cholecystokinin and Esophageal-Neoplasms

Gastrin, which induces gastric acid secretion, and a structurally similar hormone, cholecystokinin (CCK)-a potent acid inhibitor, may each play a role in gastric cancer. However, few studies have investigated this hypothesis in humans. We therefore investigated whether serum gastrin or CCK concentrations at baseline were associated with the incidence of gastric non-cardia adenocarcinomas (GNCA), oesophagogastric junctional adenocarcinomas (EGJA) or gastric carcinoid tumours over 24 years of follow-up in a study nested within the all-male Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study of Finnish smokers.. Totals of 283 incident GNCA, 96 EGJA and 10 gastric carcinoid cases, and 778 matched controls, were included in our analysis. Gastrin and CCK were measured using specific radioimmunoassays. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated by multivariable logistic regression with adjustment for all known or suspected confounding factors, including Helicobacter pylori seropositivity.. Those with high gastrin (Q4 vs Q1), had an increased risk of GNCA (fully adjusted OR: 1.92; 95% CI: 1.21, 3.05) and gastric carcinoids, though the small number of carcinoid cases meant the fully adjusted model was unstable (age-adjusted continuous model OR: 4.67; 95% CI: 2.67, 8.15). CCK was associated with risk of GNCA only for those in Q3 relative to Q1 (OR: 0.56; 95% CI: 0.33, 0.96), and no significant trend was observed.. Our data suggest that high serum concentrations of gastrin may be associated independently with an increased risk of gastric cancer; the role of CCK in cancer risk is less clear.

Topics: Adenocarcinoma; Case-Control Studies; Cholecystokinin; Esophageal Neoplasms; Finland; Follow-Up Studies; Gastrins; Helicobacter Infections; Helicobacter pylori; Humans; Incidence; Logistic Models; Male; Middle Aged; Multivariate Analysis; Prospective Studies; Risk Factors; Smokers; Stomach Neoplasms

We studied the effect of early postoperative enteral hyperalimentation on the nutritional state and hormones in digestive organs in twenty patients who underwent resection of thoracic esophageal carcinoma and reconstruction of new esophagus. Following results were obtained. 1. Although enteral hyperalimentation was started in the early postoperative period (postoperative 3 day), the incidence of complications including diarrhea was decreased dramatically and satisfactory nutritional effect was obtained due to the development of many excellent chemically defined enteral nutrients. 2. Gut hormones including CCK showed the same response as in the preoperative period to the loading of enteral nutrients. And that, it is suggested that the response of CCK is affected by the lipid content in the nutrients and that this response was effective to prevent the postoperative biliary stasis. 3. Enteral nutrition made it possible to self-regulate water absorption from digestive organs, to control body fluid volume and to prevent over hydration or hypovolemia to comparison with parenteral nutrition.

Topics: Aged; Aged, 80 and over; Cholecystokinin; Digestive System; Enteral Nutrition; Esophageal Neoplasms; Female; Gastrointestinal Hormones; Humans; Male; Middle Aged; Postoperative Care

Twenty-six patients who had typical symptoms of biliary tract disease, e.g. postprandial right upper quadrant pain, nausea and vomiting, fatty food intolerance and flatulence and who had had two or more normal oral cholecystograms were subjected to cholecytokinin cholescystography. Ten patients showed a normal response to the intravenous administration of cholecystokinin, namely prompt and complete emptying of the gallbladder without producing any adverse reaction or symptoms. Sixteen patients demonstrated either no contraction or incomplete contraction of the gallbladder in response to cholecystokinin; several patients had moderate contraction of the gallbladder accompanied by symptoms of biliary colic. This latter group underwent cholecystectomy and operative cholangiography. Fifteen of the 16 patients are asymptomatic or improved, and only one patient continues to have symptoms. All removed gallbladders had histologic evidence of chronic cholecystitis. It is concluded that in some individuals with continuing symptoms suggesting gallbladder disease but normal oral cholecystograms, cholecystokinin cholecystography may be helpful in identifying physiologic dysfunction of the gallbladder.

Topics: Adult; Aged; Cholecystectomy; Cholecystitis; Cholecystography; Cholecystokinin; Diagnosis, Differential; Esophageal Achalasia; Esophageal Neoplasms; Female; Gallbladder; Gallbladder Diseases; Gastritis; Humans; Male; Middle Aged