Page 92 - Magyar Gasztroenterológiai Társaság 2020. november 6–7. – ONLINE KONGRESSZUS

Előadáskivonatok / Abstracts

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of one or a combination of more diagnostic tests for H. pylori Zsigrai S. , Kalmár A. , Szigeti K. , Nagy Z. , Barták B. ,
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in patients with bleeding peptic ulcer. Valcz G. , Galamb O. , Dankó T. , Tulassay Z. , Igaz
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Methods: A comprehensive literature search was carried out P. , Molnár B.
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from inception to November 2018 to perform a network meta- 1. 2nd Department of Internal Medicine, Semmelweis
analysis. Diagnostic test accuracy studies for H. pylori were University; 2. Molecular Medicine Research Group,
included. We collected the raw data of diagnostic tests such Hungarian Academy of Sciences; 3. 1st Department of
as true positive, true negative, false positive, and false Pathology and Experimental Cancer Research, Semmelweis
negative values. All statistical calculations were performed University
by the R programming language using an ANOVA arm-
based model by Nyaga et al., 2018. We ranked the methods, Introduction: S-adenosylmethionine (SAM) is involved in
index tests according to the superiority index. DNA methylation processes, thereby it may have a favorable
Results: We analyzed five arbitrary gold standards effect on gene expression of cancer-associated genes
(histology, rapid urease test, PCR, urea breath test, through epigenetic modifications, but may also influence
serology) in 5 network against single and combination of DNA folding during repair processes.
diagnostic tests. None of the calculated superiority indices Aims: We aimed to analyze the effect of SAM treatment on
proved that any of the tests have better diagnostic accuracy global and promoter-specific DNA methylation levels, gene
than the individual index tests. expression, DNA integrity, cell cycle, and the proliferation of
Conclusion: Our results showed that none of the current two colorectal cancer cell lines.
diagnostic tests for H. pylori alone or in combination, is Methods: HT-29 and SW480 cells were treated with SAM in
superior in the diagnosis of the infection in the context of different concentrations (0, 0.5, 1 mmol/l) for 48 hours. Global
peptic ulcer bleeding. DNA methylation status was analyzed by bisulfite
pyrosequencing. Promoter specific DNA methylation
152. CHALLENGES OF HELICOBACTER PYLORI alterations were determined by RRBS method. Gene
ERADICATION AFTER MULTIPLE ANTIBIOTIC expression changes were detected using microarray chips.
TREATMENTS- CASE STUDY OF THREE PATIENTS DNA integrity analysis was performed with γH2AX ELISA,
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Zsigmond K. , Hardy V. , Gelley A. immunostaining, and comet assay. FACS and SRB assay
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1. Buda Hospital of the Hospitaller Order of Saint John of were assessed for cell cycle and proliferation determination.
God, Budapest, Hungary Results: DNA methylation alterations and decreased
expression of epithelial-mesenchymal transition-related
Introduction: Nowadays, eradication of resistant genes were observed after SAM treatment. Increased
Helicobacter pylori (H.pylori) strains and the initiation of the phosphorylation of H2AX and decreased micronucleus
appropriate treatment strategy is an increasing challenge. number were referred to DNA repair activation, that was
Case Reports: A 70-year-old female with a history of supported by the changes of comet tale lengths. SAM
fundoplication due to gastro-esophageal reflux. Gastroscopy decreased the proportion of cells in G0/G1 phase, while
confirmed H.pylori positivity. First-line PPI + clarithromycin + increased in S and G2/M. A significant reduction of cell
amoxicillin (PAC) treatment was successful. Four years later proliferation was detected with SRB assay.
her abdominal pain returned and H.pylori positivity was Conclusion: SAM can alter the DNA methylation pattern of
confirmed again. Secondly the same PAC combination was tumor cells and able to induce DNA repair. Activation of these
used, with no success. Third-line bismuth dicitrate quadruple processes can lead to cell cycle arrest, decreased
therapy (BQT) had been effective. proliferation, and inhibition of epithelial-mesenchymal
The second patient is a 70-year-old woman with a history of transition. Tumor cells could be targeted by SAM through
antibiotic treatment for Lyme disease and chronic sinusitis. different pathways; therefore, it may enhance the effect of
H.pylori positive chronic gastritis was confirmed in the chemotherapeutic agents.
background of epigastric pain. Until 2007 she had received
four unsuccessful eradications with PAC, followed by 154. ERCP BEYOND THE AGE OF 80
sequential therapies. Considering the previous treatments, Zsóri G. , Vágó A. , Netye Z. , Crai S. , Bordás L. , Rácz B. ,
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we decided on a high dose dual therapy followed by a Ilyés S. , Szalai L. , Fazekas I. , Gurzó Z. , Novák J.
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levofloxacin-based eradication, but both attempts failed. 1. Department of Gastroenterology, Kálmán Pándy Hospital,
Lastly the BQT protocol proved to be successful again. Békés County Central Hospital, Gyula; 2. Endoscopic
The third patient is a 42-year-old male who was previous Laboratory, Kálmán Pándy Hospital, Békés County Central
treated with trimethoprim/sulfamethoxazole and doxycycline Hospital, Gyula
for two months long for chronic sinusitis. H. pylori-associated
chronic gastritis was confirmed in the background of Introduction: Endoscopic retrograde
epigastric complaints. First-line treatment was a bismuth- cholangiopancreatography (ERCP) is an invasive procedure,
supplemented PAC therapy, which proved to be ineffective. which still has multiple complications (such as bleeding,
Second line BQT was successful. perforation, and pancreatitis) in part due to endoscopy and in
Conclusion: The accumulation of antibiotic therapies may part due to endoscopic sphincterotomy, and interventions in
have contributed to the development of more resistant the biliary tract – despite the ever-involving nature of the
H.pylori strains and the failure of conventional eradication method, and even with the greatest care during the
attempts. In such cases, the first-line use of BQT should be procedure.
considered. Aims: The aim of our research was to examine the frequency
of complications, and the efficacy of the ERCP procedure in
153. ALTERATIONS OF DNA METHYLATION, DNA the age group of patients 80 years and above. In comparison,
REPAIR, AND EPITHELIAL-MESENCHYMAL we used the corresponding results published in the latest
TRANSITION IN COLORECTAL CANCER CELL LINES BY edition of the ESGE Guideline (December 2019).
S-ADENOSYLMETHIONINE TREATMENT Methods: We conducted our retrospective research on
patients who have turned 80 between 2015 and 2019, and
have at least had one ERCP done so far.
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90 Central European Journal of Gastroenterology and Hepatology
Volume 6, Supplementum 2 / November 2020