The Korean Journal of Internal Medicine Vol. 29, No. 5 (Suppl. 1)
WCIM 2014 SEOUL KOREA 25
Slide Session
OS-GAS-13 Gastroenterology
Digestive Cancers in Hadhramout, Republic of Yemen
Rasheed Mohammed BAMEKHLAH1, Abdullah BIN NABHAN2 Hadhramout University, Yemen1, Hadhramout University, Yemen2
Background: Digestive cancers (DCs) are among the leading cancer types in the world and our country. In Hadhramout there is no published work on DCs. So our objective were to focus in these cancers.
Methods: A retrospective study for all registered cancers in Hadhramout Cancer Registry (HCR) between 2000-2011 looking for DCs in regard to age, sex and, histopa- thology, age-standardized incidence rate and clinical presentation. The neoplasms had been coded and classifi ed according to the international classifi cation of diseases for oncology.
Results: The total cancer cases registered in HRC in the period 2000-2011 were (2988) and DCs were 447 cases (16%) of them, in which (66.2%) were males and (33.8%) females. Colorectal cancer (CRC) was the most common (30.9%) of DCs, followed by hepatocellular carcinoma (HCC) (20.1%), Gastric cancer (GC) (19.7%), pancreas (11.9%) and esophagus cancer (EC) (8.9%). All DCs were more common in males except gallbladder, biliary, duodenal cancers were more common in females. All cancer types were common in old age (˃60 years), duodenal ones which occurred in age (40-60 years). Clinically, CRC was more presented by abdominal pain in 56.1%, rectal bleeding in 34.8% and altered bowel habit in 28.9%, HCC was more presented by hepato- megaly in 39.9%, right hypochondrial pain in 35.8% and ascites in 22.6%, GC was more presented by epigastric pain in 56.8% vomiting in 36.4% and anemia in 25%.
Histopathologically, adenocarcinoma was the most common type in CRC (50%), and in GC (53.5%) while 46.6% of CRC and 35.2% of GC were documented as carcinomas without specifi cation
Conclusions: Digestive cancers were the most common cancers in males, and the second in females after breast, CRC is the most one, followed by HCC and GC while duodenal and gallbladder cancers were rare. Elderly patients were more affected.
OS-GAS-14 Gastroenterology
Predictors of Mortality in Caustic Ingestion: A Single, Tertiary Center Study
Gian Carlo CARPIO1, Jeffrey LIBUIT1 Philippine General Hospital, Philippines1
Background: Caustic ingestion causes severe injury to the esophagus and the stomach and may be associated with signifi cant morbidity and mortality. Several factors have been identifi ed as possible predictors for these outcomes.
Methods: This is a retrospective cross-sectional study which included all adult pa- tients who ingested caustic agents who were admitted at the Philippine General Hos- pital Acute Care Unit from January 1, 2008 to December 31, 2012. This study aimed to determine the predictors of mortality, determined the incidence of caustic ingestion and surgical and mortality rates; and characterized patients admitted for caustic in- gestion.
Results: There were 303 cases of caustic ingestion admitted. Ingestion of acidic corro- sive agents (49.2%) was more common than alkaline substances (36.0%) Among 154 patients who underwent esophagogastroduodenoscopy, half had mild (Zargar grades 1-2b) mucosal injury. One-third had severe (Zargar grade 3) mucosal injury. Only met- abolic acidosis, presence of a psychiatric disorder, need for surgical intervention, and presence of documented perforation were signifi cantly different between patients who expired and who survived. On univariate analysis, presence of psychiatric abnormality did not show signifi cant association with mortality (Table 1). Multivariate analysis re- vealed that surgery was the most consistent predictor of mortality. Perforation had no effect in the absence of metabolic acidosis.
Conclusion:The clinico-demographic profiles of the adult subjects, distribution of severity of mucosal injury, all-cause mortality rate and surgery rate in this study are similar to the other publication. Patients with metabolic acidosis on admission, under- going surgical intervention, and with perforation are at higher risk of death. Among these, institution of surgical intervention was the most consistent predictor of mortal- ity. We recommend that these patients be closely monitored during their hospital stay in order to lower the possibility of mortality.
OS-GAS-15 Gastroenterology
Blatchford Score and Blood Transfusion Correlation in Patients with Non Variceal Upper Gastrointestinal Bleeding (nVUGIB). A Teaching Hospital Experience
Hector Raul IBARRA SIFUENTES1, Carlos Javier RODRIGUEZ ALVAREZ2, Erick Joel RENDON RAMIREZ1, Perla Rocio COLUNGA PEDRAZA1, Iris Jazmin COLUNGA PEDRAZA1
University Hospital “Dr. José Eleuterio González” and Faculty of Medicine, Mexico1, Christus Muguerza Hospital, Universidad De Monterrey, Mexico2
Background: The Glasgow-Blatchford scale has been used to classify patients into low or high risk and the need for medical or endoscopic treatment
Methods: A cross-sectional study, which retrospectively Blatchford scale is calculated for patients with nVUGIB, requiring blood transfusion, to determine the likelihood of blood transfusion, using Pearson correlation applying SPSS Statistics 18; in a period beginning from January 1, 2009 to December 31, 2013
Results: 42 patients with diagnosis of nVUGIB were studied, of which 26 patients (61.9%) required blood transfusion. By sex the highest percentage was 65% for men (17 men and 9 women). 95.3% of the patients had a Blatchford scored greater than 0 and 61.9% required blood transfusion. A Pearson correlation index of 0.815 was found.
Conclusions: The Pearson correlation showed a positive relationship between the variables, fi nding that the Blatchford scale was useful in determining which patients required blood transfusion when a cutoff 3 was used.
OS-GAS-16 Gastroenterology
The Use of Immunohistochemistry (CDX2, MUC2, H2AX and P53) in Patients with Barrett’s Esophagus – The Stratifi cation and the Risk Assessment
Jan GREGAR1, Pavla LUZNA2, Jirí EHRMANN JR.2, Vlastimil PROCHAZKA1, Premek FALT3, Stepan SUCHANEK4, Josef SROVNAL5
University Hospital Olomouc, Czech Republic1, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic2, Vítkovice Hospital, Czech Republic3, Military University Hospital, Czech Re- public4, IMTM, Czech Republic5
Background: Barrett’s esophagus (BE) is premalignant condition. Sequence of histo- logical changes from intestinal metaplasia (IM) through low-grade dysplasia (LG) up to high-grade dysplasia and adenocarcinoma. Endoscopy and histopathology assessment is „gold standard“ for diagnosis. But immunohistochemistry can be helpful for stratifi - cation and assessment of risk of dysplasia/malignancy.
Methods: The aim of the study was to investigate the role and the diagnostic po- tential of the immunohistochemistry in the disease progression. BE was inspected by endoscopy (narrow band imaging and zoom) and biopsies from all suspicious lesions were obtained for histopathological assessment (50 patients, diagnosed in the last 3 years). 25 patients with non-dysplastic BE (IM) and 25 patients with low-grade dys- plasia BE (LG). Bioptic samples (50 patients) were used for indirect immunohistochem- ical labelling and analysis of expression of proteins playing an important role during BE progression (CDX2, MUC2, H2AX and p53). Expression of selected proteins was assessed semiquantitatively by „histoscore“ (H score), which is the result of intensity of staining (0 = negative, 1 = weakly visible intensity, 2 = ligh brown intensity, 3 = dark brown intensity of staining) multiplied by percentage of positive cells.
Results: Immunohistochemical detection of expression of selected proteins showed the rising histoscore of all selected proteins in BE with LG dysplasia against non-dys- plastic IM BE: CDX (16.7% vs. 33.3%), MUC2 (6.3% vs. 36.4%), H2AX (25.9% vs.
44.4%) and p53 (75.0% vs. 89.6%). Statistical signifi cance was found in CDX, MUC2 and H2AX proteins.
Conclusions: Immunohistochemistry of selected proteins could be helpful method how to estimate progression of BE, and how to select patients with risk of dysplastic changes in BE.
