vasoactive-intestinal-peptide and Esophageal-Neoplasms

Topics: alpha-Fetoproteins; Amines; Animals; Bombesin; Bronchi; Calcitonin; Calmodulin; Carcinoembryonic Antigen; Carcinoma in Situ; Carcinoma, Bronchogenic; Chorionic Gonadotropin; Cytoskeletal Proteins; Esophageal Neoplasms; Glycogen; Growth Hormone; Hormones; Humans; Intestinal Neoplasms; Lung Neoplasms; Parathyroid Hormone; Physalaemin; Placental Lactogen; Precancerous Conditions; Somatostatin; Vasoactive Intestinal Peptide

Topics: Animals; Atropine; Cats; Dogs; Esophageal and Gastric Varices; Esophageal Diseases; Esophageal Neoplasms; Esophagitis; Esophagogastric Junction; Esophagoscopy; Esophagus; Gastroesophageal Reflux; Hexamethonium Compounds; Humans; Opossums; Papio; Peristalsis; Rats; Swine; Vasoactive Intestinal Peptide

We have found 20 cases of ectopic gastric mucosa in the proximal esophagus. Five patients had symptoms, usually a burning sensation in the neck and/or dysphagia. We report the results of immunoperoxidase staining of this tissue for gastrin, somatostatin, vasoactive intestinal peptide, and bombesin. In 85% of biopsy specimens tested, one or more polypeptides were present. Gastrin and bombesin were found more frequently in symptomatic patients, and somatostatin in asymptomatic patients. Chronic inflammatory changes were more frequent in symptomatic patients.

Topics: Biopsy; Bombesin; Choristoma; Esophageal Neoplasms; Female; Gastric Mucosa; Gastrins; Humans; Immunoenzyme Techniques; Male; Middle Aged; Somatostatin; Vasoactive Intestinal Peptide

Smooth muscle specimens were taken from the lower esophageal sphincter of patients suffering from achalasia or hiatus hernia with gastro-esophageal reflux. The specimens were analysed for neurohormonal peptides using immunochemistry and immunocytochemistry. Control specimens were obtained from patients subjected to esophageal resection because of esophageal cancer. The concentration of vasoactive intestinal polypeptide (VIP) was higher and the VIP nerve supply greater in patients with hiatus hernia than in control patients. The VIP nerve supply and the content of this peptide was lower in patients with achalasia than in controls. The same tendency was observed for substance P and enkephalin although the changes in their concentrations were not statistically significant. Enkephalin fibers were few, both in specimens from control patients and from patients with hiatus hernia; they could not be detected in specimens from patients with achalasia. Never fibers containing somatostatin or gastrin/cholecystokinin could not be detected in any of the groups and somatostatin and gastrin/cholecystokinin could not be measured in extracts of the lower esophageal sphincter. We propose that changes in the concentration of neuropeptides may at least contribute to manifestations of achalasia and of decreased lower esophageal sphincter pressure and gastro-esophageal reflux.

Topics: Adolescent; Adult; Aged; Diabetes Mellitus; Enkephalins; Esophageal Achalasia; Esophageal Neoplasms; Esophagogastric Junction; Female; Hernia, Hiatal; Histocytochemistry; Humans; Male; Middle Aged; Nerve Tissue Proteins; Radioimmunoassay; Substance P; Vasoactive Intestinal Peptide

The watery diarrhea-hypokalemia-achlorhydria syndrome associated with ectopic secretion of vasoactive intestinal peptide has only been conclusively documented with tumors originating in the pancreas or sympathetic chain. We report here the case of a 50-yr-old woman who developed this syndrome 3 wk after an apparently effective course of radiotherapy for an obstructing, mixed-cell carcinoma of the esophagus. High concentrations of vasoactive intestinal peptide were found in plasma (100-200 pmol/L; normal less than 20 pmol/L) and in the metastatic skin nodules (750 pmol/g) that later developed and that contained one of the two cell types from the original tumor. Stool volumes reached a plateau of 15-20 L/day, and potassium requirements were greater than 1000 mmol/day. Symptoms failed to respond to any of the regimens previously described as effective in this syndrome. After 14 wk of massive fecal fluid and electrolyte losses, symptoms resolved dramatically with the first dose of 5-fluorouracil. Plasma vasoactive intestinal peptide concentration returned to normal, where it remained despite subsequent evidence of renewed tumor spread. This case illustrates the unpredictability of the response of this syndrome to medical treatment, and suggests that vasoactive intestinal peptide secretion may occur in a wider range of tumors than has so far been described.

Topics: Achlorhydria; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Chromatography, High Pressure Liquid; Diarrhea; Esophageal Neoplasms; Female; Fluorouracil; Humans; Hypokalemia; Middle Aged; Streptozocin; Syndrome; Vasoactive Intestinal Peptide