pancreastatin and Carcinoma--Small-Cell

The plasma levels of chromogranin A (CGA) in patients with islet cell tumor and plasma CGA responses to administration of a somatostatin analogue (Octreotide) in two of these patients were examined in comparison with plasma pancreastatin (PST) levels. There was a significant correlation between the fasting plasma levels of CGA and PST (r = 0.6, P < 0.001). Administration of the somatostatin analogue reduced the plasma concentrations of PST and CGA within 1 h, but the responses of CGA and PST to the analogue were not parallel in either patient. Thus, the suppressive effects of the analogue on the secretions of PST and CGA may be different. The results suggest the value of the PST and CGA assays used in this study.

Topics: Adenoma, Islet Cell; Carcinoma, Small Cell; Chromogranin A; Chromogranins; Fasting; Humans; Immunoenzyme Techniques; Octreotide; Pancreatic Hormones; Pancreatic Neoplasms; Radioimmunoassay

Plasma pancreastatin (PST)-like immunoreactivity in normal subjects and patients with various diseases was estimated by a RIA, using antiserum raised against a synthetic C-terminal peptide of human PST deduced from the sequence of human chromogranin-A. The mean level +/- SEM was 13.2 +/- 0.6 pmol/L in normal subjects, but was significantly higher in patients with chronic renal failure (526.7 +/- 48.5). An immunoreactive form corresponding to a human PST-like sequence [human chromogranin-A-(250-301)] and a larger form were detected by gel filtration of plasma from these patients, suggesting accumulation of the larger molecular form in these patients. A significant increase in PST-like immunoreactivity was also found in patients with liver cirrhosis (20.8 +/- 3.0 pmol/L), but not in patients with noninsulin-dependent diabetes mellitus, chronic pancreatitis, or pancreatic cancer. Elevated levels were found in 16 of the 21 patients with small cell lung carcinoma examined. High levels were also found in 3 of 11 patients with islet cell tumor.

Topics: Adenoma, Islet Cell; Biomarkers; Carcinoma; Carcinoma, Small Cell; Chromogranin A; Diabetes Mellitus; Humans; Kidney Diseases; Liver Cirrhosis; Lung Neoplasms; Pancreatic Hormones; Pancreatic Neoplasms; Pancreatitis; Radioimmunoassay; Reference Values

We have reported previously the localization of the 49 amino acid peptide pancreastatin to all identifiable endocrine cells of porcine gut, pancreas and adrenal, thyroid and pituitary glands. In this study, we have investigated the occurrence of pancreastatin in a series of human neuroendocrine tumours using an antibody to whole synthetic porcine pancreastatin. The most consistent immunostaining for pancreastatin was found in carcinoid tumours of ileum (four out of six), rectum (four out of six), ovary (two out of two) and lung (nine out of 10). Radioimmunoassay of tumour extracts showed that the concentrations of pancreastatin in ileal carcinoids were very high (mean 71.6, range 31.0-184.0 pmol g-1). The high rate of positivity in lung carcinoids contrasted sharply with the results of 10 pulmonary small cell carcinomas which displayed no immunoreactivity and contained minimal concentrations of pancreastatin (mean 2.0, range 0-6.0 pmol g-1). Extra-adrenal paragangliomas also contained pancreastatin (seven out of 10), but although radioimmunoassay detected peptide in phaeochromocytomas (mean 29.8, range 8.0-69.0 pmol g-1), immunocytochemistry did not. Porcine pancreastatin shows structural homology with bovine chromogranin A, an observation which has led to suggestions that chromogranin is a precursor for the peptide. More recently, a sequence homologous to porcine pancreastatin has been identified in the human chromogranin A molecule. In this study, immunostaining with an antiserum to human chromogranin gave positive results in most cases of each tumour type except the small cell carcinomas. The lack of consistent relationships between chromogranin and pancreastatin immunoreactivities may reflect the fact that the antiserum to pancreastatin was raised against the porcine peptide. When antibodies to human pancreastatin become available, the peptide may prove to be a more consistent marker for neuroendocrine tumours.

Topics: Adenocarcinoma; Adrenal Gland Neoplasms; Carcinoid Tumor; Carcinoma, Small Cell; Chromogranin A; Chromogranins; Cross Reactions; Humans; Immunohistochemistry; Lung Neoplasms; Neoplasms; Pancreatic Hormones; Pancreatic Neoplasms; Pheochromocytoma; Radioimmunoassay