Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0007095 (carcinoid)
 6,990 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Non-small cell lung cancer with neuroendocrine differentiation may represent a subset of patients with a more aggressive (like small cell lung cancer) or less aggressive (like carcinoid) biological behavior. To investigate their prognostic significance, immunohistochemical stains for 4 neuroendocrine markers (neuron-specific enolase, chromogranin A, Leu-7, and synaptophysin) and carcinoembryonic antigen (CEA) were studied in 260 patients with surgically resected stage I and II non-small cell lung cancer. The following percentages of cases were positive for each marker: neuron-specific enolase, 70.0%; chromogranin A, 14.2%; Leu-7, 7.7%; synaptophysin, 11.2%; and CEA, 68.5%. Sixty-one (23.5%) were positive for > or = 2 neuroendocrine markers. When compared to adenocarcinoma, squamous cell carcinoma displayed lower positivity for CEA and > or = 2 neuroendocrine markers. There was no significant difference in stage, site of relapse (distant versus local), disease-free, or overall survival for each marker individually or for those with > or = 2 neuroendocrine markers. Multivariate analysis showed that higher nodal stage (N1 versus N0), tumor stage (T2 versus T1), older age, and the presence of mucin predicted for poorer overall survival. Neuroendocrine markers and CEA were not of prognostic significance in this group of patients with resected stage I and II non-small cell lung cancer.
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PMID:The prognostic significance of neuroendocrine markers and carcinoembryonic antigen in patients with resected stage I and II non-small cell lung cancer. 818 76

Sleeve lobectomy is a lung-saving procedure indicated for central tumors for which the alternative is a pneumonectomy. The relation between survival and nodal status is controversial because, in most series, the presence of N1 disease adversely affects the prognosis with few or no long-term survivors. During the period 1972 to 1992, 142 patients underwent sleeve resection for lung cancer at our institution. Mean age (+/- standard deviation) was 60.7 +/- 9.1 years (range 11 to 78 years), and indications for operation were a central tumor in 112 patients (79%), a peripheral tumor in 18 patients (13%), and compromised pulmonary function in 12 patients (8%). Histologic type was predominantly squamous (72.5%) followed by nonsquamous (24.6%) and carcinoid tumors (2.8%). Resection was complete in 124 patients (87%) and incomplete in 18 (13%), and the operative mortality was 2.1% (n = 3). Follow-up was complete for the 139 remaining patients. Including operative deaths, survivals at 5 and 10 years for all patients were 46% (95% confidence intervals 38% to 55%) and 33% (95% confidence intervals 24% to 42%), respectively. For patients with N0 status (n = 73), 5- and 10-year survivals were 57% (95% confidence intervals 45% to 69%) and 46% (95% confidence intervals 32% to 60%); for patients with N1 status (n = 55), these rates were 46% (95% confidence intervals 32% to 60%) and 27% (95% confidence intervals 14% to 40%) (p = 0.13). No patient with N2 status (n = 14) survived 5 years. Local recurrences occurred in 23% of cases, but the prevalence was not statistically different between patients with N0 disease (16.6%) and N1 disease (23.1%) (p = 0.43). These data suggest that sleeve resection is an adequate operation for patients with resectable lung cancer and N0 N1 status. The presence of N2 disease significantly worsens the prognosis and may contraindicate the use of the procedure.
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PMID:Survival related to nodal status after sleeve resection for lung cancer. 830 77

Immunohistochemical expression of p53, bcl-2, CD44 standard (CD44S), and the v6 isoform of CD44 (CD44v6) proteins were studied in 14 typical carcinoid tumors (TCs), 11 atypical carcinoids (ACs), and eight small cell carcinomas (SCLCs) in an attempt to use these markers of mutational events and cellular adhesion to discriminate neoplasms demonstrating neuroendocrine differentiation. p53 and bcl-2 overexpression were associated with more aggressive neuroendocrine cell types. p53 nuclear staining was weakly positive in 21% of the TCs, whereas strong nuclear staining was seen in 64% of the ACs and 88% of the SCLCs (P = 0.0047). bcl-2 was present in 21% of the TCs, 91% of the ACs, and 100% of the SCLCs (P = 0.0001). In contrast, CD44S and CD44v6 were inversely correlated with more aggressive types of neuroendocrine tumors. CD44S expression was moderate to strong in all of the TCs and 91% of the ACs but in only 37% of the SCLCs (P = 0.0018). There was no correlation between expression of these markers and tumor size or nodal status, although loss of CD44v6 was associated with lymph node metastases in the TC group only. In the spectrum of neuroendocrine tumors of the lung, p53 and bcl-2 overexpression correlates with more aggressive histologic cell types. The decreasing CD44S expression in AC and SCLC is similar to findings in cancer of the colon and in non-small cell carcinoma of the lung, where loss of CD44S is associated with poor prognosis. In AC and SCLC, but not in cancer of the colon, loss of CD44v6 correlates with more aggressive neoplasms and might correlate with lymph node metastases in TCs.
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PMID:Bcl-2, p53, CD44, and CD44v6 isoform expression in neuroendocrine tumors of the lung. 873 62

Gastrointestinal endocrine tumors consist of pancreatic endocrine neoplasms and carcinoid tumors. Except for insulinoma, a majority of gastrointestinal endocrine tumors are malignant. With improved medical treatment of syndromes of hormonal excess, growth of the primary tumor and metastatic spread has increasingly become an important determinant of long-term survival. Although few randomized, prospective data are available given the rare occurrence of malignant gastrointestinal endocrine tumors, surgery appears to be the only potentially curative treatment for malignant endocrine tumors, and complete resection of localized or regional nodal metastases provides the highest probability of cure. Surgery may also be the most effective treatment for hepatic metastases if most or all of the tumor can be resected, and patients with solitary, localized metastatic disease appear to benefit most. Symptoms from extensive metastases may respond to chemotherapy or octreotide. Gastrointestinal endocrine tumors are generally indolent, slow-growing neoplasms, and when symptoms are adequately controlled, patients can live comfortably and productively for many years with metastatic disease.
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PMID:Gastrointestinal endocrine cancers and nodal metastasis: biologic significance and therapeutic implications. 878

One hundred and thirty-seven lung cancer patients (123 non-small-cell lung cancers (NSCLC), 10 small-cell lung cancers (SCLC) and four carcinoid tumours) who underwent surgery in an attempt at complete resection were prospectively entered in a study whose aim was to determine the prognostic significance of a hypodiploidy or a multiploidy pattern of tumour cell DNA content and a high immunohistochemical reactivity of Ki-67, a nuclear antigen related to the cell cycle. Indirect immunoperoxidase reactivity of Ki-67 on frozen tumour tissue sections was evaluated both visually, using a classical semiquantitative scale, and by means of a computer-assisted image processor. Cell DNA content analysis was done using static computer-assisted cytometry on tumour cytological prints stained by the pararosaline Feulgen-Schiff technique. The ploidy was characterised for each tumour by DNA index (DI), percentage of hypodiploid cells and type of DNA content histogram (near diploid, hyperdiploid, hypodiploid and multiploid). Ki-67 immunostaining was negative in 64 tumours (48%) and positive in 69 (52%). DNA histogram classification disclosed 57 (42%) near diploid tumours. Among the 80 (58%) aneuploid tumours, 16 were hypodiploid, 44 hyperdiploid and 20 multiploid. The prevalence of both a positive Ki-67 immunostaining and an aneuploid DNA histogram differed according to histology as SCLC demonstrated a higher frequency of both features when compared with NSCLC and carcinoid tumours. On the other hand, Ki-67 immunostaining and ploidy did not significantly differ according to degree of differentiation, nodal status and Mountain's stage grouping. The percentage of cells in the hypodiploid modal DNA was significantly higher for tumours which demonstrated a high Ki-67 immunostaining, suggesting a link between growth fraction and DNA content abnormalities. In univariate analysis, survival did not differ significantly according to either the Ki-67 immunohistochemical reactivity or the DNA index. Patients with a hypodiploid tumour had a shorter survival than patients with other DNA histogram patterns but, owing to the low frequency of hypodiploidy, this difference did not reach statistical significance. In Cox's proportional hazard model, an SCLC histology, an advanced tumour status, a positive nodal status and a hypodiploid tumour (hazard ratio: 2.070; 95% confidence interval 1.041-4.116) were significant determinants of survival. We conclude that hypodiploidy in lung cancer is a distinct DNA content abnormality as it contributes significantly to prognosis. Neither visually assessed nor computer-generated Ki-67 immunostaining measurements significantly determine prognosis.
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PMID:Hypodiploidy, Ki-67 growth fraction and prognosis of surgically resected lung cancers. 882 67

We report a patient who presented with small intestinal ischaemia due to metastatic mesenteric disease from an oesophageal carcinoma. Enteroclysis suggested the diagnosis of small intestinal ischaemia, which was found at laparotomy to be due to compression of mesenteric veins by a nodal mass at the root of the small intestinal mesentery. Although this phenomenon has been described particularly in patients with carcinoid tumours, we believe that mesenteric venous ischaemia resulting from spread to the mesentery from an extra-abdominal primary neoplasm is extremely rare.
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PMID:Metastatic oesophageal carcinoma presenting as small intestinal ischaemia: imaging findings. 908 55

Carcinoid tumours of the papilla of Vater, like all those of the gastroenteric tract, belong to the PUD system: in fact they excrete different amines and polypeptidic hormones that cause articulated and complex clinical features. We describe the clinical picture of a non secreting carcinoid tumour in a patient suffering from cholelithiasis in who jaundice has appeared after video-laparocholecystectomy; ERCP detected a papillary neoplasia which proved to be a carcinoid tumour at immunohistochemical investigation. The patient was submitted to surgical removal of the neoplasia by the trans-duodenal way. This kind of operation was chosen considering the small dimension of the tumour, the absence of lymph nodal and hepatic involvement and the elevated risk of pancreaticoduodenectomy. Eight months later hematic gastrine, NSE and total body scintigraphy with octreotide have shown normal values and the patients is in good clinical condition. The diagnosis of these tumours is always difficult when the typical hormonal syndrome is not present. The prognosis of this kind of tumours is better than others of the gastrointestinal tract due to the early symptoms (jaundice), and, consequently, of the treatment. A strict follow-up is recommended in these patients because a resumption of the tumour could also appear many years after the surgical intervention.
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PMID:[Carcinoid of Vater's papilla. The authors' own experience]. 947 75

The authors reported a case of a carcinoid tumor of the ileum with nodal metastasis. Diagnosis was made by histological examination of the tumor after its removal. Immunohistochemistry demonstrated the presence of serotonin, synaptophysin, chromogranin and neuron-specific enolase (NSE) in the tumor cells. The patient was followed up for 15 months. Tumor ablation resulted in the total cessation of bronchospastic episodes in the patient, suggesting that these symptoms were mediated by tumor secretion. We also present a review of the literature concerning clinical, paraclinical and treatment aspects of gastrointestinal carcinoid tumors.
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PMID:[Digestive carcinoid tumors: often undiagnosed endocrine tumors (a case report)]. 1062 73

A case of primary carcinoid tumor arising within a horseshoe kidney in a 51-year-old woman is reported. The tumor was found incidentally by computed tomography (CT) during a check-up for a suspected gall bladder polyp. Histologic, immunohistochemical and electron microscopic analyses of this tumor revealed features typical of carcinoid tumor. Primary carcinoid tumor of the kidney is extremely rare and only 32 cases were previously reported, including five cases in horseshoe kidneys. None of these five cases in horseshoe kidneys demonstrated any evidence of local or distant metastases and all were alive at the time of reporting without evidence of disease after up to 3 years of follow up. The present case, even with accompanying lymph nodal metastasis, also has had no evidence of local recurrence or distant metastasis for 3 years post operation. Primary carcinoid tumor arising within horseshoe kidneys appear to be more benign than those within non-horseshoe kidneys.
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PMID:Primary carcinoid tumor in a horseshoe kidney. 1083 Aug 26

To evaluate long-term survival of patients with gastrointestinal carcinoid tumors and to assess factors that may influence prognosis, 154 patients (49% females, 51% males), median age 62 years (range 12-84 years) treated at our institution during 1972-1982 have been followed long term. Tumor location included the foregut (7%), midgut (62%), and hindgut (30%). Ninety-five percent of the patients underwent surgical or endoscopic excision of the primary tumor, with overall operative mortality and postoperative morbidity rates of 2. 6% and 11%, respectively. At follow-up, 60 patients (39%) were alive (median follow-up 18 years; range 1-26 years). The main causes of death included carcinoid tumor burden (32%), unrelated causes (45%), other malignancy (19%), and unknown causes (4%). Observed overall 5- and 10-year survivals were 69% and 53%, respectively. Survival was not related to gender or symptoms at presentation. However, age, embryologic origin, tumor size, depth of invasion, nodal status, and stage of disease proved to be of statistical significance (log-rank). In a multivariate Cox' model, only older age (> 62 years) [P = 0. 001, odds ratio (OR) = 3.4) and embryologic origin (midgut versus foregut) (P = 0.045, OR = 0.45) provided independent prognostic power when death from any cause was taken as the end-point. This study confirms that patient's age and the site of the primary tumor have prognostic significance. Carcinoid tumors are neuroendocrine tumors with a relatively good prognosis, and long-term survival is possible despite advanced stages of disease.
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PMID:Gastrointestinal carcinoid tumors: long-term prognosis for surgically treated patients. 1103 18


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