Endocrine Abstracts

With the ENETS guidelines update, there are a number of key issues tackled with this common subtype of NET. Terminology is clarified. Whether one uses neuroendocrine tumour, or neoplasm, as mentioned in the guidelines, the terms ‘midgut’ or ‘hindgut’ are thought not to be as helpful as indicating the primary anatomical site e.g. jejuno-ileal, rectal, colonic, caecal, appendiceal, etc.Grading with Ki-67 proliferation index, assessed fr...

Duodenal neuroendocrine neoplasms (d-NENs) account for approximately 2% of all NENs, frequently encountered incidentally at endoscopy. They can be classified in a number of ways: ampullary/peri-ampullary and non-ampullary; gastrinomas, somatostatinomas, non-functional d-NENs, duodenal gangliocytic paragangliomas and high-grade poorly differentiated NECs. More than 90% arise in the 2st or 2nd part of the duodenum. ENETS guidelines suggest managing d-NENs according to size, with...

Background: Neuroendocrine tumours (NETs) are a heterogenous group of slow growing tumours with an increasing incidence. Disease-related diarrhoea, surgery and medical treatment can lead to malabsorption, resulting in vitamin deficiencies.Objective: To establish the prevalence of vitamin deficiencies in patients with NETs.Method: Retrospective review of NET patients seen since 2014 in South Wales across 6 health boards. Deficiencie...

The South Wales regional NET Multidisciplinary Meeting (MDT) discusses patients on a monthly basis. The European Neuroendocrine Tumour Society (ENETS) have guidance on expected pathology input into a NET MDT service. We assessed pathology reports submitted and discussed in 2016 for compliance with ENETS criteria, and determined the time from pathology reporting to MDT discussion. 117 patients had pathology submitted for review in 2016 and were assessed by one specialist NET pa...

Objective: To compare 3 methods of generating Ki-67% in gastroenteropancreatic neuroendocrine tumours (GEP-NETs).Methods: Twenty-four slides were used to generate 49 images for analysis. Each image was analysed and 3 different methods were used to calculate Ki-67%.Results: The comparison of Ki-67% from counting and estimating using the diameter (shortcut method) was strongly positively correlated, whereas the Ki-67% from counting a...

Introduction: Neuroendocrine tumours (NETs) have diverse natural history and clinical syndromes. As a result of the disease or related to management, patients may have altered gut or pancreatic function that can cause nutritional deficiencies. There is a lack of consistent evidence-based dietetic guidance for patients with NETs.Aim: This study evaluated whether nutritional status and nutritional deficiencies had been assessed in patients with NETs in an ...

Background: CALM-NET (EudraCT 2013-002194-22; NCT02075606), a prospective, exploratory study, evaluated enumeration of pre-treatment circulating tumour cells as a predictor of symptomatic response to lanreotide autogel (LAN) in patients with functional midgut neuroendocrine tumours (NETs). Here, we describe the effect of LAN on biomarkers.Methods: Patients, ≥18 years, with functional, well- or moderately-differentiated midgut NETs were treated with...

Background: Approximately 20% of NET patients develop CS, characterised by diarrhoea and flushing. However, CS is not the only cause of diarrhoea among NET patients. Non-CS causes should be considered to allow for appropriate management. We investigated the reported occurrence of diarrhoea from various non-CS causes in patients with gastroenteropancreatic NETs (GEP-NETs), to explore the need for differential diagnosis (DDx) of NET diarrhoea.Methods: MEDL...

Monitoring patients with NETs reveals a significant prevalence of gastrointestinal symptoms, often unrelated directly to the tumour1. Exocrine pancreatic insufficiency exemplifies a common treatable cause of gastrointestinal symptoms in NET patients undergoing therapy with somatostatin analogues. There is a paucity of data regarding this important issue which affects quality of life in NETs. We explored the value of faecal elastase (FE) as a marker of exocrine pancr...

Background: Depression and anxiety are frequently associated with functional gastrointestinal disorders (FGID), inducing personal suffering and a decreased quality of life. There is limited data in patients with NETs. Therefore, adequate research identifying the prevalence of these mood disorders among GI patients and NETs are necessary to inform holistic clinical management. Further, due to the nature of hospital clinics being fast-paced, quick and effective screening tools a...