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Clinical symptoms, hormone profiles, treatment, and prognosis in patients with gastric carcinoids.

ABSTRACT: BACKGROUND: Type 1 gastric carcinoids are associated with hypergastrinaemia and chronic atrophic gastritis, type 2 occur in patients with multiple endocrine neoplasia type 1 combined with Zollinger-Ellison syndrome, and type 3 lack any relation to hypergastrinaemia. Type 1 tumours are usually benign whereas type 3 are highly malignant. AIMS: To identify possible tumour markers in patients with gastric carcinoids. PATIENTS/METHOD: Nine patients with type 1, one with type 2, and five with type 3 were evaluated with regard to symptoms, hormone profile, and prognosis. RESULTS: Plasma chromogranin A was increased in all patients but was higher (p < 0.01) in those with type 3 than those with type 1 carcinoids. All patients with type 3 carcinoids died from metastatic disease, but none of the type 1 patients died as a result of their tumours. One type 1 patient with a solitary liver metastasis received interferon alpha and octreotide treatment. Nine months later, the metastasis was no longer detectable. She is still alive eight years after diagnosis, without recurrent disease. This represents the only reported case of foregut carcinoid with an unresectable liver metastasis that seems to be have been cured by biotherapy. CONCLUSIONS: Plasma chromogranin A appears to be a valuable tumour marker for all types of gastric carcinoid. Combination therapy with interferon alpha and octreotide may be beneficial in patients with metastasising type 1 gastric carcinoids.

SUBMITTER: Granberg D

PROVIDER: S-EPMC1727202 | biostudies-other | 1998 Aug

REPOSITORIES: biostudies-other

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Project description:Gastric cancer (GC) has a high incidence and mortality rate. If discovered late, GC tends to have a poor prognosis. Improvements in the prognostic accuracy of GC through combined analysis of multiple relevant genes and clinical factors may solve this problem. In the present study, GSE62254 (including 300 GC tissues), obtained from the Gene Expression Omnibus database, was used as a training set, and the mRNA?sequencing data of GC (including 384 GC tissues) downloaded from the Cancer Genome Atlas database served as a validation set. Based on the t?test and Wilcoxon test, the significantly differentially expressed genes (DEGs) were obtained by screening the intersecting DEGs. The prognosis-associated genes and clinical factors were identified using Cox regression analysis in the R survival package. The optimal prognosis?associated pathways were examined using the Cox?proportional hazards (Cox?PH) model in the R penalized package. Finally, risk prediction models were constructed and validated using the Cox?PH model and the Kaplan?Meier method, respectively. There were a total of 382 significant DEGs, including 268 upregulated genes and 114 downregulated genes. A total of 50 prognosis?associated genes were identified, 16 optimal prognosis?associated pathways (including mitochondrial pathway and the tyrosine?protein kinase JAK?signal transducer and activator of transcription signaling pathway, which involve caspase 7, phosphoinositide?3?kinase regulatory subunit 3, peroxisome proliferator?activated receptor ? and collagen triple helix repeat containing 1) and four prognosis?associated clinical factors [including Pathologic_N, Pathologic_stage, mutL homolog 1 (MLH1) mutation and recurrence]. The pathway? and clinical?factor?based risk prediction model exhibited marked prognostic accuracy. The clinical?factor?based risk prediction model with improved P?values for prognosis prediction may be superior to the pathway?based risk prediction model in predicting the prognosis of GC patients.

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Clinical symptoms, hormone profiles, treatment, and prognosis in patients with gastric carcinoids.

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