Current Issues of Pharmacy and Medical Sciences

Gastric neuroendocrine tumor treated with endoscopic submucosal dissection

Curr Issues Pharm Med Sci., Vol. 29, No. 4, 176-179

Pawel Bojar1, Jaroslaw Swatek1, Jaroslaw Drabko2,
Katarzyna Golec1, Anna Ostrowska1, Justyna Szumilo1

1 Department of Clinical Pathomorphology Medical University of Lublin, Jaczewskiego 8b, 20-090 Lublin, Poland
2 Gastromed Healthcare Center, Onyksowa 10, 20-582 Lublin, Poland

DOI: 10.1515/cipms-2016-0037

Full Text


Periodontal disease is an inflammatory disease of multifactorial etiology. In order for it to appear there must come to an imbalance between the effects of pathogens and host defense mechanisms. As a result of its course the destruction of structures supporting the teeth appears (periodontium, cement, bone), and consequently leads to teeth loosening and loss. In recent years, the participation of RANKL/RANK/OPG in bone remodeling process was highligted.
At the molecular level the bone resorption is regulated through the interaction of the ligand receptor activator of nuclear NF-kappa B (RANKL) and osteoprotegerin (OPG), which is a system of two proteins belonging to the protein tumor necrosis factor (TNF).
Recent findings about the RANKL protein and OPG have shed new light on the previously unexplained phenomenon of the basis of bone resorption. Research has shown that both protein OPG and RANKL can be detected in gingival crevicular fluid, which has become a window of opportunity in the analysis of noninvasive markers of periodontal tissues, confirming elevated levels of RANKL protein in periodontal disease, and decreased levels of OPG protein. Bone resorption is initiated by the binding of the RANKL protein to receptors RANK present on the surface of mature osteoclasts, and their precursors, which leads to the differentiation and activation of osteoclasts. OPG, being RANKL’s inhibitor, has, in turn, opposite characteristics to RANKL, resulting in the reduction of osteoclastogenesis process. Despite all this, the exact mechanism of bone resorption has not yet been elucidated.


neuroendocrine tumor, carcinoid, endoscopic submucosal dissection, stomach.


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