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Neuroendocrine tumour markers 

Neuroendocrine tumour markers
Chapter:
Neuroendocrine tumour markers
Author(s):

R. Ramachandran

and W. Dhillo

DOI:
10.1093/med/9780199235292.003.0625
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date: 22 November 2019

Neuroendocrine cells occur either singly or in small groups in a variety of tissues and organs. Although morphologically and embryologically diverse, they are characterized by a number of unifying features. They have dense core secretory vesicles in the cytoplasm and hormone receptors on the cell membranes. There is evidence of prohormone activity within the cells and they synthesize, store, and secrete hormones. In addition, neuroendocrine cells possess an ability to take up and decarboxylate amine precursors.

Components of this diffuse endocrine system are particularly prominent in the gastrointestinal tract, pancreas, C cells of the thyroid, adrenal medulla, parathyroid tissue, respiratory tract, skin, and genitourinary system. Neuroendocrine tumours (NETs) are known to occur in all these tissues.

Historically, the diagnosis of NET was made on the basis of characteristic histological findings. The significantly worse prognosis in advanced disease and the availability of multiple therapeutic options have highlighted the need for robust tumour markers that can be used both for diagnosis and follow-up. Currently, a number of normal and abnormal forms of peptides, biogenic amines, and hormones, secreted by NETs, are routinely measured as markers of disease.

An ideal tumour marker would be one that is secreted exclusively by the tumour cells and is useful (1) for screening and differential diagnosis of NETs; (2) as a prognostic indicator; (3) as an estimate of tumour burden; and (4) as a surveillance tool. Although none of the currently available markers completely fits the paradigm for an ideal tumour marker, when measured in conjunction with each other, they are useful not only for making a diagnosis but also for monitoring response to therapy and in surveillance post-remission.

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