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1. Rekhi B, Saxena S, Chintamani: Gastric outlet obstruction and cutaneous metastasis in adenocarcinoid tumor of stomach - unusual presentations with cytologic and ultra structural findings. Indian J Cancer; 2005 Apr-Jun;42(2):99-101
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  • [Title] Gastric outlet obstruction and cutaneous metastasis in adenocarcinoid tumor of stomach - unusual presentations with cytologic and ultra structural findings.
  • Neuroendocrine tumors, including carcinoids account for less than 1% of gastric tumors.
  • Various subtypes of gastric carcinoids have been reported earlier.
  • The present case deals with two unusual presentations, diagnosis and course of a gastric neuroendocrine tumor in an adult patient.
  • A 35-years-old male initially presented with gastric outlet obstruction for an antral growth in the emergency ward.
  • He underwent radical gastrectomy and was diagnosed with a gastric carcinoid tumor, on histopathology.
  • After 6 months, he developed hepatic along with nodular cutaneous lesions over the scalp.
  • Aspiration cytology (FNAC) from these metastatic lesions showed two distinct cell types with rosette formation.
  • Subsequently, he underwent 2 cycles of chemotherapy.
  • We present a case of a gastric adenocarcinoid tumor, with 2 rare presentations.
  • The metastatic lesions exhibited neuroendocrine features on cytology and electron microscopy.
  • [MeSH-major] Neuroendocrine Tumors / diagnosis. Stomach Neoplasms / diagnosis
  • [MeSH-minor] Adult. Diagnosis, Differential. Fatal Outcome. Gastric Outlet Obstruction / etiology. Humans. Liver Neoplasms / complications. Liver Neoplasms / diagnosis. Liver Neoplasms / secondary. Male. Microscopy, Electron. Neoplasm Metastasis. Skin Neoplasms / complications. Skin Neoplasms / diagnosis. Skin Neoplasms / secondary. Skin Neoplasms / ultrastructure

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  • (PMID = 16141510.001).
  • [ISSN] 0019-509X
  • [Journal-full-title] Indian journal of cancer
  • [ISO-abbreviation] Indian J Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] India
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2. Hamilton K, Chiappori A, Olson S, Sawyers J, Johnson D, Washington K: Prevalence and prognostic significance of neuroendocrine cells in esophageal adenocarcinoma. Mod Pathol; 2000 May;13(5):475-81
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  • [Title] Prevalence and prognostic significance of neuroendocrine cells in esophageal adenocarcinoma.
  • Neuroendocrine differentiation is common in adenocarcinomas of the stomach and colon and may be associated with a slightly better prognosis in gastric adenocarcinoma.
  • We studied neuroendocrine differentiation in esophageal adenocarcinomas and associated Barrett's esophagus (BE) to determine association with patient outcome.
  • Medical records were reviewed for tumor stage, response to therapy, and patient survival.
  • Thirty-two patients received radiation and chemotherapy, and four received radiation.
  • Tumors with CG-positive cells were moderately to poorly differentiated, and many consisted of large cribriform glands, similar to intestinal-type adenocarcinomas.
  • One case of small cell carcinoma of the esophagus was weakly CG positive; another was negative.
  • Neuroendocrine differentiation was retained in lymph node metastases in two cases but lost in three other cases.
  • There was no difference in tumor stage at surgery or survival time between CG-positive and CG-negative tumors.
  • In summary, neuroendocrine differentiation is common in BE and is retained in low- and high-grade dysplasia but is usually lost in esophageal adenocarcinoma.
  • The presence of scattered neuroendocrine cells does not affect patient outcome.
  • [MeSH-major] Adenocarcinoma / pathology. Carcinoma, Neuroendocrine / pathology. Esophageal Neoplasms / pathology

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  • (PMID = 10824917.001).
  • [ISSN] 0893-3952
  • [Journal-full-title] Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
  • [ISO-abbreviation] Mod. Pathol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA 68485
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Chromogranins
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3. Ekeblad S, Sundin A, Janson ET, Welin S, Granberg D, Kindmark H, Dunder K, Kozlovacki G, Orlefors H, Sigurd M, Oberg K, Eriksson B, Skogseid B: Temozolomide as monotherapy is effective in treatment of advanced malignant neuroendocrine tumors. Clin Cancer Res; 2007 May 15;13(10):2986-91
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  • [Title] Temozolomide as monotherapy is effective in treatment of advanced malignant neuroendocrine tumors.
  • PURPOSE: A retrospective analysis of the toxicity and efficacy of temozolomide in advanced neuroendocrine tumors.
  • EXPERIMENTAL DESIGN: Thirty-six patients with advanced stages of neuroendocrine tumor (1 gastric, 7 thymic and 13 bronchial carcinoids, 12 pancreatic endocrine tumors, 1 paraganglioma, 1 neuroendocrine foregut, and 1 neuroendocrine cecal cancer) were treated with temozolomide (200 mg/m(2)) for 5 days every 4 weeks.
  • Tumor response was evaluated radiologically according to the Response Evaluation Criteria in Solid Tumors every 3 months on an intent-to-treat basis.
  • The circulating tumor marker plasma chromogranin A was also assessed.
  • The expression of O(6)-methylguanine DNA methyltransferase, an enzyme implicated in chemotherapy resistance, was studied by immunohistochemistry (n=23) and compared with response to temozolomide.
  • RESULTS: Median overall time to progression was 7 months (95% confidence interval, 3-10).
  • CONCLUSIONS: Temozolomide as monotherapy had acceptable toxicity and antitumoral effects in a small series of patients with advanced malignant neuroendocrine tumors and four of these showed radiologic responses.
  • [MeSH-major] Bronchial Neoplasms / drug therapy. Carcinoid Tumor / drug therapy. Dacarbazine / analogs & derivatives. Neuroendocrine Tumors / drug therapy. Thyroid Neoplasms / drug therapy
  • [MeSH-minor] Aged. Female. Hematologic Diseases / chemically induced. Humans. Male. Middle Aged. Retrospective Studies. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 17505000.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 7GR28W0FJI / Dacarbazine; 85622-93-1 / temozolomide
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4. Burkitt MD, Varro A, Pritchard DM: Importance of gastrin in the pathogenesis and treatment of gastric tumors. World J Gastroenterol; 2009 Jan 7;15(1):1-16
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  • [Title] Importance of gastrin in the pathogenesis and treatment of gastric tumors.
  • In addition to regulating acid secretion, the gastric antral hormone gastrin regulates several important cellular processes in the gastric epithelium including proliferation, apoptosis, migration, invasion, tissue remodelling and angiogenesis.
  • Elevated serum concentrations of this hormone are caused by many conditions, particularly hypochlorhydria (as a result of autoimmune or Helicobacter pylori (H pylori)-induced chronic atrophic gastritis or acid suppressing drugs) and gastrin producing tumors (gastrinomas).
  • There is now accumulating evidence that altered local and plasma concentrations of gastrin may play a role during the development of various gastric tumors.
  • In the absence of H pylori infection, marked hypergastrinemia frequently results in the development of gastric enterochromaffin cell-like neuroendocrine tumors and surgery to remove the cause of hypergastrinemia may lead to tumor resolution in this condition.
  • In animal models such as transgenic INS-GAS mice, hypergastrinemia has also been shown to act as a cofactor with Helicobacter infection during gastric adenocarcinoma development.
  • However, it is currently unclear as to what extent gastrin also modulates human gastric adenocarcinoma development.
  • Therapeutic approaches targeting hypergastrinemia, such as immunization with G17DT, have been evaluated for the treatment of gastric adenocarcinoma, with some promising results.
  • Although the mild hypergastrinemia associated with proton pump inhibitor drug use has been shown to cause ECL-cell hyperplasia and to increase H pylori-induced gastric atrophy, there is currently no convincing evidence that this class of agents contributes towards the development of gastric neuroendocrine tumors or gastric adenocarcinomas in human subjects.

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  • (PMID = 19115463.001).
  • [ISSN] 2219-2840
  • [Journal-full-title] World journal of gastroenterology
  • [ISO-abbreviation] World J. Gastroenterol.
  • [Language] ENG
  • [Grant] United Kingdom / Wellcome Trust / /
  • [Publication-type] Editorial; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Gastrins
  • [Number-of-references] 120
  • [Other-IDs] NLM/ PMC2653300
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5. Christopoulos C, Balatsos V, Rotas E, Karoumpalis I, Papavasileiou D, Kontogeorgos G, Dupasquier S, Calender A, Skandalis N, Economopoulos P: The syndrome of gastric carcinoid and hyperparathyroidism: a family study and literature review. Eur J Endocrinol; 2009 Apr;160(4):689-94
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  • [Title] The syndrome of gastric carcinoid and hyperparathyroidism: a family study and literature review.
  • OBJECTIVE: To present evidence supporting the hypothesis that the coexistence of gastric carcinoids (GCs) and hyperparathyroidism may represent a distinct clinical entity, not related to multiple endocrine neoplasia type 1 (MEN1).
  • All siblings underwent serial gastroscopies for the assessment of gastric neuroendocrine cell proliferations over a mean follow-up period of 31.2 months.
  • Imaging, biochemical and hormonal as well as molecular genetic investigations were performed in the direction of MEN1 syndrome.
  • RESULTS: Four of the siblings, all male, were found to have GCs in a background of Helicobacter pylori-associated chronic atrophic gastritis and pernicious anaemia, with no serological evidence of gastric autoimmunity.
  • Screening for hyperparathyroidism seems to be justified in patients with GC of any type.

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  • (PMID = 19155316.001).
  • [ISSN] 1479-683X
  • [Journal-full-title] European journal of endocrinology
  • [ISO-abbreviation] Eur. J. Endocrinol.
  • [Language] ENG
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Chromogranin A; 0 / Hormones; 0 / Pancreatic Hormones; 0 / Pituitary Hormones; 9007-49-2 / DNA
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6. Grozinsky-Glasberg S, Kaltsas G, Gur C, Gal E, Thomas D, Fichman S, Alexandraki K, Barak D, Glaser B, Shimon I, Gross DJ: Long-acting somatostatin analogues are an effective treatment for type 1 gastric carcinoid tumours. Eur J Endocrinol; 2008 Oct;159(4):475-82
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  • [Title] Long-acting somatostatin analogues are an effective treatment for type 1 gastric carcinoid tumours.
  • 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.
  • 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.
  • 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.

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  • (PMID = 18662970.001).
  • [ISSN] 1479-683X
  • [Journal-full-title] European journal of endocrinology
  • [ISO-abbreviation] Eur. J. Endocrinol.
  • [Language] ENG
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; RWM8CCW8GP / Octreotide
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7. Saif MW, Sellers S, Li M, Wang W, Cusimano L, Wang H, Zhang R: A phase I study of bi-weekly administration of 24-h gemcitabine followed by 24-h irinotecan in patients with solid tumors. Cancer Chemother Pharmacol; 2007 Nov;60(6):871-82
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  • Pharmacokinetic parameters of both drugs and their metabolites were estimated by using non-compartmental methods.
  • No patient developed acute cholinergic symptoms at any dose.
  • Tumor responses were observed in three patients (one CR: cholangiocarcinoma; two PR: SCLC, gastric neuroendocrine tumor).
  • Stable disease >3 months was found in six patients including five patients who had failed short infusions of either drug.
  • Pharmacokinetic analysis showed that C (max) of each drug and active metabolites were dose-dependent.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neoplasms / drug therapy
  • [MeSH-minor] Aged. Aged, 80 and over. Area Under Curve. Camptothecin / administration & dosage. Camptothecin / adverse effects. Camptothecin / analogs & derivatives. Camptothecin / pharmacokinetics. Carcinoma, Small Cell / drug therapy. Cholangiocarcinoma / drug therapy. Deoxycytidine / administration & dosage. Deoxycytidine / adverse effects. Deoxycytidine / analogs & derivatives. Deoxycytidine / pharmacokinetics. Diarrhea / chemically induced. Dose-Response Relationship, Drug. Drug Interactions. Female. Gastrointestinal Hemorrhage / chemically induced. Half-Life. Humans. Infusions, Intravenous. Lung Neoplasms / drug therapy. Male. Middle Aged

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  • (PMID = 17345085.001).
  • [ISSN] 0344-5704
  • [Journal-full-title] Cancer chemotherapy and pharmacology
  • [ISO-abbreviation] Cancer Chemother. Pharmacol.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase I; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 0W860991D6 / Deoxycytidine; 7673326042 / irinotecan; B76N6SBZ8R / gemcitabine; XT3Z54Z28A / Camptothecin
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8. Khuroo MS, Khuroo MS, Khuroo NS: Treatment of type I gastric neuroendocrine tumors with somatostatin analogs. J Gastroenterol Hepatol; 2010 Mar;25(3):548-54
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  • [Title] Treatment of type I gastric neuroendocrine tumors with somatostatin analogs.
  • BACKGROUND AND AIM: There are limited data on response and long-term follow-up of octreotide therapy in type-I gastric neuroendocrine tumors.
  • The objective of the present study was to assess the response of type-I gastric neuroendocrine tumors to octreotide-long acting, repeatable (LAR) therapy and evaluate long-term follow up of such patients after therapy.
  • METHODS: Three patients with documented type-I gastric neuroendocrine tumors from a tertiary gastroenterology centre were studied.
  • Octreotide-LAR therapy 20 mg intramuscularly every 28 days was administered for one year.
  • Serum gastrin and chromogranin levels, gastroscopies and biopsies from tumor nodules at 6 months and one year on therapy and every 6 months after completion of drug therapy were taken.
  • Follow-up after completion of therapy extended for 3 years in two and 2.5 years in one patient.
  • RESULTS: During octreotide therapy there was normalization of serum gastrin levels and serum chromogranin levels.
  • Tumors in all three patients had regressed at 6 months of treatment.
  • Following cessation of therapy, there was progressive rise of serum gastrin to pre-treatment levels.
  • Gastroscopic and histologic examination of gastric biopsies did not reveal recurrence of tumors in any patients.
  • All patients tolerated therapy well and became asymptomatic soon after drug therapy.
  • CONCLUSIONS: Octreotide-LAR therapy causes regression of type-I gastric neuroendocrine tumors.
  • After completion of drug therapy there was no recurrence of tumors even with continued hypergastrinemia.
  • Octreotide therapy should be considered as one of the treatment options in such patients.
  • [MeSH-major] Antineoplastic Agents, Hormonal / therapeutic use. Carcinoid Tumor / drug therapy. Octreotide / therapeutic use. Stomach Neoplasms / drug therapy
  • [MeSH-minor] Adult. Biomarkers, Tumor / blood. Chromogranins / blood. Female. Follow-Up Studies. Gastrins / blood. Humans. Injections, Intramuscular. Male. Middle Aged. Treatment Outcome

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  • (PMID = 20074162.001).
  • [ISSN] 1440-1746
  • [Journal-full-title] Journal of gastroenterology and hepatology
  • [ISO-abbreviation] J. Gastroenterol. Hepatol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Australia
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Biomarkers, Tumor; 0 / Chromogranins; 0 / Gastrins; RWM8CCW8GP / Octreotide
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9. Hiramatsu Y, Konno H, Kamiya K, Baba M, Ohta M, Kondo K, Terada H, Tanaka T, Nakamura S: [Two cases of recurrent gastric cancer treated by combined chemotherapy of TS-1 and low-dose cis-platinum]. Gan To Kagaku Ryoho; 2004 May;31(5):763-6
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  • [Title] [Two cases of recurrent gastric cancer treated by combined chemotherapy of TS-1 and low-dose cis-platinum].
  • We report 2 patients with recurrent gastric cancer treated by combined chemotherapy of TS-1 and low-dose cis-platinum (TS-1/LCDDP).
  • Case 1: A 60-year-old man underwent total gastrectomy for gastric cancer (pT3, pN2, Stage III B).
  • Three months after surgery, multiple liver metastases were identified, for which TS-1/LCDDP therapy (TS-1 100 mg/body/day, CDDP 10 mg/body/week; 1 course for 4 weeks) was started without hospitalization.
  • At present, 1 year and 11 months have passed since the initial treatment, and CR has been maintained.
  • Case 2: A 65-year-old man with gastric cancer (pT3, pN1, Stage III A) underwent distal gastrectomy.
  • Twelve courses of TS-1/LCDDP therapy have been carried out for 2 years and 4 months.
  • Therapeutic effect was NC, but the patient was able to tolerate the treatments as an outpatient without any subjective symptoms.
  • Both patients received TS-1/LCDDP therapy as outpatients with good QOL and performance status (0).
  • Recently, chemotherapy for recurrent cancer has been focusing on long-term survival and maintenance of QOL, instead of tumor shrinkage.
  • These results suggest that TS-1/LCDDP treatment is useful as a first-line chemotherapy for patients with recurrent gastric cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Neuroendocrine / drug therapy. Stomach Neoplasms / drug therapy
  • [MeSH-minor] Aged. Cisplatin / administration & dosage. Drug Administration Schedule. Drug Combinations. Humans. Male. Middle Aged. Oxonic Acid / administration & dosage. Pyridines / administration & dosage. Quality of Life. Remission Induction. Tegafur / administration & dosage

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  • (PMID = 15170989.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Drug Combinations; 0 / Pyridines; 150863-82-4 / S 1 (combination); 1548R74NSZ / Tegafur; 5VT6420TIG / Oxonic Acid; Q20Q21Q62J / Cisplatin
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10. Oberg K: State of the art and future prospects in the management of neuroendocrine tumors. Q J Nucl Med; 2000 Mar;44(1):3-12
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] State of the art and future prospects in the management of neuroendocrine tumors.
  • Neuroendocrine gastroenteropancreatic tumors are rather rare neoplasms with an incidence of 1-2 cases per 100,000 people.
  • They show rather varying tumor biology and present sometimes distinct clinical symptoms such as flushing, diarrhoea, hypoglycemia and gastric ulcers.
  • The biochemical diagnosis is today significantly improved by the introduction of chromogranin A as a general tumor marker, which is also useful in histopathology.
  • The basis for treatment of neuroendocrine GEP tumors is not only a curative intent but merely amelioration of clinical symptoms, abrogation of tumor growth, maintaining and improvement of quality of life.
  • Surgery has always to be considered in the treatment of neuroendocrine GEP tumors.
  • Liver dearterialization procedures can furthermore reduce the tumor masses in liver together with laser treatment or radiofrequency therapy.
  • The medical treatment includes cytotoxic agents, alpha interferons and somatostatin analogues.
  • Chemotherapy is particularly useful for patients with more aggressive tumors with high proliferation capacity, whereas alpha interferon is beneficial in classical midgut carcinoids with low proliferation capacity.
  • Quite recently somatostatin based radioactive tumor targeted treatment has evolved with preliminary promising data but further studies are needed to deliniate its future role in the treatment of neuroendocrine tumors in patients.
  • [MeSH-major] Gastrointestinal Neoplasms. Neuroendocrine Tumors. Pancreatic Neoplasms

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  • (PMID = 10932597.001).
  • [ISSN] 1125-0135
  • [Journal-full-title] The quarterly journal of nuclear medicine : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR)
  • [ISO-abbreviation] Q J Nucl Med
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] ITALY
  • [Number-of-references] 87
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11. Nouira R, Janabi I, Ben Achour J, Guesmi F, Hani MA, Cherif A, Daghfous M, Bouasker I, Zribi R, Ben Osman S, Zoghlami A, Najah N: Neuroendocrine tumours of the digestive tract report of two cases and literature review. Tunis Med; 2003 Jul;81(7):505-9
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  • [Title] Neuroendocrine tumours of the digestive tract report of two cases and literature review.
  • Neuroendocrine tumors (NET) of the digestive system are rare.
  • The aim of this study is to report two cases of exceptional localization of non secretary neuroendocrine tumors.
  • Their difficulty in diagnosis, treatment and controversy in chemotherapy merit their study in depth.
  • These are two patients that were treated in the department of general surgery (Beau Séjour) in Charles Nicolle Hospital for non secretary (NET) of the pancreas and stomach.
  • Surgery remains the first line of treatment.
  • It was possible for the gastric, but not for the pancreatic tumor.
  • Chemotherapy of both cases was mal tolerated and was discussed in details.
  • [MeSH-major] Neuroendocrine Tumors. Pancreatic Neoplasms. Stomach Neoplasms
  • [MeSH-minor] Adult. Female. Follow-Up Studies. Gastrectomy. Humans. Immunohistochemistry. Lymph Node Excision. Middle Aged. Neoplasm Metastasis. Time Factors

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  • (PMID = 14534963.001).
  • [ISSN] 0041-4131
  • [Journal-full-title] La Tunisie médicale
  • [ISO-abbreviation] Tunis Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Tunisia
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12. Seshimo K, Tanaka N, Yamashita Y, Oishi M, Kodera M, Yamamura M, Katoh H, Ikeda H, Yokomichi N, Toshima T, Kawai Y, Shibagaki K, Maejima R, Fujita H, Ichimura K, Takita K: [A case of early poorly-differentiated neuroendocrine carcinoma of stomach]. Gan To Kagaku Ryoho; 2010 Feb;37(2):319-21
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  • [Title] [A case of early poorly-differentiated neuroendocrine carcinoma of stomach].
  • Gastric endoscopy showed a type IIa+IIc tumor at the anterior wall of the gastric angle.
  • Based on the pathology of the biopsy specimen, poorly-differentiated adenocarcinoma was diagnosed.
  • Computed tomography scans showed regional lymph node swelling.
  • Distal gastrectomy with a D2 lymph node dissection was performed.
  • On pathology, the tumor was immunohistochemically positive for chromogranin A and synaptophysin.
  • The tumor was diagnosed as poorly-differentiated neuroendocrine carcinoma of the stomach.
  • He was treated with S-1 and CPT-11.
  • Neuroendocrine cell carcinoma of the stomach is rare and usually has a very poor prognosis.
  • Thus, we are reporting this case of early poorly-differentiated neuroendocrine carcinoma of the stomach that was curatively resected and had 12-month survival without recurrence.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Camptothecin / analogs & derivatives. Carcinoma, Neuroendocrine / pathology. Cell Differentiation. Oxonic Acid / therapeutic use. Stomach Neoplasms / pathology. Tegafur / therapeutic use
  • [MeSH-minor] Combined Modality Therapy. Drug Combinations. Humans. Male. Middle Aged. Neoplasm Staging. Remission Induction

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  • (PMID = 20154494.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Drug Combinations; 150863-82-4 / S 1 (combination); 1548R74NSZ / Tegafur; 5VT6420TIG / Oxonic Acid; 7673326042 / irinotecan; XT3Z54Z28A / Camptothecin
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13. Ma J, Kimura W, Takeshita A, Hirai I, Moriya T, Mizutani M: Neuroendocrine carcinoma of the stomach with peripancreatic lymph node metastases successfully treated with pancreaticoduodenectomy. Hepatogastroenterology; 2007 Oct-Nov;54(79):1945-50
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  • [Title] Neuroendocrine carcinoma of the stomach with peripancreatic lymph node metastases successfully treated with pancreaticoduodenectomy.
  • Neuroendocrine carcinoma of the stomach is an uncommon tumor, usually associated with highly malignant biological behavior and extremely poor prognosis.
  • In this report, we described a case of advanced neuroendocrine carcinoma of the stomach with the peripancreatic lymph node metastases which was treated with pancreaticoduodenectomy with extended lymphadenectomy.
  • An upper gastrointestinal endoscopy revealed a 4x4-cm fungating tumor with its fundus locating mainly in the duodenal bulbus and extending to the gastric antrum, and tumor biopsy revealed the histological findings of adenocarcinoma.
  • Computed tomography (CT) showed a large mass in the duodenal bulbus with regional lymph node metastases.
  • Histopathologically, the origin of the primary tumor was considered as a gastric origin, and the tumor was composed of diffused small cells with a moderate mitotic index and occasional rosette formation.
  • Immunohistochemical investigations of the neoplastic cells confirmed the tumor to be neuroendocrine carcinoma.
  • Adjuvant chemotherapy with TS-1 was administered on an out-patient basis 6 weeks after the operation.
  • The patient is well and has now been free of symptoms of recurrence and metastasis for 8 months.
  • [MeSH-major] Carcinoma, Neuroendocrine / surgery. Stomach Neoplasms / surgery
  • [MeSH-minor] Aged. Antineoplastic Agents / therapeutic use. Chemotherapy, Adjuvant. Duodenum / pathology. Endoscopy, Gastrointestinal. Humans. Immunohistochemistry. Lymph Node Excision. Lymphatic Metastasis. Male. Neoplasm Invasiveness. Pancreaticoduodenectomy. Silicates / therapeutic use. Titanium / therapeutic use. Tomography, X-Ray Computed

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  • (PMID = 18251134.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Silicates; 12067-57-1 / titanium silicide; D1JT611TNE / Titanium
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14. Hosoya Y, Nagai H, Koinuma K, Yasuda Y, Kaneko Y, Saito K: A case of aggressive neuroendocrine carcinoma of the stomach. Gastric Cancer; 2003;6(1):55-9
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  • [Title] A case of aggressive neuroendocrine carcinoma of the stomach.
  • An 18 cm x 16 cm x 10 cm tumor of the stomach, invading the left lobe of the liver, pancreatic body and tail, and transverse colon, with peritoneal deposits on the major omentum, was resected by total gastrectomy plus left hepatic lobectomy, transverse colectomy, distal pancreatectomy, splenectomy, and omentectomy.
  • Histopathologically, the tumor consisted of large uniform cells with significant nuclear atypia, showing solid growth patterns with occasional small nests without adenocarcinoma components.
  • Immunohistochemical investigations of the neoplastic cells confirmed the tumor as a neuroendocrine (NE) carcinoma. molecular analyses disclosed loss of heterozygosity at the MEN1 gene locus on chromosome 11q13.
  • Following percutaneous transhepatic biliary drainage, intensive chemotherapy (20 mg/m(2) cisplatin on days 1-5 div, 100 mg/m(2) etoposide on days 1, 3, and 5 div, and 800 mg/m(2) 5-fluorouracil on days 1-5 bolus iv) was started.
  • The recurrent tumor shrank dramatically, and could not be detected on image modalities after five courses of chemotherapy.
  • The patient was well and free of symptoms without biliary drainage for 5 months.
  • An aggressive form of NE carcinoma has been known to be associated with an extremely poor prognosis.
  • However, it is notable that treatment with extensive surgery and intensive chemotherapy could contribute to an improvement in quality of life even if the beneficial effect lasted for only half a year.
  • [MeSH-major] Carcinoma, Neuroendocrine / therapy. Stomach Neoplasms / therapy
  • [MeSH-minor] Antimetabolites, Antineoplastic / administration & dosage. Antineoplastic Agents / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / administration & dosage. Etoposide / administration & dosage. Fluorouracil / administration & dosage. Gastrectomy. Humans. Liver Neoplasms / secondary. Liver Neoplasms / therapy. Male. Middle Aged. Omentum / pathology. Omentum / radiography. Omentum / surgery. Pancreatic Neoplasms / secondary. Pancreatic Neoplasms / therapy. Peritoneal Neoplasms / secondary. Peritoneal Neoplasms / therapy. Tomography, X-Ray Computed

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  • (PMID = 12673427.001).
  • [ISSN] 1436-3291
  • [Journal-full-title] Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association
  • [ISO-abbreviation] Gastric Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0 / Antineoplastic Agents; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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15. Kaubisch A, Kaleya R, Haynes H, Rozenblit A, Wadler S: Phase II clinical trial of parenteral hydroxyurea in combination with fluorouracil, interferon and filgrastim in the treatment of advanced pancreatic, gastric and neuroendocrine tumors. Cancer Chemother Pharmacol; 2004 Apr;53(4):337-40
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  • [Title] Phase II clinical trial of parenteral hydroxyurea in combination with fluorouracil, interferon and filgrastim in the treatment of advanced pancreatic, gastric and neuroendocrine tumors.
  • In the clinic, prolonged infusion of the RR inhibitor, hydroxyurea (HU), may be more effective than bolus or oral administration of drug.
  • METHODS: A clinical trial of parenteral, weekly, high-dose HU in combination with weekly, high-dose infusional fluorouracil (5FU) was initiated in patients with advanced pancreatic and gastric cancer.
  • Patients also received the biologic agent interferon alfa-2a 9 MU subcutaneously (s.c.) three times per week and filgrastim 480 microg s.c. on days 3 (starting after midday), 4, 5, and 6 each week.
  • Each cycle required treatment on days 1 and 8 every 22 days.
  • Primary sites included pancreas (18), gastric (13) and islet cell (1).
  • Of the 30 patients, 4 developed grade 3/4 diarrhea.
  • Of 12 evaluable patients with gastric cancer, 1 had a partial response, and there were no responders among patients with pancreatic cancer.
  • CONCLUSIONS: Combined inhibition of RR and TS using this high-dose, weekly, 48-h infusional regimen is not an improvement over single-agent therapy in these tumor types.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neuroendocrine Tumors / drug therapy. Pancreatic Neoplasms / drug therapy. Stomach Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Drug Administration Schedule. Female. Filgrastim. Fluorouracil / administration & dosage. Fluorouracil / adverse effects. Granulocyte Colony-Stimulating Factor / administration & dosage. Granulocyte Colony-Stimulating Factor / adverse effects. Humans. Hydroxyurea / administration & dosage. Hydroxyurea / adverse effects. Infusions, Intravenous. Injections, Subcutaneous. Interferons / administration & dosage. Interferons / adverse effects. Male. Middle Aged. Neoplasm Metastasis. Recombinant Proteins. Treatment Outcome

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  • (PMID = 14704829.001).
  • [ISSN] 0344-5704
  • [Journal-full-title] Cancer chemotherapy and pharmacology
  • [ISO-abbreviation] Cancer Chemother. Pharmacol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA 13330
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Recombinant Proteins; 143011-72-7 / Granulocyte Colony-Stimulating Factor; 9008-11-1 / Interferons; PVI5M0M1GW / Filgrastim; U3P01618RT / Fluorouracil; X6Q56QN5QC / Hydroxyurea
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16. Corbetta S, Peracchi M, Cappiello V, Lania A, Lauri E, Vago L, Beck-Peccoz P, Spada A: Circulating ghrelin levels in patients with pancreatic and gastrointestinal neuroendocrine tumors: identification of one pancreatic ghrelinoma. J Clin Endocrinol Metab; 2003 Jul;88(7):3117-20
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  • [Title] Circulating ghrelin levels in patients with pancreatic and gastrointestinal neuroendocrine tumors: identification of one pancreatic ghrelinoma.
  • We measured plasma ghrelin levels in 16 patients with gastrointestinal carcinoid (10 with midgut and 6 with gastric carcinoid), 24 patients with pancreatic tumor (8 with gastrinoma, 2 with insulinoma, 2 with vipoma, 1 with glucagonoma, and 11 with nonfunctioning tumor), and 35 healthy controls.
  • Plasma ghrelin levels recorded in patients with gastroenteropancreatic tumors were similar to controls (mean +/- SE, 182.7 +/- 66.5 pM in patients vs. 329 +/- 32 pM in controls, P = not significant), and no significant difference between gastrointestinal and pancreatic, functioning and nonfunctioning, and metastatic and nonmetastatic tumors was observed.
  • One patient with metastatic nonfunctioning pancreatic tumor had circulating ghrelin levels of 12,000 pM that were slightly reduced during chemotherapy and interferon therapy.
  • [MeSH-major] Carcinoma, Neuroendocrine / blood. Gastrointestinal Neoplasms / blood. Pancreatic Neoplasms / blood. Peptide Hormones / blood
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Biomarkers, Tumor / blood. Female. Gastrinoma / blood. Ghrelin. Glucagonoma / blood. Humans. Insulinoma / blood. Male. Middle Aged. Retrospective Studies. Vipoma / blood

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  • (PMID = 12843152.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Ghrelin; 0 / Peptide Hormones
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17. Wang CH, Tang CW: [Inhibition of activator protein-1 on the growth of gastric cancer by octreotide]. Ai Zheng; 2002 Aug;21(8):850-4
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  • [Title] [Inhibition of activator protein-1 on the growth of gastric cancer by octreotide].
  • Somatostatin and its analogues are able to inhibit the growth of neuroendocrine tumors and some gastrointestinal tumors.
  • However, the effect of octreotide on growth of gastric carcinoma is still unknown.
  • This study was designed to explore the mechanism of the effect of octreotide on growth of gastric cancer.
  • The nude mice bearing human stomach carcinoma were treated by octreotide for eight weeks.
  • The c-Fos and extracellular signal-regulated protein kinase (ERK) protein expression levels were examined in SGC-7901 cells and carcinoma tissue by immunohistochemistry and immunoblotting.
  • Octreotide could significantly inhibit the growth of orthotopical implanted gastric cancer, the inhibition rate for tumors was 62.3%.
  • The c-Fos and ERK-1/ERK-2 proteins were decreased in the nude mice carcinoma tissues and SGC-7901 gastric carcinoma cells which treated with octreotide by immunohistochemistry or immunoblotting analysis.
  • Moreover, the fetal calf serum (FCS) stimulated AP-1 binding activity on gastric cancer cell and the somatostatin analogue octreotide could inhibit this response efficiently.
  • CONCLUSION: Octreotide inhibits not only ERK-1/ERK-2 and c-Fos expressions but also AP-1 binding activity, which result in inhibition to proliferation of gastric carcinoma cell.
  • [MeSH-major] Antineoplastic Agents, Hormonal / pharmacology. Octreotide / pharmacology. Stomach Neoplasms / drug therapy. Transcription Factor AP-1 / drug effects
  • [MeSH-minor] Animals. Blotting, Western. Cell Division / drug effects. DNA / metabolism. Dose-Response Relationship, Drug. Electrophoretic Mobility Shift Assay. Humans. Immunohistochemistry. Male. Mice. Mice, Inbred BALB C. Mice, Nude. Mitogen-Activated Protein Kinase 1 / metabolism. Mitogen-Activated Protein Kinase 3. Mitogen-Activated Protein Kinases / metabolism. Neoplasm Transplantation. Protein Binding / drug effects. Proto-Oncogene Proteins c-fos / metabolism. Thymidine / metabolism. Tritium. Tumor Cells, Cultured / drug effects. Tumor Cells, Cultured / metabolism. Xenograft Model Antitumor Assays

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  • (PMID = 12478891.001).
  • [Journal-full-title] Ai zheng = Aizheng = Chinese journal of cancer
  • [ISO-abbreviation] Ai Zheng
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Proto-Oncogene Proteins c-fos; 0 / Transcription Factor AP-1; 10028-17-8 / Tritium; 9007-49-2 / DNA; EC 2.7.11.24 / Mitogen-Activated Protein Kinase 1; EC 2.7.11.24 / Mitogen-Activated Protein Kinase 3; EC 2.7.11.24 / Mitogen-Activated Protein Kinases; RWM8CCW8GP / Octreotide; VC2W18DGKR / Thymidine
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18. Yoshimura K, Joh K, Kitamura H, Takahashi Y, Yokote S, Kasai K, Hosoya T: A case report of glomerulopathy-associated podocytic infolding in a patient with tumor lysis syndrome. Clin Exp Nephrol; 2008 Dec;12(6):522-6
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  • [Title] A case report of glomerulopathy-associated podocytic infolding in a patient with tumor lysis syndrome.
  • A 59-year-old man underwent total gastrectomy and splenectomy for gastric cancer 14 months before admission.
  • The pathological diagnosis was neuroendocrine carcinoma of the stomach.
  • Eight months after the operation, systemic chemotherapy with irinotecan and cisplatin was started because of multiple metastases to lymph nodes.
  • After two courses of chemotherapy, renal function continued to decline.
  • These clinicopathological findings suggested that tumor lysis syndrome was the cause of acute renal insufficiency.
  • The present case was a rare case of glomerulopathy associated with podocytic infolding, which was not associated with collagen disease but with tumor lysis syndrome.
  • [MeSH-major] Glomerular Basement Membrane / pathology. Glomerulonephritis, Membranous / pathology. Podocytes / pathology. Tumor Lysis Syndrome / pathology

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  • [Cites] Clin Nephrol. 2002 Aug;58(2):161-5 [12227690.001]
  • [Cites] Virchows Arch A Pathol Anat Histopathol. 1992;420(5):447-51 [1595195.001]
  • [Cites] Nihon Jinzo Gakkai Shi. 2007;49(2):61-9 [17375610.001]
  • [Cites] Semin Nephrol. 1993 May;13(3):273-80 [8321927.001]
  • (PMID = 18979061.001).
  • [ISSN] 1342-1751
  • [Journal-full-title] Clinical and experimental nephrology
  • [ISO-abbreviation] Clin. Exp. Nephrol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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19. Kianmanesh R, O'toole D, Sauvanet A, Ruszniewski P, Belghiti J: [Surgical treatment of gastric, enteric, and pancreatic endocrine tumors Part 1. Treatment of primary endocrine tumors]. J Chir (Paris); 2005 May-Jun;142(3):132-49
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  • [Title] [Surgical treatment of gastric, enteric, and pancreatic endocrine tumors Part 1. Treatment of primary endocrine tumors].
  • [Transliterated title] Traitement chirurgical des tumeurs endocrines gastro-entéro-pancréatiques.
  • Endocrine tumors (ET) of the digestive tract (formerly called neuroendocrine tumors) are rare.
  • They are classified into two principal types: gastrointestinal ET's (formerly called carcinoid tumors) which are the most common, and pancreaticoduodenal ET's.
  • Poorly-differentiated ET's have a poor prognosis and are treated by chemotherapy.
  • Surgical excision is the only curative treatment of well-differentiated ET's.
  • The surgical goals are to: 1. prolong survival by resecting the primary tumor and any nodal or hepatic metastases, 2. control the symptoms related to hormonal secretion, 3. prevent or treat local complications.
  • The most common sites of gastrointestinal ET's ( carcinoids) are the appendix and the rectum; these are often small (<1 cm), benign, and discovered fortuitously at the time of appendectomy or colonoscopic removal.
  • Insulinoma and gastrinoma (cause of the Zollinger-Ellison syndrome) are the most common functional ET's. 80% are sporadic; in these cases, tumor size, location, and malignant potential determine the type of resection which may vary from a simple enucleation to a formal pancreatectomy.
  • In 10-20% of cases, pancreaticoduodenal ET presents in the setting of multiple endocrine neoplasia (NEM type I), an autosomal-dominant genetic disease with multifocal endocrine involvement of the pituitary, parathyroid, pancreas, and adrenal glands.
  • For insulinoma with NEM-I, enucleation of lesions in the pancreatic head plus a caudal pancreatectomy is the most appropriate procedure.
  • [MeSH-major] Carcinoid Tumor / surgery. Carcinoma, Islet Cell / surgery. Carcinoma, Neuroendocrine / surgery. Insulinoma / surgery. Intestinal Neoplasms / surgery. Multiple Endocrine Neoplasia Type 1 / surgery. Pancreatic Neoplasms / surgery. Stomach Neoplasms / surgery. Zollinger-Ellison Syndrome / surgery

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  • (PMID = 16142076.001).
  • [ISSN] 0021-7697
  • [Journal-full-title] Journal de chirurgie
  • [ISO-abbreviation] J Chir (Paris)
  • [Language] fre
  • [Publication-type] Comparative Study; English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Number-of-references] 236
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20. Snady H: Interventional endoscopy, neoadjuvant therapy and the gastroenterologist. Hematol Oncol Clin North Am; 2002 Feb;16(1):53-79
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  • [Title] Interventional endoscopy, neoadjuvant therapy and the gastroenterologist.
  • With current treatment, survival of greater than 1 year should be anticipated for many patients with pancreatic cancer.
  • Obstructive jaundice is managed successfully with endoscopic placement of a plastic stent early in the evaluation of a patient with suspected regional pancreatic cancer, and a metal wall stent is reserved for patients with known 1997 AJCC stage IVB carcinoma or nonoperative patients.
  • Relief of biliary obstruction allows improvement in liver function and more time to evaluate tumor stage accurately to determine initial treatment (see Fig. 1).
  • A cost-effective algorithm to determine accurate stage and treatment can start with the size of the mass on initial imaging studies.
  • EUS-guided FNA represents a significant improvement over CT scan-guided FNA to make a tissue diagnosis.
  • Tumors reliably staged as unresectable by nonoperative imaging methods including EUS are treated with chemotherapy with or without concurrent radiotherapy because median survival of these patients is 2 years in some series.
  • For chronic pain or gastric outlet obstruction not responding or treatable by chemoradiotherapy, endoscopically guided celiac plexus nerve block and stenting improve the quality of life for patients with pancreatic cancer.
  • [MeSH-major] Adenocarcinoma / therapy. Endoscopy. Endoscopy, Gastrointestinal. Endosonography. Neoadjuvant Therapy. Pancreatic Neoplasms / therapy
  • [MeSH-minor] Ampulla of Vater / surgery. Antineoplastic Agents / therapeutic use. Autonomic Nerve Block / methods. Carcinoma, Neuroendocrine / diagnosis. Carcinoma, Neuroendocrine / therapy. Chemotherapy, Adjuvant. Cholangiopancreatography, Endoscopic Retrograde. Cholestasis / etiology. Cholestasis / therapy. Combined Modality Therapy. Common Bile Duct Neoplasms / surgery. Diagnostic Imaging / methods. Gastric Outlet Obstruction / surgery. Humans. Lymphoma, Non-Hodgkin / diagnosis. Lymphoma, Non-Hodgkin / therapy. Neoplasm Staging / methods. Pain Management. Palliative Care. Pancreatic Cyst / therapy. Prognosis. Radiotherapy, Adjuvant. Stents

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  • (PMID = 12063829.001).
  • [ISSN] 0889-8588
  • [Journal-full-title] Hematology/oncology clinics of North America
  • [ISO-abbreviation] Hematol. Oncol. Clin. North Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 115
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21. Auernhammer CJ, Göke B: Medical treatment of gastrinomas. Wien Klin Wochenschr; 2007;119(19-20):609-15
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  • [Title] Medical treatment of gastrinomas.
  • Gastrinomas are functional neuroendocrine tumors of the gastroenteropancreatic system.
  • Surgery is first line treatment in gastrinomas, however often fails to be curative.
  • This manuscript reviews current strategies of medical treatment of surgically non-curable gastrinoma.
  • Symptomatic treatment with H(+)-K(+)-ATPase proton-pump inhibitors suppresses hypersecretion of gastric acid and substantially improves quality of life in patients with Zollinger-Ellison syndrome.
  • Further medical therapy is only recommended in cases of progressive metastatic gastrinoma.
  • In well differentiated neuroendocrine carcinoma (G1 and G2) a so-called biotherapy with somatostatin analogues exists as first-line and chemotherapy with streptocotozin plus doxorubicine/5-FU as second-line medical treatment option.
  • In poorly differentiated neuroendocrine carcinoma (G3) chemotherapy with etoposide plus cisplatin is possible.
  • Prospective future therapeutic strategies may include treatment with novel somatostatin analogues as well as angiogenesis inhibitors and kinase inhibitors targeting tumor-specific signaling cascades.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Duodenal Neoplasms / drug therapy. Gastrinoma / drug therapy. Gastrins / blood. Pancreatic Neoplasms / drug therapy. Proton Pump Inhibitors / therapeutic use. Somatostatin / analogs & derivatives. Zollinger-Ellison Syndrome / drug therapy
  • [MeSH-minor] Angiogenesis Inhibitors / therapeutic use. Clinical Trials as Topic. Humans. Interferon-alpha / therapeutic use. Octreotide / therapeutic use. Peptides, Cyclic / therapeutic use

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  • (PMID = 17985097.001).
  • [ISSN] 0043-5325
  • [Journal-full-title] Wiener klinische Wochenschrift
  • [ISO-abbreviation] Wien. Klin. Wochenschr.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Austria
  • [Chemical-registry-number] 0 / Angiogenesis Inhibitors; 0 / Gastrins; 0 / Interferon-alpha; 0 / Peptides, Cyclic; 0 / Proton Pump Inhibitors; 0G3DE8943Y / lanreotide; 51110-01-1 / Somatostatin; RWM8CCW8GP / Octreotide
  • [Number-of-references] 76
  •  go-up   go-down


22. Banasch M, Schmitz F: Diagnosis and treatment of gastrinoma in the era of proton pump inhibitors. Wien Klin Wochenschr; 2007;119(19-20):573-8
MedlinePlus Health Information. consumer health - Peptic Ulcer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Diagnosis and treatment of gastrinoma in the era of proton pump inhibitors.
  • The Zollinger-Ellison syndrome is characterized pathophysiologically by a significant hypergastrinemia derived from a gastrin-secreting neuroendocrine tumor with a primary location in the pancreas or duodenum.
  • Chronic hypergastrinemia in turn triggers gastric acid hypersecretion yielding in chronic or recurrent or refractory peptic ulcer disease and/or chronic diarrhea.
  • One half of patients with ZES will have distant metastases in the liver by the time the diagnosis is established and one half of all patients with ZES will experience chronic diarrhea as chief complaint rather than peptic ulcer-related symptoms and signs.
  • Diagnosis is based on the patients history which is typically characterized by recurrent episodes of peptic ulcer disease or by severe reflux esophagitis and/or diarrhea or by acid-related symptoms which fail to respond to standard treatment regimens.
  • A gastric pH > 2 is mutually exclusive for ZES.
  • High sensitivity and specificity for the diagnosis of ZES is provided by determining the ratio of basal versus pentagastrin-stimulated gastric acid secretion: The ratio of BAO / MAO > 0.6 is highly specific for gastrinoma.
  • To localize the gastrin-secreting tumor computer-assisted tomography, endoscopic ultrasound, and somatostatin receptor scintigraphy provide useful help but most recently, endoscopic ultrasound with high resolution transducers appear to improve preoperative site localization.
  • If modern imaging techniques fail to elucidate the site of the tumor, intraoperative diaphany may help to detect gastrinomas within the duodenal wall.
  • Definitive treatment will only be achieved by total surgical resection of the gastrin-producing tumor in the pancreas or duodenum including dissection of the regional lymph nodes.
  • Control of symptoms will have to be achieved by administration of highly potent proton pump inhibitors in up to 2-3-fold increased standard doses to inhibit gastric acid hypersecretion.
  • Elevation of gastric pH > 4 will be the therapeutic target to protect the mucosa of the upper gastrointestinal tract.
  • [MeSH-major] Duodenal Neoplasms / diagnosis. Esophagitis, Peptic / drug therapy. Gastrinoma / diagnosis. Gastrins / blood. Pancreatic Neoplasms / diagnosis. Peptic Ulcer / drug therapy. Proton Pump Inhibitors / therapeutic use. Zollinger-Ellison Syndrome / diagnosis
  • [MeSH-minor] Diagnosis, Differential. Gastric Acidity Determination. Humans

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  • (PMID = 17985090.001).
  • [ISSN] 0043-5325
  • [Journal-full-title] Wiener klinische Wochenschrift
  • [ISO-abbreviation] Wien. Klin. Wochenschr.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Austria
  • [Chemical-registry-number] 0 / Gastrins; 0 / Proton Pump Inhibitors
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23. Lendel I, Manni A, Ruggiero FM: Novel association of duodenal gastrinoma and atrophic gastritis: case report and literature review. Endocr Pract; 2007 Nov-Dec;13(7):770-5
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  • RESULTS: In a 46-year-old woman with a history of stable pituitary microprolactinoma, multiple gastrointestinal symptoms developed and prompted the performance of an esophagogastroduodenoscopy in conjunction with small bowel biopsies.
  • A 2-mm duodenal gastrin-producing neuroendocrine tumor was discovered.
  • The tumor stained negative for serotonin and somatostatin and involved the mucosa and submucosa.
  • Immunohistochemical staining of the gastrinoma tissue with a monoclonal antibody to the cholecystokinin-B (gastrin) receptor was negative.
  • After pantoprazole therapy was discontinued, the serum gastrin level remained elevated at 403 pg/mL.
  • There was no family history of multiple endocrine neoplasia type 1, and genetic testing for the MEN1 mutation was negative.
  • An upper endoscopy with measurement of gastric pH and performance of gastric biopsies confirmed the presence of chronic atrophic gastritis.
  • CONCLUSION: Patients with atrophic gastritis and associated hypergastrinemia are known to have a high frequency of hypergastrinemia-induced gastric carcinoid tumors, some of which are actual gastrinomas or are thought to arise from the G cells of the stomach.
  • Gastrin is a well-recognized growth factor for many tissues.
  • No gastrin receptors were detected on the gastrinoma cells; however, that result might have been attributable to technical (fixation or antibody) or tumor (dedifferentiation) problems.
  • [MeSH-minor] Carcinoid Tumor / complications. Carcinoid Tumor / diagnosis. Carcinoid Tumor / secretion. Female. Gastrins / blood. Gastrins / secretion. Humans. Immunohistochemistry. Middle Aged. Pituitary Neoplasms / complications. Pituitary Neoplasms / drug therapy. Prolactinoma / complications. Prolactinoma / drug therapy

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  • (PMID = 18194935.001).
  • [ISSN] 1934-2403
  • [Journal-full-title] Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
  • [ISO-abbreviation] Endocr Pract
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Gastrins
  • [Number-of-references] 34
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24. Javle M, Hsueh CT: Recent advances in gastrointestinal oncology--updates and insights from the 2009 annual meeting of the American society of clinical oncology. J Hematol Oncol; 2010;3:11
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  • Adding trastuzumab to chemotherapy improved the survival of patients with advanced gastric cancer overexpressing human epidermal growth factor receptor 2.
  • Gemcitabine plus cisplatin has become a new standard for first-line treatment of advanced biliary cancer.
  • Octreotide LAR significantly lengthened median time to tumor progression compared with placebo in patients with metastatic neuroendocrine tumors of the midgut.
  • Addition of oxaliplatin to fluoropyrimidines for preoperative chemoradiotherapy in patients with stage II or III rectal cancer did not improve local tumor response but increased toxicities.
  • Bevacizumab did not provide additional benefit to chemotherapy in adjuvant chemotherapy for stage II or III colon cancer.
  • In stage IV colorectal cancer, data have supported the routine use of prophylactic skin treatment in patients receiving antibody against epidermal growth factor receptor, and the use of upfront chemotherapy as initial management in patients with synchronous metastasis without obstruction or bleeding from the primary site.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Gastrointestinal Neoplasms / diagnosis. Gastrointestinal Neoplasms / therapy

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  • (PMID = 20331897.001).
  • [ISSN] 1756-8722
  • [Journal-full-title] Journal of hematology & oncology
  • [ISO-abbreviation] J Hematol Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 79
  • [Other-IDs] NLM/ PMC2856525
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25. Nikou GC, Lygidakis NJ, Toubanakis C, Pavlatos S, Tseleni-Balafouta S, Giannatou E, Mallas E, Safioleas M: Current diagnosis and treatment of gastrointestinal carcinoids in a series of 101 patients: the significance of serum chromogranin-A, somatostatin receptor scintigraphy and somatostatin analogues. Hepatogastroenterology; 2005 May-Jun;52(63):731-41
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  • [Title] Current diagnosis and treatment of gastrointestinal carcinoids in a series of 101 patients: the significance of serum chromogranin-A, somatostatin receptor scintigraphy and somatostatin analogues.
  • BACKGROUND/AIMS: Carcinoids are relatively rare tumors that arise from neuroendocrine cells and have proved to be slow growing malignancies which involve many organs and most frequently the gastrointestinal (GI) tract.
  • The diagnosis was confirmed histologically in all cases, after surgical excision of the primary tumor or by biopsies taken during endoscopy.
  • All pts were evaluated several times per year with clinical, biochemical and imaging assessments, including neuroendocrine markers [urinary 5-Hydroxyindoleacetic acid (5-HIAA), serum Chromogranin-A (CgA)] and Somatostatin Receptor Scintigraphy (OCTREOSCAN).
  • The follow-up period ranged between 1.5 to 12.5 years (mean time: 5 years and 3 months) and it is still in progress.
  • Furthermore, it revealed the primary and the metastatic lesions in 16% and 33% of pts with carcinoids of the small intestine respectively, while other conventional imaging procedures (including MRI) were negative at the same time.
  • Seventy-four percent of the pts underwent a surgical resection of the primary tumor, while in 21%, an endoscopic polypectomy was performed.
  • All pts with metastatic tumors and positive OCTREOSCAN, were treated with Somatostatin analogues, which resulted in control of symptoms (75%), stabilization of tumor growth (71%) or tumor shrinkage (9%).
  • A combined therapy with the addition of interferon-a was initiated in pts in whom, despite the increase of drug dosage and the shortening of administration intervals, a complete clinical and biochemical response was no more achieved with Somatostatin analogues alone.
  • CONCLUSIONS: a) Tumor size (especially in appendiceal and gastric carcinoids) and, also, the dispersion of disease, highly predict the evolution of the patients;.
  • b) serum Chromogranin-A seems to be a very useful tumor marker for the diagnosis and follow-up of pts with GI carcinoids;.
  • c) the introduction of new imaging techniques and especially OCTREOSCAN contributes to a better localization of the primary tumors and their metastases, as well as, to the right decision of the appropriate medical treatment;.
  • d) surgical excision is the treatment of choice in nonmetastatic tumors; and e) in pts with metastatic disease, the administration of Somatostatin analogues improves their quality of life.
  • [MeSH-major] Biomarkers, Tumor / blood. Carcinoid Tumor / diagnosis. Chromogranins / blood. Gastrointestinal Neoplasms / diagnosis. Receptors, Somatostatin / blood. Somatostatin / analogs & derivatives

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  • (PMID = 15966194.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / CHGA protein, human; 0 / Chromogranin A; 0 / Chromogranins; 0 / Receptors, Somatostatin; 51110-01-1 / Somatostatin; 54-16-0 / Hydroxyindoleacetic Acid; G083B71P98 / pentetreotide
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26. Fykse V, Sandvik AK, Waldum HL: One-year follow-up study of patients with enterochromaffin-like cell carcinoids after treatment with octreotide long-acting release. Scand J Gastroenterol; 2005 Nov;40(11):1269-74
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  • [Title] One-year follow-up study of patients with enterochromaffin-like cell carcinoids after treatment with octreotide long-acting release.
  • The aim of the present study was to follow neuroendocrine (NE) markers in the blood and macroscopic and histopathological changes in the stomach during a 12-month follow-up after discontinuation of octreotide LAR treatment.
  • MATERIAL AND METHODS: Five patients underwent upper gastrointestinal endoscopy at 6 and 12 months' follow-up after octreotide LAR treatment.
  • At the same time-point, biopsies from flat, oxyntic mucosa showed a slightly (non-significant) elevated number of CgA immunoreactive (IR) cells.
  • [MeSH-major] Antineoplastic Agents, Hormonal / administration & dosage. Carcinoid Tumor / drug therapy. Delayed-Action Preparations / administration & dosage. Enterochromaffin Cells / drug effects. Octreotide / administration & dosage. Stomach Neoplasms / drug therapy
  • [MeSH-minor] Dose-Response Relationship, Drug. Female. Follow-Up Studies. Gastric Mucosa / pathology. Humans. Male. Prospective Studies. Risk Assessment. Sampling Studies. Time Factors. Treatment Outcome

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  • (PMID = 16334435.001).
  • [ISSN] 0036-5521
  • [Journal-full-title] Scandinavian journal of gastroenterology
  • [ISO-abbreviation] Scand. J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Norway
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Delayed-Action Preparations; RWM8CCW8GP / Octreotide
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27. Goldberg RM, Niedzwiecki D, Bertagnolli M, Blackstock AW, Tepper JE, Mayer RJ: Cancer and leukemia group B gastrointestinal cancer committee. Clin Cancer Res; 2006 Jun 1;12(11 Pt 2):3589s-95s
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  • The Committee has done trials in patients with esophageal, gastric, pancreatic, colon, rectal, and anal cancers.
  • New initiatives are under way in hepatocellular cancer, cholangiocarcinoma, and neuroendocrine tumors originating in the gastrointestinal tract.
  • The Committee has increasingly concentrated on translational studies using tumor blocks, germ-line DNA, and plasma to evaluate biological correlates of tumor response and clinical outcomes.
  • A broad program of pharmacogenomics has been incorporated for virtually all studies, including trials that prospectively use polymorphisms in drug-metabolizing genes to assign treatments.
  • Future efforts aim to evolve new standards of care, evaluate new therapies, and answer relevant biological questions in gastrointestinal cancer.
  • [MeSH-major] Gastrointestinal Neoplasms / therapy. Medical Oncology / history
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Clinical Trials as Topic. Digestive System Surgical Procedures. History, 20th Century. Humans. Leukemia / therapy. Neoplasms / therapy. Societies, Medical

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  • (PMID = 16740790.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] eng
  • [Publication-type] Historical Article; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 43
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28. Yuan R, Kay A, Berg WJ, Lebwohl D: Targeting tumorigenesis: development and use of mTOR inhibitors in cancer therapy. J Hematol Oncol; 2009 Oct 27;2:45
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  • [Title] Targeting tumorigenesis: development and use of mTOR inhibitors in cancer therapy.
  • Consequently, inhibitors of mTOR, including temsirolimus, everolimus, and ridaforolimus (formerly deforolimus) have been developed and assessed for their safety and efficacy in patients with cancer.
  • Temsirolimus is an intravenously administered agent approved by the US Food and Drug Administration (FDA) and the European Medicines Agency (EMEA) for the treatment of advanced renal cell carcinoma (RCC).
  • Everolimus is an oral agent that has recently obtained US FDA and EMEA approval for the treatment of advanced RCC after failure of treatment with sunitinib or sorafenib.
  • The use of mTOR inhibitors, either alone or in combination with other anticancer agents, has the potential to provide anticancer activity in numerous tumor types.
  • Cancer types in which these agents are under evaluation include neuroendocrine tumors, breast cancer, leukemia, lymphoma, hepatocellular carcinoma, gastric cancer, pancreatic cancer, sarcoma, endometrial cancer, and non-small-cell lung cancer.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Cell Transformation, Neoplastic / drug effects. Drug Delivery Systems / methods. Drug Discovery. Intracellular Signaling Peptides and Proteins / antagonists & inhibitors. Neoplasms / drug therapy. Protein-Serine-Threonine Kinases / antagonists & inhibitors

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  • (PMID = 19860903.001).
  • [ISSN] 1756-8722
  • [Journal-full-title] Journal of hematology & oncology
  • [ISO-abbreviation] J Hematol Oncol
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Intracellular Signaling Peptides and Proteins; 0 / Protein Kinase Inhibitors; EC 2.7.1.1 / MTOR protein, human; EC 2.7.1.1 / TOR Serine-Threonine Kinases; EC 2.7.11.1 / Protein-Serine-Threonine Kinases
  • [Number-of-references] 103
  • [Other-IDs] NLM/ PMC2775749
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