Treatment of ECL cell carcinoids with octreotide LAR

• Published in: Scandinavian journal of gastroenterology Vol. 39; no. 7; pp. 621 - 628
• Main Authors: Fykse, V., Sandvik, A. K., Qvigstad, G., Falkmer, S. E., Syversen, U., Waldum, H. L.
• Format: Journal Article
• Language: English
• Published: Copenhagen Informa UK Ltd 01-07-2004; Oslo Taylor & Francis; Stockholm Scandinavian University Press
• Subjects: Aged; Antineoplastic Agents, Hormonal - administration & dosage; Biological and medical sciences; Carcinoid; Carcinoid Tumor - drug therapy; Carcinoid Tumor - pathology; Cell Proliferation - drug effects; Chromogranin A; Chromogranins - blood; Chromogranins - drug effects; Delayed-Action Preparations; ECL cell; Enterochromaffin-like Cells - drug effects; Female; Gastric Mucosa - drug effects; Gastric Mucosa - pathology; Gastrins - blood; Gastrins - drug effects; Gastroenterology. Liver. Pancreas. Abdomen; Gastroscopy; Humans; hypergastrinaemia; Male; Medical sciences; Middle Aged; Octreotide - administration & dosage; somatostatin analogue; Stomach Neoplasms - drug therapy; Stomach Neoplasms - pathology; Time Factors; ECL cell; Treatment; Gastroenterology; Octreotide; Carcinoid; somatostatin analogue; hypergastrinaemia; Cell
• ISSN: 0036-5521; 1502-7708
• DOI: 10.1080/00365520410005225

Background: Patients with chronic atrophic gastritis (CAG) and hypergastrinaemia are at risk of developing hyperplasia of the enterochromaffin-like (ECL) cells and ECL-cell-derived tumours. The effect of the somatostatin analogue octreotide on ECL cell carcinoids is examined. Methods: Five patients with hypergastrinaemia and ECL cell carcinoids were enrolled in a 1-year study of octreotide LAR (long-acting release) 20 mg given at monthly intervals. Biopsies from tumours and from flat oxyntic mucosa were done at the start and 3, 6 and 12 months thereafter. Sections were stained with haematoxylin-erythrosin, immunostained with chromogranin A (CgA) and doublestained with CgA and Ki-67. Serum gastrin and CgA were measured. Results: The number of visible tumours was reduced by more than 50 %. Sections from both tumours and flat mucosa showed a reduced number of CgA immunoreactive cells. Mean serum gastrin decreased from 421 to 186 pM (normal <40 pM); P > 0.05, and serum CgA from 73 to 25 ng ml (normal <30 ng ml); P < 0.001. Conclusions: During treatment the patients were still markedly hypergastrinaemic, whereas the serum CgA showed normalization. A diminished tumour load and reduced ECL cell density were found, indicating an antiproliferative effect of octreotide directly on the ECL cells.