Introduction: Patients with acromegaly have increased risk of developing tumors of the gastrointestinal tract. There are some data that insulin, IGFBP-3, folic acid and 25-OH-D may influence the development of these tumors.
Aim: To study the influence of insulin, IGFBP-3, folic acid and 25-OH-D, CA 19-9, CA 72-4 in the development of tumors of the gastrointestinal tract, and the frequency of neoplasms detection.
Materials and Methods: The study included 120 patients with acromegaly. All patients underwent gastroscopy and colonoscopy with biopsy of revealed tumors. The levels of neoplasms also were studied in all cases.
Results: Neoplasms were found in 43 patients (35.8%). Histologically hyperplastic and adenomatous polyps (24/12), two patients had villous and tubulo-vesicular adenoma, serrated polyp was found in one case, and five patients had cancer of stomach and colon. Thus, the frequency of malignant tumors was 4.2%. Insulin levels higher than 48.6 mU/ml lead to significantly increased risk of developing tumors. The level of Insulin more than 30.1 mU/ml and diagnosed neoplasm significantly increased risk of malignancy (sensitivity 80%, specificity 95.2%). In addition, the level of IGF-GB3≥3510 mg/ml was also significantly increased the risk of malignancy (sensitivity 80%, specificity 98%). The level of CA-19-9≤8.8 U/l also increased the risk of tumors of the gastrointestinal tract in patients with acromegaly (sensitivity 79.3% and specificity 42.3%). Patients with tumors and without them were comparable by CA 72-4, folic acid and 25-OH-D levels.
Conclusion: Patients with acromegaly have the increased risk of neoplasms formation, including malignant tumors. Levels of insulin, IGFBP-3, and CA 19-9 can be used as the diagnostic criteria of tumors of the gastrointestinal tract in patients with acromegaly.
28 - 31 May 2016
European Society of Endocrinology