Multiple endocrine neoplasia type 1(MEN1)is an autosomal-inherited syndrome involving multiple endocrine tumors.It is characterized by multiple mutations in the tumor suppressor gene MEN1,which is located on chromosom...Multiple endocrine neoplasia type 1(MEN1)is an autosomal-inherited syndrome involving multiple endocrine tumors.It is characterized by multiple mutations in the tumor suppressor gene MEN1,which is located on chromosome 11q13.As main etiology of MEN1 is genetic mutations,clinical symptoms may vary.In this editorial,we comment on the article by Yuan et al.This article describes a case of(MEN1)characterized by low incidence and diagnostic complexity.MEN1 co-mmonly presents as parathyroid,pancreatic,and pituitary tumors.Diagnosis requires a combination of serologic tests,magnetic resonance imaging,computed tomography,endoscopic ultrasonography,immunologic and pathology.The diagnosis is unique depending on the site of disease.Surgical resection is the treatment of choice for MEN1.The prognosis depends on the site of origin,but early detection and intervention is the most effective.展开更多
BACKGROUND Mixed tumors of the colon and rectum,composed of a combination of epithelial and endocrine elements of benign and malignant potential are rare neoplasms.These can occur anywhere in the gastrointestinal trac...BACKGROUND Mixed tumors of the colon and rectum,composed of a combination of epithelial and endocrine elements of benign and malignant potential are rare neoplasms.These can occur anywhere in the gastrointestinal tract and are often diagnosed incidentally.Though they have been a well-documented entity in the pancreas,where the exocrine-endocrine mixed tumors have been known for a while,recognition and accurate diagnosis of these tumors in the colon and rectum,to date,remains a challenge.This is further compounded by the different terminologies that have been attributed to these lesions over the years adding to increased confusion and misclassification.Therefore,dedicated literature reviews of these lesions in the colon and rectum are inconsistent and are predominantly limited to case reports and case series of limited case numbers.Though,most of these tumors are high grade and of advanced stage,intermediate and low grade lesions of these mixed tumors are also increasingly been reported.There are no established independent consensus based guidelines for the therapeutic patient management of these unique lesions.AIM To provide a comprehensive targeted literature review of these complex mixed tumors in the colon and rectum that chronicles the evolution over time with summarization of historical perspectives of terminology and to further our understanding regarding their pathogenesis including genomic landscape,clinicoradiological features,pathology,treatment,prognosis,the current status of the management of the primary lesions,their recurrences and metastases.METHODS A comprehensive review of the published English literature was conducted using the search engines PubMed,MEDLINE and GOOGLE scholar.The following search terms[“mixed tumors colon”OR mixed endocrine/neuroendocrine tumor/neoplasm/lesion colon OR adenocarcinoma and endocrine/neuroendocrine tumor colon OR mixed adenocarcinoma and endocrine/neuroendocrine carcinoma colon OR Amphicrine tumors OR Collision tumors]were used.Eligibility criteria were defined and all potential relevant items,including full articles and/or abstracts were independently reviewed,assessed and agreed upon items were selected for in-depth analysis.RESULTS In total 237 full articles/abstracts documents were considered for eligibility of which 45 articles were illegible resulting in a total of 192 articles that were assessed for eligibility of which 139 have been selected for reference in this current review.This seminal manuscript is a one stop article that provides a detailed outlook on the evolution over time with summarization of historical perspectives,nomenclature,clinicoradiological features,pathology,treatment,prognosis and the current status of the management of both the primary lesions,their recurrences and metastases.Gaps in knowledge have also been identified and discussed.An important outcome of this manuscript is the justified proposal for a new,simple,clinically relevant,non-ambiguous terminology for these lesions to be referred to as mixed epithelial endocrine neoplasms(MEENs).CONCLUSION MEEN of the colon and rectum are poorly understood rare entities that encompass an extensive range of heterogeneous tumors with a wide variety of combinations leading to tumors of high,intermediate or low grade malignant potential.This proposed new revised terminology of MEEN will solve the biggest hurdle of confusion and misclassification that plagues these rare unique colorectal neoplasms thus facilitating the future design of multi institutional prospective randomized controlled clinical trials to develop and evaluate newer therapeutic strategies that are recommended for continued improved understanding and personal optimization of clinical management of these unique colorectal neoplasms.展开更多
Suicide is defined as the act of a person attempting to take their own life by causing death.Suicide is a complex phenomenon that is influenced by a multitude of factors,including psychosocial,cultural,and religious a...Suicide is defined as the act of a person attempting to take their own life by causing death.Suicide is a complex phenomenon that is influenced by a multitude of factors,including psychosocial,cultural,and religious aspects,as well as genetic,biochemical,and environmental factors.From a biochemical perspective,it is crucial to consider the communication between the endocrine,immune,and nervous systems when studying the etiology of suicide.Several pathologies involve the bidirectional communication between the peripheral activity and the central nervous system by the action of molecules such as cytokines,hormones,and neurotransmitters.These humoral signals,when present in optimal quantities,are responsible for maintaining physiological homeostasis,including mood states.Stress elevates the cortisol and proinflammatory cytokines levels and alter neurotransmitters balance,thereby increasing the risk of developing a psychiatric disorder and subsequently the risk of suicidal behavior.This review provides an integrative perspective about the neurochemical,immunological,and endocrinological disturbances associated with suicidal behavior,with a particular focus on those alterations that may serve as potential risk markers and/or indicators of the state preceding such a tragic act.展开更多
Endocrine disorders frequently lead to metabolic disturbances that significantly affect liver function.Understanding the complex interplay between hormonal imbalances and liver dysfunction is essential for advancing t...Endocrine disorders frequently lead to metabolic disturbances that significantly affect liver function.Understanding the complex interplay between hormonal imbalances and liver dysfunction is essential for advancing targeted therapeutic strategies.This comprehensive review explores the pathophysiological mechanisms linking major endocrine disorders to liver disease,with a focus on the roles of the thyroid,parathyroid,pancreas,adrenal glands,and sex hormones.Thyroid dysfunction is associated with alterations in liver enzyme levels and metabolic regulation,often resulting in hepatic steatosis or cholestasis.Hyperparathyroidism and consequent hypercalcemia have been linked to hepatic calcifications.Insulin resistance,both hepatic and peripheral,contributes to excessive lipid accumulation in the liver,exacerbating steatotic changes.Adrenal gland disorders,particularly in the setting of chronic liver disease,impair cortisol metabolism and may worsen hepatic injury.Additionally,sex hormones such as estrogen and testosterone modulate the progression of liver fibrosis and influence the development of metabolic syndrome.The intricate relationship between endocrine and hepatic systems underscores the need for a multidisciplinary approach in the management of liver disease.Addressing underlying hormonal disturbances may enhance patient outcomes and prevent further hepatic deterioration.Future research should prioritize integrative therapeutic strategies that concurrently target endocrine and liver dysfunction.展开更多
Transgender individuals often undergo gender-affirming hormonal therapy(GAHT)to align their physical characteristics with their gender identity,which introduces unique challenges in the management of critically ill pa...Transgender individuals often undergo gender-affirming hormonal therapy(GAHT)to align their physical characteristics with their gender identity,which introduces unique challenges in the management of critically ill patients.In the setting of critical illness,the interactions between GAHT and the body's endocrine response are complex.GAHT can influence the hypothalamic-pituitary-adrenal axis,sex hormone levels,and metabolic parameters,potentially complicating the clinical picture.For example,estrogen therapy in transgender women increases the risk of venous thromboembolism,which is further exacerbated by the immobility and hypercoagulable state often present in critically ill patients.Testosterone therapy in transgender men can lead to erythrocytosis,increasing the risk of thromboembolic events during critical illness.The potential for drug interactions,particularly with medications used in the intensive care unit,also requires careful consideration.Monitoring hormone levels and adjusting GAHT in the acute setting are crucial,although evidence-based guidelines are lacking.The need for individualized care and vigilant monitoring of endocrine and metabolic parameters is paramount to improve outcomes in this vulnerable population.展开更多
Endocrine disorders are increasingly recognized as potentially reversible causes of secondary cardiomyopathies,yet they often remain underdiagnosed in clinical practice.These conditions-including thyroid dysfunction,a...Endocrine disorders are increasingly recognized as potentially reversible causes of secondary cardiomyopathies,yet they often remain underdiagnosed in clinical practice.These conditions-including thyroid dysfunction,acromegaly,pheochromocytoma,diabetes mellitus,adrenal disorders,among others-can significantly alter cardiac structure and function through hormonal excess,metabolic remodeling,and neurohumoral activation.Hyperthyroidism may lead to high-output heart failure(HF)and atrial fibrillation,while hypothyroidism is associated with diastolic dysfunction,pericardial effusion,and accelerated atherosclerosis.Acromegaly promotes biventricular hypertrophy and myocardial fibrosis via insulin-like growth factor 1 overproduction.Pheochromocytoma triggers catecholamine-induced cardiomyopathy,resembling Takotsubo syndrome and carrying a high risk of mortality if left untreated.Diabetes induces a distinct phenotype of cardiomyopathy,affecting both systolic and diastolic function through microvascular injury and oxidative stress.Recognizing these endocrine etiologies is crucial,as targeted hormonal therapies-such as antithyroid agents,somatostatin analogs,or adrenalectomy-can reverse or significantly mitigate cardiac dysfunction.Comprehensive endocrine screening in patients with unexplained cardiomyopathy is therefore essential.This review synthesizes current knowledge on the pathophysiological mechanisms,clinical manifestations,and therapeutic strategies for endocrine cardiomyopathies and proposes a diagnostic algorithm for early recognition.Emerging biomarkers,such as galectin-3 in diabetic heart disease,may further enhance diagnostic accuracy and risk stratification.The interplay between endocrine and cardiovascular systems offers a unique opportunity for early intervention,potentially preventing progression to irreversible HF.展开更多
BACKGROUND Pancreas transplantation(PT)has emerged as a critical therapeutic intervention for patients with type 1 diabetes mellitus(T1DM).This procedure restores neuroendocrine communication,which is essential for op...BACKGROUND Pancreas transplantation(PT)has emerged as a critical therapeutic intervention for patients with type 1 diabetes mellitus(T1DM).This procedure restores neuroendocrine communication,which is essential for optimal pancreatic function and insulin regulation.The recovery process involves multiple phases,including neural regeneration,revascularization,and the re-establishment of synaptic connections,all of which contribute to the restoration of both endocrine and neurological functions.AIM To systematically examine the mechanisms underlying neurological recovery following PT,to explore the role of endocrine factors in restoring neurofunctional integrity,and to evaluate the impact of immunosuppressive therapy on nerve regeneration and its clinical outcomes.METHODS A comprehensive literature search was conducted across international databases such as PubMed,Web of Science,and Cochrane Library to identify studies addressing PT,neurological recovery,and endocrine regulation.Inclusion criteria encompassed randomized controlled trials,cohort studies,and systematic reviews.The review focused on the neurogenic mechanisms activated post-transplantation,the effect of glycemic control on nerve repair,and the implications of immunosuppressive drugs on the process of neurological recovery.RESULTS A total of 211 articles were initially identified through the literature search across international databases such as PubMed,Web of Science,and Cochrane Library.Following a detailed evaluation and the application of inclusion and exclusion criteria,56 articles were further reviewed,and 8 were selected for the final analysis.Additionally,a comprehensive patent search yielded 168 patents,out of which 6 were selected for further examination.These sources,including both journal literature and patents,offer significant insights into the mechanisms of neurological recovery and endocrine function following PT,with an emphasis on nerve regeneration,glycemic control,and the impact of immunosuppressive therapy.CONCLUSION PT represents a promising intervention for restoring both endocrine and neurological functions in patients with T1DM.Glycemic control,neural regeneration,and the restoration of neuroendocrine signaling are key components of successful recovery.While the procedure yields substantial improvements in nerve function,challenges persist,particularly in patients with long-standing diabetes or severe neuropathy.The dual impact of immunosuppressive drugs on immune suppression and neurotoxicity necessitates careful management.Future research should focus on refining immunosuppressive protocols and exploring advanced therapeutic options,including stem cell-based interventions,to enhance neural regeneration and further improve clinical outcomes.展开更多
The increasing longevity of patients with transfusion-dependent homozygous beta-thalassemia has brought endocrine complications to the forefront of longterm care.While iron overload remains a central mechanism,additio...The increasing longevity of patients with transfusion-dependent homozygous beta-thalassemia has brought endocrine complications to the forefront of longterm care.While iron overload remains a central mechanism,additional contributors such as hypothalamic dysfunction,neurosecretory disturbances,and chronic inflammation have been identified.Endocrine disorders including hypothyroidism,adrenal insufficiency,hypogonadotropic hypogonadism,hypoparathyroidism,osteoporosis,and growth axis impairment-are prevalent and often underdiagnosed.Diagnostic challenges include normal hormone levels in early stages,necessitating the use of dynamic endocrine testing and pituitary magnetic resonance imaging to detect subclinical dysfunction.Risk is modulated by sex,age,and chelation adherence.Early identification and proactive,multidisciplinary management of endocrine sequelae are essential in reducing morbidity and maintaining functional independence in this aging patient population.展开更多
In this manuscript,we comment on a recent publication by Yuan et al.This article provides a detailed scientific diagnostic process for a multiple endocrine neo-plasia type 1 patient,thus offering strong guidance for c...In this manuscript,we comment on a recent publication by Yuan et al.This article provides a detailed scientific diagnostic process for a multiple endocrine neo-plasia type 1 patient,thus offering strong guidance for clinical practice.However,we believe that the authors should also provide information on the patient's long-term prognosis.展开更多
Objective:Recurrence continues to be a pivotal challenge among hormone receptor-positive(HR^(+))/human epidermal growth factor receptor 2^(−)negative(HER2^(−))breast cancers.In the international consensus guidelines,H...Objective:Recurrence continues to be a pivotal challenge among hormone receptor-positive(HR^(+))/human epidermal growth factor receptor 2^(−)negative(HER2^(−))breast cancers.In the international consensus guidelines,HR^(+)/HER2^(−)breast cancer relapse patterns are divided into three distinct types:primary resistant,secondary resistant,and endocrine sensitive.However,owing to the lack of cohorts with treatment and follow-up data,the heterogeneity among different recurrence patterns remains uncharted.Current treatments still lack precision.Methods:This analysis included data from a large-scale multiomics study of a HR^(+)/HER2^(−)breast cancer cohort(n=314).Through the analysis of transcriptomics(n=312),proteomics(n=124),whole-exome sequencing(n=290),metabolomics(n=217),and digital pathology(n=228)data,we explored distinctive molecular features and identified putative therapeutic targets for patients experiencing recurrence.Results:We explored distinct clinicopathological characteristics,biological heterogeneity,and potential therapeutic strategies for recurrence.Based on a shared relapse signature,we stratified patients into high-and lowrecurrence-risk groups.Patients with different relapse patterns presented unique molecular features in primary tumors.Specifically,receptor tyrosine kinase(RTK)pathway activation in the primary resistant group suggested the utility of RTK inhibitors,whereas mammalian target of rapamycin(mTOR)and cell cycle pathway activation in the secondary resistant group highlighted the potential of mTOR and CDK4/6 inhibitors.Interestingly,the endocrine-sensitive group displayed a quiescent state and high genomic instability,suggesting that targeting quiescent cells and using poly-ADP-ribose polymerase(PARP)inhibitors could be effective strategies.Conclusions:These findings illuminate the clinicopathological and molecular landscape of HR^(+)/HER2^(−)breast cancer patients with distinct recurrence patterns,highlighting potential targeted therapies.展开更多
The latest data from the NATALEE trial showed the absolute 3-year invasive disease-free survival benefit was 4.9%between the experimental and control groups.That is to say,in the intermediate-risk hormone receptor pos...The latest data from the NATALEE trial showed the absolute 3-year invasive disease-free survival benefit was 4.9%between the experimental and control groups.That is to say,in the intermediate-risk hormone receptor positive/human epidermal growth factor receptor-2 negative subgroup,there are also some patients with primary resistance to ribociclib.These patients benefit less from ribociclib,and they are unable to gain significant benefit even with the intensive adjuvant therapy of ribociclib.Considering the drug toxicity and health economic benefits,a 3-year course of ribociclib may not be appropriate for all intermediate-risk populations.Therefore,how to screen out the prime population for intensive adjuvant therapy of ribociclib needs to worth explored.In this paper,we discussed that the adaptive neoadjuvant endocrine therapy can screen out the prime population for intensive adjuvant therapy of ribociclib.展开更多
Environmental endocrine disrupting chemicals （EDCs）, commonly found in the environment, come from industry and agriculture, including pesticides, fungicides, insecticides, herbicides, and other chemicals. Nowadays, ...Environmental endocrine disrupting chemicals （EDCs）, commonly found in the environment, come from industry and agriculture, including pesticides, fungicides, insecticides, herbicides, and other chemicals. Nowadays, more and more EDCs were released into the environment. EDCs go into water body via atmosphere sedi-mentation, surface runoff, soil eluviation, etc., so water body becomes the main place for existing. In order to attract scientific and public attention worldwide and to prevent EDCs pol ution, in this study we reviewed the classification of EDCs and their concentrations in natural water bodies, drinking water sources and water plants, and the reproductive toxicity of EDCs to fish were reviewed. EDCs could disturb the endocrine system and make reproductive organs and reproduction abnor-mal, resulting in fertility descending, reproduction function damage, community quan-tity decrease and even species extinction. In addition, EDCs could disrupt the homeostasis maintained by hormones, which would result in defects of neural de-velopment and abnormalities of the endocrine and reproductive systems. The exact molecular mechanisms have not been completely reported, but researches have suggested that multiple mechanisms were involved in the action of EDCs. Although there have been researches on the biohazard of EDCs, there stil exist problems of weakness in fundamental researches, difficulties in recognizing and identifying EDCs and high cost, which restraint the knowledge on them.展开更多
[Objective] The study was to immunohistochemical localize the endocrine cells from digestive tract of Misgurnus [ Method ] Using six gastrointestinal hormone antisera, the endocrine cells from digestive tract of M. an...[Objective] The study was to immunohistochemical localize the endocrine cells from digestive tract of Misgurnus [ Method ] Using six gastrointestinal hormone antisera, the endocrine cells from digestive tract of M. anguillicaudatus was localized. [ Result ]The 5-hydroxytryptamine immunoreactive（5-HT-IR） cells distribute in oesophagus, foregut and midgut; the distribution density was determined to be forepart of foregut 〉 oesophagus and hindpart of foregut 〉 gut, and the differences in the three density gradients reached significant level. Like PP-IR, SS-IR cells were observed mostly in oesophagus, followed by hindpart of foregut, least in forepart of foregut, but never found in gut and hindgut. The three kinds of immunocompetent cells Gas-IR, Glu-IR and SP-IR were not detected in each part of digestive tract. [ Conctusion] This study may provide basic data for studying the nutritional and digestive physiology, as well as the preparation of meridic diets for M. anguillicaudatus.展开更多
Recent advances in localization techniques,such as the selective arterial secretagogue injection test(SASI test) and somatostatin receptor scintigraphy have promoted curative resection surgery for patients with pancre...Recent advances in localization techniques,such as the selective arterial secretagogue injection test(SASI test) and somatostatin receptor scintigraphy have promoted curative resection surgery for patients with pancreatic neuroendocrine tumors(PNET).For patients with sporadic functioning PNET,curative resection surgery has been established by localization with the SASI test using secretin or calcium.For curative resection of functioning PNET associated with multiple endocrine neoplasia type 1(MEN 1) which are usually multiple and sometimes numerous,resection surgery of the pancreas and/or the duodenum has to be performed based on localization by the SASI test.As resection surgery of PNET has increased,several important pathological features of PNET have been revealed.For example,in patients with Zollinger-Ellison syndrome(ZES),duodenal gastrinoma has been detected more frequently than pancreatic gastrinoma,and in patients with MEN 1 and ZES,gastrinomas have been located mostly in the duodenum,and pancreatic gastrinoma has been found to co-exist in 13% of patients.Nonfunctioning PNET in patients with MEN 1 becomes metastatic to the liver when it is more than 1 cm in diameter and should be resected after careful observation.The most important prognos-tic factor in patients with PNET is the development of hepatic metastases.The treatment strategy for hepatic metastases of PNET has not been established and aggressive resection with chemotherapy and trans-arterial chemoembolization have been performed with significant benefit.The usefulness of octreotide treatment and other molecular targeting agents are currently being assessed.展开更多
Large cell neuroendocrine carcinoma (LCNEC) in the biliary system is a poorly differentiated, high-grade neuroendocrine tumor. These tumors exhibit aggressive behavior and an increased tendency for early nodal and dis...Large cell neuroendocrine carcinoma (LCNEC) in the biliary system is a poorly differentiated, high-grade neuroendocrine tumor. These tumors exhibit aggressive behavior and an increased tendency for early nodal and distant metastases. Herein, we report an unusual case of a pure primary LCNEC of the common bile duct (CBD). A 75-year-old female presented with nausea and jaundice. The patient underwent a CBD excision with lymph node dissection. Upon histological and immunohistochemical examination, the tumor exhibited pure large cell-type neuroendocrine features. Metastases were noted in two of the eight lymph nodes. The patient was administered adjuvant chemotherapy. The patient’s cancer recurred 7 mo after surgery, and the patient died from liver failure 5 mo after recurrence. The prognosis of LCNEC of CBD remains poor despite curative resection and adjuvant chemotherapy. The role of additional therapies, such as multimodal treatment including radiation therapy, must be further studied to improve the prognoses of patients.展开更多
AIM： To search for the optimal surgery for gastrinoma and duodenopancreatic neuroendocrine tumors in patients with multiple endocrine neoplasia type 1. METHODS： Sixteen patients with genetically confirmed multiple e...AIM： To search for the optimal surgery for gastrinoma and duodenopancreatic neuroendocrine tumors in patients with multiple endocrine neoplasia type 1. METHODS： Sixteen patients with genetically confirmed multiple endocrine neoplasia type 1 （MEN 1） and Zollinger-Ellison syndrome （ZES） underwent resection of both gastrinomas and duodenopancreatic neuroendocrine tumors （NETs） between 1991 and 2009. For localization of gastrinoma, selective arterial secretagogue injection test （SASI test） with secretin or calcium solution was performed as well as somatostatin receptor scintigraphy （SRS） and other imaging methods such as computed tomography （CT） or magnetic resonance imaging （MRI）. The modus of surgery for gastrinoma has been changed over time, searching for the optimal surgery： pancreaticoduodenectomy （PD） was first performed guided by localization with the SAST test, then local resection of duodenal gastrinomas with dissection of regional lymph nodes （LR）, and recently pancreas-preserving total duodenectomy （PPTD） has been performed for multiple duodenal gastrinomas. RESULTS： Among various types of preoperative localizing methods for gastrinoma, the SASI test was the most useful method. Imaging methods such as SRS or CT made it essentially impossible to differentiate functioning gastrinoma among various kinds of NETs. However, recent imaging methods including SRS or CT were useful for detecting both distant metastases and ectopic NETs; therefore they are indispensable for staging of NETs. Biochemical cure of gastrinoma was achieved in 14 of 16 patients （87.5%）; that is, 100% in 3 patients who underwent PD, 100% in 6 patients who underwent LR （although in 2 patients （33.3%） second LR was performed for recurrence of duodenal gastri- noma）, and 71.4% in 7 patients who underwent PPTD. Pancreatic NETs more than 1 cm in diameter were resected either by distal pancreatectomy or enucleations, and no hepatic metastases have developed postoperatively. Pathological study of the resected specimens revealed co-existence of pancreatic gastrinoma with duodenal gastrinoma in 2 of 16 patients （13%）, and G cell hyperplasia and/or microgastrinoma in the duodenal Brunner＇s gland was revealed in all of 7 duodenal specimens after PPTD. CONCLUSION： Aggressive resection surgery based on accurate localization with the SASI test was useful for biochemical cure of gastrinoma in patients with MEN 1.Imamura Metal. Curative resection of gastrinoma in MEN-1展开更多
BACKGROUND: The management of metastatic disease in pancreatic endocrine tumors (PETs) demands a multidisciplinary approach and the cooperation of several medical specialties. The role of surgery is critical, even whe...BACKGROUND: The management of metastatic disease in pancreatic endocrine tumors (PETs) demands a multidisciplinary approach and the cooperation of several medical specialties. The role of surgery is critical, even when a radical excision cannot always be achieved. DATA SOURCES: A PubMed search of relevant articles published up to February 2011 was performed to identify current information about PET liver metastases regarding diagnosis and management, with an emphasis on surgery. RESULTS: The early diagnosis of metastases and their accurate localization, most commonly in the liver, is very important. Surgical options include radical excision, and palliative excision to relieve symptoms in case of failure of medical treatment. The goal of the radical excision is to remove the primary tumor bulk and all liver metastases at the same time, but unfortunately it is not feasible in most cases. Palliative excisions include aggressive tumor debulking surgeries in well-differentiated carcinomas, trying to remove at least 90% of the tumor mass, combined with other additional destructive techniques such as hepatic artery embolization or chemoembolization to treat metastases or chemoembolization to relieve symptoms in cases of rapidly growing tumors. The combination of chemoembolization and systemic chemotherapy results in better response and survival rates. Other local destructive techniques include ethanol injection, cryotherapy and radiofrequency ablation. CONCLUSION: It seems that the current management of PETs can achieve important improvements, even in advanced cases.展开更多
The reproductive endocrine activities of neuroendocrine organs and androgenic glands (AG) in male Scylla serrata were investigated with co-incubation technology. In vitro studies show that: (1) the AG in Stage Ⅲ can ...The reproductive endocrine activities of neuroendocrine organs and androgenic glands (AG) in male Scylla serrata were investigated with co-incubation technology. In vitro studies show that: (1) the AG in Stage Ⅲ can significantly accelerate the development of seminiferous tubules and spermic matu- ration; (2) the brain, thoracic ganglia and optic ganglia have no direct influence over the testicular devel- opment; (3) the brain and thoracic ganglia can significantly promote the growth of the AG cells and highly significantly boost the ratio of Type B cells, while the optic ganglia have no such effects. It is the first time for in vitro investigations to confirm that the brain and thoracic ganglia can regulate testicular development through AG in male crustaceans.展开更多
Pancreatic endocrine tumors are rare but are among the most common neuroendocrine neoplasms of the abdomen.At diagnosis many of them are already advanced and diff icult to treat.We report on an initially inoperable ma...Pancreatic endocrine tumors are rare but are among the most common neuroendocrine neoplasms of the abdomen.At diagnosis many of them are already advanced and diff icult to treat.We report on an initially inoperable malignant pancreatic endocrine tumor in a 33-year-old woman,who received neoadjuvant peptide receptor radionuclide therapy(PRRT)as firstline treatment.This resulted in a signif icant downstaging of the tumor and allowed its subsequent complete surgical removal.Follow-up for eighteen months revealed a complete remission.This is the first report on neoadjuvant PRRT in a neuroendocrine neoplasm with subsequent successful complete resection.展开更多
文摘Multiple endocrine neoplasia type 1(MEN1)is an autosomal-inherited syndrome involving multiple endocrine tumors.It is characterized by multiple mutations in the tumor suppressor gene MEN1,which is located on chromosome 11q13.As main etiology of MEN1 is genetic mutations,clinical symptoms may vary.In this editorial,we comment on the article by Yuan et al.This article describes a case of(MEN1)characterized by low incidence and diagnostic complexity.MEN1 co-mmonly presents as parathyroid,pancreatic,and pituitary tumors.Diagnosis requires a combination of serologic tests,magnetic resonance imaging,computed tomography,endoscopic ultrasonography,immunologic and pathology.The diagnosis is unique depending on the site of disease.Surgical resection is the treatment of choice for MEN1.The prognosis depends on the site of origin,but early detection and intervention is the most effective.
文摘BACKGROUND Mixed tumors of the colon and rectum,composed of a combination of epithelial and endocrine elements of benign and malignant potential are rare neoplasms.These can occur anywhere in the gastrointestinal tract and are often diagnosed incidentally.Though they have been a well-documented entity in the pancreas,where the exocrine-endocrine mixed tumors have been known for a while,recognition and accurate diagnosis of these tumors in the colon and rectum,to date,remains a challenge.This is further compounded by the different terminologies that have been attributed to these lesions over the years adding to increased confusion and misclassification.Therefore,dedicated literature reviews of these lesions in the colon and rectum are inconsistent and are predominantly limited to case reports and case series of limited case numbers.Though,most of these tumors are high grade and of advanced stage,intermediate and low grade lesions of these mixed tumors are also increasingly been reported.There are no established independent consensus based guidelines for the therapeutic patient management of these unique lesions.AIM To provide a comprehensive targeted literature review of these complex mixed tumors in the colon and rectum that chronicles the evolution over time with summarization of historical perspectives of terminology and to further our understanding regarding their pathogenesis including genomic landscape,clinicoradiological features,pathology,treatment,prognosis,the current status of the management of the primary lesions,their recurrences and metastases.METHODS A comprehensive review of the published English literature was conducted using the search engines PubMed,MEDLINE and GOOGLE scholar.The following search terms[“mixed tumors colon”OR mixed endocrine/neuroendocrine tumor/neoplasm/lesion colon OR adenocarcinoma and endocrine/neuroendocrine tumor colon OR mixed adenocarcinoma and endocrine/neuroendocrine carcinoma colon OR Amphicrine tumors OR Collision tumors]were used.Eligibility criteria were defined and all potential relevant items,including full articles and/or abstracts were independently reviewed,assessed and agreed upon items were selected for in-depth analysis.RESULTS In total 237 full articles/abstracts documents were considered for eligibility of which 45 articles were illegible resulting in a total of 192 articles that were assessed for eligibility of which 139 have been selected for reference in this current review.This seminal manuscript is a one stop article that provides a detailed outlook on the evolution over time with summarization of historical perspectives,nomenclature,clinicoradiological features,pathology,treatment,prognosis and the current status of the management of both the primary lesions,their recurrences and metastases.Gaps in knowledge have also been identified and discussed.An important outcome of this manuscript is the justified proposal for a new,simple,clinically relevant,non-ambiguous terminology for these lesions to be referred to as mixed epithelial endocrine neoplasms(MEENs).CONCLUSION MEEN of the colon and rectum are poorly understood rare entities that encompass an extensive range of heterogeneous tumors with a wide variety of combinations leading to tumors of high,intermediate or low grade malignant potential.This proposed new revised terminology of MEEN will solve the biggest hurdle of confusion and misclassification that plagues these rare unique colorectal neoplasms thus facilitating the future design of multi institutional prospective randomized controlled clinical trials to develop and evaluate newer therapeutic strategies that are recommended for continued improved understanding and personal optimization of clinical management of these unique colorectal neoplasms.
基金Supported by CONAHCYT Project,No.CF-2023-I-2663Instituto Nacional de Psiquiatría Project,No.NC24208.0(to Pérez-Sánchez G,Pavón L,Sánchez-Huerta K,Maldonado-García JL,Chin-Chan JM,Ponce-Regalado MD,Arreola R,Contis-Montes de Oca A,and Moreno-Lafont MC).
文摘Suicide is defined as the act of a person attempting to take their own life by causing death.Suicide is a complex phenomenon that is influenced by a multitude of factors,including psychosocial,cultural,and religious aspects,as well as genetic,biochemical,and environmental factors.From a biochemical perspective,it is crucial to consider the communication between the endocrine,immune,and nervous systems when studying the etiology of suicide.Several pathologies involve the bidirectional communication between the peripheral activity and the central nervous system by the action of molecules such as cytokines,hormones,and neurotransmitters.These humoral signals,when present in optimal quantities,are responsible for maintaining physiological homeostasis,including mood states.Stress elevates the cortisol and proinflammatory cytokines levels and alter neurotransmitters balance,thereby increasing the risk of developing a psychiatric disorder and subsequently the risk of suicidal behavior.This review provides an integrative perspective about the neurochemical,immunological,and endocrinological disturbances associated with suicidal behavior,with a particular focus on those alterations that may serve as potential risk markers and/or indicators of the state preceding such a tragic act.
文摘Endocrine disorders frequently lead to metabolic disturbances that significantly affect liver function.Understanding the complex interplay between hormonal imbalances and liver dysfunction is essential for advancing targeted therapeutic strategies.This comprehensive review explores the pathophysiological mechanisms linking major endocrine disorders to liver disease,with a focus on the roles of the thyroid,parathyroid,pancreas,adrenal glands,and sex hormones.Thyroid dysfunction is associated with alterations in liver enzyme levels and metabolic regulation,often resulting in hepatic steatosis or cholestasis.Hyperparathyroidism and consequent hypercalcemia have been linked to hepatic calcifications.Insulin resistance,both hepatic and peripheral,contributes to excessive lipid accumulation in the liver,exacerbating steatotic changes.Adrenal gland disorders,particularly in the setting of chronic liver disease,impair cortisol metabolism and may worsen hepatic injury.Additionally,sex hormones such as estrogen and testosterone modulate the progression of liver fibrosis and influence the development of metabolic syndrome.The intricate relationship between endocrine and hepatic systems underscores the need for a multidisciplinary approach in the management of liver disease.Addressing underlying hormonal disturbances may enhance patient outcomes and prevent further hepatic deterioration.Future research should prioritize integrative therapeutic strategies that concurrently target endocrine and liver dysfunction.
文摘Transgender individuals often undergo gender-affirming hormonal therapy(GAHT)to align their physical characteristics with their gender identity,which introduces unique challenges in the management of critically ill patients.In the setting of critical illness,the interactions between GAHT and the body's endocrine response are complex.GAHT can influence the hypothalamic-pituitary-adrenal axis,sex hormone levels,and metabolic parameters,potentially complicating the clinical picture.For example,estrogen therapy in transgender women increases the risk of venous thromboembolism,which is further exacerbated by the immobility and hypercoagulable state often present in critically ill patients.Testosterone therapy in transgender men can lead to erythrocytosis,increasing the risk of thromboembolic events during critical illness.The potential for drug interactions,particularly with medications used in the intensive care unit,also requires careful consideration.Monitoring hormone levels and adjusting GAHT in the acute setting are crucial,although evidence-based guidelines are lacking.The need for individualized care and vigilant monitoring of endocrine and metabolic parameters is paramount to improve outcomes in this vulnerable population.
文摘Endocrine disorders are increasingly recognized as potentially reversible causes of secondary cardiomyopathies,yet they often remain underdiagnosed in clinical practice.These conditions-including thyroid dysfunction,acromegaly,pheochromocytoma,diabetes mellitus,adrenal disorders,among others-can significantly alter cardiac structure and function through hormonal excess,metabolic remodeling,and neurohumoral activation.Hyperthyroidism may lead to high-output heart failure(HF)and atrial fibrillation,while hypothyroidism is associated with diastolic dysfunction,pericardial effusion,and accelerated atherosclerosis.Acromegaly promotes biventricular hypertrophy and myocardial fibrosis via insulin-like growth factor 1 overproduction.Pheochromocytoma triggers catecholamine-induced cardiomyopathy,resembling Takotsubo syndrome and carrying a high risk of mortality if left untreated.Diabetes induces a distinct phenotype of cardiomyopathy,affecting both systolic and diastolic function through microvascular injury and oxidative stress.Recognizing these endocrine etiologies is crucial,as targeted hormonal therapies-such as antithyroid agents,somatostatin analogs,or adrenalectomy-can reverse or significantly mitigate cardiac dysfunction.Comprehensive endocrine screening in patients with unexplained cardiomyopathy is therefore essential.This review synthesizes current knowledge on the pathophysiological mechanisms,clinical manifestations,and therapeutic strategies for endocrine cardiomyopathies and proposes a diagnostic algorithm for early recognition.Emerging biomarkers,such as galectin-3 in diabetic heart disease,may further enhance diagnostic accuracy and risk stratification.The interplay between endocrine and cardiovascular systems offers a unique opportunity for early intervention,potentially preventing progression to irreversible HF.
基金Supported by National Natural Science Foundation of China,No.82305376The Project of Supporting Young Scientific and Technological Talents in Jiangsu Province in 2024,No.JSTJ-2024-380.
文摘BACKGROUND Pancreas transplantation(PT)has emerged as a critical therapeutic intervention for patients with type 1 diabetes mellitus(T1DM).This procedure restores neuroendocrine communication,which is essential for optimal pancreatic function and insulin regulation.The recovery process involves multiple phases,including neural regeneration,revascularization,and the re-establishment of synaptic connections,all of which contribute to the restoration of both endocrine and neurological functions.AIM To systematically examine the mechanisms underlying neurological recovery following PT,to explore the role of endocrine factors in restoring neurofunctional integrity,and to evaluate the impact of immunosuppressive therapy on nerve regeneration and its clinical outcomes.METHODS A comprehensive literature search was conducted across international databases such as PubMed,Web of Science,and Cochrane Library to identify studies addressing PT,neurological recovery,and endocrine regulation.Inclusion criteria encompassed randomized controlled trials,cohort studies,and systematic reviews.The review focused on the neurogenic mechanisms activated post-transplantation,the effect of glycemic control on nerve repair,and the implications of immunosuppressive drugs on the process of neurological recovery.RESULTS A total of 211 articles were initially identified through the literature search across international databases such as PubMed,Web of Science,and Cochrane Library.Following a detailed evaluation and the application of inclusion and exclusion criteria,56 articles were further reviewed,and 8 were selected for the final analysis.Additionally,a comprehensive patent search yielded 168 patents,out of which 6 were selected for further examination.These sources,including both journal literature and patents,offer significant insights into the mechanisms of neurological recovery and endocrine function following PT,with an emphasis on nerve regeneration,glycemic control,and the impact of immunosuppressive therapy.CONCLUSION PT represents a promising intervention for restoring both endocrine and neurological functions in patients with T1DM.Glycemic control,neural regeneration,and the restoration of neuroendocrine signaling are key components of successful recovery.While the procedure yields substantial improvements in nerve function,challenges persist,particularly in patients with long-standing diabetes or severe neuropathy.The dual impact of immunosuppressive drugs on immune suppression and neurotoxicity necessitates careful management.Future research should focus on refining immunosuppressive protocols and exploring advanced therapeutic options,including stem cell-based interventions,to enhance neural regeneration and further improve clinical outcomes.
文摘The increasing longevity of patients with transfusion-dependent homozygous beta-thalassemia has brought endocrine complications to the forefront of longterm care.While iron overload remains a central mechanism,additional contributors such as hypothalamic dysfunction,neurosecretory disturbances,and chronic inflammation have been identified.Endocrine disorders including hypothyroidism,adrenal insufficiency,hypogonadotropic hypogonadism,hypoparathyroidism,osteoporosis,and growth axis impairment-are prevalent and often underdiagnosed.Diagnostic challenges include normal hormone levels in early stages,necessitating the use of dynamic endocrine testing and pituitary magnetic resonance imaging to detect subclinical dysfunction.Risk is modulated by sex,age,and chelation adherence.Early identification and proactive,multidisciplinary management of endocrine sequelae are essential in reducing morbidity and maintaining functional independence in this aging patient population.
基金Supported by National Natural Science Foundation of China,No.821706751·3·5 Project for Disciplines of Excellence,West China Hospital,Sichuan University,No.ZYJC21011.
文摘In this manuscript,we comment on a recent publication by Yuan et al.This article provides a detailed scientific diagnostic process for a multiple endocrine neo-plasia type 1 patient,thus offering strong guidance for clinical practice.However,we believe that the authors should also provide information on the patient's long-term prognosis.
基金supported by the National Key Research and Development Program of China (No. 2020YFA0112304)the National Natural Science Foundation of China (No. 82373167, 82341003 and 92159301)+4 种基金the Natural Science Foundation of Shanghai (No. 22ZR1479200)the Shanghai Key Laboratory of Breast Cancer (No. 12DZ2260100)the SHDC Municipal Project for Developing Emerging and Frontier Technology in Shanghai Hospitals (No. SHDC12 021103)Shanghai Medical Innovation Research Project (No. 22Y11912700)Shanghai Anticancer Association EYAS PROJECT (No. SACA-CY22A05)
文摘Objective:Recurrence continues to be a pivotal challenge among hormone receptor-positive(HR^(+))/human epidermal growth factor receptor 2^(−)negative(HER2^(−))breast cancers.In the international consensus guidelines,HR^(+)/HER2^(−)breast cancer relapse patterns are divided into three distinct types:primary resistant,secondary resistant,and endocrine sensitive.However,owing to the lack of cohorts with treatment and follow-up data,the heterogeneity among different recurrence patterns remains uncharted.Current treatments still lack precision.Methods:This analysis included data from a large-scale multiomics study of a HR^(+)/HER2^(−)breast cancer cohort(n=314).Through the analysis of transcriptomics(n=312),proteomics(n=124),whole-exome sequencing(n=290),metabolomics(n=217),and digital pathology(n=228)data,we explored distinctive molecular features and identified putative therapeutic targets for patients experiencing recurrence.Results:We explored distinct clinicopathological characteristics,biological heterogeneity,and potential therapeutic strategies for recurrence.Based on a shared relapse signature,we stratified patients into high-and lowrecurrence-risk groups.Patients with different relapse patterns presented unique molecular features in primary tumors.Specifically,receptor tyrosine kinase(RTK)pathway activation in the primary resistant group suggested the utility of RTK inhibitors,whereas mammalian target of rapamycin(mTOR)and cell cycle pathway activation in the secondary resistant group highlighted the potential of mTOR and CDK4/6 inhibitors.Interestingly,the endocrine-sensitive group displayed a quiescent state and high genomic instability,suggesting that targeting quiescent cells and using poly-ADP-ribose polymerase(PARP)inhibitors could be effective strategies.Conclusions:These findings illuminate the clinicopathological and molecular landscape of HR^(+)/HER2^(−)breast cancer patients with distinct recurrence patterns,highlighting potential targeted therapies.
基金supported by China Postdoctoral Science Foundation(No.2022M721987)Natural Science Foundation of Shandong Province(No.ZR2024QH058).
文摘The latest data from the NATALEE trial showed the absolute 3-year invasive disease-free survival benefit was 4.9%between the experimental and control groups.That is to say,in the intermediate-risk hormone receptor positive/human epidermal growth factor receptor-2 negative subgroup,there are also some patients with primary resistance to ribociclib.These patients benefit less from ribociclib,and they are unable to gain significant benefit even with the intensive adjuvant therapy of ribociclib.Considering the drug toxicity and health economic benefits,a 3-year course of ribociclib may not be appropriate for all intermediate-risk populations.Therefore,how to screen out the prime population for intensive adjuvant therapy of ribociclib needs to worth explored.In this paper,we discussed that the adaptive neoadjuvant endocrine therapy can screen out the prime population for intensive adjuvant therapy of ribociclib.
基金Supported by the China Agriculture Research System(CARS49)~~
文摘Environmental endocrine disrupting chemicals （EDCs）, commonly found in the environment, come from industry and agriculture, including pesticides, fungicides, insecticides, herbicides, and other chemicals. Nowadays, more and more EDCs were released into the environment. EDCs go into water body via atmosphere sedi-mentation, surface runoff, soil eluviation, etc., so water body becomes the main place for existing. In order to attract scientific and public attention worldwide and to prevent EDCs pol ution, in this study we reviewed the classification of EDCs and their concentrations in natural water bodies, drinking water sources and water plants, and the reproductive toxicity of EDCs to fish were reviewed. EDCs could disturb the endocrine system and make reproductive organs and reproduction abnor-mal, resulting in fertility descending, reproduction function damage, community quan-tity decrease and even species extinction. In addition, EDCs could disrupt the homeostasis maintained by hormones, which would result in defects of neural de-velopment and abnormalities of the endocrine and reproductive systems. The exact molecular mechanisms have not been completely reported, but researches have suggested that multiple mechanisms were involved in the action of EDCs. Although there have been researches on the biohazard of EDCs, there stil exist problems of weakness in fundamental researches, difficulties in recognizing and identifying EDCs and high cost, which restraint the knowledge on them.
基金Supported by Anhui Key Laboratory of Plant Resources and Biology~~
文摘[Objective] The study was to immunohistochemical localize the endocrine cells from digestive tract of Misgurnus [ Method ] Using six gastrointestinal hormone antisera, the endocrine cells from digestive tract of M. anguillicaudatus was localized. [ Result ]The 5-hydroxytryptamine immunoreactive（5-HT-IR） cells distribute in oesophagus, foregut and midgut; the distribution density was determined to be forepart of foregut 〉 oesophagus and hindpart of foregut 〉 gut, and the differences in the three density gradients reached significant level. Like PP-IR, SS-IR cells were observed mostly in oesophagus, followed by hindpart of foregut, least in forepart of foregut, but never found in gut and hindgut. The three kinds of immunocompetent cells Gas-IR, Glu-IR and SP-IR were not detected in each part of digestive tract. [ Conctusion] This study may provide basic data for studying the nutritional and digestive physiology, as well as the preparation of meridic diets for M. anguillicaudatus.
文摘Recent advances in localization techniques,such as the selective arterial secretagogue injection test(SASI test) and somatostatin receptor scintigraphy have promoted curative resection surgery for patients with pancreatic neuroendocrine tumors(PNET).For patients with sporadic functioning PNET,curative resection surgery has been established by localization with the SASI test using secretin or calcium.For curative resection of functioning PNET associated with multiple endocrine neoplasia type 1(MEN 1) which are usually multiple and sometimes numerous,resection surgery of the pancreas and/or the duodenum has to be performed based on localization by the SASI test.As resection surgery of PNET has increased,several important pathological features of PNET have been revealed.For example,in patients with Zollinger-Ellison syndrome(ZES),duodenal gastrinoma has been detected more frequently than pancreatic gastrinoma,and in patients with MEN 1 and ZES,gastrinomas have been located mostly in the duodenum,and pancreatic gastrinoma has been found to co-exist in 13% of patients.Nonfunctioning PNET in patients with MEN 1 becomes metastatic to the liver when it is more than 1 cm in diameter and should be resected after careful observation.The most important prognos-tic factor in patients with PNET is the development of hepatic metastases.The treatment strategy for hepatic metastases of PNET has not been established and aggressive resection with chemotherapy and trans-arterial chemoembolization have been performed with significant benefit.The usefulness of octreotide treatment and other molecular targeting agents are currently being assessed.
文摘Large cell neuroendocrine carcinoma (LCNEC) in the biliary system is a poorly differentiated, high-grade neuroendocrine tumor. These tumors exhibit aggressive behavior and an increased tendency for early nodal and distant metastases. Herein, we report an unusual case of a pure primary LCNEC of the common bile duct (CBD). A 75-year-old female presented with nausea and jaundice. The patient underwent a CBD excision with lymph node dissection. Upon histological and immunohistochemical examination, the tumor exhibited pure large cell-type neuroendocrine features. Metastases were noted in two of the eight lymph nodes. The patient was administered adjuvant chemotherapy. The patient’s cancer recurred 7 mo after surgery, and the patient died from liver failure 5 mo after recurrence. The prognosis of LCNEC of CBD remains poor despite curative resection and adjuvant chemotherapy. The role of additional therapies, such as multimodal treatment including radiation therapy, must be further studied to improve the prognoses of patients.
基金Supported by a Health and Labor Sciences Research Grant from the Ministry of Health, Labor and Welfare, Government of Japan (Grant No. H21-Nanchi-Ippan-037)
文摘AIM： To search for the optimal surgery for gastrinoma and duodenopancreatic neuroendocrine tumors in patients with multiple endocrine neoplasia type 1. METHODS： Sixteen patients with genetically confirmed multiple endocrine neoplasia type 1 （MEN 1） and Zollinger-Ellison syndrome （ZES） underwent resection of both gastrinomas and duodenopancreatic neuroendocrine tumors （NETs） between 1991 and 2009. For localization of gastrinoma, selective arterial secretagogue injection test （SASI test） with secretin or calcium solution was performed as well as somatostatin receptor scintigraphy （SRS） and other imaging methods such as computed tomography （CT） or magnetic resonance imaging （MRI）. The modus of surgery for gastrinoma has been changed over time, searching for the optimal surgery： pancreaticoduodenectomy （PD） was first performed guided by localization with the SAST test, then local resection of duodenal gastrinomas with dissection of regional lymph nodes （LR）, and recently pancreas-preserving total duodenectomy （PPTD） has been performed for multiple duodenal gastrinomas. RESULTS： Among various types of preoperative localizing methods for gastrinoma, the SASI test was the most useful method. Imaging methods such as SRS or CT made it essentially impossible to differentiate functioning gastrinoma among various kinds of NETs. However, recent imaging methods including SRS or CT were useful for detecting both distant metastases and ectopic NETs; therefore they are indispensable for staging of NETs. Biochemical cure of gastrinoma was achieved in 14 of 16 patients （87.5%）; that is, 100% in 3 patients who underwent PD, 100% in 6 patients who underwent LR （although in 2 patients （33.3%） second LR was performed for recurrence of duodenal gastri- noma）, and 71.4% in 7 patients who underwent PPTD. Pancreatic NETs more than 1 cm in diameter were resected either by distal pancreatectomy or enucleations, and no hepatic metastases have developed postoperatively. Pathological study of the resected specimens revealed co-existence of pancreatic gastrinoma with duodenal gastrinoma in 2 of 16 patients （13%）, and G cell hyperplasia and/or microgastrinoma in the duodenal Brunner＇s gland was revealed in all of 7 duodenal specimens after PPTD. CONCLUSION： Aggressive resection surgery based on accurate localization with the SASI test was useful for biochemical cure of gastrinoma in patients with MEN 1.Imamura Metal. Curative resection of gastrinoma in MEN-1
文摘BACKGROUND: The management of metastatic disease in pancreatic endocrine tumors (PETs) demands a multidisciplinary approach and the cooperation of several medical specialties. The role of surgery is critical, even when a radical excision cannot always be achieved. DATA SOURCES: A PubMed search of relevant articles published up to February 2011 was performed to identify current information about PET liver metastases regarding diagnosis and management, with an emphasis on surgery. RESULTS: The early diagnosis of metastases and their accurate localization, most commonly in the liver, is very important. Surgical options include radical excision, and palliative excision to relieve symptoms in case of failure of medical treatment. The goal of the radical excision is to remove the primary tumor bulk and all liver metastases at the same time, but unfortunately it is not feasible in most cases. Palliative excisions include aggressive tumor debulking surgeries in well-differentiated carcinomas, trying to remove at least 90% of the tumor mass, combined with other additional destructive techniques such as hepatic artery embolization or chemoembolization to treat metastases or chemoembolization to relieve symptoms in cases of rapidly growing tumors. The combination of chemoembolization and systemic chemotherapy results in better response and survival rates. Other local destructive techniques include ethanol injection, cryotherapy and radiofrequency ablation. CONCLUSION: It seems that the current management of PETs can achieve important improvements, even in advanced cases.
基金This work was supported by the National Natural Science Foundation of China (No.30300269) and the Fujian Province Key Foundation Re-search Program (1998-2002).
文摘The reproductive endocrine activities of neuroendocrine organs and androgenic glands (AG) in male Scylla serrata were investigated with co-incubation technology. In vitro studies show that: (1) the AG in Stage Ⅲ can significantly accelerate the development of seminiferous tubules and spermic matu- ration; (2) the brain, thoracic ganglia and optic ganglia have no direct influence over the testicular devel- opment; (3) the brain and thoracic ganglia can significantly promote the growth of the AG cells and highly significantly boost the ratio of Type B cells, while the optic ganglia have no such effects. It is the first time for in vitro investigations to confirm that the brain and thoracic ganglia can regulate testicular development through AG in male crustaceans.
文摘Pancreatic endocrine tumors are rare but are among the most common neuroendocrine neoplasms of the abdomen.At diagnosis many of them are already advanced and diff icult to treat.We report on an initially inoperable malignant pancreatic endocrine tumor in a 33-year-old woman,who received neoadjuvant peptide receptor radionuclide therapy(PRRT)as firstline treatment.This resulted in a signif icant downstaging of the tumor and allowed its subsequent complete surgical removal.Follow-up for eighteen months revealed a complete remission.This is the first report on neoadjuvant PRRT in a neuroendocrine neoplasm with subsequent successful complete resection.
