopy. According to distinct prognosis and treatment these tumors are classified as colonic or rectal NET. This paper provides the consensus guidelines for management of patients with these neoplasms recommended by the Polish Neuroendocrine Tumor Network Group. Furthermore the epidemiology and clinical presentation are described.

We have recently observed an increased interest in gastro-entero-pancreatic neuroendocrine tumors (GEP NET). They are rare cancer types and therefore collaborative effort of specialists in various disciplines of medicine is necessary to work out the diagnostic and therapeutic guidelines. In this publication we present general guidelines of the Polish Network of Neuroendocrine Tumors for the management of patients with GEP NET, developed at the Round Table Conference which took place in Kliczków near Wrocław in November 2007. In the subsequent parts of this publication, we present the rules of diagnostic and therapeutic management of: - endocrine tumors of the stomach and duodenum (including gastrinoma); - pancreatic endocrine tumors; - neuroendocrine tumors of the small intestine and the appendix; - neuroendocrine tumors of the colon. We hope that the proposed guidelines by Polish and foreign experts representing various disciplines of medicine, including endocrinology, gastroenterology, surgery, oncology, nuclear medicine and pathomorphology, will become a useful tool in the diagnostics and treatment of these patients.

Unlabelled: Mutation of the p53 gene belongs to the most common genetic alteration in human cancer. Prognostic significance of serum anti-p53 antibodies in patients with gastric cancer is still a matter of controversy. The aim of the study was to estimate the presence of anti-p53 antibodies in serum of gastric cancer patients and relationship between anti-p53 antibodies and chosen clinical and pathomorphological data age, sex, localization of cancer, histology, stage of disease, metastases to lymph nodes and the time of survival., Material and Method: Serum samples from 71 patients with gastric cancer were analyzed by specific enzyme-linked immunosorbent assay (ELISA) to determine the presence of serum anti-p53 antibodies. The results were statistically compared with clinical and pathological features and postoperative survival., Results: Anti-p53 antibodies were detected in 16 (23%) gastric cancer patients. The presence of p53 antibodies was connected with intestinal tumor type (p < 0.05) and older age (p = 0.0035). There were no association between anti-p53 antibodies, stage and the time of survival., Conclusion: These results suggest that in gastric cancer patients serum anti-p53 antibodies detected by ELISA are not predictor of prognosis.

Aim: The expression of p53 protein was compared in primary gastric carcinomas and coexisting regional and distant metastases. The purpose of the study was to evaluate whether p53 staining in regional lymph-node metastases might improve the value of p53 as a prognostic marker and determine the behaviour of its protein during gastric cancer progression., Material and Methods: 60 gastric cancer patients were included into the study. In all patients the expression of p53 was assessed in primary tumours and in regional lymph-node metastases. Additionally in 12 patients the p53 expression was determinated in distant metastases. The number of all secondary tumours studied was 153. Formalin fixed, paraffin embedded material and three-stage immunohistochemical methods were used., Results: p53 accumulation was detected in 24 (40%) of primary gastric carcinomas. In each patient p53 expression in primary regional and distant metastatic tumours was identical., Conclusions: Our results show that assessment of p53 in lymphnode metastases does not improve prognostic value of p53 in gastric carcinoma and support the view that p53 alterations occur before and maintain during metastatic spread.

Study Aim: The aim of the study was to evaluate the role of Helicobacter pylori CagA(+) infection in gastric cancer., Material and Methods: 475 patients were included into the study (270 gastric cancer patients and 205 control subjects). Helicobacter pylori CagA status was determined by enzyme-linked immunoabsorbent assay (ELISA). The frequency of H. pylori CagA infection in gastric cancer patients and control group was compared. The relationship between presence of anti-H. pylori CagA antibodies and selected clinical and pathomorphological parameters was analysed., Results: Gastric cancer patients and controls had the same prevalence of H. pylori CagA antibodies (54.4 vs 52.5%; p = 0.078). The persons with H. pylori CagA(+) and CagA(-) were at the same risk for developing gastric cancer (OR = 1.08; 95%CI = 0.66-1.49). However subgroup analysis showed that the risk of gastric cancer development in H. pylori CagA(+) depended on age being 2 times higher for young people (15-40 years) (OR = 2.0; 95% CI = 0-4.25) and four times higher for those under the age of 30 years (OR = 4.0; 95%CI = 0-15.9). There was a positive relationship between H. pylori CagA(+) infection and age (p = 0.043). H. pylori CagA(+) infection was independent of sex, family history of cancers, duration of symptoms, ABO blood group, tumour site, stage, histology and p53 accumulation in cancer gastric tissue., Conclusion: Our study shows that H. pylori CagA(+) infection increases the risk for developing gastric cancer in young persons and does not protect the host against cardia cancer. The results suggest also that infection by H. pylori CagA(+) in gastric cancer has no influence on p53 gene mutation development.

Unlabelled: The aim of the study was to evaluate the role of Helicobacter pylori infection in gastric cancer development., Material and Methods: 475 patients were included into the study (270 gastric cancer patients and 205 controls). Helicobacter pylori status was determined by enzyme linked immunoabsorbent assay (ELISA). The frequency of H. pylori infection in gastric cancer patients and the control group was compared. The relationship between the presence of anti-H. pylori antibodies and selected clinical and pathomorphological parameters was analysed., Results: H. pylori infection was statistically more frequent in gastric cancer patients than in controls (94.4% vs. 86.3%, p = 0.0039). Subjects infected with H. pylori were about 2.5-fold more likely to develop gastric cancer than uninfected individuals (OR = 2.69; 95% CI = 0.93-4.45) and the risk depended on age. A positive relationship between H. pylori infection and family history of cancer was found (p = 0.045). H. pylori status was irrespective of patient's age, sex, duration of symptoms, AB0 blood group, tumour site, stage, histology and p53 status in cancer tissue., Conclusion: Our study confirms a positive relationship between H. pylori infection and gastric cancer, however, in contrast to previous reports fails to demonstrate that bacteria protect the host from cardia cancer. Our results suggest also that in gastric cancer H. pylori does not induce p53 mutations.