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Comparative studies on the expression of somatostatin receptor subtypes, outcome of octreotide scintigraphy and response to octreotide treatment in patients with carcinoid tumours.

Journal article
Authors Ola Nilsson
Lars Kölby
Bo Wängberg
A Wigander
Håkan Billig
L William-Olsson
M Fjälling
Eva Forssell-Aronsson
Håkan Ahlman
Published in British journal of cancer
Volume 77
Issue 4
Pages 632-7
ISSN 0007-0920
Publication year 1998
Published at Institute of Selected Clinical Sciences, Department of Radiation Physics
Institute of Physiology and Pharmacology
Institute of Surgical Sciences, Department of Surgery
Pages 632-7
Language en
Keywords Aged, Antineoplastic Agents, Hormonal, therapeutic use, Carcinoid Tumor, chemistry, drug therapy, metabolism, radionuclide imaging, Female, Gastrointestinal Agents, diagnostic use, Gastrointestinal Neoplasms, chemistry, drug therapy, metabolism, radionuclide imaging, Humans, Ileal Neoplasms, chemistry, drug therapy, metabolism, radionuclide imaging, Indium Radioisotopes, pharmacokinetics, Male, Middle Aged, Neoplasm Proteins, analysis, Octreotide, diagnostic use, therapeutic use, Receptors, Somatostatin, analysis, Stomach Neoplasms, chemistry, drug therapy, metabolism, radionuclide imaging, Thymus Neoplasms, chemistry, drug therapy, metabolism, radionuclide imaging
Subject categories Cancer and Oncology, Surgery


We have compared the expression of somatostatin receptor (sstr) subtypes with the outcome of somatostatin receptor scintigraphy and the effect of somatostatin receptor activation in patients with disseminated carcinoid tumours. Tumour tissues from nine patients with midgut carcinoids (ileal) and three patients with foregut carcinoids (gastric, thymic) were analysed using Northern blotting. Expression of somatostatin receptors was demonstrated in all tumours (12 out of 12), with all five receptor subtypes present in 9 out of 12 tumours. Somatostatin receptor scintigraphy using [111In]DTPA-D-Phe1-octreotide visualized tumours in all patients (12 out of 12). The 111In activity concentrations in tumour tissue (T) and blood (B) were determined in three tumours 1-7 days after injection of the radionuclide. The T/B 111In activity concentration ratios ranged between 32 and 651. Clinically, treatment with the long-acting somatostatin analogue octreotide resulted in marked symptom relief accompanied by a significant reduction in tumour markers, for example urinary-5-HIAA levels (28-71% reduction). Incubation of midgut carcinoid tumours in primary culture with octreotide (10 microM) resulted in a reduction in spontaneously secreted serotonin (45-71% reduction) and 5-HIAA (41-94% reduction). The results demonstrate that carcinoid tumours possess multiple somatostatin receptor subtypes and that somatostatin analogues such as octreotide, which preferentially bind to somatostatin receptor subtype 2 and 5, can be used in the diagnosis and medical treatment of these tumours. In the future, novel somatostatin analogues with subtype specific receptor profiles may prove to be of value for individualizing the treatment of disseminated carcinoid tumour disease.

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