Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P61278 (somatostatin)
 22,083 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eighty-four carcinoids of the colon and rectum were studied with emphasis on prognostic features, immunohistochemical characteristics, and pitfalls in diagnosis. Follow-up data were available on 35 patients. Tumors with adenocarcinomatous components, or those resembling small cell carcinomas of the lung, were excluded. Eighty-one tumors were in the rectum and three tumors were in the distal sigmoid colon. Neuron-specific enolase, chromogranin, and Leu-7 were positive in 87%, 58%, and 53% of the tumors, respectively. Hormones were positive in the following percentages: serotonin, 45%; pancreatic polypeptide, 46%; glucagon, 10%; gastrin, 3%; somatostatin, 3%; adrenocorticotrophic hormone, 1%; cholecystokinin, 0%; calcitonin, 0%; and insulin, 0%. Many tumors elaborated more than one hormone. Fifty-five percent of the tumors were argyrophil and 28% were argentaffin. Carcinoembryonic antigen was present in 24% of the tumors; 82% of the tumors contained prostatic acid phosphatase. Three patients had liver metastases; their tumors ulcerated, invaded muscularis propria, and had more than 2 mitoses per 10 high-power fields (HPF). One patient with a 2.5-cm tumor without mitoses had regional lymph node metastases. All non-metastasizing tumors had less than one mitosis in 10 HPF. We conclude that large bowel carcinoid tumors are essentially limited to the rectum and sigmoid, that they are indolent if mitotically inactive and smaller than 2 cm, and that most show production of a selected group of endocrine markers.
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PMID:Rectal and colonic carcinoids. A clinicopathologic study of 84 cases. 229 59

A 27-year-old woman with multiple bilobal liver metastases of a carcinoid tumour and carcinoid syndrome was treated with the somatostatin analogue Octreotide, 450-600 micrograms daily subcutaneously. This improved previous attacks of marked epigastric pain, while endocrine activity and tumour mass remained unchanged. Shortly after treatment had begun, soft fatty stools and oxaluria were noted. After six months severe renal colics were found to be due to non-opaque caliceal calculi, and a contracted non-functioning gallbladder was discovered. The calculi consisted of oxalate. The enteric hyperoxalosis, oxaluria and urolithiasis were presumably side effects of the Octreotide treatment.
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PMID:[Enteral hyperoxalosis due to therapy with a somatostatin analog]. 229 34

Immediately after a fine-needle aspiration biopsy (FNAB) was performed of a carcinoid liver metastasis, a patient had severe flushing, nausea, and faintness, followed by generalized seizure activity, profound hypotension, and cardiopulmonary arrest refractory to resuscitative efforts. This was considered due to massive release of vasoactive substances into the systemic circulation, caused by manipulation of the tumor at biopsy and aggravated by resuscitative efforts. Hypotensive crisis should be considered a potential, although unusual, complication of FNAB of liver metastases in patients with carcinoid syndrome. If biopsy is necessary, an intravenous access line should be established before biopsy is performed, and personnel should be prepared to administer emergency resuscitation. Medication with a somatostatin analogue before biopsy is performed is suggested. Catecholamine administration should be avoided.
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PMID:Fatal carcinoid crisis after percutaneous fine-needle biopsy of hepatic metastasis: case report and literature review. 240 83

Surgery has always been considered to be the primary treatment in patients with neuroendocrine gut and pancreatic tumors, but a significant number of patients present liver metastases already at the first visit. There is obviously a need for effective medical treatment and in the present paper we report our experience of treatment with chemotherapy, the somatostatin analogue SMS 201-995 and interferons. In 30 patients with malignant endocrine pancreatic tumors, chemotherapy including streptozotocin plus 5-fluorouracil had an objective response rate of 63% with a mean duration of the objective response of 17.4 months. There was a difference between clinically functioning and nonfunctioning tumors, which had objective response rates of 68% and 50% and mean response duration of 21 and 9.4 months respectively. The new somatostatin analogue SMS 201-995 was used in 10 patients giving an objective response rate of 40% with a mean duration of 13.5 months. In a series of 22 patients treated with human leukocyte interferon, an objective response rate of 77% was obtained with a mean duration of 8.5 months. A combination of streptozotocin plus 5-fluorouracil gave an objective response rate of 10% with a mean duration of 2.7 months among 31 patients with midgut carcinoid tumors. The somatostatin analogue SMS 201-995, tested in 22 patients with carcinoid tumors, gave an objective response rate of 28% with a mean duration of 18.5 months. Interferon has been tried in three separate studies. The first study, including 36 patients with malignant carcinoid tumors treated with human leukocyte interferon, showed an objective response rate of 47% with a mean duration of 34 months. In a randomized controlled study, where human leukocyte interferon was compared with streptozotocin plus 5-fluorouracil including 10 patients in each arm, no objective response was obtained during the six months' observation in the group of patients receiving chemotherapy, whereas 50% responded in the interferon-treated group. In the third study, IFN-alpha 2b or IntronA was tested in 20 patients with malignant carcinoid tumors and gave an objective response rate of 55% during a six-month observation period. With regard to these data chemotherapy and interferons seem to be equally potent in the treatment of malignant endocrine pancreatic tumors, whereas interferons seem to be superior to both chemotherapy and the somatostatin analogue SMS 201-995 in malignant carcinoid tumors. The somatostatin analogue has proved to be particularly useful in the treatment of patients with severe hormone-related clinical symptoms and in the perioperative period.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Medical treatment of neuroendocrine gut and pancreatic tumors. 247 26

In this study, liver metastases from a patient with a pancreatic glucagonoma producing the syndrome have been investigated histologically, ultrastructurally, and immunocytochemically. A comparison has also been made between the metastases and the primary pancreatic tumor investigated in a parallel study. In the metastatic tissue, glucagon-, pancreatic polypeptide (PP)-, and somatostatin-containing cells were found together with a majority of cells without any immunoreactivity. Glucagon-positive cells were much more numerous than PP- and somatostatin-immunoreactive cells. As in the primary tumor, double immunogold staining of ultrathin sections demonstrated the co-existence of glucagon and PP immunoreactivities in most of the granulated cells, but PP immunolabeling was often faint, so that it probably could not be revealed by the PAP method in light microscopical sections. Such a finding, together with the histological and ultrastructural features, is consistent with an ontogenic and phylogenetic primitiveness of the metastatic cell population.
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PMID:A malignant tumor of the pancreas producing glucagonoma syndrome: immunocytochemistry and ultrastructure of liver metastases and comparison with the primary tumor. 254 78

We report a case of a 29-yr-old man with a rectal carcinoid that metastasized to the liver, secreting somatostatin. The patient first presented with an abdominal mass and mild diabetes, and, subsequently, rectal tumor and hypersomatostatinemia. Microscopic examination of the rectal tumor showed characteristic features of carcinoid. Multiple liver metastases were recognized. The plasma level of somatostatin was remarkably high (2,839 pg/ml). Plasma gut glucagon and pancreatic polypeptide (PP) increased with progress of the disease. He died of hepatic failure 20 months after his first admission. Immunoperoxidase staining showed that rectal tumor cells contained somatostatin-like-immunoreactivity. Electron microscopy of tumor tissue showed neurosecretory (D-cell) granules. Somatostatin content of the rectal tumor was very high (5,629 pg/mg).
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PMID:Somatostatinoma of the rectum. 257 69

The increased knowledge of the pathobiology of gastrointestinal carcinoid (neuroendocrine) tumours and the improved therapeutic possibilities have brought a demand for more precise diagnosis. Although the carcinoid tumours can often be tentatively recognized in routinely processed microscopic slides, their more accurate identification requires additional diagnostic procedures. General neuroendocrine markers such as the argyrophil reaction of Grimelius and immunohistochemistry with application of antibodies against chromogranin A and of neuron-specific enolase are discriminatory staining methods which are used to reveal the neuroendocrine origin of almost all highly differentiated carcinoid tumours of the gastrointestinal tract. Mid-gut carcinoids, which predominate among these tumours almost unexceptionally contain serotonin. This biogenic amine can be demonstrated by the argentaffin reaction of Masson, serotonin immunoreactively or by formalin-induced fluorescence. The characteristic staining pattern of mid-gut carcinoids is almost invariably preserved in the metastatic deposits and consequently the staining methods for identifying serotonin can also be used on metastases to reveal a primary mid-gut carcinoid. The enterochromaffin-like (ECL) cell carcinoids of the body and fundic area of the stomach often seen in association with pernicious anaemia are argyrophil with the Sevier-Munger silver stain. Other neuroendocrine tumours, viz. antral, duodenal and rectal carcinoids should be studied by a battery of relevant peptide hormone antisera for adequate diagnosis. During the last decade new peptide hormones have been found in circulation in patients with carcinoid tumours, but serotonin and urinary 5-HIAA are still the most important markers for carcinoids of the mid-gut origin. Other clinically useful tumour markers are chromogranin A + B, pancreatic polypeptide, human chorionic gonadotropin alpha and beta subunits. For localizing procedures, angiography is the most reliable investigative method for primary tumours in the gut, whereas CT-scan and ultrasound investigations are good for detection of liver metastases. During the last five years, the therapy for malignant carcinoid tumours has been considerably improved. Chemotherapy has only revealed objective response rates in about 10-30% of the patients giving median survivals from start of therapy of about 10 months. Recently treatment with alpha interferons and the new somatostatin analogue octreotide have given objective responses in 50-75% of patients with malignant mid-gut carcinoid tumours. These patients have now a median survival from start of therapy of 70 months when treated with alpha interferons. In the future new therapies will come into use such as monoclonal antibodies and perhaps also agents blocking different growth factors.
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PMID:Gastrointestinal carcinoid tumours. Histogenetic, histochemical, immunohistochemical, clinical and therapeutic aspects. 266 60

Many advances have been made in the recognition, diagnosis, and management of patients with functional islet cell tumors during the past three decades. Improved results should occur in those patients with functional islet cell tumors causing recognizable syndromes. The likelihood of this occurring is predicated upon an awareness, high index of suspicion, the use of immunoassays, provocative tests, and appropriate localization studies. Earlier diagnosis is providing the opportunity to cure many patients who could be treated only with palliative procedures or drugs in the past. Figure 1 summarizes the current management plan utilized in evaluating patients whose findings suggest the possibility of a functional islet cell tumor syndrome. Nonfunctional islet cell tumors continue to be a therapeutic problem because their detection (with the exception of those discovered incidentally during upper abdominal explorations, CT scanning for other indications, or CT scanning of the pancreas in MEN-1 patients) usually does not occur until the tumor is locally invasive or associated with liver metastases. The treatment of these tumors has usually been palliative, utilizing chemotherapy and medical therapy including the somatostatin analogue Sandostatin or an operation to bypass an obstruction of the biliary tract or duodenum.
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PMID:Treatment of endocrine tumors of the pancreas. 266 83

A 69 year-old male with carcinoid syndrome and undetectable primary tumour, but disseminated liver metastases, was treated with somatostatin analogue octreotide (Sandostatin) and later additionally with recombinant interferon alpha 2 b (r IFN alpha 2 b, Intron A). The carcinoid symptoms (flushing, diarrhoea) were stopped within hours by octreotide. Simultaneously, the urinary 5-hydroxyindolacetic acid (5-HIAA) excretion and serum serotonin levels decreased by more than 50%. In spite of continued treatment with r IFN alpha 2 b a reduction in dosage of octreotide resulted in a rapid recurrence of carcinoid symptoms, suggesting that IFN alpha 2 b had no effect on the carcinoid symptoms in this patient. Since, furthermore, no regression of the tumour mass was observed, treatment with IFN was stopped after 8 months. During 15 months of treatment to date the patient has been kept free of symptoms by octreotide.
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PMID:[Therapy of metastatic carcinoid with the somatostatin analog octreotide and with recombinant interferon alfa 2b]. 276 66

Seven cases of dog islet cell carcinomas were studied by conventional and immunohistochemical light- and electron-microscopy. Antisera to insulin, pancreatic polypeptide, somatostatin and glucagon were used. In 6 tumours several hormones were demonstrated. Glucagon never occurred. Insulin was the only hormone present in every tumour, thus it seems to be a good marker for these neoplasms. Liver metastases contained less immunoreactive cells than primary tumours and cell types found in primary carcinomas were sometimes not present in liver metastases. In two cases a degenerative neuropathy occurred.
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PMID:Islet cell carcinomas in dogs. 298 30


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