2006 - UZ Leuven

Objective: To evaluate the expression of carbonic anhydrase IX (CAIX) and vascular-endothelial growth factor (VEGF) in esophageal andgastric adenocarcinomas and in turn with the histologic subtype.Summary background data: Tumor hypoxia is an important factor intherapy resistance. A low oxygen concentration in tumors stimulatesa.o. the expression of CA IX, a marker of hypoxia, and VEGF, a proangiogenicfactor.Methods: We evaluated the immunohistochemical expression of CA IXand VEGF on paraffin-embedded material of 154 resectionspecimens: 39 esophageal, 73 cardiac, and 42 distal gastricadenocarcinomas (UICC classification). The adenocarcinomas weresubtyped according to the Lauren classification (intestinal- and diffusetype).Statistical analysis: chi test, Kaplan-Meier survival analysis, log-ranktest, and Cox proportional hazards model.Results: CA IX and VEGF expression were independent of thelocalization of the tumor. However, intestinal-type adenocarcinomasshowed a significantly higher expression of CA IX as well as VEGFthan diffuse-type tumors. VEGF expression was associated with ahigh microvessel density. Although survival analysis showed that CAIX expression (P = 0.008) as well as the coexpression of CA IX andVEGF (P = 0.008) correlate with a poor outcome, only CA IXexpression is an independent prognostic factor for overall survival andmetastasis-free survival.Conclusion: The difference in expression of CA IX and VEGF betweenintestinal- and diffuse-type adenocarcinomas may possibly explain thedifferent clinical behavior of these tumors. CA IX expression, ratherthan VEGF positivity in tumors, enables the identification of asubpopulation, characterized by a more aggressive behavior and apoorer prognosis.DUPONT L.J., BLONDEAU K., SIFROM D., VAN RAEMDONCK D.M.,VERLEDEN G.M.: Is gastro-oesophageal reflux more frequent in lungtransplant patients with chronic rejection? J. Heart Lung Transplant.,2006; 25: S84(117).Chronic allograft dysfunction predisposes to poor long-term survivalafter lung transplantation (LTx). It has been suggested that gastrooesophagealreflux (GOR) contributes to non-alloimmune lung injuryand the development of BOS. A cross-sectional study was performedto determine the prevalence of GOR in a cohort of lung transplantrecipients by means of combined oesophageal 24-hr pH andimpedance testing. This allowed accurate detection of all GOR events(acid and nonacid) while acid suppression therapy (omeprazole 20 mgor ranitidine 300 mg)- was continued. Thirty-six patients were included97