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Serum markers for pancreatic islet cell and intestinal carcinoid tumors: a comparison of neuron-specific enolase, beta-human chorionic gonadotropin and pancreatic polypeptide.

Neuron-specific enolase (NSE) (a glycolytic enzyme that occurs only in neuroendocrine cells), human pancreatic polypeptide (hPP) (a probable peptide hormone), and the beta-subunit of human chorionic gonadotropin (beta hCG) (a glycoprotein hormone), have been suggested as serum markers for the diagnosis and management of apudomas of the pancreas and intestinal tract. Serum levels of NSE, hPP, and beta hCG were measured in 21 patients with pancreatic islet cell cancer (including nine "nonfunctioning" tumors, six gastrinomas, three glucagonomas, two insulinomas, and one somatostatinoma) and in five patients with intestinal carcinoid tumors. Sixteen of the 26 patients (62%) had elevated circulating levels of at least one tumor marker. All three markers were elevated in only one patient, a woman with a "nonfunctioning" islet cell carcinoma. Five patients had increased levels of two serum markers. In three patients both NSE and hPP levels were above normal and in two patients both NSE and beta hCG levels were above normal. In nine patients only one marker was elevated. These included six with elevated NSE levels, two with elevated hPP levels, and one with elevated beta hCG levels. Thus NSE levels were elevated in 12, hPP levels in six, and beta hCG levels in four of the 26 patients. While no single marker was elevated in all patients, each of the three can be elevated in an individual case. When elevated, these markers may be valuable to estimate prognosis or monitor response to therapy.

Adenoma, Islet Cell↗

[Adenocarcinoma of the small intestine. Endoscopic diagnosis (author's transl)].

Adenocarcinomas of the small intestine are among the rarest tumours of the digestive tract. Their prognosis, which is usually very bad, is due to late diagnosis. In a 54 year-old-man, formerly tuberculous, the first sign was abdominal pain without any specific character. The diagnosis was confirmed by jejunal endoscopy, with biopsy under direct vision. The technique was made easier by the tumour developing on the first loop of small intestine, leading to a curative surgical operation.

Adenocarcinoma↗

[An autopsy case of squamous cell carcinoma of the lung presenting with small and large bowel metastasis].

A 81-year-old male with primary squamous cell carcinoma of the lung was admitted because of melena. Upon autopsy, bleeding sites were found in the small and large bowel; they were lesions from the lung carcinoma. Gastrointestinal metastases from primary lung carcinoma are clinically rare, although they are seen in autopsy cases. Review of autopsy data on 1181 cases of primary lung carcinoma showed that 218 (18.5%) manifested gastrointestinal metastases.

Aged↗

An unusual case of malignant melanoma of the small intestine.

A 42-year-old woman presented with abdominal pain and diarrhea. Small bowel x-rays and endoscopy revealed a diffuse, infiltrating lesion of the small intestine, which on biopsy proved to be melanoma diffusely infiltrating the lamina propria. Because of marked hypoalbuminemia, protein-losing enteropathy was suspected. This is an unusual case, because melanoma of the small intestine usually does not produce diffuse involvement.

Adult↗

Site-specific cancer mortality among workers involved in the production of high nickel alloys.

This report describes the cause-specific mortality patterns of 28 261 workers employed at 12 plants involved in the production of high nickel alloys during the late 1950s and 1960s and followed up to 31 December 1977. Findings for site-specific cancers that have previously been related to nickel exposures are: (1) Overall, no statistically significant increased risk has been observed for cancers of the lung, nasal sinuses, larynx or kidney. (2) When data were examined by occupational groupings, an excess risk of dying from cancers of the lung of about 25-50% for males employed in maintenance categories has been noted. It is unclear whether the greater risk is directly associated with nickel exposures, particularly since a similar excess is not found in other occupational groups where nickel exposures are also present. Two other cancer sites, liver and large intestine, not previously associated with nickel exposures in epidemiological studies, demonstrate a statistically significant standardized mortality ratio (SMR). The SMRs are 182 and 233 respectively, and observed increases in SMRs are found primarily among longer-term workers in the industry but are not concentrated in a particular work area or occupational category. No conclusion regarding a causal association with nickel has been drawn for these two sites at this time.

Adult↗

[Rheumatoid polyarthritis with Gougerot-Sjögren's syndrome, pulmonary pseudolymphoma and digestive lymphoma. Apropos of a case].

The authors report a case of the Gougerot-Sjögren syndrome with rheumatoid arthritis, of particular interest because of lymphocytic proliferation. This was initially confined to the broncho-pulmonary tissues with histological appearances of pseudo-lymphoma, a diagnosis supported by clinical regression with immunosuppressive drugs, over a 5 years period. This difficult diagnosis needs histological, biochemical and clinical confirmation and, the very existence of this entity is debatable. The occurrence of a malignant lymphoma of the small intestine in the same patient a few years later is an argument in favour of the hypothesis that the pseudo-lymphoma was an intermediary pre-malignant stage of B-lymphocytic proliferation.

Adult↗