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| 1 | Epithelial-mesenchymal, mesenchymal-epithelial, and endothelial-mesenchymal transitions in malignant tumors: An update显示文摘Epithelial-to-mesenchymal transition(EMT) represents conversion of an epithelial cell in an elongated cell with mesenchymal phenotype, which can occur in physiologic and pathologic processes such as embryogenesis(type 1 EMT), wound healing and/or fibrosis(type 2 EMT) and malignant tumors(type 3 EMT). The proliferation rate, metastasizing and recurrence capacity, as also the individualized response at chemotherapics, in both epithelial and mesenchymal malignant tumors is known to be influenced by reversible switch between EMT and mesenchymal-to-epithelial transition(MET). Although much research work has already been done in these fields, the specific molecular pathways of EMT, relating to the tumor type and tumor localization, are yet to be elucidated. In this paper, based on the literature and personal experience of the authors, an update in the field of EMT vs MET in epithelial and mesenchymal tumors is presented. The authors tried to present the latest data about the particularities of these processes, and also of the so-called endothelialto-mesenchymal transition, based on tumor location. The EMT-angiogenesis link is discussed as a possible valuable parameter for clinical follow-up and targeted therapeutic oncologic management. The paper begins with presentation of the basic aspects of EMT, its classification and assessment possibilities, and concludes with prognostic and therapeutic perspectives. The particularities of EMT and MET in gastric and colorectal carcinomas, pancreatic cancer, hepatocellular and cholangiocarcinomas, and lung, breast and prostate cancers, respectively in sarcomas and gastrointestinal stromal tumors are presented in detail. | Simona Gurzu Sabin Turdean Attila Kovecsi Anca Otilia Contac Ioan Jung | 2015 | World Journal of Clinical Cases2015，3，5： | 20 |
| 2 | Mixed adenoneuroendocrine carcinoma of gastrointestinal tract: Report of two cases显示文摘Mixed adenoneuroendocrine carcinoma(MANEC) is a rare tumor of the gastrointestinal tract that consists of a dual adenocarcinomatous and neuroendocrine differentiation, each component representing at least 30% of the tumor. To date, only seven cases have been reported in the cecum, and less than 40 in the stomach. Our first case was diagnosed in a 74-years-old female as a polypoid lesion of the cecum with direct invasion in the transverse colon, without lymph node metastases. The second case was diagnosed in the stomach of a 46-years-old male as a polypoid tumor of the antral region that invaded the pancreas and presented metastases in 22 regional lymph nodes. The metastatic tissue was represented by the glandular component. In both cases, the tumor consisted of a moderately-differentiated tubular adenocarcinoma(with mucinous component in Case 1) intermingled with neuroendocrine carcinoma. Ki67 index was lower than 20% in Case 1, respectively higher than 20% in Case 2. The neuroendocrine component was marked by synaptophysin and neuron specific enolase, being negative for Keratins 7/20. The neuroendocrine component represented 60% in Case 1, and 40% in Case 2, respectively. The glandular components were marked by carcinoembryonic antigen, maspin and keratin 20/7(Case 1/2). Both cases were proved to be microsatellite stable. Independently by the localization and tumor stage, MANECs appear to be highly malignant tumors, with high risk for distant metastases. The aggressiveness seems to depend on the endocrine component, independent of its proportion. The neuroendocrine component could be a dedifferentiated adenocarcinoma with a neuroendocrine phenotype. | Simona Gurzu Zoltan Kadar Tivadar Bara Tivadar Jr. Bara Adrian Tamasi Leonard Azamfirei Ioan Jung | 2015 | World Journal of Gastroenterology2015，21，4： | 14 |
| 3 | Systematic review of the old and new concepts in the epithelial-mesenchymal transition of colorectal cancer显示文摘Epithelial-to-mesenchymal transition(EMT) is defined as the transformation of an epithelial cell into a spindle cell with the loss of membrane E-cadherin expression and the gain of mesenchymal markers positivity. In the field of colorectal cancer(CRC), first data about EMT was published in 1995 and more than 400 papers had been written up to March 2016. Most of them are focused on the molecular pathways and experimentally-proved chemoresistance. In the present article, an update in the field of EMT in CRC based on the review of the literature and personal experience of the authors is presented. The information about the molecular and immunohistochemical(IHC) particularities of these processes and their possible role in the prognosis of CRC were also up-dated. This article focuses on the IHC quantification of the EMT, the immunoprofile of tumor buds and on the relation between EMT, angiogenesis, and stem cells activation. The EMT-induced chemoresistance vs chemotherapyor radiotherapy-induced EMT and cellular senescence was also synthesized for both conventional and targeted therapy. As a future perspective, the EMTangiogenesis-stemness link could be used as a possible valuable parameter for clinical follow-up and targeted therapeutic oncologic management of patients with CRC. Association of dexamethasone and angiotensin converting enzyme inhibitors combined with conventional chemotherapies could have clinical benefits in patients with CRC. The main conclusion is that, although many studies have been published, the EMT features are still incompletely elucidated and newly discovered EMT markers provide confusing data in understanding this complicated process, which might have significant clinical impact. | Simona Gurzu Camelia Silveanu Annamaria Fetyko Vlad Butiurca Zsolt Kovacs Ioan Jung | 2016 | World Journal of Gastroenterology2016，22，30： | 8 |
| 4 | Single skip metastasis in sentinel lymph node: In an early gastric cancer显示文摘Lymph node status is considered a key prognostic and predictive factor in patients with gastric cancer(GC).Although there is a practical approach to the intraoperative detection of sentinel lymph nodes(SLNs),such a procedure is not included in the European surgical protocol.In this report,we present a practical approach to SLN mapping in a representative case with early gastric cancer(EGC).A 74-year-old female was hospitalized with an endoscopically observed,superficially ulcerated tumor located in the antral region.Subtotal gastrectomy with D2 lymphadenectomy and SLN mapping was performed by injecting methylene blue dye into the peritumoral submucosal layer.An incidentally detected blue-stained lymph node located along the middle colic artery was also removed.This was detected 40 min after injection of the methylene blue.Histopathologic examination showed a p T1b-staged well-differentiated HER-2-negative adenocarcinoma.All of the 41 LNs located at the first,third,and fifth station of the regional LN compartments were found to be free of tumor cells.The only lymph node with metastasis was located along the middle colicartery and was considered a non-regional lymph node.This incidentally identified skip metastasis indicated stage Ⅳ GC.A classic chemotherapy regimen was given,and no recurrences were observed six months after surgery.In this representative case,low-cost SLN mapping,with a longer intraoperative waiting time,totally changed the stage of the tumor in a patient with EGC. | Tivadar Jr Bara Simona Gurzu Ioan Jung Zoltan Kadar Haruhiko Sugimura Tivadar Bara | 2015 | World Journal of Gastroenterology2015，21，33： | 8 |
| 5 | Angiogenesis of hepatocellular carcinoma: An immunohistochemistry study显示文摘BACKGROUND Although hepatocellular carcinoma(HCC) is one of the most vascular solid tumors, antiangiogenic therapy has not induced the expected results.AIM To uncover immunohistochemical(IHC) aspects of angiogenesis in HCC.METHODS A retrospective cohort study was performed and 50 cases of HCC were randomly selected. The angiogenesis particularities were evaluated based on the IHC markers Cyclooxygenase-2(COX-2), vascular endothelial growth factor(VEGF) A and the endothelial area(EA) was counted using the antibodies CD31 and CD105.RESULTS The angiogenic phenotype evaluated with VEGF-A was more expressed in small tumors without vascular invasion(pT1), whereas COX-2 was rather expressed in dedifferentiated tumors developed in non-cirrhotic liver. The CD31-related EA value decreased in parallel with increasing COX-2 intensity but was higher in HCC cases developed in patients with cirrhosis. The CD105-related EA was higher in tumors developed in patients without associated hepatitis.CONCLUSION In patients with HCC developed in cirrhosis, the newly formed vessels are rather immature and their genesis is mediated via VEGF. In patients with non-cirrhotic liver, COX-2 intensity and number of mature neoformed vessels increases in parallel with HCC dedifferentiation. | Decebal Fodor Ioan Jung Sabin Turdean Catalin Satala Simona Gurzu | 2019 | World Journal of Hepatology2019，11，3： | 6 |
| 6 | Current status of familial gastrointestinal polyposis syndromes显示文摘Because of the rarity of familial gastrointestinal cancerpredisposing syndromes,their exploration in literature is not extensive.In this review,an update of the clinicopathological and molecular criteria of gastrointestinal familial polyposis syndromes with potential malignant transformation is performed.In addition,a guide for screening and surveillance was synthesized and a distribution of gene mutations according to the specific syndromes and geographic distribution was included.The following inherited polyposes syndromes were analyzed: familial adenomatous polyposis,the hamartomatous familial polyposes(Juvenile polyposis,Peutz-Jeghers syndrome,Cowden syndrome,BannayanRiley-Ruvalcaba syndrome,hereditary mixed polyposis syndrome,Gorlin syndrome,Birt-Hogg-Dube syndrome,neurofibromatosis type Ⅰand multiple endocrine neoplasia syndrome 2B),Li-Fraumeni syndrome,and MUTYHassociated adenomatous polyposis.For proper medical care,subspecialization of gastroenterologists,pathologists,and genticists in the field of familial diseases should be introduced in the medical curriculum. | Ioan Jung Simona Gurzu Gligore Sabin Turdean | 2015 | World Journal of Gastrointestinal Oncology2015，7，11： | 2 |
| 7 | Tuberculosis terminal ileitis:A forgotten entity mimicking Crohn's disease显示文摘Intestinal tuberculosis(TB) is an uncommon lesion for which differential diagnosis can be difficult. We present a case of a 53-year-old male and a systematic review of the literature, from clinical symptoms to differential diagnosis, unusual complications and therapy. The patient was admitted to the hospital with signs of acute abdomen as a result of a perforated terminal ileitis. Based on the skip lesions of the terminal ileum and cecum, Crohn's disease(CD) was clinically suspected. An emergency laparotomy and right colectomy with terminal ileum resection was performed and systematic antibiotherapy was prescribed. The patient's status deteriorated and he died 4 d after the surgical intervention. At the autopsy, TB ileotyphlitis was discovered. The clinical criteria of the differential diagnosis between intestinal TB and CD are not very well established. Despite the large amount of published articles on this subject, only 50 papers present new data regarding intestinal TB. Based on these studies and our experience, we present an update focused on the differential diagnosis and therapy of intestinal TB. We highlight the importance of considering intestinal TB as a differential diagnosis for inflammatory bowel disease. Despite the modern techniques of diagnosis and therapy, the fulminant evolution of TB can still lead to a patient's death. | Simona Gurzu Calin Molnar Anca Otilia Contac Annamaria Fetyko Ioan Jung | 2016 | World Journal of Clinical Cases2016，4，9： | 2 |
| 8 | Possible Neuroendocrine Phenotype of Poorly Differentiated Cell Clusters in Colorectal Carcinoma, as a Prognostic Parameter显示文摘 | Simona Gurzu Orsolya Serester Ioan Jung | 2014 | The American Journal of Surgical Pathology2014，，1： | 2 |
| 9 | Primary gastric choriocarcinoma-a rare and aggressive tumor with multilineage differentiation: A case report显示文摘BACKGROUND Primary choriocarcinoma of the stomach (PCCS) is a rare tumor, with fewer than 60 cases published in the English-language literature up to December 2018. In this paper, we present the complex immunoprofile of one PCCS and a hypothesis regarding its histogenesis. CASE SUMMARY A 66-year-old previously healthy male underwent an emergency palliative gastrectomy for a gastric obstructive tumor. The histologic examination and immunoprofile of tumor cells showed a mixed tumor that consisted of choriocarcinoma (90%) and moderate differentiated adenocarcinoma (10%), with hepatic metastases (Stage pT2NxM1L1V1R0) and microsatelite stable status. The patient died one month after surgery. The tumor cells showed focal positivity for CDX2 (adenocarcinoma component), HCG (choriocarcinoma) and CD138 (plasmacytoid carcinoma component) and were negative for HER-2,α- fetoprotein, VEGF, maspin and markers of epithelial-mesenchymal transition. The gastric mucosa cells displayed positivity for CDX2, Hepar A and CD138. The complex immunoprofile and literature data synthesis prove that the gastric mucosa cells can present a multilineage differentiation. CONCLUSION PCCS should be considered as an aggressive variant of microsatellite stable gastric adenocarcinoma of an epithelial type, and not a germ cell tumor. | Simona Gurzu Constantin Copotoiu Alexandra Tugui Cedric Kwizera Rita Szodorai Ioan Jung | 2019 | World Journal of Clinical Cases2019，7，14： | 2 |
| 10 | Paradoxical expression pattern of the epithelial mesenchymal transition-related biomarkers CD44, SLUG, N-cadherin and VSIG1/Glycoprotein A34 in gastrointestinal stromal tumors显示文摘AIM To evaluate the immunohistochemical(IHC) expression of five biomarkers, commonly involved in epithelial mesenchymal/mesenchymal epithelial transition(EMT/MET), in gastrointestinal stromal tumors(GISTs). METHODS In 80 consecutive GISTs the IHC examinations were performed using the EMT-related antibodies E-cadherin,N-cadherin, SLUG, V-set and immunoglobulin domain containing 1(VSIG1) and CD44. RESULTS The positivity rate was 88.75% for SLUG, 83.75% for VSIG1, 36.25% for CD44 and 10% for N-cadherin. No correlation was noted between the examined markers and clinicopathological parameters. Nuclear positivity for SLUG and VSIG1 was observed in all cases with distant metastasis. The extra-gastrointestinal stromal tumors(e-GISTs) expressed nuclear positivity for VSIG1 and SLUG, with infrequent positivity for N-cadherin and CD44. The low overall survival was mainly dependent on VSIG1 negativity(P = 0.01) and nuclear positivity for SLUG and/or CD44. CONCLUSION GIST aggressivity may be induced by nuclear upregulation of SLUG and loss or cytoplasm-to-nuclear translocation of VSIG1. SLUG and VSIG1 may act as activated nuclear transcription factors. The CD44, but not N-cadherin, might also have an independent prognostic value in these tumors. The role of the EMT/MET-related transcription factors in the evolution of GISTs, should be revisited with a larger dataset. This is the first study exploring the IHC pattern of VSIG1 in GISTs. | Attila Kovecsi Simona Gurzu Zoltan Szentirmay Zsolt Kovacs Tivadar Jr Bara Ioan Jung | 2017 | World Journal of Gastrointestinal Oncology2017，9，11： | 2 |
| 11 | Interactions between apelin and angiotensin Ⅱ on rat portal vein 显示文摘 | Gurzu B Petrescu BC Costuleanu M | 2006 | J Renin Angiotensin Aldosterone Syst2006，7，4： | 1 |
| 12 | Decreased vascular endothelial growth factor expression in lung tissue during acute respiratory distress syndrome显示文摘 | Azamfirei L Gurzu S Copotoiu S | 2009 | Critical Care2009，13，1： | 1 |
| 13 | The expression of cytoskeleton regulatory protein mena in colorectal lesions显示文摘 | Gurzu S Jung I Prantner I | 2008 | Rom J Morphol Embryol2008，49，3： | 1 |
| 14 | The expression of cytoskeleton regulatory protein Mena in colorectal lesions显示文摘 | Gurzu S Jung I Prantner I | 2008 | Rom J Morphol Embryol2008，49，3： | 1 |
| 15 | The immunohistochemical aspects of protein Mena in cervical lesions显示文摘 | Gurzu S Jung I Pranmer I | 2009 | Rom J Morphol Embryol2009，50，2： | 1 |
| 16 | Are multiple angiotensin receptor types involved in angiotensin ( 1-7 ) actions on isolated rat portal vein显示文摘 | GURZU B COSTULEANU M SLATINEANU SM | 2005 | J Renin Angiotensin Aldosterone Syst2005，6，： | 1 |
| 17 | Clinico-pathological particu- larities of the shock-related pancreatitis 显示文摘 | Kovacs J Gurzu S Jung J | 2012 | Pathol Oncol Res2012，18，4： | 1 |
| 18 | Inflammatory myofibroblastic tumor of the colon显示文摘 | Gurzu S Bara T Jung I | 2013 | Clin Oncol2013，31，10： | 1 |
| 19 | The expression of cytoskeleton regulatory protein Mena in colorectal lesions显示文摘 | Gurzu S Jung I Prantner I | 2008 | Rom J Morphol Embryol2008，49，3： | 1 |
| 20 | Mena, a new available marker in tumors of salivary glands 显示文摘 | Gurzu S Krause M Ember I | 2012 | Eur J Histochem2012，56，1： | 1 |
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