Endocrine Pathology: pp 351-365 | Cite as
Endocrine Tumors of the Gastrointestinal System
Abstract
Endocrine tumors of the gastrointestinal tract constitute a heterogeneous anatomical and functional group of cells with respect to clinical syndromes, clinico-pathological associations, and prognosis. The WHO classification is now used for the diagnosis and classification of these tumors with respect to anatomical location, tumor cell type, and differentiation. These include well-differentiated endocrine tumors with benign behavior, low-grade well-differentiated endocrine carcinomas, and high-grade poorly differentiated endocrine carcinomas. Cellular and molecular studies, such as Ki67 index, p53 overexpression or mutations, and loss of heterozygosity have contributed to the understanding of these tumors and the ability to predict the behavior of these tumors.
Keywords
Gastrointestinal endocrine tumors Stomach Small intestine–duodenum Large intestine AppendixNotes
Ackowledgements
This work was in part supported by grants from the Italian Ministry of the University and Scientific and Technological Research, the Ministry of Health and the University of Parma (to GR and CB).
References
- 1.Heidenhain R (1870) Unterschunger über den Bau der Labdrüser. Ark Mikrosk Anat 6:368–406Google Scholar
- 2.Nicolas A (1891) Recherches sur l'épithélium de l'intestine grele. Int Mschr Anat Physiol 8:1–8Google Scholar
- 3.Kultschitzky N (1897) Zur Frage über den Bau des Darmcanals. Arch Mikrosk Anat 49:7–35Google Scholar
- 4.Schmidt JE (1905) Beiträge zur normalen und patologischen Histologie eininger Zellarten der Schleimhaut des menschlichen Darm-Kanals. Arch Mikrosk Anat 66:12–40Google Scholar
- 5.Ciaccio C (1907) Sopra speciali cellule granulose della mucosa intestinale. Arch Ital Anat Embriol 6:482Google Scholar
- 6.Bayliss WM, Starling EH (1902) The mechanism of pancreatic secretion. J Physiol 28:325–353PubMedGoogle Scholar
- 7.Bayliss WM, Starling EH (1902) On the causation of the so-called peripheral reflex secretion of the pancreas. Proc R Soc Lond B Biol Sci 69:352–353Google Scholar
- 8.Feyrter F (1938) Über diffuse endokrine epitheliale Organe. Liepzig Zentr Inn Mediz 29:545–571Google Scholar
- 9.Masson P (1914) La glande endocrine del'intestin chez l'homme. Compt Rend Hebdom Seances Acad Sci 158:52–61Google Scholar
- 10.Feyrter F (1953) Über die peripheren endockrinen (parakrinen) Druesen des Menschen. Maudrich W, Wien, DüsseldorfGoogle Scholar
- 11.Pearse AGE (1966) Common cytochemical properties of cells producing polypeptide hormones, with particular reference to calcitonin and C-cells. Vet Records 79:303–313Google Scholar
- 12.Pearse AGE (1969) The cytochemistry and ultrastructure of polypeptide-hormone producing cells of the APUD series and the embryologic, physiologic and pathologic implication of the concept. J Histochem Cytochem 17:303–313PubMedGoogle Scholar
- 13.Erspamer V, Asero B (1952) Identification of enteramine, the specific hormone of the enetrochromaffin cell system, as 5-hydroxytryptamine. Nature 169:800–801PubMedGoogle Scholar
- 14.Öberendorfer S (1907) Karzinoide tumoren des Dünndarms. Frankf Z Pathol 1:426–432Google Scholar
- 15.Gosset A, Masson P (1914) Tumeurs endcorine de l'appendice. Presse Med 25:237Google Scholar
- 16.Masson P (1928) Carcinoid (argentaffin-cell tumors) and nerve hyperplasia of the appendicular mucosa. Am J Pathol 4:181–212PubMedGoogle Scholar
- 17.Rehfeld JF (1998) The new biology of gastrointestinal hormones. Physiol Rev 78:1087–1108PubMedGoogle Scholar
- 18.Solcia E, Capella C, Fiocca R, Sessa F, LaRosa S, Rindi G (1998) Disorders of the endocrine system. In: Ming SC Goldman H (ed) Pathology of the gastrointestinal tract, 2nd edn. Williams and Wilkins, Philadelphia, pp 295–322Google Scholar
- 19.Bishop AE, Power RF, Polak JM (1988) Markers for neuroendocrine differentiation. Pathol Res Pract 183:119–128PubMedGoogle Scholar
- 20.Hamperl H (1927) Über de gelben (chromaffinen) Zellen im gesunden und karnaken Magendarmschlauch. Virchows Arch 266:509–548Google Scholar
- 21.Grimelius L (1968) A silver nitrate stain for a2 cells in human pancreatic islets. Acta Soc Med Upsal 73:243–270PubMedGoogle Scholar
- 22.Portela-Gomes GM (1982) Enterochromaffin cells. A qualitative and quantitative study. Acta Univ Ups 434:1–44Google Scholar
- 23.Bishop AE, Polak JM, Facer P, Ferri GL, Marangos PJ, pearse AG (1982) Neuron specific enolase: a common marker for the endocrine cells and innervation of the gut and pancreas. Gastroenterology 83:902–915Google Scholar
- 24.Thompson RJ, Doran JF, Jackson P, Dhillon AP, Rode J (1983) PGP9.5 a new marker for vertebrate neurons and neuroendocrine differentiation. Brain Res 278:224–228Google Scholar
- 25.Rode J, Dhillon AP, Doran JF, Jackson P, Thompson RJ (1985) PGP 9.5, a new marker for human neuroendocrine tumours. Histopathology 9:147–158Google Scholar
- 26.Wilkinson KD, Lee KM, Desphande S, Duerksen-Hughes P, Boss JM, Pohl J (1989) The neuron-specific protein PGP 9.5 is a ubiquitin carboxyl-terminal hydrolase. Science 246:670–673Google Scholar
- 27.Lloyd RV, Wilson BS (1983) Specific endocrine tissue marker defined by a monoclonal antibody. Science 222:628–630PubMedGoogle Scholar
- 28.Rindi G, Buffa R, Sessa F, Tortora O, Solcia E (1986) Chromogranin A, B and C immunoreactivities of mammalian endocrine cells. Distribution, distinction from costored hormones/prohormones and relationship with the argyrophil component of secretory granules. Histochemistry 85:19–28Google Scholar
- 29.Suzuki H, Christofides ND, Chretien M, Seidah N, Polak JM, Bloom SR (1987) Developmental changes in immunoreactive content of novel pituitary protein 7B2 in human pancreas and its identification in pancreatic tumours. Diabetes 36:1276–1279PubMedGoogle Scholar
- 30.Azzoni C, Yu JY, Baggi MT et al (1992) Studies on co-localization of 7B2 and pancreatic hormones in normal and tumoural islet cells. Virchows Arch A Pathol Anat Histopathol 421:457–466PubMedGoogle Scholar
- 31.Jahn R, Schiebler W, Ouimet C, Greengard P (1985) A 38,000-dalton membrane protein (p38) present in synaptic vesicles. Proc Natl Acad Sci U S A 82:4137–4141PubMedGoogle Scholar
- 32.Wiedenmann B, Franke WW, Kuhn C, Moll R, Gould VE (1986) Synaptophysin: a marker protein for neuroendocrine cells and neoplasms. Proc Natl Acad Sci U S A 83:3500–3504PubMedGoogle Scholar
- 33.Buffa R, Rindi G, Sessa F et al (1988) Synaptophysin immunoreactivity and small clear vescicles in neuroendocrine cells and related tumours. Mol Cell Probes 1:367–381Google Scholar
- 34.Erickson JD, Schafer MK, Bonner TI, Eiden LE, Weihe E (1996) Distinct pharmacological properties and distribution in neurons and endocrine cells of two isoforms of the human vesicular monoamine transporter. Proc Natl Acad Sci U S A 93:5166–5171PubMedGoogle Scholar
- 35.Dimaline RN, Struthers J (1996) Expression and regulation of a vescicular monoamine transporter (VMAT2) in rat stomach: a putative histamine transporter. J Physiol 490:249–256PubMedGoogle Scholar
- 36.Kolby L, Wangberg B, Ahlman H et al (1998) Gastric carcinoid with histamine production, histamine transporter and expression of somatostatin receptors. Digestion 59:160–166PubMedGoogle Scholar
- 37.Rindi G, Paolotti D, Fiocca R, Wiedenmann B, Henry JP, Solcia E (2000) Vesicular monoamine transporter 2 as a marker of gastric enterochromaffin-like cell tumors. Virchows Arch 436:217–223PubMedGoogle Scholar
- 38.Rindi G, Licini L, Necchi V et al (2007) Peptide products of the neurotrophin-inducible gene vgf are produced in human neuroendocrine cells from early development and increase in hyperplasia and neoplasia. J Clin Endocrinol Metab 92:2811–2815PubMedGoogle Scholar
- 39.Bordi C, D’Adda T, Azzoni C, Canavese G, Brandi ML (1998) Gastointestinal endocrine tumors: recent developments. Endocr Pathol 9:99–115Google Scholar
- 40.Roberts WC, Sjoerdsma A (1964) The cardiac disease associated with carcinoid syndrome (carcinoid heart disease). Am J Med 36:5–34PubMedGoogle Scholar
- 41.Reubi JC, Schaer JC, Markwalder R, Waser B, Horisberger U, Laissue J (1997) Distribution of somatostatin receptors in normal and neoplastic human tissues: recent advances and potential relevance. Yale J Biol Med 70:471–479PubMedGoogle Scholar
- 42.Reubi JC, Kappeler A, Waser B, Schonbrunn A, Laissue J (1998) Immunohistochemical localization of somatostatin receptor sst2A in human pancreatic islets. Clin Endocrinol Metab 83:3746–3749Google Scholar
- 43.Janson ET, Stridsberg M, Gobl A, Westlin JE, Oberg K (1998) Determination of somatostatin receptor subtype 2 in carcinoid tumors by immunohistochemical investigation with somatostatin receptor subtype 2 antibodies. Cancer Res 58:2375–2378PubMedGoogle Scholar
- 44.Reubi JC, Kappeler A, Waser B, Laissue J, Hipkin RW, Schonbrunn A (1998) Immunohistochemical localization of somatostatin receptors sst2A in human tumors. Am J Pathol 153:233–245PubMedGoogle Scholar
- 45.Kulaksiz H, Eissele R, Rossler D et al (2002) Identification of somatostatin receptor subtypes 1, 2A, 3, and 5 in neuroendocrine tumours with subtype specific antibodies. Gut 50:52–60PubMedGoogle Scholar
- 46.Krenning EP, de Jong M, Kooij PPM et al (1999) Radiolabeled somatostatin analogues for peptide receptor scintigraphy and radionuclide therapy. Ann Oncol 10:S23–S29PubMedGoogle Scholar
- 47.Öberg K (2001) Established clinical use of octreotide and lanreotide in oncology. Chemotherapy 47(S2):40–53Google Scholar
- 48.Volante M, Brizzi MP, Faggiano A et al (2007) Somatostatin receptor type 2A immunohistochemistry in neuroendocrine tumors: a proposal of scoring system correlated with somatostatin receptor scintigraphy. Mod Pathol 20:1172–1182PubMedGoogle Scholar
- 49.Lemmer K, Ahnert-Hilger G, Hopfner M et al (2002) Expression of dopamine receptors and transporter in neuroendocrine gastrointestinal tumor cells. Life Sci 71:667–678PubMedGoogle Scholar
- 50.O’Toole D, Saveanu A, Couvelard A et al (2006) The analysis of quantitative expression of somatostatin and dopamine receptors in gastro-entero-pancreatic tumours opens new therapeutic strategies. Eur J Endocrinol 155:849–857PubMedGoogle Scholar
- 51.Pivonello R, Ferone D, de Herder WW et al (2004) Dopamine receptor expression and function in human normal adrenal gland and adrenal tumors. J Clin Endocrinol Metab 89:4493–4502PubMedGoogle Scholar
- 52.Pivonello R, Ferone D, de Herder WW et al (2004) Dopamine receptor expression and function in corticotroph pituitary tumors. J Clin Endocrinol Metab 89:2452–2462PubMedGoogle Scholar
- 53.Pivonello R, Matrone C, Filippella M et al (2004) Dopamine receptor expression and function in clinically nonfunctioning pituitary tumors: comparison with the effectiveness of cabergoline treatment. J Clin Endocrinol Metab 89:1674–1683PubMedGoogle Scholar
- 54.Ferone D, Arvigo M, Semino C et al (2005) Somatostatin and dopamine receptor expression in lung carcinoma cells and effects of chimeric somatostatin-dopamine molecules on cell proliferation. Am J Physiol 289:E1044–E1050Google Scholar
- 55.Ferone D, Saveanu A, Culler MD et al (2007) Novel chimeric somatostatin analogs: facts and perspectives. Eur J Endocrinol 156(Suppl 1):S23–S28PubMedGoogle Scholar
- 56.Resmini E, Dadati P, Ravetti JL et al (2007) Rapid pituitary tumor shrinkage with dissociation between antiproliferative and antisecretory effects of a long-acting octreotide in an acromegalic patient. J Clin Endocrinol Metab 92:1592–1599PubMedGoogle Scholar
- 57.Hanahan D (1985) Heritable formation of pancreatic beta-cell tumours in transgenic mice expressing recombinant insulin/simian virus 40 oncogenes. Nature 315:115–122PubMedGoogle Scholar
- 58.Rindi G, Grant SG, Yiangou Y et al (1990) Development of neuroendocrine tumors in the gastrointestinal tract of transgenic mice. Heterogeneity of hormone expression. Am J Pathol 136:1349–1363PubMedGoogle Scholar
- 59.Rindi G, Efrat S, Ghatei MA, Bloom SR, Solcia E, Polak JM (1991) Glucagonomas of transgenic mice express a wide range of general neuroendocrine markers and bioactive peptides. Virchows Arch A Pathol Anat Histopathol 419:115–129PubMedGoogle Scholar
- 60.Crabtree JS, Scacheri PC, Ward JM et al (2001) A mouse model of multiple endocrine neoplasia, type 1, develops multiple endocrine tumors. Proc Natl Acad Sci U S A 98:1118–1123PubMedGoogle Scholar
- 61.Bertolino P, Tong WM, Galendo D, Wang ZQ, Zhang CX (2003) Heterozygous MEN1 mutant mice develop a range of endocrine tumors mimicking multiple endocrine neoplasia type 1. Mol endocrinol 17:1880–1892Google Scholar
- 62.Pellegata NS, Quintanilla-Martinez L, Siggelkow H et al (2006) Germ-line mutations in p27Kip1 cause a multiple endocrine neoplasia syndrome in rats and humans. Proc Natl Acad Sci U S A 103:15558–15563PubMedGoogle Scholar
- 63.Rindi G, Solcia E (2007) Endocrine hyperplasia and dysplasia in the pathogenesis of gastrointestinal and pancreatic endocrine tumors. Gastroenterol Clin North Am 36:851–865, viGoogle Scholar
- 64.Rindi G, Villanacci V, Ubiali A, Scarpa A (2001) Endocrine tumors of the digestive tract and pancreas: histogenesis, diagnosis and molecular basis. Expert Rev Mol Diagn 1:323–333PubMedGoogle Scholar
- 65.Brandi ML, Bordi C, Tonelli F, Falchetti A, Marx SJ (2002) Multiple endocrine neoplasia type 1. In: Bilezikian JP, Raisz LG, Rodan GA (eds) Principles of bone biology, 2nd edn. Academic, San Diego, pp 783–797Google Scholar
- 66.Larsson K, Skogseid B, Öberg K, Nakamura Y, Nordenskjöld M (1988) Multiple endocrine neoplasia type 1 gene maps to chromosome 11 and is lost in insulinoma. Nature 332:85–87PubMedGoogle Scholar
- 67.Chandrasekharappa SC, Guru SC, Manickam P et al (1997) Positional cloning of the gene for multiple endocrine neoplasia-type 1. Science 276:404–407PubMedGoogle Scholar
- 68.Agarwal SK, Guru SC, Heppner C et al (1999) Menin interacts with the AP1 transcription factor JunD and represses JunD-activated transcription. Cell 96:143–152PubMedGoogle Scholar
- 69.Heppner C, Bilimoria KY, Agarwal SK et al (2001) The tumor suppressor protein menin interacts with NF-κB proteins and inhibits NF-κB-mediated transactivation. Oncogene 20:4917–4925PubMedGoogle Scholar
- 70.Beckers A, Abs R, Reyniers E et al (1994) Variable regions of chromosome 11 loss in different pathological tissues of a patient with the multiple endocrine neoplasia type I syndrome. J Clin Endocrinol Metab 79:1498–1502PubMedGoogle Scholar
- 71.Jakobovitz O, Nass D, DeMarco L et al (1996) Carcinoid tumors frequently display genetic abnormalities involving chromosome 11. J Clin Endocrinol Metab 81:3164–3167PubMedGoogle Scholar
- 72.Bordi C, Falchetti A, Azzoni C et al (1997) Aggressive forms of gastric neuroendocrine tumors in multiple endocrine neoplasia type I. Am J Surg Pathol 21:1075–1082PubMedGoogle Scholar
- 73.Debelenko LV, Emmert-Buck MR, Zhuang Z et al (1997) The multiple endocrine neoplasia type I gene locus is involved in the pathogenesis of type II gastric carcinoids. Gastroenterology 113:773–781PubMedGoogle Scholar
- 74.D’Adda T, Keller G, Bordi C, Hofler H (1999) Loss of heterozygosity in 11q13–14 regions in gastric neuroendocrine tumors not associated with multiple endocrine neoplasia type 1 syndrome. Lab Invest 79:671–677PubMedGoogle Scholar
- 75.Lubensky IA, Debelenko LV, Zhuang Z et al (1996) Allelic deletions on chromosome 11q13 in multiple tumors from individual MEN1 patients. Cancer Res 56:5272–5278PubMedGoogle Scholar
- 76.Debelenko LV, Zhuang Z, Emmert-Buck MR et al (1997) Allelic deletions on chromosome 11q13 in multiple endocrine neoplasia type 1-associated and sporadic gastrinomas and pancreatic endocrine tumors. Cancer Res 57:2238–2243PubMedGoogle Scholar
- 77.Zhuang Z, Vortmeyer AO, Pack S et al (1997) Somatic mutations of the MEN1 tumor suppressor gene in sporadic gastrinomas and insulinomas. Cancer Res 57:4682–4686PubMedGoogle Scholar
- 78.Mailman MD, Muscarella P, Schirmer WJ, Ellison EC, O’Dorisio TM, Prior TW (1999) Identification of MEN1 mutations in sporadic enteropancreatic neuroendocrine tumors by analysis of paraffin-embedded tissue. Clin Chem 45:29–34PubMedGoogle Scholar
- 79.Fujii T, Kawai T, Saito K et al (1999) MEN1 gene mutations in sporadic neuroendocrine tumors of foregut derivation. Pathol Int 49:968–973PubMedGoogle Scholar
- 80.D’Adda T, Pizzi S, Azzoni C et al (2002) Different patterns of 11q allelic losses in digestive endocrine tumors. Hum Pathol 33:322–329PubMedGoogle Scholar
- 81.Toliat MR, Berger W, Ropers HH, Neuhaus P, Wiedenmann B (1997) Mutations in the MEN I gene in sporadic neuroendocrine tumours of gastroenteropancreatic system. Lancet 350:1223PubMedGoogle Scholar
- 82.Goebel SU, Heppner C, Burns AL et al (2000) Genotype/phenotype correlation of multiple endocrine neoplasia type 1 gene mutations in sporadic gastrinomas. J Clin Endocrinol Metab 85:116–123PubMedGoogle Scholar
- 83.Görtz B, Roth J, Krahenmann A et al (1999) Mutations and allelic deletions of the MEN1 gene are associated with a subset of sporadic endocrine pancreatic and neuroendocrine tumors and not restricted to foregut neoplasms. Am J Pathol 154:429–436PubMedGoogle Scholar
- 84.Higham AD, Bishop LA, Dimaline R et al (1999) Mutations of RegIalpha are associated with enterochromaffin-like cell tumor development in patients with hypergastrinemia. Gastroenterology 116:1310–1318PubMedGoogle Scholar
- 85.Liu L, Broaddus RR, Yao JC et al (2005) Epigenetic alterations in neuroendocrine tumors: methylation of RAS-association domain family 1, isoform A and p16 genes are associated with metastasis. Mod Pathol 18:1632–1640PubMedGoogle Scholar
- 86.Pizzi S, Azzoni C, Bassi D, Bottarelli L, Milione M, Bordi C (2003) Genetic alterations in poorly differentiated endocrine carcinomas of the gastrointestinal tract. Cancer 98:1273–1282PubMedGoogle Scholar
- 87.Pizzi S, Azzoni C, Bottarelli L et al (2005) RASSF1A promoter methylation and 3p21.3 loss of heterozygosity are features of foregut, but not midgut and hindgut, malignant endocrine tumours. J Pathol 206:409–416Google Scholar
- 88.Serrano J, Goebel SU, Peghini PL, Lubensky IA, Gibril F, Jensen RT (2000) Alterations in the p16INK4a/CDKN2A tumor suppressor gene in gastrinomas. J Clin Endocrinol Metab 85:4146–4156PubMedGoogle Scholar
- 89.Lubomierski N, Kersting M, Bert T et al (2001) Tumor suppresor genes in the 9p21 gene cluster are selective targets of inactivation in neuroendocrine gastroenteropancreatic tumors. Cancer Res 61:5905–5910Google Scholar
- 90.Lohmann DR, Fesseler B, Putz B et al (1993) Infrequent mutations of the p53 gene in pulmonary carcinoid tumors. Cancer Res 53:5797–5801PubMedGoogle Scholar
- 91.Vortmeyer AO, Lubensky IA, Merino MJ et al (1997) Concordance of genetic alterations in poorly differentiated colorectal neuroendocrine carcinomas and associated adenocarcinomas. J Natl Cancer Inst 89:1448–1453PubMedGoogle Scholar
- 92.Rindi G, Alberizzi P, Candusso M, LaRosa S, Capella C, Solcia E (1999) Loss of heterozygosity for chromosome 17p, P53 gene, and chromosome 18q, DCC gene, in aggressive endocrine tumors of the stomach. Gastroenterology 116:G2156 (abstract)Google Scholar
- 93.Rindi G, Azzoni C, La Rosa S et al (1999) ECL cell tumor and poorly differentiated endocrine carcinoma of the stomach: prognostic evaluation by pathological analysis. Gastroenterology 116:532–542PubMedGoogle Scholar
- 94.Furlan D, Bernasconi B, Uccella S, Cerutti R, Carnevali I, Capella C (2005) Allelotypes and fluorescence in situ hybridization profiles of poorly differentiated endocrine carcinomas of different sites. Clin Cancer Res 11:1765–1775PubMedGoogle Scholar
- 95.Terris B, Meddeb M, Marchio A et al (1998) Comparative genomic hybridization analysis of sporadic neuroendocrine tumors of the digestive system. Genes Chromosomes Cancer 22:50–56PubMedGoogle Scholar
- 96.Zhao J, de Krijger RR, Meier D et al (2000) Genomic alterations in well-differentiated gastrointestinal and bronchial neuroendocrine tumors (Carcinoids): marked differences indicating diversity in molecular pathogenesis [In Process Citation]. Am J Pathol 157:1431–1438PubMedGoogle Scholar
- 97.Kytola S, Hoog A, Nord B et al (2001) Comparative genomic hybridization identifies loss of 18q22-qter as an early and specific event in tumorigenesis of midgut carcinoids. Am J Pathol 158:1803–1808PubMedGoogle Scholar
- 98.Tonnies H, Toliat MR, Ramel C et al (2001) Analysis of sporadic neuroendocrine tumours of the enteropancreatic system by comparative genomic hybridisation. Gut 48:536–541PubMedGoogle Scholar
- 99.Lollgen RM, Hessman O, Szabo E, Westin G, Akerstrom G (2001) Chromosome 18 deletions are common events in classical midgut carcinoid tumors. Int J Cancer 92:812–815PubMedGoogle Scholar
- 100.Petzmann S, Ullmann R, Halbwedl I, Popper HH (2004) Analysis of chromosome-11 aberrations in pulmonary and gastrointestinal carcinoids: an array comparative genomic hybridization-based study. Virchows Arch 445:151–159PubMedGoogle Scholar
- 101.Wang GG, Yao JC, Worah S et al (2005) Comparison of genetic alterations in neuroendocrine tumors: frequent loss of chromosome 18 in ileal carcinoid tumors. Mod Pathol 18:1079–1087PubMedGoogle Scholar
- 102.Kim do H, Nagano Y, Choi IS, White JA, Yao JC, Rashid A (2008) Allelic alterations in well-differentiated neuroendocrine tumors (carcinoid tumors) identified by genome-wide single nucleotide polymorphism analysis and comparison with pancreatic endocrine tumors. Genes Chromosomes Cancer 47:84–92Google Scholar
- 103.Kulke MH, Freed E, Chiang DY et al (2008) High-resolution analysis of genetic alterations in small bowel carcinoid tumors reveals areas of recurrent amplification and loss. Genes Chromosomes Cancer 47:591–603PubMedGoogle Scholar
- 104.Pizzi S, D’Adda T, Azzoni C et al (2002) Malignancy-associated allelic losses on the X-chromosome in foregut but not in midgut endocrine tumours. J Pathol 196:401–407PubMedGoogle Scholar
- 105.Missiaglia E, Moore PS, Williamson J et al (2002) Sex chromosome anomalies in pancreatic endocrine tumors. Int J Cancer 98:532–538PubMedGoogle Scholar
- 106.D’Adda T, Bottarelli L, Azzoni C et al (2005) Malignancy-associated X chromosome allelic losses in foregut endocrine neoplasms: further evidence from lung tumors. Mod Pathol 18:795–805PubMedGoogle Scholar
- 107.Azzoni C, Bottarelli L, Pizzi S, D’Adda T, Rindi G, Bordi C (2006) Xq25 and Xq26 identify the common minimal deletion region in malignant gastroenteropancreatic endocrine carcinomas. Virchows Arch 448:119–126PubMedGoogle Scholar
- 108.Gerdes B, Ramaswamy A, Simon B et al (1999) Analysis of beta-catenin gene mutations in pancreatic tumors. Digestion 60:544–548PubMedGoogle Scholar
- 109.Semba S, Kusumi R, Moriya T, Sasano H (2000) Nuclear accumulation of B-catenin in human endocrine tumors: association with Ki-67 (MIB-1) proliferative activity. Endocr Pathol 11:243–250PubMedGoogle Scholar
- 110.Fujimori M, Ikeda S, Shimizu Y, Okajima M, Asahara T (2001) Accumulation of beta-catenin protein and mutations in exon 3 of beta-catenin gene in gastrointestinal carcinoid tumor. Cancer Res 61:6656–6659PubMedGoogle Scholar
- 111.Barshack I, Goldberg I, Chowers Y, Horowitz A, Kopolovic J (2002) Different beta-catenin immunoexpression in carcinoid tumors of the appendix in comparison to other gastrointestinal carcinoid tumors. Pathol Res Pract 198:531–536PubMedGoogle Scholar
- 112.Li CC, Xu B, Hirokawa M et al (2002) Alterations of E-cadherin, alpha-catenin and beta-catenin expression in neuroendocrine tumors of the gastrointestinal tract. Virchows Arch 440: 145–154PubMedGoogle Scholar
- 113.Hervieu V, Lepinasse F, Gouysse G et al (2006) Expression of beta-catenin in gastroenteropancreatic endocrine tumours: a study of 229 cases. J Clin Pathol 59:1300–1304PubMedGoogle Scholar
- 114.Su MC, Wang CC, Chen CC et al (2006) Nuclear translocation of beta-catenin protein but absence of beta-catenin and APC mutation in gastrointestinal carcinoid tumor. Ann Surg Oncol 13:1604–1609PubMedGoogle Scholar
- 115.Pizzi S, Azzoni C, Tamburini E et al (2008) APC alteration in digestive endocrine tumours: correlation with nuclear translocation of {beta}-catenin and chromosomal instability. Endocrine-related cancer 15(4):1013–1024Google Scholar
- 116.Nakakura EK, Sriuranpong VR, Kunnimalaiyaan M et al (2005) Regulation of neuroendocrine differentiation in gastrointestinal carcinoid tumor cells by notch signaling. J Clin Endocrinol Metab 90:4350–4356PubMedGoogle Scholar
- 117.Solcia E, Klöppel G, Sobin LH (2000) Histological typing of endocrine tumours, 2nd edn. Springer-Verlag, New YorkGoogle Scholar
- 118.Soga J, Tazawa K (1971) Pathologic analysis of carcinoids; histologic reevaluation of 62 cases. Cancer 28:990–998PubMedGoogle Scholar
- 119.Rindi G, Luinetti O, Cornaggia M, Capella C, Solcia E (1993) Three subtypes of gastric argyrophil carcinoid and the gastric neuroendocrine carcinoma: a clinicopathologic study [see comments]. Gastroenterology 104:994–1006PubMedGoogle Scholar
- 120.Kim T, Tao-Cheng J-H, Eiden LE, Loh PY (2001) Chromogranin A, an “On/Off” switch controlling dense-core secretory granule biogenesis. Cell 106:499–509Google Scholar
- 121.Rigaud G, Missiaglia E, Moore PS et al (2001) High resolution allelotype of nonfunctional pancreatic endocrine tumors: identification of two molecular subgroups with clinical implications. Cancer Res 61(1):285–292Google Scholar
- 122.Pelosi G, Bresaola E, Bogina G et al (1996) Endocrine tumors of the pancreas: Ki-67 immunoreactivity on paraffin sections is an independent predictor for malignancy: a comparative study with proliferating-cell nuclear antigen and progesterone receptor protein immunostaining, mitotic index, and other clinicopathologic variable. Hum Pathol 27:1124–1134PubMedGoogle Scholar
- 123.La Rosa S, Sessa F, Capella C et al (1996) Prognostic criteria in nonfunctioning pancreatic endocrine tumours. Virchows Arch 429:323–333PubMedGoogle Scholar
- 124.von Herbay A, Sieg B, Schürmann G, Hofmann JW, Betzler M, Otto F (1991) Proliferative activity of neuroendocrine tumours of the gastroenteropancreatic endocrine system: DNA flow cytometric and immunohistological investigations. Gut 32:949–953Google Scholar
- 125.Chaudry A, Öberg K, Wilander E (1992) A study of biological behavior on the expression of a proliferating antigen in neuroendocrine tumors of the digestive system. Tumor Biol 13:27–35Google Scholar
- 126.Canavese G, Azzoni C, Pizzi S et al (2001) p27: a potential main inhibitor of cell proliferation in digestive endocrine tumors but not a marker of benign behavior. Hum Pathol 32:1094–1101PubMedGoogle Scholar
- 127.Shimizu T, Tanaka S, Haruma K et al (2000) Growth characteristics of rectal carcinoid tumors. Oncology 59:229–237Google Scholar
- 128.Kujari H, Joensuu H, Klemi P, Asola R, Nordman E (1981) A flow cytometric analysis of 23 carcinoid tumors. Cancer 61:2517–2520Google Scholar
- 129.Tsushima K, Nagorney DM, Weiland LH, Lieber MM (1989) The relationship of flow cytometric DNA analysis and clinicopathology in small-intestinal carcinoids. Surgery 105:366–373PubMedGoogle Scholar
- 130.Tsioulias G, Muto T, Kubota Y et al (1991) DNA ploidy pattern in rectal carcinoid tumors. Dis Colon Rectum 34:31–36PubMedGoogle Scholar
- 131.Rindi G, Kloppel G, Alhman H et al (2006) TNM staging of foregut (neuro)endocrine tumors: a consensus proposal including a grading system. Virchows Arch 449:395–401PubMedGoogle Scholar
- 132.Rindi G, Kloppel G, Couvelard A et al (2007) TNM staging of midgut and hindgut (neuro) endocrine tumors: a consensus proposal including a grading system. Virchows Arch 451:757–762PubMedGoogle Scholar
- 133.Pape UF, Jann H, Muller-Nordhorn J et al (2008) Prognostic relevance of a novel TNM classification system for upper gastroenteropancreatic neuroendocrine tumors. Cancer 113:256–265PubMedGoogle Scholar
- 134.Kubo I, Watanabe H (1971) Neoplastic argentaffin cells in gastric and intestinal carcinomas. Cancer 27:447–454PubMedGoogle Scholar
- 135.Proks C, Feit V (1982) Gastric carcinomas with argyrophil and argentaffin cells. Virchows Arch 395:201–206Google Scholar
- 136.Smith DM, Haggit RT (1984) The prevalence and prognostic significance of argyrophil cells in carcinomas of the colon and rectum. Am J Surg Pathol 8:123–128PubMedGoogle Scholar
- 137.Papotti M, Cassoni P, Volante M, Deghenghi R, Muccioli G, Ghigo E (2001) Ghrelin-producing endocrine tumors of the stomach and intestine. J Clin Endocrinol Metab 86:5052–5059PubMedGoogle Scholar
- 138.Rindi G, Savio A, Torsello A et al (2002) Ghrelin expression in gut endocrine growths. J Histochem Cell Biol 117(6):521–525Google Scholar
- 139.Bordi C, D’Adda T, Azzoni C, Pilato FP, Caruana P (1995) Hypergastrinemia and gastric enterochromaffin-like cells. Am J Surg Pathol 19(suppl 1):S8–S19PubMedGoogle Scholar
- 140.Rindi G, Bordi C, Rappel S, La Rosa S, Stolte MS, Solcia E (1996) Gastric carcinoids and neuroendocrine carcinomas: pathogenesis, pathology and behavior. World J Surg 20:168–172PubMedGoogle Scholar
- 141.Bordi C, Yu JY, Baggi MT, Davoli C, Pilato FP, Baruzzi G, Gardini G, Zamboni G, Franzin G, Papotti M, et al. (1991) Gastric carcinoids and their precursor lesions. A histologic and immunohistochemical study of 23 cases. Cancer 67:663–672PubMedGoogle Scholar
- 142.Lechago J, Shah IA (1991) The endocrine digestive system. In: Kovacs K, Asa SL (eds) Functional endocrine pathology. Blackwell, Boston, pp 458–477Google Scholar
- 143.Ooi A, Ota M, Katsuda S, Nakanishi I, Sugawara H, Takahashi I (1995) An unusual case of multiple gastric carcinoids associated with diffuse endocrine cell hyperplasia and parietal cell hypertrophy. Endocr Pathol 6:229–237PubMedGoogle Scholar
- 144.Abraham SC, Carney JA, Ooi A, Choti MA, Argani P (2005) Achlorhydria, parietal cell hyperplasia, and multiple gastric carcinoids: a new disorder. Am J Surg Pathol 29:969–975PubMedGoogle Scholar
- 145.Capella C, Heitz PU, Hofler H, Solcia E, Kloppel G (1995) Revised classification of neuroendocrine tumours of the lung, pancreas and gut. Virchows Arch 425:547–560PubMedGoogle Scholar
- 146.Pipeleers-Marichal M, Somers G, Willems G et al (1990) Gastrinomas in the duodenums of patients with multiple endocrine neoplasia type 1 and the Zollinger-Ellison syndrome. N Engl J Med 322:723–727PubMedGoogle Scholar
- 147.Soga J, Yakuwa Y, Osaka M (1999) Evaluation of 342 cases of mediastinal/thymic carcinoids collected from literature: a comparative study between typical carcinoids and atypical varieties. Ann Thorac Cardiovasc Surg 5:285–292PubMedGoogle Scholar
- 148.Lundqvist M, Wilander E (1987) A study of the histopathogenesis of carcinoid tumors of the small intestine and appendix. Cancer 60:201–206PubMedGoogle Scholar
- 149.Lester WM, Gotlieb AI (1991) The cardiovascular system. In: Kovacs K, Asa SL (eds) Functional endocrine pathology. Blackwell, Boston, pp 724–747Google Scholar
- 150.Fiocca R, G. R, Capella C et al (1987) Glucagon, glicentin, proglucagon, PYY, PP and proPP-icosa-peptide immunoreactivites of rectal carcinoid tumours and related non-tumour cells. Reg Pep 17:9–29Google Scholar
- 151.Bordi C, Azzoni C, D’Adda T, Pizzi S (2002) Pancreatic polypeptide-related tumors. Peptides 23:339–348PubMedGoogle Scholar
- 152.Rindi G, Capella C, Solcia E (1999) Pathobiology and classification of digestive endocrine tumors. In: Mignon M, Colombel JF (eds) Recent advances in the pathophysiology of inflammatory bowel disease and digestive endocrine tumors. John Libbey Eurotext, Montrouge-London-Rome, pp 177–191Google Scholar
- 153.Sobin LH, Wittekind C (eds) (2002) TNM classification of malignant tumours. Wiley-Liss, New York-TorontoGoogle Scholar