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Neuroendocrine tumours
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Sairah R Khan, Kathryn L Wallitt, Adil Al-Nahhas, Tara D Barwick
The SEER database only includes malignant tumours, so benign tumours such as benign insulinomas, are underestimated. Insulinomas (Figure 24.2), are the most common PNETs, accounting for up to 50% of all cases (73). Benign insulinomas occur slightly more frequently in women (F3:M2), with an equal sex incidence in the rare malignant insulinomas. Other PNETs are more likely to be malignant, with gastrinoma being the next most common type (Table 24.7).
Gastrointestinal cancer
Published in Peter Hoskin, Peter Ostler, Clinical Oncology, 2020
Gastrinoma is a gastrin-secreting tumour which leads to Zollinger–Ellison syndrome, characterized by hypersecretion of acid in the stomach leading to intractable peptic ulceration. An elevated serum gastrin level is diagnostic and about two-thirds are malignant. It is sometimes associated with adenomata of the pituitary and parathyroid as part of multiple endocrine neoplasia type 1 (MEN 1). After detailed staging with a CT scan and selective venous angiography, the treatment of choice is a partial pancreatectomy.
Postulated Physiological and Pathophysiological Roles on Motility
Published in Edwin E. Daniel, Neuropeptide Function in the Gastrointestinal Tract, 2019
Hans-Dieter Allescher, Sultan Ahmad
Gastrin is a potent stimulator of gastric acid secretion. Its role in the regulation of gastrointestinal motility is far less characterized. Excessive secretion of gastrin can be observed due to a gastrinoma, a gastrin-producing tumor, or as a consequence of reduced acid secretion caused by Billroth II surgery, atrophic gastritis, or drugs (H2 blockers or omeprazol). No specific motility changes in these hypergastrinemia conditions have been reported, and the diarrhea observed in gastrinoma patients probably is primarily due to the changes in the secretory responses and, to a minor extent, to motility changes. The possible physiological role in the regulation of antral motility and in the maintenance of the basal lower esophageal sphincter pressure awaits further confirmation with new selective gastrin receptor antagonists.
Palliative Role of Aqueous Ginger Extract on N-Nitroso-N-Methylurea-Induced Gastric Cancer
Published in Nutrition and Cancer, 2020
Debjani P. Mansingh, Shalini Pradhan, Deeptarup Biswas, R. Barathidasan, Hannah R. Vasanthi
Gastrin, a peptide hormone secreted in the gastric mucosa, is involved in the pathogenesis of gastric cancer and hyper-gastrinoma and leads to gastric carcinogenesis (19, 20) and hence considered as a specific marker for gastric cancer. This is clearly evident in our study that the gastrin level is fourfold higher in MNU-induced cancerous rats in comparison with the normal controls. But it is interesting to note that gastrin level was decreased to fourfold as compared to MNU-induced rats. So, it might be hypothesized that the treatment of AGE has potent therapeutic effect which is substantiated in our study. Although 5-FU, a standard anticancer agent, exhibited a decrease in the serum gastrin levels (P ≤ 0.01) in the cancer-induced animals, it is impressive to note that AGE significantly reduced the gastrin level (P ≤ 0.001) to fourfold when compared to the cancer control. The amelioration of gastrin level in MNU-induced gastric cancer in Wistar rats in the present study by AGE is possibly due to the bioactive ingredients in ginger (21). Likewise, AGE-treated rats exhibited reduced ALP and LDH activity in both the 8th week and 16th week of drug treatment possibly due to its chemoprotective effect of potent phytochemicals present in it. However, the decrease in γ-GT activity observed in serum (P ≤ 0.05) of cancer control rat when compared to normal rats is not impressive as that of the other molecules which clearly shows that γ-GT is not a specific marker of stomach lesions.
Proton pump inhibitors: use and misuse in the clinical setting
Published in Expert Review of Clinical Pharmacology, 2018
Vincenzo Savarino, Elisa Marabotto, Patrizia Zentilin, Manuele Furnari, Giorgia Bodini, Costanza De Maria, Gaia Pellegatta, Claudia Coppo, Edoardo Savarino
This is the best-characterized acid hypersecretory disorder and is caused by the tumor gastrinoma producing a large amount of gastrin, which in turn stimulates a remarkable acid hypersecretion [70]. PPIs are the drug of choice for the medical treatment of ZES, but relatively high doses (3–4 times the standard dose) are required in comparison with those usually adopted for the other acid-related conditions [71]. In fact, it is important that acid secretion is reduced below 10 mEq/h or below 5 mEq/h in the postsurgical stomach to avoid ulcer recurrence and complications [72].
The safety and efficacy of endoscopic ultrasound-guided ablation therapy for solid pancreatic tumors: a systematic review
Published in Scandinavian Journal of Gastroenterology, 2020
Lu Zhang, Shali Tan, Shu Huang, Chunyu Zhong, Muhan Lü, Yan Peng, Xiaowei Tang
Among 158 patients in all included studies, the major types of solid pancreatic tumors were nonfunction p-NETs (n = 78, 49.4%), LAPDAC (n = 48, 30.4%) and insulinomas (n = 26, 16.5%). There was a small part of gastrinoma (n = 1, 0.6%), SPN (n = 4, 2.5%) and renal cancer metastasis (n = 1, 0.6%) (Figure 2).