No abstract

Antibodies against thyroid antigens are commonly found in patients with chronic gastritis type B (20-30%) and pernicious anaemia (50%), two disorders that predispose to gastric cancer. In addition, thyroid disease in increased incidence has been reported in breast and in colon cancer. In order to determine a) the incidence of antithyroid antibodies (ATA) in gastric cancer, b) the thyroid function in patients with ATA and c) the correlation between ATA and the presence of chronic gastritis, we examined the sera of 32 patients with gastric cancer (GC) for the presence of antithyroglobulin and antimicrosomal antibodies. T3, T4 and TSH values were also measured. The sera of 36 patients with malignant tumours of the GI tract other than stomach (OMT) and of 40 healthy blood donors were used as controls. Three of the 32 GC patients had antithyroglobulin antibodies, 4 had antimicrosomal and one had both types. Of the eight patients with ATA (25%) only two had hypothyroidism and another two histologically diagnosed chronic gastritis. Three sera of the healthy controls and one of the OMT had also antithyroid antibodies. To conclude, a significant number of patients with GC had ATA as compared to controls (p < 0.01) but the presence of ATA did not necessarily indicate an abnormality of thyroid function. The presence of antibodies did not correlate with chronic gastritis type B.

PurposeTo conduct an economic evaluation comparing Ferinject® (ferric carboxymaltose [FCM]) with Venofer® (iron sucrose [IS]) and CosmoFer® (low-molecular-weight iron dextran [LMWID]) in the management of iron deficiency anemia in Greece.Patients and methodsA cost-minimization analysis was conducted since there are no clear data indicating that one of these regimens is superior to the others in terms of efficacy. Main data inputs were based on bibliography and validated by clinicians. The economic evaluation was conducted for inpatients (ie, surgical patients or patients hospitalized due to a disease related to chronic or acute blood loss) and outpatients (eg, nondialysis chronic kidney disease patients), separately. Analysis was carried out from a National Health Service (NHS) perspective and also from a patient perspective. Total cost treatment reflects the cost of drugs, the cost of all resources expended in patient management such as the cost of disposables for each infusion, the monitoring costs during infusion (salaries of personnel), other hospital expenses, the cost for management of adverse events, the productivity loss, and the traveling cost for patients.ResultsIn the case of outpatients, the mean total cost per patient in the FCM arm was €198.6, in the IS arm €627.7, and in the LMWID arm, €510.5. For inpatients the mean total cost was estimated at €189.2 for FCM while it was €419.9 and €228.8 for IS and LMWID, respectively. Budget impact analysis for a typical Greek hospital with 100 patients revealed that the total cost of FCM (inpatients analysis) was 113% and 15.4% lower against their comparators. In an outpatient situation, the total cost of FCM was 201.1% and 151.8% lower compared with IS and LMWID, respectively.ConclusionFerric carboxymaltose may represent a cost-saving option compared with the most likely alternative existing therapies used for the management of anemia in the National Health Service of Greece.

Pancreatic adenocarcinoma (PA) patients often present high serum titres of several autoantibodies including autoantibodies against [j-islet cells and insulin. In the present study we examined with an hemagglutination method the sera of 33 patients with PA for the presence of both anti-mitochondria1 and anti-thyroglobulin antithyroid autoantibodies (ATA). Twenty-six surgical patients with other non-malignant gastrointestinal tract (GI) disease (chronic pancreatitis or hernia) and 40 healthy volunteers were used as controls. Eight of the 33 PA patients were found to have ATA autoantibodies. whereas only one patient with chronic pancreatitis and 2 normal individuals had high serum ATA titres. The difference between the PA patients and either of the control groups was statistically significant ( p < 0.05). The production of autoantibodies could be attributed to impaired immunoregulation caused by the malignant cells.

Using an ELISA method, the sera of 43 patients with colon adenocarcinoma (CA) and of 26 surgical patients with nonmalignant disease of the gastrointestinal tract were studied for the presence of autoantibodies against cardiolipin (CLP) before and 1 month after surgery. Forty healthy volunteers were used as controls. Fourteen CA patients were found to be positive for anti-CLP autoantibodies before surgical treatment, and 15 patients were found to be positive 1 month after surgery. The difference between the group of CA patients and either the group of patients with nonmalignant diseases of the GI tract, or the group of healthy individuals was statistically significant (p = 0.003). The group of CA patients with high anti-CLP serum titer had a better outcome compared with the group of patients without detectable autoantibody titer (p = 0.08), estimated based on the frequency of recurrences, during the follow-up period. Further studies are in progress to evaluate the significance of anti-CLP antibodies as a biological marker of prognosis in CA patients.