Neuroendocrine tumours of the upper gastrointestinal tract, characteristics and comparison of localization diagnostics

Česká verzia

Authors: R. Hyrdel ¹; I. Režnák ²; P. Hyrdel ¹; H. Poláček jr. ²; H. Poláček ³; M. Hladká ³; S. M. Agouba ¹; J. Janík ⁴; Ľ. Laca ⁴
Authors place of work: Interná klinika gastroenterologická, Centrum pre rezistentné peptické vredy a neuroendokrinné nádory Jesseniovej lekárskej fakulty UK a UNM Martin, Slovenská republika, prednosta prof. MUDr. Rudolf Hyrdel, CSc. ¹; Klinika nukleárnej medicíny Jesseniovej lekárskej fakulty UK a UNM Martin, Slovenská republika, prednosta doc. MUDr. Ivan Režňák, CSc., mim. prof. ²; Rádiologická klinika Jesseniovej lekárskej fakulty UK a UNM Martin, Slovenská republika, prednosta MUDr. Hubert Poláček, CSc. ³; Klinika transplantačnej a cievnej chirurgie Jesseniovej lekárskej fakulty UK a UNM Martin, Slovenská republika, prednosta prof. MUDr. Ľudovít Laca, PhD. ⁴
Published in the journal: Vnitř Lék 2011; 57(12): 1017-1024
Category: 70th birthday of prof. MUDr. Petr Dítě, DrSc.

Summary

In daily clinical practice it’s important to think of neuroendocrine tumors, since their prevalence for the past 5 years exceeded even the common occurrences of stomach, esophageal and pancreatic cancers. Patients diagnosed early and accurately with NET, have a greater chance for complete cure. The diagnostic tools over the past century were significantly inefficient in diagnosing NET i.e. (40% of tumors were not localized after USG, CT, MRI, AG investigations). Until the past 2 decades that major turnover in diagnostic methods has been achieved. In particular, the introduction of the somatostatine receptor scintigrafy (SRS) and endoscopic ultrasonography (EUS) have increased sensitivity of localization diagnostics up to 90%. Our work is to test the success of the localization diagnostics in 22 patients with surgically and histologically confirmed NET of the pancreas and duodenum. These patients fulfilled jointly SRS, CT and/or MRI, but also classic USG and EUS. From our comparison, clearly endoscopic USG is the most efficient tool with 90% sensitivity.

Key words:
neuroendocrine tumors – characteristic – localization diagnostics – EUS – somatostatin receptor scintigraphy – CT scan – MRI – USG

Zdroje

1. Yao JC, Hassan M, Phan A et al. One hundred years after “carcinoid”: epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol 2008; 26: 3063–3072.

2. Kaltsas GA, Besser GM et al. The diagnosis and medical management of advanced neuroendocrine tumors. Endocr Rev 2004; 25: 458–511.

3. Modlin IM, Moss SF, Chung DC et al. Priorities for improving the management of gastroenteropancreatic neuroendocrine tumors. J Natl Cancer Inst 2008; 100: 1282–1289.

4. Kaplan LM. Endocrine tumors of the gastrointestinal tract and pancreas. In: Isselbacher KJ et al (eds). Harrison’s Principles of Internal Medicine. 13th ed. New York, NY: McGraw-Hill 1994: 1535–1542.

5. Rorstad O. Prognostic indicators for carcinoid neuroendocrine tumors of the gastrointestinal tract. J Surg Oncol 2005; 89: 151–160.

6. Creutzfeldt W. Carcinoid tumors: development of our knowledge. World J Surg 1996; 20: 126–131.

7. National Comprehensive Cancer Network. NCNN Clinical Practice Guidelines in Oncology: Neuroendocrine Tumors V.2.2010

8. Oberg K. Pancreatic endocrine tumors. Semin Oncol 2010; 37: 594–618.

9. Modlin IM, Lye KD, Kidd MA. 5-decade analysis of 13,715 carcinoid tumors. Cancer 2003; 97: 934–959.

10. National Cancer Institute. SEER Cancer Statistics Review 1975–2004. http://seer.cancer.gov/csr/1975_2004/#contents.

11. Metz DC, Jensen RT. Gastrointestinal neuroendocrine tumors: pancreatic endocrine tumors. Gastroenterology 2008; 135: 1469–1492.

12. Hauso O, Gustafsson BI, Modlin IM et al. Neuroendocrine tumor epidemiology: contrasting Norway and North America. Cancer 2008; 113: 2655–2664.

13. Zhuang Z, Vortmeyer AO, Pack S et al. Somatic mutations of the MEN1 tumor suppressor gene in sporadic gastrinomas and insulinomas. Cancer Res 1997; 57: 4682–4686.

14. Moore PS, Missiaglia E, Antonello D et al. Role of disease-causing genes in sporadic pancreatic endocrine tumors: MEN1 and VHL. Genes Chromosomes Cancer 2001; 32: 177–181.

15. Wang EH, Ebrahimi SA, Wu AY et al. Mutation of the MENIN gene in sporadic pancreatic endocrine tumors. Cancer Res 1998; 58: 4417–4420.

16. Yao JC, Lombard-Bohas C, Baudin E et al. Daily oral everolimus activity in patients with metastatic pancreatic neuroendocrine tumors after failure of cytotoxic chemotherapy: a phase II trial. J Clin Oncol 2010; 28: 69–76.

17. Bech P, Ramachadran R et al. Chromogranin B is a Prognostic Marker in NETs. 8th Annual ENETS Conference for the Diagnosis and Treatment of Neuroendocrine Tumor Disease. Lisbon, Portugal 2011.

18. Bosman FT, Carneiro F, Hruban RH et al. WHO classiffication of Tumours of the Digestive System. 4th ed. Lyon, France: International Agency for Research on Cancer (IARC) 2010: 280.

19. Rindi G, Arnold R, Bosman FT et al. Nomenclature and classification of neuroendocrine neoplasms of the digestive system. In: Bosman FT, Carneiro F, Hruban RH et al (eds). WHO Classification of Tumors of the Digestive System. Lyon: IARC 2010.

20. Toth-Fejel S, Pommier RF. Relationships among delay of diagnosis, extent of disease, and survival in patients with abdominal carcinoid tumors. Am J Surg 2004; 187: 575–579.

21. Modlin IM, Oberg K, Chung DC et al. Gastroenteropancreatic neuroendocrine tumours. Lancet Oncol 2008; 9: 61–72.

22. Grant CS. Insulinoma. Best Pract Res Clin Gastroenterol 2005; 19: 783–798.

23. Hyrdel R. Klinický význam sérového gastrínu. Banská Bystrica: Centro Median 2001.

24. Marks IN, Bank S, Louw JH. Islet cell tumor of the pancreas with reversible watery diarrhea and achylorhydria. Gastroenterology 1967; 52: 695–708.

25. Wermers RA, Fatourechi V, Kvols LK. Clinical spectrum of hyperglucagonemia associated with malignant neuroendocrine tumors. Mayo Clin Proc 1996; 71: 1030–1038.

26. Hyrdel R, Kašuba J, Pokorný O et al. The significance of selective intratherial secretin test for localisation of gastrinoma. Hepato-Gastroenterology 1991; 38 (Suppl): 14.

27. Varas Lorenzo MJ, Miquel Collell JM, Maluenda Colomer MD et al. Preoperative detection of gastrointestinal neuroendocrine tumors using endoscopic ultrasonography. Rev Esp Enferm Dig 2006; 98: 828–836.

28. Ahmad NA, Kochman ML, Long WB et al. Efficacy, safety, and clinical outcomes of endoscopic mucosal resection: a study of 101 cases. Gastrointest Endosc 2002; 55: 390–396.

29. Dalenbäck J, Havel G. Local endoscopic removal of duodenal carcinoid tumors. Endoscopy 2004; 36: 651–655.

30. Zimmer T, Stölzel U, Bäder M et al. Endoscopic ultrasonography and somatostatin receptor scintigraphy in the preoperative localisation of insulinomas and gastrinomas. Gut 1996; 39: 562–568.

31. Anderson MA, Carpenter S, Thompson NW et al. Endoscopic ultrasound is highly accurate and directs management in patients with neuroendocrine tumors of the pancreas. Am J Gastroenterol 2000; 95: 2271–2277.

32. Wittmann J, Kocjan G, Sgouros SN et al. Endoscopic ultrasound-guided tissue sampling by combined fine needle aspiration and trucut needle biopsy: a prospective study. Cytopathology 2006; 17: 27–33.

33. Gauger PG, Scheiman JM, Wamsteker EJ et al. Role of endoscopic ultrasonography in screening and treatment of pancreatic endocrine tumours in asymptomatic patients with multiple endocrine neoplasia type 1. Br J Surg 2003; 90: 748–754.

34. Stafford-Johnson DB, Francis IR, Eckhauser FE et al. Dual-phase helical CT of nonfunctioning islet cell tumors. J Comput Assist Tomogr 1998; 22: 335–339.

35. Ichikawa T, Peterson MS, Federle MP et al. Islet cell tumor of the pancreas: biphasic CT versus MR imaging in tumor detection. Radiology 2000; 216: 163–171.

36. Thoeni RF, Mueller-Lisse UG, Chan R et al. Detection of small, functional islet cell tumors in the pancreas: selection of MR imaging sequences for optimal sensitivity. Radiology 2000; 214: 483–490.

37. Shi W, Johnston CF, Buchanan KD et al. Localization of neuroendocrine tumours with [l 1JIn]-DTPA-octreotide scintigraphy (Octreoscan): a comparative study with CT and MR imaging. QJM 1998; 91: 295–301.

38. Carlson B, Johnson CD, Stephens DH et al. MRI of pancreatic islet cell carcinoma. J Comput Assist Tomogr 1993; 17: 735–740.

39. Dromain C, de Baere T, Lumbroso J et al. Detection of liver metastases from endocrine tumors: a prospective comparison of somatostatin receptor scintigraphy, computed tomography, and magnetic resonance imaging. J Clin Oncol 2005; 23: 70–78.

40. Papotti M, Bongiovanni M, Volante M et al. Expression of somatostatin receptor types 1-5 in 81 cases of gastrointestinal and pancreatic endocrine tumors. A correlative immunohistochemical and reverse-transcriptase polymerase chain reaction analysis. Virchows Arch 2002; 440: 461–475.

41. Krenning EP, Kwekkeboom DJ, Bakker WH et al. Somatostatin receptor scintigraphy with [111In-DTPA-D-Phe1]- and [123I-Tyr3]-octreotide: the Rotterdam experience with more than 1000 patients. Eur J Nucl Med 1993; 20: 716–731.

42. Oberg K, Eriksson B. Nuclear medicine in the detection, staging and treatment of gastrointestinal carcinoid tumours. Best Pract Res Clin Endocrinol Metab 2005; 19: 265–276.