Open Access Medical Books



Edited by Anthony Lowell .

70 pages .
Open Access .

Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are rare and heterogeneous neoplasms with overall increasing incidence, but not an associated increase in survival rate over the past few decades. Tumors originate from at least 16 different cells of diffuse endocrine system (DES), scattered through mucosa of gastrointestinal tract. They are mainly sporadic, but sometimes exhibit familial inheritance. Tumors often preserve the ability to synthesize, store and secrete numerous hormones and biogenic amines which sometimes lead to distinct hypersecretory and clinically recognizable syndromes (such as carcinoid, Zollinger-Ellison, WDHA etc.).1 The resulting clinical symptoms are generally well controlled by somatostatin analogs and/or interferon-α.2 More often, GEP-NETs remain clinically silent until late, when they present with mass effect, and have unfortunately already locally or distantly spread. In the later case tumor growth and spread are not always well controlled by either biotherapy or chemotherapy. 
Although many biochemical and tissue markers for GEP-NETs already exist, sensitive and specific markers that predict tumor growth and behavior are lacking.3 According to our unpublished data chromogranin A (CgA) and 5-hydroxyindolacetic acid (5-HIAA), currently used as standard biochemical markers of neuroendocrine tumors were only positive in 76.84% and 20.79% of GEP-NET cases respectively. Tumor markers were analyzed in 101 patients (61.2% with localized and 38.8% with metastatic disease) diagnosed with GEP-NETs. According to same investigation, CgA levels were much higher when tumors were part of MEN1 syndrome, while 5-HIAA levels were higher in case of metastatic disease, especially when hepatic metastases were present. When 5-HIAA values were compared among patients with different tumor localizations, the highest values were detected in patients with functional midgut tumors. This is consistent with data of other authors on biochemical diagnostics of gastrointestinal neuroendocrine tumors.......



 1 The Association of Chronic Inflammation and Gastroenteropancreatic Neuroendocrine Tumors (GEP-NETs) 1 Maja Cigrovski Berković, Davorka Herman Mahečić, Vedran Tomašić, Davor Hrabar and Vanja Zjačić-Rotkvić

 2 Chromogranin A and Neuroendocrine Tumors 11 Angela Prestifilippo, Giusi Blanco, Maria Paola Vitale and Dario Giuffrida

 3 Circulating Markers in Gastroenteropancreatic Neuroendocrine Tumors (GEP NETs) 19
Sara Massironi, Matilde Pia Spampatti, Roberta Elisa Rossi, Dario Conte, Clorinda Ciafardini, Federica Cavalcoli and Maddalena Peracchi

 4 The Diagnosis and Management of Neuroendocrine Carcinoma of Unknown Primary 37 Jennifer Keiser, Emily Bergsland and Eric Nakakura

 5 Gastrointestinal Neuroendocrine Tumors 47 Ozcan Yildiz and Suheyla Serdengecti

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Published by: Unknown - Thursday, May 2, 2013


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