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The Neuroendocrine Neoplasms of the Digestive Tract: Diagnosis, Treatment and Nutrition
- Source :
- Nutrients, Nutrients, Vol 12, Iss 1437, p 1437 (2020)
- Publication Year :
- 2020
- Publisher :
- MDPI, 2020.
-
Abstract
- Nuroendocrine neoplasms (NENs) are a group of rare neoplasms originating from dispersed neuroendocrine cells, mainly of the digestive and respiratory tract, showing characteristic histology and immunoprofile contributing to classification of NENs. Some NENs have the ability to produce biogenic amines and peptide hormones, which may be associated with clinical syndromes like, e.g., the carcinoid syndrome caused by unmetabolized overproduced serotonin, hypoglycemic syndrome in case of insulinoma, or Zollinger-Ellison syndrome accompanying gastrinoma. Diagnostics for these include ultrasound with endoscopic ultrasound (EUS), computed tomography (CT), magnetic resonance imaging (MRI), and positron-emission tomography/computed tomography (PET/CT). Different nuclear medicine procedures can also be used, like somatostatin analogues scintigraphy (SRS) and 68Ga-Dota-Peptide PET/CT, as well as biochemical methods to determine the level of general neuroendocrine markers, such as chromogranin A (CgA), 5-hydroxyindolacetic acid (5-HIAA), synaptopfysin and cell type-specific peptide hormones, and neurotransmitters like gastrin, insulin, serotonin, and histamine. NENs influence the whole organism by modulating metabolism. The treatment options for neuroendocrine neoplasms include surgery, somatostatin analogue therapy, radionuclide therapy, chemotherapy, molecular targeted therapies, alpha-interferon therapy, and inhibitors of serotonin production. In the case of hypersensitivity to biogenic amines, a diet that limits the main sources of amines should be used. The symptoms are usually connected with histamine, tyramine and putrescine. Exogenic sources of histamine are products that take a long time to mature and ferment. Patients with a genetic insufficiency of the diamine oxidase enzyme (DAO), and those that take medicine belonging to the group of monoamine oxidases (MAO), are particularly susceptible to the negative effects of amines. Diet plays an important role in the initiation, promotion, and progression of cancers. As a result of the illness, the consumption of some nutrients can be reduced, leading to nutritional deficiencies and resulting in malnutrition. Changes in metabolism may lead to cachexia in some patients suffering from NENs. The aim of this narrative review was to advance the knowledge in this area, and to determine possibilities related to dietary support. The authors also paid attention to role of biogenic amines in the treatment of patients with NENs. We can use this information to better understand nutritional issues faced by patients with gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs), and to help inform the development of screening tools and clinical practice guidelines.
- Subjects :
- medicine.medical_specialty
Biogenic Amines
lcsh:TX341-641
030209 endocrinology & metabolism
Review
Neuroendocrine tumors
Digestive System Neoplasms
Gastroenterology
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
Insulinoma
Gastrinoma
therapy
Nutrition and Dietetics
neuroendocrine neoplasms (NEN)
biology
business.industry
Chromogranin A
medicine.disease
Gastrointestinal Tract
Neuroendocrine Tumors
Somatostatin
nutrition
030220 oncology & carcinogenesis
Radionuclide therapy
biology.protein
Serotonin Production
Nutrition Therapy
business
lcsh:Nutrition. Foods and food supply
gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs)
Carcinoid syndrome
Food Science
Subjects
Details
- Language :
- English
- ISSN :
- 20726643
- Volume :
- 12
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Nutrients
- Accession number :
- edsair.doi.dedup.....e1543aa0e698c0e798e0679f112dce24