Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0178874 (tumor progression)
 40,807 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Over the past few years the usefulness of some somatostatin's analogues in the treatment of intestinal tract endocrine tumors has been demonstrated. Notwithstanding, the results obtained are variable. The case of a carcinoid tumor with a hepatic metastasis is presented and its clinical as well as its biochemical and its morphological results are evaluated after treatment with octreotide over a seven months period. It is important to highlight the great clinical improvement obtained at the beginning of treatment. Treatment was not effective in the control of tumor progression. After the injection of such a drug, a decrease in serotonin and 5-hydroxy-indoleacetic acid serum levels was observed as well as a reduction in the urinary metabolite. It is concluded that octreotide is very useful for the symptomatic treatment of carcinoid syndrome.
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PMID:[Treatment with octreotide (SMS 201-995) in a case of intestinal carcinoid tumor]. 138 Jan 73

In situ hybridization (ISH) is a widely used method to detect particular mRNA synthesizing cells. The method can be used to determine neuroendocrine properties of tumors by identifying the hormone and neuropeptide mRNA-producing tumor cells. Also, monitoring the production of particular mRNA under tumor progression or during certain therapies might be of prognostic value in the management of the tumor. In this paper are described methodological backgrounds and applications of the ISH method in detecting hormone and peptide mRNA in neuroendocrine tumors, especially midgut carcinoid.
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PMID:In situ hybridization for detection of hormone and peptide mRNA in carcinoid tumors. 185 3

Malignant carcinoid tumors with the carcinoid syndrome has over the years presented a therapeutic challenge. Surgery is the treatment of choice in local disease but when liver metastases have developed other treatment procedures must be considered. Conventional chemotherapy has been of little benefit, whereas a new somatostatin analogue octreotide gives a good control of clinical symptoms but not of tumor progression. Interferon treatment was introduced in 1982 by our group and we are now presenting results of medical treatment in 130 patients with histologically verified malignant carcinoid tumors and liver metastases. One hundred and eleven patients were treated with alpha-interferon, whereas 19 patients received conventional chemotherapy. Forty-seven out of 111 patients (42%) treated with alpha-interferon demonstrated a significant biochemical response and 15% also more than 50% reduction of tumor size. In another 43 (39%) patients stabilization of the carcinoid disease was noted whereas 21 (19%) showed progressive disease. The median duration of response was 34 months. Subjective response with improvement of diarrheas, flush and/or bronchoconstriction was noticed in 76 patients (68%). Among the 19 patients treated with conventional chemotherapy only 2 showed biochemical response and it lasted only for 3-5 months. The patients treated with chemotherapy had a median survival of only 8 months compared with 80+ months in the group treated with alpha-interferon. The adverse reactions of alpha-interferon are manageable and consist mainly of fatigue, weight reduction and reduction of blood cell counts. Neutralizing interferon antibodies might occur in patients treated with recombinant alpha-interferons (5-15%).
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PMID:The role of interferons in the management of carcinoid tumors. 185 9

Carcinoid tumors of the stomach are rare (0.4% of all malignancies of the stomach). Long-lasting hypergastrinemia, most often due to chronic atrophic gastritis, leads to hyperplasia of ECL-cells in the gastric fundic mucosa with consequent dysplasia or neoplasia. Between 1974 and 1988 four patients underwent surgical treatment after diagnosis of a gastric carcinoid tumor. One patient was treated by local excision, two by subtotal resection and one patient underwent complete gastrectomy. None of the patients had local or distant metastases or died in the follow-up period due to tumor progression. The different approaches to surgical therapy are discussed.
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PMID:[Carcinoid tumor of the stomach--aspects of surgical therapy]. 186 Mar 53

In this study the relationship between the initial clinical presentation and the extent of tumor progression was determined in a group of 31 patients with carcinoid tumors. The proportion of patients with symptomatic tumors was similar to those patients with carcinoid tumors that were incidentally found (55% versus 45%; SE = 0.089). Symptoms were caused by metastatic tumor in nine (30%) of the patients and by local effects of the primary tumor in eight (26%) of the patients. The patients with symptoms had a significantly increased frequency of metastatic disease, even when the symptoms were due to the primary tumor, compared to patients with no symptoms (76% versus 7%; p less than 0.001). Tumor size was related to the presence of symptoms and metastases. Symptoms were most common when the size of the primary tumor was greater than 1.0 cm (p less than 0.005), although the rate of metastases increased when primary tumors were 2.0 cm and larger (p less than 0.01). These results indicate that the presence of symptoms or a primary tumor 2.0 cm or larger are associated with an increased risk of metastatic disease in patients with carcinoid tumors. These patients should be treated with wide resection of the primary tumor and its lymphatic drainage.
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PMID:Carcinoid tumors: the relationship between clinical presentation and the extent of disease. 186 95

A 39 year old male patient was treated with daily 5 X 10(6) IU interferon alpha 2b s.c. for 22 months because of advanced carcinoid tumor. Objective response was achieved with greater than 50% reduction of 5-HIAA-excretion. Multiple metastases (liver, lung, bones, thyroid gland) were not progressing in size. An unintentional omission of treatment resulted in a rapid biochemical and morphological tumor progression. Reversibility was achieved with reinstitution of effective interferon therapy. Thus, interferon therapy of advanced carcinoid tumor is able to induce a long-term objective response. It seems to be superior to conventional chemotherapy.
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PMID:[2 year interferon therapy of metastatic carcinoid tumor]. 210 57

In a prospective study of 103 patients with carcinoid tumors consecutively referred for medical treatment, the most common sites of the primary tumors were the ileum (73%), bronchi (7%), and jejunum (4%). All patients had local metastases, and 96 (93%) also had liver metastases. The most common initial symptoms were diarrhea (32%), ileus (25%), and flush (23%). The overall frequency of diarrhea was 84% and of flush was 75%. Heart insufficiency caused by cardiac valve disease was seen in 33% of the patients. The carcinoid syndrome, including flush, diarrhea, and elevated urinary 5-hydroxyindole acetic acid (5-HIAA) concentrations, was manifested by 69 patients (67%), 64 of whom (93%) had carcinoid tumors of mid-gut origin. Elevated urinary 5-HIAA was found in 91 patients (88%), of which 89 displayed liver metastases. The plasma concentration of the tachykinin neuropeptide K (NPK) was elevated in 67 patients (66%), 63 of whom had tumors of the mid-gut region. Serum pancreatic polypeptide (PP) and human chorionic gonadotrophin alpha levels were elevated in 43% and 28% of the patients, respectively, and the highest levels were found in patients with metastatic bronchial carcinoid tumors. Thirty-nine of the 103 patients are now dead; 18 died of tumor progression, whereas 14 patients died of heart failure secondary to a carcinoid tricuspidal valve insufficiency. The estimated median survival from the time of histologic diagnosis was 14 years, and from the time of carcinoid syndrome was 8 years.
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PMID:Malignant carcinoid tumors. An analysis of 103 patients with regard to tumor localization, hormone production, and survival. 244 Mar 90

Seven patients with progressive ileal or caecal carcinoid tumors and liver metastases were treated with human recombinant alpha-interferon (IFN alfa-2b) at a dosage of 2-4 x 10(6) U daily or every other day subcutaneously. Six patients had symptoms of the carcinoid syndrome. No change of tumor size lasting 4 to 40+ months (median, 18 months) was noted in 6 patients, and 1 patient had hepatic tumor progression. A decrease in urinary excretion of 5-hydroxyindoleacetic acid by more than 50% lasting 2-11 months (median, 4) was observed in 5 patients. Four patients were completely or partially relieved of flushing, diarrhea, obstruction or abdominal pain. The side-effects were negligible with the exception of mild fever, headache and confusion only during the first days of therapy. Treatment with IFN alfa-2b offers good palliation to patients with disseminated ileal or caecal carcinoid tumor and carcinoid syndrome.
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PMID:[Treatment of metastasized carcinoid tumor of the ileum and cecum with recombinant alpha-2b interferon]. 245 Mar 26

Non-small cell lung cancers (non-SCLC) differ from small cell lung cancers (SCLC) by many clinical features and prognosis. However, recent studies suggest that lung cancer heterogeneity frequently leads to the association of SCLC and non-SCLC in the same tumor. This phenotypic heterogeneity can be analyzed by immunohistochemistry using monoclonal antibodies (Mab) raised against differentiation related antigens. It may have clinical relevance inasmuch as the diversification of malignant cells is a well-known factor of tumor progression and may be due to chromosomal instability because inappropriate gene expression leads to the formation of antigens unrelated to cell lineage. Chromosomal instability in cancer leads to aneuploidy detectable by cell DNA content analysis. In a prospective study, we analyzed, in parallel, the expression of neuroendocrine related antigens by immunohistochemistry and the cell DNA content in frozen specimens from 40 patients who underwent complete surgical resection of primary non-SCLC in an attempt (a) to characterize the phenotypic heterogeneity and (b) to determine whether this heterogeneity is correlated with aneuploidy and clinical staging. Three Mabs were used in association as a marker of neuroendocrine antigen expression (S-L 11.14, MOC-1, and NE-25); reactivity of these Mabs in 9 SCLC and 3 lung carcinoid tissue sections was used as positive control. All SCLC and 2 of 3 lung carcinoids tested were homogeneously positive with Mabs S-L 11.14, MOC-1, and NE-25; 13 of 40 non-SCLC were homogeneously positive and 11 additional specimens focally positive with Mabs S-L 11.14, MOC-1, and NE-25. The frequency of this abnormal phenotype was significantly higher in poorly differentiated squamous cell carcinomas (chi 2 10.08; P less than 0.005), in clinical stage III non-SCLC (chi 2 5.93; P less than 0.02), and in tumors involving mediastinal lymph nodes (chi 2 5; P less than 0.03). The percentage of cells in the modal DNA of G0-G1 phase was significantly lower in non-SCLC homogeneously positive with Mabs S-L 11.14, MOC-1, and NE-25 [27.4 +/- 10.3% (SD)] in comparison with non-SCLC negative with these same Mabs [56.8 +/- 21.3%; P less than 0.01, Mann-Whitney U test]. We conclude that (a) mixed SCLC-non-SCLC differentiation is frequent and can be assessed by immunohistochemistry, (b) neuroendocrine differentiation in non-SCLC is mainly observed in poorly differentiated tumors and in advanced clinical stages, and that (c) this heterotopic phenotype is correlated with aneuploidy and has clinical implications.
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PMID:Phenotypic heterogeneity studied by immunohistochemistry and aneuploidy in non-small cell lung cancers. 254 Sep 8

We reviewed the computerized tomographic features of pathologically proven metastases to the ovary in 12 patients. Serial CT scans were available in nine of the 12 patients--before removal of the ovaries in five cases (showing typical growth characteristics of these metastases) and afterward in six (showing common patterns of tumor progression). Primary neoplasms metastasizing to the ovary included adenocarcinoma of the colon (seven), stomach (two), appendix (one), and endometrium (one), and carcinoid tumor (one). On CT, metastases to the ovary were large lobulated or oval masses with cystic and solid components. Nine were bilateral and three were unilateral. Three patterns of ovarian enlargement were seen: macrocystic (six), microcystic (three), and predominantly solid enlargement with necrosis (three). Other associated CT findings included carcinomatosis, hydronephrosis, ascites, liver metastases, and lymphadenopathy. The primary tumor in patients without a prior history of malignancy was identifiable retrospectively on CT in four of the five cases.
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PMID:Krukenberg tumors: CT features and growth characteristics. 215 42


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