Urinary serotonin in the diagnosis of carcinoid tumors.

1986 ◽  
Vol 32 (5) ◽  
pp. 840-844 ◽  
Author(s):  
J M Feldman
Keyword(s):  
Carcinoid Tumor ◽  
Normal Subjects ◽  
Carcinoid Tumors ◽  
Serotonin Concentration ◽  
Complementary Information ◽  
Normal Platelet ◽  
Platelet Serotonin ◽  
Hydroxyindoleacetic Acid

Abstract To determine whether measurement of serotonin in urine would give useful complementary information to the usual measurement of 5-hydroxyindoleacetic acid (5-HIAA) in urine and platelet serotonin in platelets, I measured these analytes in 75 consecutive patients with carcinoid tumors, and found that 75% had above-normal urinary 5-HIAA excretion, 64% had above-normal serotonin excretion, and 64% had above-normal platelet serotonin concentration. Six patients had increased urinary serotonin, but 5-HIAA excretion and platelet serotonin concentration were normal. Only two of a further 50 patients with solid noncarcinoid tumors--and none of 55 patients with flushing or diarrhea, who did not prove to have a carcinoid tumor--had increased urinary serotonin. Ingestion of four bananas (a food rich in serotonin) increased urinary 5-HIAA but not urinary serotonin excretion of seven normal subjects. Evidently, measurement of urinary serotonin excretion is helpful in the evaluation of patients with suspected carcinoid tumors.

Improved Diagnosis of Carcinoid Tumors by Measurement of Platelet Serotonin

1992 ◽  
Vol 38 (4) ◽  
pp. 534-540 ◽  
Author(s):  
I P Kema ◽  
E G de Vries ◽  
A M Schellings ◽  
P E Postmus ◽  
F A Muskiet
Keyword(s):  
Carcinoid Tumors ◽  
Fluorometric Detection ◽  
Complementary Information ◽  
Serotonin Content ◽  
Platelet Serotonin ◽  
Serotonin Secretion ◽  
Hydroxyindoleacetic Acid ◽  
Plasma Serotonin ◽  
Term Monitoring

Abstract Carcinoid patients are diagnosed biochemically on the basis of increased urinary excretion of 5-hydroxyindoleacetic acid (5-HIAA); urinary and platelet serotonin concentrations are considered to provide complementary information. Using established HPLC methods with fluorometric detection, we evaluated the clinical usefulness of measurements of urinary 5-HIAA and urinary, plasma, and platelet serotonin in 30 consecutive patients with histologically proven carcinoid tumors of fore-, mid-, and hindgut origin before treatment. Ten patients showed no signs of serotonin overproduction; 14 had increased concentrations of urinary 5-HIAA and platelet serotonin; and platelet serotonin, but not urinary 5-HIAA, was increased in 6. None had increased urinary 5-HIAA excretion without an increase in platelet serotonin content. In cases with high rates of tumor serotonin secretion, platelet serotonin reached a maximum and did not correlate with serotonin secretion rate, whereas urinary 5-HIAA was correlated. Increased platelet serotonin was correlated with increased plasma serotonin and with occurrence of carcinoid syndrome. Increased urinary serotonin, allegedly caused by increases in circulating 5-hydroxytryptophan, almost invariably coincided with increased platelet serotonin, but not necessarily with above-normal urinary 5-HIAA excretion. From these results and long-term monitoring of three patients during treatment, we conclude that platelet serotonin is more sensitive than urinary 5-HIAA for detecting carcinoids that secrete only small amounts of serotonin.

scholarly journals Effect of Mini-Dose of Chlorpromazine on the Bleeding time and Platelet Aggregation

1977 ◽  
Author(s):  
J. Zahavi ◽  
G. Schwartz
Keyword(s):  
Platelet Aggregation ◽  
Bleeding Time ◽  
Adenosine Diphosphate ◽  
Normal Subjects ◽  
Serotonin Concentration ◽  
Initial Wave ◽  
Platelet Serotonin ◽  
Significant Prolongation ◽  
Platelet Release

The impairment, of hemostasis by ehlorpromazine (c) at concentrations below those which inhibit platelet release reaction, has been evaluated in 24 normal subjects. In each individual, modidied Ivy bleeding time and platelet aggregations (PAg) induced by adenosine diphosphate (ADP) 0,6 MM and 4 MM collagen 0,003% and 1-epinephrine 3MM well as platelet serotonin concentration, were performed prior to and 20 min. after intramuscular administration of (C) or saline. Normal saline was injected to 6 subjects and 5, 12,5 and 20 mg. of (c) to another 8, 5 and 5 subjects respectively. There was a slight but significant prolongation of the bleeding time and a decrease in the initial wave of aggregation to ADP 0,6 MM in the subjects on (C) compared to those on-saline. Platelet serotonin, however, and (PAg) to collagen, 1-epinephrine and ADP 4 MM, were the same in both groups. The impaired hemostasis by mini-dose of (C) might be attributed to the prevention of leakage of ADP from intact erythrocytes in-vivo and, if so, may signify an important new application of this drug in the treatment of thrombotic disorders.

scholarly journals Discriminating Capacity of Indole Markers in the Diagnosis of Carcinoid Tumors

2000 ◽  
Vol 46 (10) ◽  
pp. 1588-1596 ◽  
Author(s):  
Wim G Meijer ◽  
Ido P Kema ◽  
Marcel Volmer ◽  
Pax H B Willemse ◽  
Elisabeth G E de Vries
Keyword(s):  
Positive Predictive Value ◽  
Carcinoid Tumor ◽  
Predictive Value ◽  
Roc Analysis ◽  
Reference Group ◽  
Curve Analysis ◽  
Carcinoid Tumors ◽  
Healthy Controls ◽  
Roc Curve Analysis ◽  
Platelet Serotonin

Abstract Background: We evaluated the discriminating capacity of the indole markers urinary 5-hydroxyindoleacetic acid (5-HIAA), urinary serotonin, and platelet serotonin in the diagnosis of carcinoid tumors. Methods: Indole markers were measured in 688 patients with suspected carcinoid disease. The initial values of indole markers from patients in whom a carcinoid tumor was confirmed during follow-up (n = 98) were used for ROC analysis. Two groups served as reference populations. The first consisted of 45 healthy individuals (“healthy controls”). The second was a random sample of 40 patients, drawn from the 590 (688 minus 98) patients with carcinoid-like symptoms but without a carcinoid tumor (“clinically suspected patients”). Results: ROC curve analysis showed platelet serotonin to have the highest discriminating capacity, especially in foregut carcinoids. Cutoff values for platelet serotonin obtained from ROC analysis with healthy controls as reference group (5.4 nmol/109 platelets) gave a sensitivity of 74%, specificity of 91%, positive predictive value of 63%, and negative predictive value of 95% when applied to the initial 688 patients. Using the cutoff value with the clinically suspected patients as the reference group (9.3 nmol/109 platelets) gave a sensitivity of 63%, specificity of 99%, positive predictive value of 89%, and negative predictive value of 93%. Indole markers were increased in 169 (25%) of 688 patients. In 76 (45%) of these 169 patients, a carcinoid tumor was present. Slight increases of markers were associated with non-carcinoid neuroendocrine tumors, non-neuroendocrine tumors, and disturbed bowel motility. Conclusions: ROC curve analysis shows that platelet serotonin is the most discriminating indole marker for the diagnosis of carcinoid tumors. Platelet serotonin especially improves the diagnosis of carcinoids producing small amounts of serotonin.

Serotonin, catecholamines, histamine, and their metabolites in urine, platelets, and tumor tissue of patients with carcinoid tumors

1994 ◽  
Vol 40 (1) ◽  
pp. 86-95 ◽  
Author(s):  
I P Kema ◽  
E G de Vries ◽  
M J Slooff ◽  
B Biesma ◽  
F A Muskiet
Keyword(s):  
Tumor Tissue ◽  
Carcinoid Tumors ◽  
Platelet Serotonin ◽  
Histamine Production ◽  
Hydroxyindoleacetic Acid ◽  
Catecholamine Metabolites ◽  
Urinary Dopamine ◽  
Urinary Histamine ◽  
Primary Localization

Abstract We monitored long-term (median 11 months) concentrations of platelet serotonin and urinary serotonin, 5-hydroxyindoleacetic acid, and seven catecholamine metabolites in 44 patients with carcinoid tumors. Tumor serotonin and catecholamine contents (11 patients) and urinary histamine and N-methylhistamine (15 patients) were determined. Consistently increased concentrations of indoles, notably platelet serotonin, were observed in 96%, 43%, and 0% of patients with mid-, fore-, and hindgut carcinoids, respectively. Urinary dopamine metabolites, notably 3-methoxytyramine, were consistently increased in 38%, 20%, and 7% of patients with mid-, hind-, and foregut carcinoids, respectively. For urinary norepinephrine/epinephrine metabolites, notably normetanephrine and metanephrine, these data were 33%, 20%, and 14%, respectively. Midgut carcinoid tumors had the highest serotonin contents, whereas concentrations of catecholamines were independent of primary localization. There was no consistent relation between biogenic amine contents in tumors and urinary excretion of the amine metabolites. Occurrence of carcinoid syndrome was related to increased serotonin production rate. Increased histamine production is not an important feature in patients with lung carcinoids or liver-metastasized ileum carcinoids.

scholarly journals An infertile female delivered a baby after removal of primary renal carcinoid tumor

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 146-148
Author(s):  
Syu Jhang ◽  
Allen W. Chiu
Keyword(s):  
Carcinoid Tumor ◽  
English Literature ◽  
Carcinoid Tumors ◽  
Primary Infertility ◽  
First Case

Abstract Primary renal carcinoid tumors are exceedingly rare. We report a 37-year-old woman with primary infertility, who was found to have a primary renal carcinoid tumor. She became pregnant and gave birth to a baby after removal of the tumor. This is the first case in the English literature of primary renal carcinoid tumor related with primary infertility.

scholarly journals Our Parenchyma-Sparing Surgical Treatment Results in Carcinoid Tumors and Changes in the Surgical Approach

2021 ◽  
Author(s):  
Figen Türk ◽  
Gökhan Yuncu ◽  
Tolga Semerkant ◽  
Yasin Ekinci ◽  
Gökhan Öztürk
Keyword(s):  
Surgical Treatment ◽  
Carcinoid Tumor ◽  
Surgical Approach ◽  
Carcinoid Tumors ◽  
Diagnostic Methods ◽  
Normal Lung ◽  
Sleeve Resection ◽  
Surgical Methods ◽  
Prolonged Air Leak ◽  
Parenchyma Sparing

INTRODUCTION: Hilar/mediastinal lymph node sampling with lobectomy are the most common surgical methods used for the surgical treatment of carcinoid tumors. Bronchoplastic approaches together with lobectomy enable sparing of normal lung tissue and provide an alternative surgical approach to avoid pneumonectomy by enabling sleeve resection for centrally located tumors. The aim of this study was to present our parenchyma-sparing open surgical treatment experiences with the carcinoid tumor cases operated in our clinic in light of the new developments in the literature METHODS: The 11 tumor cases that had been diagnosed with carcinoid tumor and undergone surgical resection at our clinic between 2006 and 2012 were retrospectively revealed for tumor epidemiology, diagnostic methods, tumor localization, surgical treatment method, type and stage and postoperative complications. RESULTS: There were 7 males and 4 females with a mean age of 54.81±13.75 years (31-72 years). Cough was the most common presentation symptom with 8 cases (72.7%). A bronchoscopic biopsy was used for the definite diagnosis in 8 cases (72.7%). There were 11 (84.6%) typical and 2 (15.4%) atypical carcinoid tumors in the 11 cases. The most common surgical methods were lobectomy in 7 cases (53.8%) (3 sleeve, 1 bronchoplastic) and wedge resection in 4 cases. We found bilateral synchronous and 3 years later metachronous carcinoid tumor in a single case. The postoperative pathology diagnosis was T2N0M0 in 6 cases (54.5%) and T1N0M0 in 3 cases (27.2%). There was 1 atelectasis and 1 prolonged air leak in the postoperative stage. DISCUSSION AND CONCLUSION: Although we still use thoracotomy and lobectomy for the surgical treatment of carcinoid tumors in our clinic, we currently prefer minimal invasive surgery with the VATS and robotic surgery techniques that are gradually becoming more popular.

scholarly journals The single-cell transcriptional landscape of lung carcinoid tumors

2021 ◽  
Author(s):  
Philip Bischoff ◽  
Alexandra Trinks ◽  
Jennifer Wiederspahn ◽  
Benedikt Obermayer ◽  
Jan Patrick Pett ◽  
...  
Keyword(s):  
Gene Expression ◽  
Single Cell ◽  
Carcinoid Tumor ◽  
Expression Profiles ◽  
Gene Expression Profiles ◽  
Carcinoid Tumors ◽  
Cellular Composition ◽  
Cell Gene Expression ◽  
Cell Gene ◽  
Lung Carcinoid

AbstractLung carcinoid tumors, also referred to as pulmonary neuroendocrine tumors or lung carcinoids, are rare neoplasms of the lung with a more favorable prognosis than other subtypes of lung cancer. Still, some patients suffer from relapsed disease and metastatic spread while no consensus treatment exists for metastasized carcinoids. Several recent single-cell studies have provided detailed insights into the cellular heterogeneity of more common lung cancers, such as adeno- and squamous cell carcinoma. However, the characteristics of lung carcinoids on the single-cell level are yet completely unknown.To study the cellular composition and single-cell gene expression profiles in lung carcinoids, we applied single-cell RNA sequencing to three lung carcinoid tumor samples and normal lung tissue. The single-cell transcriptomes of carcinoid tumor cells reflected intertumoral heterogeneity associated with clinicopathological features, such as tumor necrosis and proliferation index. The immune microenvironment was specifically enriched in noninflammatory monocyte-derived myeloid cells. Tumor-associated endothelial cells were characterized by distinct gene expression profiles. A spectrum of vascular smooth muscle cells and pericytes predominated the stromal microenvironment. We found a small proportion of myofibroblasts exhibiting features reminiscent of cancer-associated fibroblasts. Stromal and immune cells exhibited potential paracrine interactions which may shape the microenvironment via NOTCH, VEGF, TGFβ and JAK/STAT signaling. Moreover, single-cell gene signatures of pericytes and myofibroblasts demonstrated prognostic value in bulk gene expression data.Here, we provide first comprehensive insights into the cellular composition and single-cell gene expression profiles in lung carcinoids, demonstrating the non-inflammatory and vessel-rich nature of their tumor microenvironment, and outlining relevant intercellular interactions which could serve as future therapeutic targets.

Platelet serotonin concentration in alcoholic subjects

Life Sciences ◽  
2004 ◽  
Vol 76 (5) ◽  
pp. 521-531 ◽  
Author(s):  
Nela Pivac ◽  
Dorotea Mück-Šeler ◽  
Maja Mustapić ◽  
Korona Nenadić-Šviglin ◽  
Dragica Kozarić-Kovačić
Keyword(s):  
Serotonin Concentration ◽  
Platelet Serotonin

scholarly journals Correlation Between Salivary, Platelet and Central Serotonin Levels in Children

2019 ◽  
Vol 47 (2) ◽  
pp. 214-218 ◽  
Author(s):  
Csilla Egri ◽  
Mary Dunbar ◽  
Gabriella Ana Horvath
Keyword(s):  
Clinical Care ◽  
Quantitative Measure ◽  
Therapeutic Monitoring ◽  
Metabolite Analysis ◽  
Strong Negative Correlation ◽  
Bivariate Correlation ◽  
Platelet Serotonin ◽  
Hydroxyindoleacetic Acid ◽  
Serotonin Turnover ◽  
Noninvasive Marker

ABSTRACT:Background:Serotonin (5-HT) is a neurotransmitter synthesized in both the central nervous system (CNS) and in enterochromaffin cells of the gut. 5-HT biosynthesis is separate between the periphery and the CNS. Any observed correlations between centrally and peripherally measured 5-HT remain to be elucidated. Previous efforts have looked for a noninvasive marker of central serotonin, including serotonin in whole blood, plasma, platelets, saliva, and urine; however, results are conflicting.Aim:Finding a noninvasive marker for central serotonin turnover that can be used for diagnosis and therapeutic monitoring in patients with primary neurotransmitter deficiencies.Methods:Inclusion criterion was all children presenting with neurological symptoms whose clinical investigations included lumbar puncture (LP) for cerebrospinal fluid (CSF) collection and neurotransmitter metabolite analysis, were recruited. For central serotonin turnover, the serotonin metabolite 5-hydroxyindoleacetic acid (5HIAA) was used. Bivariate correlation between the serotonin levels in CSF (5HIAA), platelets, and saliva was calculated.Results:Twenty-six patients (aged 6 months to 15 years) with various neurologic presentations had LP for CSF collection and neurotransmitter metabolite analysis as part of their clinical care. An additional salivary and blood sample was obtained at the same time. Eighteen patients had suitable samples for quantitative measure of serotonin. There was no correlation between platelet serotonin and CSF 5HIAA levels (Pearson’s coefficient of correlation – PCC: 0.010) or between salivary serotonin and CSF 5HIAA (PCC: 0.258). There was a strong negative correlation between salivary and platelet serotonin (PCC: −0.679).Conclusion:Our findings suggest that salivary serotonin measurement is not a suitable noninvasive marker for measuring central serotonin turnover.

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