c-peptide and Adenocarcinoma

Topics: Adenocarcinoma; Aged; Antineoplastic Combined Chemotherapy Protocols; Autoantibodies; Autoimmune Diseases; C-Peptide; Dexamethasone; Diazoxide; Diet, Diabetic; Female; Glucose; Glucose Intolerance; Humans; Hyperinsulinism; Hypoglycemia; Immunosuppressive Agents; Insulin; Liver Neoplasms; Polyethylene Glycols; Proinsulin; Sigmoid Neoplasms

Somatostatin analogs act directly on breast cancer cells and indirectly on insulin and insulin-like growth factor 1 (IGF-1) levels. This trial was undertaken to assess whether octreotide would lower insulin and IGF-1 levels and reduce risk of breast cancer recurrence.. The NCIC CTG MA.14 (NCIC Clinical Trials Group MA.14) trial randomly assigned postmenopausal women to 5 years of tamoxifen 20 mg daily (TAM) or TAM plus 2 years of octreotide 90 mg depot intramuscular injections monthly (TAM-OCT) as adjuvant therapy. The primary end point was event-free survival (EFS). Secondary end points were relapse-free survival (RFS), overall survival (OS), toxicity, and effects of treatment on IGF physiology.. Among 667 women with a median follow-up of 7.9 years, 220 events occurred-108 with TAM-OCT and 112 with TAM. Adjusted hazard ratios (HRs; TAM-OCT to TAM) were 0.93 for EFS (95% CI, 0.71 to 1.22; P = .62), 0.84 for RFS (95% CI, 0.59 to 1.18; P = .31), and 0.97 for OS (95% CI, 0.69 to 1.37; P = .86). Among patients with normal baseline gallbladder imaging, cholecystectomy was required in 23.0% of those receiving TAM-OCT but in only 1.4% of those receiving TAM (P < .001). At 4 months, TAM-OCT had significantly (P < .001) lowered IGF-1, IGF binding protein 3, and C-peptide levels. Older age (P = .02), tumor size (P = .001), nodal status (P = .01), high C-peptide levels (P < .001), and higher body mass index (BMI) in models excluding C-peptide (P < .001) were associated with poorer EFS in multivariate analysis.. Octreotide-related changes in circulating IGF-1 and C-peptide levels were statistically significant. Octreotide did not add significant clinical benefit. High C-peptide levels (surrogate for insulin secretion rate) and high BMI were associated with poor outcome.

Topics: Adenocarcinoma; Adult; Aged; Antineoplastic Agents, Hormonal; Antineoplastic Combined Chemotherapy Protocols; Breast Neoplasms; C-Peptide; Chemotherapy, Adjuvant; Disease-Free Survival; Female; Humans; Insulin; Insulin-Like Growth Factor I; Middle Aged; Octreotide; Postmenopause; Quality of Life; Tamoxifen; Treatment Outcome; Vitamin D

The authors studied carbohydrate metabolism 4 weeks to 12 months after pancreatoduodenal resection (PDR) in 21 patients whose ages ranged from 40 to 55 years. Seven of them had been operated on for carcinoma of the major duodenal papillas and the other patients for carcinoma of the major duodenal papillas and the other patients for carcinoma of tree pancreas. The control group was formed of 10 healthy volunteers of the same age as the patients of the two groups under study; 10 patients who were subjected to PDR with pancreatojejunostomy and 11 patients in whom resection of the pancreatic stump was completed by intraductal occlusion of the formed stump. None of them had disorders of carbohydrate metabolism before the operation. The patients were examined by the oral test for glucose tolerance (OTGT, 75 g of glucose) with glycemia determination and by intravenous glucose tolerance test (i.v. GTT) with determination of glycemia and C-peptide. It was found that the glycemia curves obtained during OTGT did not have a diabetic character according to the WHO criteria. In performing TTG, the coefficient K was diabetic in both groups. Study of the C-peptide level during the i.v. GTT showed that in the group with occluded ducts the level of the C-peptide and the nature of its secretion differed obviously from those in the other groups under study, which testified to disturbances in the homeostai mechanisms.

Topics: Adenocarcinoma; Adult; Ampulla of Vater; Blood Glucose; C-Peptide; Common Bile Duct Neoplasms; Glucose Tolerance Test; Humans; Middle Aged; Pancreatic Neoplasms; Pancreaticoduodenectomy; Pancreaticojejunostomy; Postoperative Care; Time Factors

The correlation of abnormal glucose metabolism and thyroid carcinoma, especially the aggressiveness of thyroid cancer, still remains controversial. We conducted this study to investigate the relationship between abnormal glucose metabolism parameters and differentiated thyroid carcinoma (DTC) in the Chinese population.. The study was designed as a hospital-based case-control study and was approved by the Ethics Committee of our hospital and registered in the Clinical Trial Protocol Registration and Results System (Registration code: NCT03006289). From January 1, 2018 to June 30, 2021, a total of 377 DTC patients were enrolled in the study. Demographic and general characteristics, details of thyroid surgery and histopathological results, hematological test indicators were collected. Glucose metabolism parameters were calculated. Variables were analyzed by t-test, ANOVA, chi-squared analysis and Fisher's exact test. Pearson bi-variate correlation and Spearman's correlation analysis were used for bi-variate analysis.. More than 40% of patients with DTC were multifocality, more than half were extra-glandular invasion, and nearly 85% complied by lymph node metastasis. The prevalence of diabetes mellitus (DM) was about 10.08% in DTC patients. It was found that the proportion of postprandial 2 h blood glucose ≥11.1mmol/L and HbA1c ≥6.5% was significantly higher than the known proportion of DM (17.8%, 16.7% vs. 10.08%). Additionally, 87.3% of the DTC patients in this study had varying degrees of insulin resistance. Further analysis found that higher T staging was associated with higher levels of area under curve of C-peptide (. Abnormal glucose metabolism, namely, DM, hyperinsulinemia and insulin resistance, were significantly associated with the carcinogensis and aggressiveness of DTC.

Topics: Adenocarcinoma; C-Peptide; Case-Control Studies; China; Glucose; Hospitals; Humans; Insulin Resistance; Thyroid Neoplasms

Insulin-resistance and hyperinsulinemia could have a role in the growing incidence of esophageal adenocarcinoma (EAC) and its pre-cancerous lesion Barrett's Esophagus (BE). HER2 activation has also a pivotal role in EAC carcinogenesis but no data correlate these two phenomena in this disease context.. To investigate the role of hyperinsulinemia in BE-dysplasia-adenocarcinoma sequence and the possible relationship between insulin-mediated and HER2 signaling in EAC development.. Serum insulin, C-peptide, IGF1, glucagon, IL-6, TNF-alpha, leptin, adiponectin and Insulin-Resistance-index were analyzed in 19 patients with gastro-esophageal reflux disease, 51 with BE, 24 with dysplastic-BE and 14 with EAC. Insulin/IGF1/HER2 pathways were analyzed in esophageal biopsies using Luminex. Insulin-Resistance-index, insulin and C-peptide levels increased along with disease progression (p=0.019, p=0.002, p<0.0001, respectively) and correlated with HER2 expression and with downstream mediators phospho-Akt and phospho-mTOR in esophageal tissue. In vitro, insulin was also able to induce cell proliferation through HER2 activation.. Our data pinpoint a possible role of hyperinsulinemia in the Barrett's Esophagus metaplasia-dysplasia-adenocarcinoma sequence through HER2 activation in esophageal epithelial cells.

Topics: Adenocarcinoma; Adult; Aged; Barrett Esophagus; C-Peptide; Disease Progression; Esophageal Neoplasms; Esophagus; Female; Gastroesophageal Reflux; Humans; Immunohistochemistry; Insulin; Insulin Resistance; Interleukin-6; Italy; Male; Middle Aged; Receptor, ErbB-2; Signal Transduction; TOR Serine-Threonine Kinases; Tumor Necrosis Factor-alpha

This study investigated the relationship of obesity, insulin resistance, inflammation and angiogenesis with cancer progression and survival in a colorectal cancer cohort.. Clinical and pathological data, along with anthropometric and follow-up data, were collected from 344 consecutive colorectal cancer patients. Serum samples at diagnosis were analysed by immunoassay for adiponectin, C-reactive protein (CRP), vascular endothelial growth factor-A (VEGF-A), angiopoietin-2 (Ang-2), insulin-like growth factor-1 (IGF-1), insulin and C-peptide.. Serum Ang-2 and VEGF-A levels increased with tumour T stage (P=0.007 and P=0.025, respectively) and N stage (P=0.02 and P=0.03, respectively), and correlated with CRP levels (r=0.43, P<0.001 and r=0.23, P<0.001, respectively). Angiopoietin-2 correlated with C-peptide (r=0.14, P=0.007) and VEGF-A with IGF-1 in males (r=0.25, P=0.001). Kaplan-Meier analysis showed that patients with high serum levels of CRP and Ang-2 had significantly reduced survival (both P≤0.001). After adjusting for tumour stage and age, Ang-2 remained a significant predictor of survival. The CRP levels were inversely associated with survival in American Joint Committee on Cancer stage II patients (P=0.038), suggesting that CRP could be used to support treatment decisions in this subgroup. Serum markers and anthropometric measures of obesity correlated with each other, but not with survival.. Our study supports the concept that obesity-related inflammation, rather than obesity itself, is associated with colorectal cancer progression and survival. The study confirms serum Ang-2 as a predictive marker for outcome of colorectal cancer.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Angiopoietin-2; Biomarkers; Body Mass Index; C-Peptide; C-Reactive Protein; Colorectal Neoplasms; Enzyme-Linked Immunosorbent Assay; Female; Humans; Insulin; Insulin Resistance; Insulin-Like Growth Factor I; Male; Middle Aged; Obesity; Prospective Studies; Survival Rate; Treatment Outcome; Vascular Endothelial Growth Factor A

Blueberries may lower relative risk for cancers of the gastrointestinal tract. Previous work indicated an inhibitory effect of consumed blueberry (BB) on formation of aberrant crypt foci (ACF) in colons of male Fisher F344 rats (inbred strain). However, effects of BB on colon tumors and in both genders are unknown.. We examined efficacy of BB in inhibition of azoxymethane (AOM)-induced colon ACF and intestine tumors in male and female Sprague-Dawley rats (outbred strain). Pregnant rats were fed a diet with or without 10% BB powder; progeny were weaned to the same diet as their dam and received AOM as young adults.. Male and female rats on control diet had similar numbers of ACF at 6 weeks after AOM administration. BB increased (P < 0.05) ACF numbers within the distal colon of female but not male rats. There was a significant (P < 0.05) diet by gender interaction with respect to total colon ACF number. Colon and duodenum tumor incidences were less in females than males at 17 weeks after AOM. BB tended (0.1 > P > 0.05) to reduce overall gastrointestinal tract tumor incidence in males, however, tumor incidence in females was unaffected (P > 0.1) by BB. There was a tendency (0.1 > P > 0.05) for fewer adenocarcinomas (relative to total of adenomatous polyps plus adenocarcinomas) in colons of female than male tumor-bearing rats; in small intestine, this gender difference was significant (P < 0.05). BB favored (P < 0.05) fewer adenocarcinomas and more adenomatous polyps (as a proportion of total tumor number) in female rat small intestine.. Results did not indicate robust cancer-preventive effects of BB. Blueberry influenced ACF occurrence in distal colon and tumor progression in duodenum, in gender-specific fashion. Data indicate the potential for slowing tumor progression (adenomatous polyp to adenocarcinoma) by BB.

Topics: Adenocarcinoma; Adenomatous Polyps; Animals; Azoxymethane; Blueberry Plants; C-Peptide; Colonic Neoplasms; Disease Models, Animal; Disease Progression; Duodenal Neoplasms; Female; Incidence; Male; Nutrition Therapy; Rats; Rats, Sprague-Dawley

To investigate the mRNA, protein expression and tyrosine phosphorylation of insulin receptor substrate-1 (IRS-1) in endometrial carcinoma.. Sixty-three endometrial carcinoma (EC) patients, 21 endometrial atypical hyperplasia (AHE) patients and 22 normal control (NE) entered this study. Their clinical information were collected. Fasting serum C-peptide concentration was measured. Expression of IRS-1 in endometrium was examined by RT-PCR and western blot. Immunoprecipitation was used to measure the tyrosine phosphorylation of IRS-1.. C-peptide concentration in EC group was higher than that in NE group [(3.2 +/- 1.1) vs (2.5 +/- 0.7) microg/L, P=0.007]. There were no significant differences in IRS-1 mRNA and protein expression among the three groups. Tyrosine phosphorylation of IRS-1 in EC group [(62 +/- 36) %] was higher than that in AHE and NE groups [(53 +/-34)% and (35 +/- 33)%; P=0.048, 0.002]. IRS-1 activation in AHE group was also higher than normal control (P=0.045). IRS-1 activation in endometrioid carcinoma [(69 +/- 33) %] was higher than that in other histological types [(34 +/- 31)%; t=2.300, P=0.025]. IRS-1 tyrosine phosphorylation was significantly higher in patients with advanced stage, high grade, deep myometrial invasion and pelvic lymph node metastasis. IRS-1 activation in endometrium was positively correlated with fasting serum C-peptide concentration (r=0.491, P=0.001).. There is excessive activation of IRS-1 in endometrial carcinoma and atypical hyperplasia. Activation of IRS-1 in endometrial carcinoma is related with poor clinical-pathologic features and may be a prognostic predictor for this tumor. Over-activation of IRS-1 may be an intermediate event linking the hyperinsulinemia and endometrial carcinoma.

Topics: Adenocarcinoma; C-Peptide; Case-Control Studies; Endometrial Hyperplasia; Endometrial Neoplasms; Endometrium; Female; Humans; Insulin Receptor Substrate Proteins; Lymphatic Metastasis; Middle Aged; Neoplasm Staging; Phosphorylation; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger; Tyrosine

To evaluate beta-cell function in patients with pancreatic cancer, the glucagon stimulation test was performed in seven patients with pancreatic adenocarcinoma, seven patients with type I diabetes mellitus, seven patients with type II diabetes mellitus, and in seven healthy controls. C-peptide serum levels were determined before and after a 1-mg i.v. glucagon injection. Basal C-peptide values were normal or slightly increased in pancreatic cancer and type II diabetic patients and low in type I diabetic patients. Following glucagon stimulation, no significant increase was observed in C-peptide values of type I diabetics and pancreatic cancer patients, whereas significant increases occurred in controls and type II diabetics. It is concluded that the altered beta-cell function found in pancreatic cancer patients may lead to hyperglycemia, which is frequently associated with this tumor type.

Topics: Adenocarcinoma; Adult; C-Peptide; Female; Glucagon; Humans; Male; Middle Aged; Pancreatic Neoplasms

To investigate glucose metabolism and insulin secretion on patients with pancreatic cancer compared with healthy control subjects.. Open study.. Linköping University Hospital, Sweden.. 44 consecutive patients referred for radical operations for pancreatic carcinoma, and eight healthy age and sex matched volunteers.. Hyperglycaemic glucose clamp in 36 of patients and all volunteers.. Glucose tolerance according to WHO criteria, plasma insulin and C-peptide concentrations, and insulin secretion measurements both during hyperglycaemia and after stimulation by glucagon.. Thirty-three patients (75%) had either impaired glucose tolerance or diabetes. Fasting insulin concentrations were raised in the non-insulin-requiring diabetic patients, but similar in the insulin-requiring group compared with healthy control subjects and patients with normal glucose tolerance. In neither diabetic group was insulin secretion affected during hyperglycaemia. After stimulation with glucagon, insulin secretion increased in non-insulin-requiring diabetic patients but remained unchanged in those who required insulin. Glucose metabolic capacity and whole body insulin sensitivity were reduced in patients with diabetes and with impaired glucose tolerance, and the reduction was more pronounced in diabetic patients.. There is a high incidence of impaired glucose tolerance and diabetes in patients with pancreatic cancer, which cannot be explained by impaired secretion of insulin. Other factors that reduce insulin sensitivity seem to have a role in the development of diabetes in this group of patients.

Topics: Adenocarcinoma; Aged; C-Peptide; Diabetes Complications; Diabetes Mellitus; Female; Glucose; Glucose Clamp Technique; Humans; Insulin; Insulin Secretion; Male; Middle Aged; Pancreatic Neoplasms

Diabetes occurs frequently in patients with pancreatic cancer. To investigate the impact to tumour removal, seven patients were studied before and after 85 per cent subtotal pancreatectomy for adenocarcinoma of the pancreas. The frequency of diabetes was determined by the oral glucose tolerance test. Fasting levels of C peptide and insulin were measured in plasma, and insulin secretion was investigated by hyperglycaemic glucose clamp and glucagon stimulation. Six of the seven patients were diabetic before surgery and four required insulin treatment. Improvements in diabetic status and glucose metabolism were found in all seven patients after operation, as demonstrated by increased glucose metabolic capacity during hyperglycaemia. This occurred despite a postoperative reduction in insulin secretion and is explained by the observed augmentation of whole-body insulin sensitivity after surgery. A diabetogenic factor may be produced by pancreatic adenocarcinoma that may be responsible, directly or indirectly, for the high frequency of diabetes in patients with pancreatic cancer.

Topics: Adenocarcinoma; Adult; Aged; Blood Glucose; C-Peptide; Diabetes Mellitus; Female; Humans; Male; Middle Aged; Pancreatectomy; Pancreatic Neoplasms; Postoperative Period

High levels of gluconeogenic precursors have been reported in patients with long-term diabetes secondary to total pancreatectomy. In the present study, blood concentrations of alanine, lactate and pyruvate were measured in six patients undergoing total pancreatectomy and in nine control subjects undergoing major abdominal surgery. To exclude the simple effect of lack of insulin and hyperglycaemia in the development of hyperalaninaemia following total pancreatectomy, three pancreatectomized patients and five control subjects underwent surgical operation while connected to an artificial pancreas. Blood concentration of alanine was constant in the control subjects during surgery (182 +/- 20 and 243 +/- 31 mumol/l with and without the artificial pancreas, respectively). In pancreatectomized patients basal blood alanine levels were similar to those in control subjects. Blood alanine level rose quickly after removal of the pancreas from 182 +/- 24 to 285 +/- 15 mumol/1 (p less than 0.05) in the patients connected to the artificial pancreas, and from 198 +/- 17 to 395 +/- 47 mumol/1 (p less than 0.05) in patients undergoing total pancreatectomy without artificial pancreas. These values were higher than those observed in the control subjects at the end of the operation (192 +/- 22 and 230 +/- 45 mumol/l with and without artificial pancreas, respectively.) Basal and intraoperative blood concentrations of lactate and pyruvate were similar in pancreatectomized patients and control subjects.

Topics: Adenocarcinoma; Adult; Aged; Alanine; C-Peptide; Diabetes Mellitus, Type 1; Female; Glucagon; Humans; Insulin; Insulin Infusion Systems; Intraoperative Period; Lactates; Male; Middle Aged; Pancreatectomy; Pancreatic Neoplasms; Pyruvates

Inasmuch as the elevated levels of substance(s) immunologically cross-reactive with insulin (SICRI) in a diabetic woman with carcinoma of the corpus uteri decreased following the surgical removal of the uterus and ovaries, 80 women with cervical carcinomas of various stages and 70 women with carcinomas of the corpus uteri of various stages were screened for the levels of SICRI and C-peptide. The levels of SICRI in the second, third, and fourth stages of the cancers were elevated (up to six times above the normal levels of immunoreactive insulin) and stage-dependent. The levels of C-peptide, which are related to the insulin-secreting activity of pancreatic beta-cells, were normal and independent of the stage of cancer.

Topics: Adenocarcinoma; Aged; Blood Glucose; C-Peptide; Cross Reactions; Diabetes Complications; Diabetes Mellitus; Female; Humans; Insulin; Neoplasm Staging; Probability; Radioimmunoassay; Uterine Cervical Neoplasms; Uterine Neoplasms

A series of 229 patients with urogenital carcinomas were investigated for aberrant peptide hormone activities. Serum TSH and prolactin were frequently measured in elevated levels and showed some relation to the stage of disease. Ectopic production of beta-HCG was not observed in any of the cases, thyroid and steroid hormones did not exceed the normal ranges.

Topics: Adenocarcinoma; Antibodies; C-Peptide; Cross Reactions; Female; Follicle Stimulating Hormone; Humans; Kidney Neoplasms; Luteinizing Hormone; Male; Peptides; Pituitary Hormones; Prolactin; Prostatic Hyperplasia; Prostatic Neoplasms; Thyrotropin; Urinary Bladder Neoplasms; Urogenital Neoplasms