title: Digestive calcitonin-secreting tumors of the foregut: comparison with non-calcitonin-secreting tumors.
abstract: OBJECTIVE
  Digestive calcitonin-secreting endocrine tumors are very rare lesions of the foregut. This study was undertaken to compare the characteristics and the prognosis of these tumors and those of non-calcitonin-secreting endocrine tumors.
  
  
  METHODS
  All patients with a digestive endocrine tumor of the foregut followed up in Reims University Hospital and whose serum calcitonin levels were determined between 1988 and 2004 were included. Clinical and tumor characteristics of calcitonin-positive and calcitonin-negative patients were compared.
  
  
  RESULTS
  Thirty-two patients were included. Among the five (15.6%) with high calcitonin levels (median: 340 pg/ml, range: 42-7460 pg/ml), only one tumor was functioning (diarrhea). Significant differences between patients with positive and negative calcitonin levels were, respectively: liver metastases [5 (100%) versus 11 (40.7%); P=0.04], type according to the World Health Organization 2000 histological classification [notably 4 (80%) versus 3 (12.5%) poorly differentiated endocrine carcinomas; P=0.02] and Ki67 proliferation index [median: 25% (range: 20-30%) versus 7% (0-80%); P=0.03]. The only calcitonin-positive well-differentiated endocrine carcinoma had a high proliferation index (30%). Survival also differed significantly (P=0.001), as all calcitonin-positive patients died, with a median survival of 22.6 months (range: 1.2-27.2 months), versus five (18.5%) calcitonin-negative patients. Median follow-up period for the latter was 42.3 months (range: 3.4-208 months).
  
  
  CONCLUSIONS
  The secretion of calcitonin appears predictive of a poor prognosis. Digestive endocrine calcitonin-secreting tumors correspond histopathologically to poorly differentiated or well-differentiated carcinomas with high proliferation indexes.
authors.affiliation: Department of Gastroenterology, Hôpital Robert-Debré, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Wuilmet
authors.forename: Nicolas
authors.initials: N
authors.lastname: Jovenin
authors.forename: Hélène
authors.initials: H
authors.lastname: Larbre
authors.forename: Nathalie
authors.initials: N
authors.lastname: Lévy-Bohbot
authors.forename: Marie-Danièle
authors.initials: MD
authors.lastname: Diebold
authors.forename: Damien
authors.initials: D
authors.lastname: Jolly
authors.forename: Brigitte
authors.initials: B
authors.lastname: Delemer
authors.forename: Gérard
authors.initials: G
authors.lastname: Thiéfin
authors.forename: Guillaume
authors.initials: G
authors.lastname: Cadiot
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002116:Calcitonin / Q000097:blood / Q000378:metabolism*; D004067:Digestive System Neoplasms / Q000097:blood / Q000378:metabolism* / Q000401:mortality; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D002116:Calcitonin