The analysis of immunophenotype of gastrin‐producing tumors of the pancreas and gastrointestinal tract

Abstract

BACKGROUND Gastrinomas are located more frequently in the pancreas, which normally has no cells that can produce gastrin. They have a more aggressive course than other pancreatic endocrine tumors and extrapancreatic gastrinomas associated with multiple endocrine neoplasia Type 1 syndrome. The current study analyzed immunophenotypes of gastrinomas and compared them with other pancreatic endocrine tumors. METHODS Twenty‐one formalin‐fixed, paraffin‐embedded specimens (15‐tumors in the pancreas, 1 in the duodenum, 1 in the stomach, 1 in the liver, and 3 of unknown primary location) accompanied by Zollinger—Ellison syndrome and 17 other pancreatic endocrine tumor specimens were investigated. They were stained immunohistochemically for gastrin, chromogranin A, synaptophysin, insulin, glucagon, somatostatin, pancreatic polypeptide, calcitonin, serotonin, chorionic gonadotropin, adrenocorticotropic hormone, carcinoembryonic antigen, epithelial membrane antigen, and cytokeratin 19. RESULTS Gastrinomas coexpressed neuroendocrine and exocrine markers, including chromogranin A, synaptophysin, carcinoembryonic antigen, cytokeratin 19, and epithelial membrane antigen. Carcinoembryonic antigen was found in all 17 gastrinomas (100%), cytokeratin 19 was found in 15 of 17 (88.2%) gastrinomas, and epithelial membrane antigen was found in 16 of 18 (88.9 %) gastrinomas. Cytokeratin 19, epithelial membrane antigen, and carcinoembryonic antigen were not found to be present in the pancreatic endocrine tumors, but chromogranin A and synaptophysin were. Chorionic gonadotropin was found in 16 gastrinomas (100%), but only in 2 of 17 other pancreatic endocrine tumors (11.8 %). CONCLUSIONS Pancreatic gastrinomas were characterized by the coexpression of neuroendocrine markers, exocrine markers, and chorionic gonadotropin. Therefore, pancreatic gastrinomas made a special intermediate group of tumors, which phenotypically combined features of neuroendocrine and exocrine neoplasms. These findings suggested that sporadic pancreatic gastrinomas and other pancreatic endocrine tumors are different phenotypically and are possibly of different origin. Cancer 2003. © 2003 American Cancer Society.

Prognostic significance of cytokeratin 19 expression in pancreatic neuroendocrine tumor: A meta-analysis

“…After reading the full text, we excluded 8 more studies because the information about survival or clinicopathological features was insufficient. At the end of the screening, 10 retrospective studies met inclusion criteria and were used in this meta-analysis [ 6 , 14 – 22 ] ( Fig 1 ).…”

“…Four studies assessed the correlation of CK-19 expression and tumor size [ 14 , 18 , 20 , 22 ]. In one study, size equal to 2 centimeters (cm) belonged to small size group [ 14 ].…”

“…However, in another study, 2cm was classified in a large size group [ 18 ]. The remaining 2 studies described the tumor size and CK-19 expression of every tissue sample [ 20 , 22 ]. Therefore, two analyses were performed according to whether 2 cm is included in large tumors or not ( Fig 3 ).…”

PPI-Delayed Diagnosis of Gastrinoma: Oncologic Victim of Pharmacologic Success

“…Multiple neuropeptide hypersecretion is often seen in neuroendocrine cancer [15]; this includes that of serotonin production by gastrinomas [16], as well as that of hypergastrinemia occurring in association with carcinoids [17]. It follows from these observations that the heterogeneous clinical presentations of neuroendocrine tumors could well be explained in part by unique multi-neuropeptide signatures of individual tumors.…”

Morphological classification of digestive neuroendocrine neoplasms: the current concepts and controversies

“…Хотя большинство НЭО ЖКТ и ПЖ является кли-нически нефункционирующими, некоторые новооб-разования демонстрируют избыточную продукцию одного или нескольких биологически активных гор-монов, что вызывает определенные паранеопластиче-ские синдромы, такие как карциноидный синдром, синдром Кушинга, синдром Золлингера-Эллисона [21]. Среди функцио нирующих опухолей преобладают НЭО ПЖ, при этом чаще встречаются такие типы, как инсулинома и гаст ринома.…”