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Long-acting somatostatin analogues are an effective treatment for type 1 gastric carcinoid tumours.

Abstract：

BACKGROUND:Gastric carcinoid tumours type 1 (GCA1) originate from hyperplastic enterochromaffin-like (ECL) cells secondary to hypergastrinaemia. Treatment with somatostatin analogues (SSA) might impede ECL-cell hyperplasia by suppressing gastrin secretion and/or by a direct anti-proliferative effect on ECL cells. We conducted a multicentre prospective study to assess the effects of long-acting SSA on hypergastrinaemia and ECL-cell proliferation in patients with GCA1. METHODS:We studied 15 patients with GCA1 treated with monthly long-acting release octreotide (LAR) (20-30 mg; n=14) or Lanreotide 90 mg (n=1) for at least 6 months. Patients had serum gastrin and chromogranin A measurements performed and biopsies taken from both tumours and surrounding mucosa before, and every 6-12 months following treatment. Sections were immunostained for neuroendocrine markers. The cell proliferation index Ki-67, intensity of staining before and after treatment and the degree of gastric wall invasion were also assessed. RESULTS:All patients tolerated treatment well (mean follow-up of 18 months). In 11 patients (73%), a complete disappearance of the tumours at 1 year of treatment was observed on endoscopy, while in three patients (20%), the tumours decreased significantly in number and size. Gastrin levels normalized in 25% of patients, and were reduced by more than 80% in the remaining 75%. CONCLUSIONS:Treatment with SSAs in GCA1 leads to a substantial tumour load reduction, with a concomitant decrease of serum gastrin levels. Our data indicate an important anti-proliferative effect of SSA on ECL cells, providing clinical benefit and obviating, at least temporarily, the need for invasive therapies for GCA1.

journal_name

Eur J Endocrinol

journal_title

European journal of endocrinology

authors

Grozinsky-Glasberg S,Kaltsas G,Gur C,Gal E,Thomas D,Fichman S,Alexandraki K,Barak D,Glaser B,Shimon I,Gross DJ

doi

10.1530/EJE-08-0420

subject

Has Abstract

pub_date

2008-10-01 00:00:00

pages

475-82

issue

4

eissn

0804-4643

issn

1479-683X

pii

EJE-08-0420

journal_volume

159

pub_type

临床试验,杂志文章,多中心研究

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