The neuroendocrine markers assay and the glycemia profile in patients with neuroendocrine tumors under octreotide therapy: a 2 years study / Determinarea markerilor neuroendocrini şi a profilului glicemic la pacienţii cu tumori neuroendocrine în tratament cu octreotid

Open access


The neuroendocrine tumors (NETs) are more frequent during the last decades. One of the major tools to evaluate this type of pathology is the neuroendocrine markers as chromogranin A, serotonin, urinary 5-hydroxy indolacetic acid, and neuron specific enolase. They change related to the disease progression, regardless therapy. Some of the drugs that are used for NETs as somatostatin analogs (for example octreotide) might interfere with glucose metabolism. Objectives. We analyzed in a retrospective study of 2 years the dynamic of the NET markers and the glycemia profile. Material and Methods. All the patients had at least one assay per year. Results. 9 patients were included (5 women and 4 men), with a mean age of 57.33 years. They were treated before the study with octreotide for 18 +/- 14.69 months. The dose of octreotide varied from 20 to 50 mg, monthly. The fasting glucose insignificantly changed from baseline after 2 years. No new case of diabetes was registered. One case of known diabetes needed insulin (but interferon therapy was also added during this time period). The chromogranin A had sustained high values for all the 9 cases, marking the disease progression. The neuron specific enolase significantly increased, and the serum serotonin as well as the 5HIIA was much higher in 2 cases with aggressive carcinoid symptoms. Conclusion. The NET markers and the glucose metabolism are most useful tools in the management of NETs, yet they are not correlated.

1. Barakat MT, Meeran L, Bloom SR. Neuroendocrine tumors. Endocr Relat Cancer. 2004 Mar;11(1):1-18. DOI: 10.1677/erc.0.0110001

2. Oberndorfer S. Karzinoide tumoren des dunndarms. Frank Z Pathol. 1907;1:426-432.

3. Salazar R, Wiedenmann B, Rindi G, Ruszniewski P. ENETS 2011 Consensus Guidelines for the Management of Patients with Digestive Neuroendocrine Tumors: An Update. Neuroendocrinology. 2012;95(2):71-3. DOI: 10.1159/000335600

4. Pinchot S, Holen K, Sippel R, Chen H. Carcinoid Tumors. Oncologist. 2008;13(12):1255-1269. DOI: 10.1634/theoncologist.2008-0207

5. Bellizzi AM. Assigning site of origin in metastatic neuroendocrine neoplasms: a clinically significant application of diagnosis immunohistochemistry. Adv Anat Pathol. 2013 Sep;20(5):285-314. DOI: 10.1097/ PAP.0b013e3182a2dc67

6. Fisher-Colbrie R, Hagn C, Schober M. Chromogranins A, B, C: widespread consitituents of secretory vesicles. Ann N Y Acad Sci. 1987;493:120-34. DOI: 10.1111/ j.1749-6632.1987.tb27189.x

7. Bajetta E, Ferrari L, Martinetti A, Celio L, Procopio G, Artale S, et al. Chromogranin A, neuron specific enolase, carcinoembryonic antigen, and hydroxyindole acetic acid evaluation in patients with neuroendocrine tumors. Cancer. 1999;86(5):858-865. DOI: 10.1002/ (SICI)1097-0142(19990901)86:5<858::AID-CNCR23> 3.0.CO;2-8

8. Iacangelo AL, Eiden LE. Chromogranin A: current status as a precursor for bioactive peptide and a granulogenic/sorting factor in the regulated secretory pathway. Regul Pept. 1995 Aug 22;58(3):65-88. DOI: 10.1016/0167-0115(95)00069-N

9. Poiană C, Neamţu MC, Avramescu ET, Carşote M, Trifănescu R, Terzea D, et al. The poor prognosis factors in G2 neuroendocrine tumor. Rom J Morphol Embryol. 2013;54(3 Suppl):717-20.

10. Poiană C, Neamţu MC, Avramescu ET, Carşote M, Trifănescu R, Terzea D, et al. The dedifferentiation of neuroendocrine tumor metastases: myth or reality? Rom J Morphol Embryol. 2013;54(1):201-3.

11. Groth CM, Banzon ER. Octreotide for the treatment of hypoglycemia after insulin glargine overdose. J Emerg Med. 2013 Aug;45(2):194-8. DOI: 10.1016/j. jemermed.2012.11.099

12. Vinik Al, Silva MP, Woltering EA, Go VL, Warner R, Caplin M. Biochemical testing for neuroendocrine tumors. Pancreas. 2009;38(8):876-89. DOI: 10.1097/ MPA.0b013e3181bc0e77

13. Lawrence B, Gustafsson Bl, Kidd M, Pavel M, Svejda B, Modlin M. The clinical relevance of chromogranin A as a biomarker for gastroenteropancreatic neuroendocrine tumors. Endocrinol Metab Clin North Am 2011;40(1):111-34. DOI: 10.1016/j.ecl.2010.12.001

14. Poiană C, Carşote M, Neamtu MC, Avramescu ET, Vasilescu F, Terzea D, et al. Well-differentiated neuroendocrine tumor and osteoporosis: incidental finding? Rom J Morphol Embryol. 2013;54(4):1169-71.

15. Oberg K, Norheim I, Theodorsson E. Treatment of malignant midgut carcinoid tumours with a long-acting somatostatin analogue octreotide. Acta Oncol. 1991;30(4):503-7. DOI: 10.3109/02841869109092409

16. Panzuto F, Di Fonzo M, Iannicelli E, Sciuto R, Maini CL, Capurso G, et al. Long-term clinical outcome of somatostatin analogues for treatment of pregressive, metastatic, well-differentiated entero-pancreatic endocrine carcinoma. Ann Oncol. 2006;17(3):461-6. DOI: 10.1093/annonc/mdj113

17. Butturini G, Bettini R, Missiaglia E, Mantovani W, Dalai I, Capelli P, et al. Predictive factors of efficacy of the somatostatin analogue octreotide as first line therapy for advanced pancreatic endocrine carcinoma. Endocr Relat Cancer. 2006;13(4):1213-21. DOI: 10.1677/ erc.1.01200

Revista Romana de Medicina de Laborator

Romanian Journal of Laboratory Medicine

Journal Information

IMPACT FACTOR 2018: 0,800
5-year IMPACT FACTOR: 0,655

CiteScore 2017: 0.31

SCImago Journal Rank (SJR) 2018: 0.194
Source Normalized Impact per Paper (SNIP) 2018: 0.306


All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 222 142 7
PDF Downloads 73 62 5