[A study of malignancy in gastro-intestinal carcinoids with special reference to the association of the prognosis and peptide hormone or oncofetal protein producing pattern].
It is difficult to differentiate malignant carcinoid tumors from benign ones early in the course of the illness. We investigated retrospectively a series of thirty-nine gastro-intestinal carcinoids not only for primary tumor anatomic site, macroscopic type, tumor size, histological depth, vessel invasion and mitosis, but also for peptide, ectopic hormone and oncofetal proteins by immunohistochemistry. Carcinoids primary in the appendix or rectum rarely metastasize, but those primary in the stomach or colon grow rapidly. Those greater than 2 cm in diameter and Borrmann's type had a poor prognosis. Carcinoids with deep penetration, vessel invasion or mitosis easily metastasize to lymph nodes or to the liver. Peptide hormone producing carcinoids were present in 21 of 39 (54%) tumors, but there were no correlation between the prognosis and peptide hormone producing patterns. Carcinoids producing carcinoembryonic antigen (CEA) were demonstrated in 11 of 37 (29%) tumors. These tumors were greater in size, more deeply penetrating and had more remarkable vessel invasion and mitosis than CEA non-producing ones. These results show that CEA producing carcinoids grow rapidly and easily metastasize. We concluded that these findings in carcinoid tissue appeared to be a reliable markers for metastasis and poor prognosis.
D002272:Carcinoembryonic Antigen / Q000096:biosynthesis*; D002276:Carcinoid Tumor / Q000378:metabolism / Q000473:pathology*; D005770:Gastrointestinal Neoplasms / Q000378:metabolism / Q000473:pathology*; D006729:Hormones, Ectopic / Q000096:biosynthesis*; D006801:Humans; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies
D002272:Carcinoembryonic Antigen; D006729:Hormones, Ectopic