Clinical Significance of Serum Gastrin Levels in Patients with Colorectal Cancer

2004 ◽  
Vol 19 (1) ◽  
pp. 46-51 ◽  
Author(s):  
A. Tocchi ◽  
G. Mazzoni ◽  
F. Puma ◽  
M. Miccini ◽  
G. Daddi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Serum Gastrin ◽  
Elevated Serum ◽  
Gastrin Level ◽  
Tumor Stage ◽  
Curative Surgery ◽  
Serum Gastrin Concentration ◽  
Well Differentiated ◽  
A Prospective Study ◽  
Degree Of Differentiation

Aims An association between elevated serum gastrin levels and the presence of human colorectal cancer has been reported, and gastrin has been shown to stimulate the growth of experimentally induced colon neoplasia. The aim of this study was to determine the preoperative and postoperative concentrations of serum gastrin in 53 patients with colorectal cancer and to assess the correlation between gastrin levels and tumor characteristics and prognosis. Materials and Methods A prospective study was performed over a six-year period during which 53 patients received potentially curative surgery for colorectal cancer. The prognostic variables used for the analysis included age, sex, tumor site, stage and degree of differentiation, preoperative and postoperative serum values of carcinoembryonic antigen (CEA) and gastrin, cancer-related mortality, and survival. CEA and gastrin serum values were determined using radioimmunological methods. Follow-up was carried out with clinical and radiological tests. Results The mean preoperative gastrin concentration was 51.2 ± 27.4 pg/mL (range 12–146). Significantly increased serum gastrin concentrations, which returned to normal after surgery, were detected only in patients with well-differentiated cancer (74.2 ± 28.3 pg/mL; moderately differentiated, 52.1 ± 23.8; poorly differentiated, 29.9 ± 12.3, p=0.02). The prognosis was unrelated to serum gastrin level; instead, tumor stage, preoperative CEA value, and degree of differentiation affected patient survival. Conclusions This study showed that the serum gastrin concentration is not an appropriate clinical oncogenic factor. Although occurring only in well-differentiated tumors, serum gastrin is unrelated to the prognosis of patients with colorectal cancer.

T1036 Clinical and Laboratory Features of Patients with Significantly Elevated Serum Gastrin Level

2009 ◽  
Vol 136 (5) ◽  
pp. A-485 ◽  
Author(s):  
Gokhan Kabacam ◽  
Mehmet Bektas ◽  
Yusuf Ustun ◽  
Mustafa Yakut ◽  
Murat Toruner ◽  
...  
Keyword(s):  
Serum Gastrin ◽  
Elevated Serum ◽  
Gastrin Level ◽  
Serum Gastrin Level ◽  
Laboratory Features

Congenital Hypertrophic Pyloric Stenosis: The Role of Gastrin Reevaluated

PEDIATRICS ◽  
1978 ◽  
Vol 61 (6) ◽  
pp. 883-885
Author(s):  
Steven L. Werlin ◽  
Richard J. Grand ◽  
David E. Drum
Keyword(s):  
Cord Blood ◽  
Pyloric Stenosis ◽  
Potential Role ◽  
Serum Gastrin ◽  
Hypertrophic Pyloric Stenosis ◽  
Elevated Serum ◽  
Serum Gastrin Concentration ◽  
Congenital Hypertrophic Pyloric Stenosis ◽  
The Mean

In order to evaluate the potential role of gastrin in the etiology of pyloric stenosis, serum gastrin levels were measured in cord blood of affected infants, matched controls, and mothers of both. No differences were identified when values from infants with pyloric stenosis were compared with those from control infants. Mean cord serum gastrin levels of the infants were significantly greater than the mean maternal gastrin levels. The data effectively dismiss the possibility that elevated serum gastrin concentration in mother or infant at the time of delivery can be implicated as a cause of pyloric stenosis.

Association between smoking and tumor grade in colorectal cancer: A retrospective analysis from a single institution.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e14673-e14673
Author(s):  
Raymond Elsoueidi ◽  
Sabrina Tom ◽  
Eyob Adane ◽  
Mark Dignan
Keyword(s):  
Colorectal Cancer ◽  
Tumor Grade ◽  
Smoking History ◽  
Low Grade ◽  
High Grade ◽  
Age And Gender ◽  
Poorly Differentiated ◽  
Well Differentiated ◽  
And Gender ◽  
Degree Of Differentiation

e14673 Background: Colorectal cancer is the third most common cancer worldwide. Smoking has been increasingly reported as a risk factor. Poorly differentiated adenocarcinoma in colorectal cancer has been reported to have a worse outcome. Poorly and moderately differentiated adenocarcinomas in Non Small Cell Lung cancer were more strongly correlated with smoking than well differentiated adenocarcinoma. This study was designed to evaluate the association between cigarette smoking and tumor grade in colorectal cancer. Methods: The medical records of patients diagnosed with colorectal cancer between 2001 and 2011 at the Appalachian Regional Healthcare in Hazard, KY were retrospectively reviewed. Age, gender, pathology and smoking history were obtained. The association between smoking and tumor grade was evaluated by the χ2 test. Results: Three hundred seventeen patients were diagnosed with colorectal cancer between 2001 and 2011. The percentage of male and female patients was 53.3% and 46.7%, respectively. Among these patients, 49.5% (n=157) were smokers and 38.8% were nonsmokers (n=138), while for 11.7% (n=35) of patients smoking history was unknown. In smokers, 17.1% had high grade adenocarcinoma (poorly differentiated) and 82.9% had low grade adenocarcinoma (moderately differentiated + well differentiated) whereas in non-smokers, 13.8% had high grade adenocarcinoma and 86.2% had low grade adenocarcinoma. Although the percentage of high grade adenocarcinoma was higher among smokers this was not statistically significantly (p=0.55). Moreover, tumor grade was not significantly associated with age and gender. Conclusions: Based on these results, there was no association between degree of differentiation of tumor in colorectal cancer and smoking history, age and gender. Although to be noted that the pathologic grading may vary from one pathologist to another.

scholarly journals Adequate lymphadenectomy for colorectal cancer: a comparative analysis between open and laparoscopic surgery

2015 ◽  
Vol 28 (2) ◽  
pp. 105-108
Author(s):  
Vilson Leite BATISTA ◽  
Antonio Carlos Ribeiro Garrido IGLESIAS ◽  
Fernando Athayde Veloso MADUREIRA ◽  
Anke BERGMANN ◽  
Rachel Perez DUARTE ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Lymph Nodes ◽  
Open Surgery ◽  
Tumor Stage ◽  
Disease Stage ◽  
Stage Number ◽  
Advanced Disease Stage ◽  
Degree Of Differentiation ◽  
To Receive

BACKGROUND: In the surgical treatment of colorectal cancer, a lymphadenectomy is considered adequate when at least 12 lymph nodes are removed. AIM: To evaluate whether videolaparoscopic surgery positively affects the rates of adequate lymphadenectomy. METHODS: An observational study was conducted with patients undergoing either open or videolaparoscopic surgery for colorectal cancer between 2008 and 2013. The following variables were collected: gender, age, tumor site, histology, degree of differentiation, tumor stage, number of lymph nodes removed, and number of lymph nodes affected by the disease. RESULTS: A total of 62 patients with colorectal cancer were included; 42 (67.7%) received open surgery, and 20 (32.3%) laparoscopic surgery. Regarding lymphadenectomy, a mean of 13 lymph nodes (95% CI: 10-16) were removed in the group that received open surgery, while 19 lymph nodes were removed (95% CI: 14-24) in the laparoscopic surgery group (p=0.021). Adequate lymphadenectomy (removal of at least 12 lymph nodes) was achieved in 58.1% of the total cases, in 50.0% of the patients who received open surgery, and in 75% of those who received laparoscopic surgery. Non-elderly patients and those with an advanced disease stage were more likely to receive an adequate lymphadenectomy (p=0.004 and p=0.035, respectively). CONCLUSION: Disease stage and patient age were the factors that had the greatest influence on achieving an adequate lymphadenectomy. The type of surgery did not affect the number of lymph nodes removed.

scholarly journals Malignant Range Elevation of Serum Chromogranin A due to Inadvertent Use of Proton Pump Inhibitor in a Subject with Pancreatic Incidentaloma

2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
Usman Hammawa Malabu ◽  
Rozemary Karamatic ◽  
Gillian Mahy ◽  
Kunwarjit Singh Sangla
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Chromogranin A ◽  
Serum Gastrin ◽  
Elevated Serum ◽  
Gastrin Level ◽  
Morbidly Obese ◽  
Ultrasound Guided ◽  
Pancreatic Biopsy ◽  
Pancreatic Incidentaloma

We present a case of highly elevated tenfold rise of serum chromogranin A in a young, morbidly obese, hypertensive female being investigated for pancreatic mass, weight loss, and elevated ESR. Following extensive noninvasive investigations, an ultrasound-guided pancreatic biopsy confirmed benign haemorrhagic cyst. A clue to the etiology of the hyperchromogranin A was the elevated serum gastrin level leading to suspicion of proton pump inhibitor administration confirmed by admittance to its use. Withdrawal of the medication led to dramatic resolution of the neuroendocrine tumor marker.

scholarly journals Primary hepatic gastrinoma being diagnosed preoperatively: a case report and literature review

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Shunya Hanzawa ◽  
Hiroshi Sadamori ◽  
Masaaki Kagoura ◽  
Kazuteru Monden ◽  
Masayoshi Hioki ◽  
...  
Keyword(s):  
Serum Gastrin ◽  
Somatostatin Receptor ◽  
Gastrin Level ◽  
Serum Gastrin Level ◽  
Cystic Degeneration ◽  
Hepatic Lobectomy ◽  
Zollinger Ellison Syndrome ◽  
Right Hepatic Lobectomy ◽  
Serum Gastrin Concentration ◽  
Primary Hepatic Gastrinoma

Abstract Background A majority of gastrinomas causing Zollinger–Ellison syndrome are located in the duodenum or pancreas. Primary hepatic gastrinomas are rare and difficult to diagnose. We report a rare case of primary hepatic gastrinoma, which could be diagnosed preoperatively. Case presentation A 29-year-old man with a 55-mm tumor in segments 5 and 6 (S 5/6) of the liver was admitted to our hospital. After thorough investigations, he was treated for a suspected inflammatory pseudotumor and advised to undergo routine follow-up. Two years later, he revisited our hospital with a complaint of abdominal pain, vomiting, and diarrhea. Upper gastrointestinal endoscopy revealed multiple duodenal ulcers. His serum gastrin level was 2350 pg/mL (normal: 37–172 pg/mL), suggesting Zollinger–Ellison syndrome. Abdominal computed tomography showed a 78-mm hypervascular tumor with cystic degeneration in the S 5/6 region of the liver, with a potential to increase over time. The tumor showed hypointensity on T2-weighted and hyperintensity on diffusion-weighted abdominal contrast-enhanced magnetic resonance imaging. Somatostatin receptor scintigraphy (SRS) only detected a hepatic tumor. No tumors in the gastrinoma triangle were detected by endoscopic ultrasonography. Hence, selective arterial calcium injection (SACI) test was performed to determine the location of the gastrinoma. The serum gastrin concentration increased from 4620 pg/mL to 23,600 pg/mL at 20 s after calcium gluconate injection into the proper hepatic artery. Conversely, no effect on serum gastrin level was observed after the injection into any other arteries. Extended right hepatic lobectomy and cholecystectomy were performed after percutaneous transhepatic portal vein embolization. A histopathological examination of the liver tumor revealed a gastrinoma. The patient’s serum gastrin concentration on postoperative day 1 decreased to 65 pg/mL. Conclusion We report a surgical case of primary hepatic gastrinoma correctly diagnosed preoperatively. The patient underwent extended right hepatic lobectomy, resulting in a histological definitive diagnosis of primary hepatic gastrinoma.

scholarly journals Low Level of Microsatellite Instability Correlates with Poor Clinical Prognosis in Stage II Colorectal Cancer Patients

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Ehsan Nazemalhosseini Mojarad ◽  
Seyed Mohammad Hossein Kashfi ◽  
Hanieh Mirtalebi ◽  
Mohammad Yaghoob Taleghani ◽  
Pedram Azimzadeh ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Microsatellite Instability ◽  
Prognostic Significance ◽  
Tumor Stage ◽  
Cross Sectional Study ◽  
Stage Ii ◽  
Curative Surgery ◽  
Cross Sectional ◽  
Clinical Prognosis ◽  
Distinct Subgroup

The influence of microsatellite instability (MSI) on the prognosis of colorectal cancer (CRC) requires more investigation. We assessed the role of MSI status in survival of individuals diagnosed with primary colorectal cancer. In this retrospective cross-sectional study the MSI status was determined in 158 formalin-fixed paraffin-embedded tumors and their matched normal tissues from patients who underwent curative surgery. Cox proportional hazard modeling was performed to assess the clinical prognostic significance. In this study we found that MSI-H tumors were predominantly located in the colon versus rectum (p=0.03), associated with poorer differentiation (p=0.003) and TNM stage II/III of tumors (p=0.02). In CRC patients with stage II, MSI-L cases showed significantly poorer survival compared with patients who had MSI-H or MSS tumors (p=0.04). This study indicates that MSI-L tumors correlate with poorer clinical outcome in patients with stage II tumors (p=0.04) or in tumors located in the colon (p=0.02). MSI-L characterizes a distinct subgroup of CRC patients who have a poorer outcome. This study suggests that MSI status in CRC, as a clinical prognostic marker, is dependent on other factors, such as tumor stage and location.

scholarly journals Iron Malabsorption Associated with Elevated Serum Gastrin

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 3364-3364
Author(s):  
Michael Boxer
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Serum Gastrin ◽  
Elevated Serum ◽  
Intravenous Iron ◽  
Gastrin Level ◽  
Deficiency Anemia ◽  
Gliadin Antibodies ◽  
Gluten Enteropathy ◽  
Iron Replacement

Iron deficiency anemia (IDA) in the absence of gastrointestinal (GI) bleeding is a common cause for hematologic consultation. During a 24 month period a single hematologist evaluated 36 patients for iron deficiency anemia which was unresponsive to oral iron replacement. Patients who had active GI bleeding, bariatric or extensive gastric surgery, or menorrhagia were excluded from this study. Hematologic testing included a serum gastrin level, Helicobacter pylori antibodies, and anti gliadin antibodies. Serum cobalamin levels were not measured. 28 patients had elevated gastrin levels, 3 patients had positive anti gliadin antibodies, and 2 patients had positive anti Helicobacter antibodies. One patient had both an elevated gastrin level and a positive anti gliadin antibody. One patient had both an elevated gastrin level and an anti helicobacter antibody. One patient had profound hypothyroidism (TSH>100) whose iron deficiency corrected with thyroid replacement. Proton pump inhibitors (PPI) raise the serum gastrin levels. 16 patients with an elevated serum gastrin level were taking PPI when the gastrin measurements were obtained. However, the remaining 14 patients were not taking a PPI when gastrin levels were measured. 23 patients were women and 13 were men. No patient was under 40 years old. 11 were between 45 and 59 years of age. 25 were between 63 and 88 years old. 26 patients were non Hispanic caucasians, 8 were Hispanic caucasians, and 1 patient was African American. In the absence of a gastrin secreting tumor or use of a PPI an elevated gastrin suggests that autoimmune gastric atrophy is present which can cause both iron and vitamin B12 malabsorption. Iron malabsorption does occur in gluten enteropathy which is diagnosed by positive anti gliadin antibodies. Helicobacter infections are also associated with iron malabsorption. Intravenous iron replacement with iron dextran was administered to 35 patients. Two patients had minor reactions to iron dextran. One subsequently received iron sucrose without incident, but the other patient did not tolerate iron sucrose, iron carboxymaltose, and ferric gluconate. The 28 patients with an elevated gastrin has a complete response to intravenous iron replacement except the one patient who was intolerant to all intravenous iron preparations. Those with celiac sprue and helicobacter infections responded incompletely to intravenous iron therapy and required dietary modification and anti helicobacter therapy. An abnormal gastric biopsy was found in 3 of 28 patients with an elevated serum gastrin level. None of the 4 patients with a Helicobacter infection, gluten enteropathy, or severe hypothyroidism had a diagnostic esophagogastroduodenoscopy. In this small study no clear relationship between an elevated gastrin and either gluten enteropathy or a Helicobacter was present. This study has two interesting conclusions. First PPI therapy alone can cause iron deficiency anemia due to iron malabsorption. Also autoimmune gastric atrophy is a probable cause of IDA even when the gastrointestinal evaluation does not demonstrate bleeding or gastric atrophy. Both conditions are associated with an elevated serum gastrin. Serum gastrin measurement should be obtained during an evaluation for iron deficiency of unclear etiology. Disclosures No relevant conflicts of interest to declare.

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