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Pancreastatin is an excellent circulating marker of metastatic neuroendocrine tumours
254 P A N C R E A S T A T I N IS AN E X C E L L E N T NEUROENDOCRINE TUMOURS
CIRCULATING
MARKER
OF M E T A S T A T I C
K.D. B U C H A N A N , S. J. M c G R A T H - L I N D E N and C. F. JOHNSTON, D e p a r t m e n t of M e d i c i n e , The Q u e e n ' s U n i v e r s i t y of Belfast, G r o s v e n o r Road, Belfast, BTI2 6BJ, N I r e l a n d
N e u r o e n d o c r i n e t u m o u r s (NETs) are f r e q u e n t l y c h r o m o g r a n i n (CG) p o s i t i v e by i m m u n o c y t o c h e m i s t r y . A partial s e q u e n c e of CGA, p a n c r e a s t a t i n (PST), has a l s o b e e n l o c a t e d in NETs. This study was d e s i g n e d to assess PST as a c i r c u l a t i n g m a r k e r for NETs as m e a s u r e d by r a d i o i m m u n o a s s a y . H e a l t h y s u b j e c t s (n=42) had a m e a n ]eve] of 18.6 ng/] (range 5-50). In a m i s c e l l a n e o u s g r o u p of p a t i e n t s (n=22) w i t h o u t NETs the m e a n ]eve] was 18.2 (range 5-50). P a t i e n t s w i t h s u c c e s s f u l l y r e s e c t e d NETs (n:4) had a m e a n ]eve] of 30 ng/] (range 15-40) and those w i t h non m e t a s t a t i c NETs (n=6) h a d a m e a n ]eve] of 20.8 (range 5-50). By c o n t r a s t p a t i e n t s w i t h m e t a s t a t i c c a r c i n o i d tumours (n:lT) had a m e a n ]eve] of 1785 ng/] (range 65-9000) and e l e v a t i o n s were a l s o n o t e d in non c a r c i n o i d NETs w i t h m e t a s t a s e s (n:6), m e a n 755 ng/], (range 55-2900). However patients with u n d e t e r m i n e d NETs w i t h m e t a s t a s e s (n=3) had normal levels, m e a n 21.6 ng/] (range 15-30). In c o n c l u s i o n the m e a s u r e m e n t of c i r c u l a t i n g levels of P S T - ] i k e i m m u n o r e a c t i v i t y is an e x c e l l e n t c i r c u l a t i n g m a r k e r of NETs w i t h m e t a s t a s e s , a l t h o u g h levels are not e l e v a t e d in non m e t a s t a t i c NETs nor in u n d e t e r m i n e d types w i t h m e t a s t a s e s .
FOUR
PATTERNS
OF E N D O C R I N E
CELL POPULATIONS
IN B A R R E T T ' S
OESOPHAGUS
A.J. R I T C H I E l, C.F. JOHNSTON1, J. M c G U I G A N 2 , J.R.P. G I B B O N S 2 and K.D. B U C H A N A N I, ] D e p a r t m e n t of M e d i c i n e , The Q u e e n ' s U n i v e r s i t y of Belfast, and 2 T h o r a c i c S u r g i c a l Unit, Royal V i c t o r i a Hospital, G r o s v e n o r Road, Belfast, BTI2 6BJ, N. I r e l a n d
The h y p o t h e s i s under test in this study is w h e t h e r or not the s p e c i f i c e n d o c r i n e cell p o p u l a t i o n s seen in normal g a s t r i c or intestinal tissue are e x p r e s s e d in the m e t a p ] a s t i c s p e c i a ] i s e d intestinal or g a s t r i c d i f f e r e n t i a t i o n m i m i c k e d by B a r r e t t ' s o e s o p h a g u s . Uti]ising immunohistochemica] t e c h n i q u e s we have e x a m i n e d 43 fuji t h i c k n e s s surgical s p e c i m e n s of o e s o p h a g u s , 35 in a s s o c i a t i o n w i t h m a l i g n a n t disease. General gastrointestinal tract e n d o c r i n e m a r k e r s such as p a n c r e a s t a t i n , c h r o m o g r a n i n A, s o m a t o s t a t i n and s e r o t o n i n w e r e c o m p a r e d w i t h s p e c i f i c intestinal m a r k e r s such as g a s t r i c i n h i b i t o r y peptide, cho]ecystokinin, secretin, n e u r o t e n s i n and m o t i ] i n w i t h g a s t r i c m a r k e r s such as g a s t r i n (GI7), s o m a t o s t a t i n (28). We d e t e c t e d four p a t t e r n s of e n d o c r i n e ceil e x p r e s s i o n . In the first there is no e n d o c r i n e ceil e x p r e s s i o n and we found this in the m a j o r i t y of a d e n o c a r c i n o m a s . The s e c o n d w h i c h m a t c h e s that e x p e c t e d in normal intestinal t i s s u e s was d e t e c t e d in 75% of s p e c i a ] i s e d intestinal m e t a p ] a s i a s w i t h e n d o c r i n e ceil expression. The t h i r d was c o n s i s t e n t w i t h that e x p e c t e d in normal g a s t r i c m u c o s a and was d e t e c t e d in 70% of g a s t r i c m e t a p ] a s i a s . In the f o u r t h an a b e r r a n t e n d o c r i n e ceil p o p u l a t i o n not n o r m a l l y seen in the o e s o p h a g u s in w h i c h PP, PYY and g ] u c a g o n ceil p o p u l a t i o n w e r e d e t e c t e d was found in d y s p ] a s i a s .
CIRCULATING
MARKER
OF M E T A S T A T I C
K.D. B U C H A N A N , S. J. M c G R A T H - L I N D E N and C. F. JOHNSTON, D e p a r t m e n t of M e d i c i n e , The Q u e e n ' s U n i v e r s i t y of Belfast, G r o s v e n o r Road, Belfast, BTI2 6BJ, N I r e l a n d
N e u r o e n d o c r i n e t u m o u r s (NETs) are f r e q u e n t l y c h r o m o g r a n i n (CG) p o s i t i v e by i m m u n o c y t o c h e m i s t r y . A partial s e q u e n c e of CGA, p a n c r e a s t a t i n (PST), has a l s o b e e n l o c a t e d in NETs. This study was d e s i g n e d to assess PST as a c i r c u l a t i n g m a r k e r for NETs as m e a s u r e d by r a d i o i m m u n o a s s a y . H e a l t h y s u b j e c t s (n=42) had a m e a n ]eve] of 18.6 ng/] (range 5-50). In a m i s c e l l a n e o u s g r o u p of p a t i e n t s (n=22) w i t h o u t NETs the m e a n ]eve] was 18.2 (range 5-50). P a t i e n t s w i t h s u c c e s s f u l l y r e s e c t e d NETs (n:4) had a m e a n ]eve] of 30 ng/] (range 15-40) and those w i t h non m e t a s t a t i c NETs (n=6) h a d a m e a n ]eve] of 20.8 (range 5-50). By c o n t r a s t p a t i e n t s w i t h m e t a s t a t i c c a r c i n o i d tumours (n:lT) had a m e a n ]eve] of 1785 ng/] (range 65-9000) and e l e v a t i o n s were a l s o n o t e d in non c a r c i n o i d NETs w i t h m e t a s t a s e s (n:6), m e a n 755 ng/], (range 55-2900). However patients with u n d e t e r m i n e d NETs w i t h m e t a s t a s e s (n=3) had normal levels, m e a n 21.6 ng/] (range 15-30). In c o n c l u s i o n the m e a s u r e m e n t of c i r c u l a t i n g levels of P S T - ] i k e i m m u n o r e a c t i v i t y is an e x c e l l e n t c i r c u l a t i n g m a r k e r of NETs w i t h m e t a s t a s e s , a l t h o u g h levels are not e l e v a t e d in non m e t a s t a t i c NETs nor in u n d e t e r m i n e d types w i t h m e t a s t a s e s .
FOUR
PATTERNS
OF E N D O C R I N E
CELL POPULATIONS
IN B A R R E T T ' S
OESOPHAGUS
A.J. R I T C H I E l, C.F. JOHNSTON1, J. M c G U I G A N 2 , J.R.P. G I B B O N S 2 and K.D. B U C H A N A N I, ] D e p a r t m e n t of M e d i c i n e , The Q u e e n ' s U n i v e r s i t y of Belfast, and 2 T h o r a c i c S u r g i c a l Unit, Royal V i c t o r i a Hospital, G r o s v e n o r Road, Belfast, BTI2 6BJ, N. I r e l a n d
The h y p o t h e s i s under test in this study is w h e t h e r or not the s p e c i f i c e n d o c r i n e cell p o p u l a t i o n s seen in normal g a s t r i c or intestinal tissue are e x p r e s s e d in the m e t a p ] a s t i c s p e c i a ] i s e d intestinal or g a s t r i c d i f f e r e n t i a t i o n m i m i c k e d by B a r r e t t ' s o e s o p h a g u s . Uti]ising immunohistochemica] t e c h n i q u e s we have e x a m i n e d 43 fuji t h i c k n e s s surgical s p e c i m e n s of o e s o p h a g u s , 35 in a s s o c i a t i o n w i t h m a l i g n a n t disease. General gastrointestinal tract e n d o c r i n e m a r k e r s such as p a n c r e a s t a t i n , c h r o m o g r a n i n A, s o m a t o s t a t i n and s e r o t o n i n w e r e c o m p a r e d w i t h s p e c i f i c intestinal m a r k e r s such as g a s t r i c i n h i b i t o r y peptide, cho]ecystokinin, secretin, n e u r o t e n s i n and m o t i ] i n w i t h g a s t r i c m a r k e r s such as g a s t r i n (GI7), s o m a t o s t a t i n (28). We d e t e c t e d four p a t t e r n s of e n d o c r i n e ceil e x p r e s s i o n . In the first there is no e n d o c r i n e ceil e x p r e s s i o n and we found this in the m a j o r i t y of a d e n o c a r c i n o m a s . The s e c o n d w h i c h m a t c h e s that e x p e c t e d in normal intestinal t i s s u e s was d e t e c t e d in 75% of s p e c i a ] i s e d intestinal m e t a p ] a s i a s w i t h e n d o c r i n e ceil expression. The t h i r d was c o n s i s t e n t w i t h that e x p e c t e d in normal g a s t r i c m u c o s a and was d e t e c t e d in 70% of g a s t r i c m e t a p ] a s i a s . In the f o u r t h an a b e r r a n t e n d o c r i n e ceil p o p u l a t i o n not n o r m a l l y seen in the o e s o p h a g u s in w h i c h PP, PYY and g ] u c a g o n ceil p o p u l a t i o n w e r e d e t e c t e d was found in d y s p ] a s i a s .