Chronic pancreatitis is a well-defined disease on histopathological grounds, but for clinical purpose diagnosis is mostly made without histological specimens. Imaging procedures and complementary pancreatic function tests are therefore the diagnostic main-stay in patients with a suggestive clinical history. The correct diagnosis of chronic pancreatitis is easy in late stages but difficult in early stages of the disease.In these early stages of the disease both, endoscopic retrograde pancreatography (ERP), and endoscopic ultrasonography (EUS) are methods with reliable diagnostic accuracy. Whether EUS is superior to ERP must be evaluated by further studies.Evaluation of exocrine pancreatic function is only complementary to morphological evaluation, due to the fact that common tubeless function tests do not detect mild to moderate exocrine pancreatic insufficiency with adequate accuracy.

OBJECTIVETo clarify the role of these cyclins in human gastric cancer.

METHODS38 gastric cancer patients, 29 first degree relatives of gastric cancer patients, as well as 18 healthy subjects were included. The mRNA expression of cyclins D1, D2, D3 and E in gastric biopsies was evaluated by RT-PCR analysis using specific primers. Histomorphological features such as intestinal metaplasia, atrophy, H. pylori infection and severity of gastritis were determined by the updated Sydney System.

RESULTSSignificant mRNA overexpression was found for cyclins D2, D3 and E compared with healthy normal specimen, but cyclin D1 expression was not different between tumor and normal tissues. In addition, cyclin D2 and D3 overexpression was significantly more frequent in first degree relatives than in healthy controls (P < 0.05). Among the various pathological findings, the overexpression of cyclins D2 and E was associated with intestinal metaplasia, and the overexpression of cyclin D3 was associated with intestinal metaplasia as well as atrophy. The overexpression of cyclins D2 and D3 was significantly correlated with H. pylori infection. No correlation was observed between the overexpression of cyclin D1 and any pathological variables.

CONCLUSIONThe overexpression of cyclins D2, D3 and E is a frequent event in patients with gastric cancer and their first degree relatives and may be an early event in gastric carcinogenesis.

Adult ; Aged ; Aged, 80 and over ; Cyclin D1 ; genetics ; Cyclin D2 ; Cyclin D3 ; Cyclin E ; genetics ; Cyclins ; genetics ; Family Health ; Gastritis ; genetics ; Gene Expression Regulation, Neoplastic ; Helicobacter Infections ; genetics ; microbiology ; Helicobacter pylori ; growth & development ; Humans ; Middle Aged ; RNA, Messenger ; genetics ; metabolism ; Stomach ; metabolism ; microbiology ; pathology ; Stomach Neoplasms ; genetics ; pathology