The neoplastic ECL cells become progressively dedifferentiated with an increasing number of Ki immunoreactive IR cell nuclei. In addition, there is a substantial decrease in argynophil and IR NE cells that can be visualized by conventional methods. ECLomas secondary to hypergastrinemia should be closely followed for signs of clinical and histopathological tumor progression. Such ECLomas deserve early, active, radical surgical treatment.
Traditionally, gastric carcinoid type 1 GCA1s are endoscopically or surgically removed, depending on the number, appearance and size of the tumors. Antrectomy, with surgical excision of the majority of the G cells, is thought to facilitate regression of these tumors by removing the source of excessive gastrin secretion; however, the long-term benefits of antrectomy still remain uncertain. Although proton pump inhibitors are effective in reducing hypergastrinemia-induced gastric acid hypersecretion in GCA2, they do not affect ECL-cell hyperplasia, and therefore their role in GCA1 is limited.
Moreover, in selected cases, significant reduction of hypergastrinemia does not prevent development of ECL carcinoid, suggesting that, in addition to hypergastrinemia, other pathogenic or genetic factors may be involved. Treatment with SSAs in GCA1 leads to a substantial tumor load reduction, with a concomitant decrease of serum gastrin levels. Published 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.
Morphometric studies demonstrated that, while antrectomy specifically decreased the volume of ECL cells versus the total volume of endocrine cells, octreotide reduces the overall endocrine cell volume. Although the number of treated patients is small, it has been suggested that SSA may exert important anti-proliferative effects either directly, by inhibiting ECL-cells proliferation, or indirectly through suppression of gastrin hypersecretion. In specialized interdisciplinary centers, a broad therapeutical armentarium can be used to achieve optimal treatment.
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Keywords: surgical therapy , pulmonary neuroendocrine tumors , typical carcinoid , atypical carcinoid , long-term experience , survival. CHD is characterized by right heart fibrotic lesions and has traditionally been defined by the degree of valvular involvement, most commonly in the form of tricuspid regurgitation.
Right ventricular RV dysfunction due to mural involvement may also be a manifestation. Connective tissue growth factor CCN2 is upregulated in many fibrotic disorders. Increased tumor expression of CCN2 has been shown in patients with small intestinal NETs associated with peritoneal fibrosis. At present, its role in carcinoid heart disease is unknown.
Keywords: carcinoid heart disease , neuroendocrine tumors , right ventricular function , connective tissue growth factor. The number of CTCs detected in 7. Keywords: neuroendocrine tumor , circulating tumor cells , carcinoid , EpCAM. All Rights Reserved Worldwide. The spine may show signs of wear. Pages can include limited notes and highlighting, and the copy can include previous owner inscriptions.
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Histology of neuroendocrine tumors
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Colon and rectum neuroendocrine tumors: experience of the National Cancer Institute in Brazil
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Surgical and molecular pathology of pancreatic neoplasms
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