Treatment of ECL cell carcinoids with octreotide LAR.
BACKGROUND
Patients with chronic atrophic gastritis (CAG) and hypergastrinaemia are at risk of developing hyperplasia of the enterochromaffin-like (ECL) cells and ECL-cell-derived tumours. The effect of the somatostatin analogue octreotide on ECL cell carcinoids is examined.


METHODS
Five patients with hypergastrinaemia and ECL cell carcinoids were enrolled in a 1-year study of octreotide LAR (long-acting release) 20 mg given at monthly intervals. Biopsies from tumours and from flat oxyntic mucosa were done at the start and 3, 6 and 12 months thereafter. Sections were stained with haematoxylin-erythrosin, immunostained with chromogranin A (CgA) and doublestained with CgA and Ki-67. Serum gastrin and CgA were measured.


RESULTS
The number of visible tumours was reduced by more than 50 %. Sections from both tumours and flat mucosa showed a reduced number of CgA immunoreactive cells. Mean serum gastrin decreased from 421 to 186 pM (normal <40 pM); P > 0.05, and serum CgA from 73 to 25 ng/ml (normal < 30 ng/ml); P < 0.001.


CONCLUSIONS
During treatment the patients were still markedly hypergastrinaemic, whereas the serum CgA showed normalization. A diminished tumour load and reduced ECL cell density were found, indicating an antiproliferative effect of octreotide directly on the ECL cells.
Fykse
V
V
Department of Cancer Research and Molecular Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
Sandvik
A K
AK
Qvigstad
G
G
Falkmer
S E
SE
Syversen
U
U
Waldum
H L
HL
D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage*; D002276:Carcinoid Tumor / Q000188:drug therapy* / Q000473:pathology; D049109:Cell Proliferation / Q000187:drug effects; D053379:Chromogranin A; D002864:Chromogranins / Q000097:blood / Q000187:drug effects; D003692:Delayed-Action Preparations; D019861:Enterochromaffin-like Cells / Q000187:drug effects*; D005260:Female; D005753:Gastric Mucosa / Q000187:drug effects / Q000473:pathology; D005755:Gastrins / Q000097:blood / Q000187:drug effects; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000008:administration & dosage*; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology; D013997:Time Factors
D018931:Antineoplastic Agents, Hormonal; D053379:Chromogranin A; D002864:Chromogranins; D003692:Delayed-Action Preparations; D005755:Gastrins; D015282:Octreotide