Carcinoid

Carcinoid is a family of the neuroendocrinal new growths consisting of cells of diffusion endocrine system. Such cells are in all bodies and fabrics, but their main accumulations are revealed in digestive tract, bronchial tubes, uric ways. Feature of diffusion endocrine system is ability to produce a number of biologically active compounds (hormones). Though incidence steadily grows in recent years, carcinoid remains rather rare pathology. Carcinoids differ depending on an embryonal origin, a secretory profile, and also zlokachestvennost degree. By origin carcinoids are divided into tumors from cells of a front, average and back gut. Carcinoids of respiratory tracts, a pancreas, initial department of a duodenum and stomach concern to the first. To the second – intestines carcinoids from back department of a duodenum to an appendix, and to the third – new growths from a surrounding stroma and vessels. Potential of a zlokachestvennost of carcinoids widely varies from high-quality character of a new growth to high degree of a zlokachestvennost.

Carcinoids are capable to produce biologically active compounds, including prostaglandins, kinina, serotonin, kallikrein. The more active agents develops a tumor, the clinical picture of a disease is expressed more brightly.

Typical display of a disease is the carcinoid syndrome. The following symptomatology is characteristic: inflows, colicy pains in a stomach, a diarrhea, defeat of the valve device of heart, short wind, cyanosis of skin, a telangiectasia. In hard cases carcinoid crisis can develop. This life-threatening state at which are broken blood circulation, breath, functions of a nervous system. The clinical picture depends on location of a tumor.

Lung carcinoid

Carcinoids of lungs are presented by typical and atypical tumors, macrocellular neuroendocrinal cancer and small-celled cancer of a lung. The typical tumor has low degree of a zlokachestvennost, atypical - average degree. Macrocellular neuroendocrinal cancer and small-celled cancer of a lung are diseases with a high potential of a zlokachestvennost. Generally men are ill 60 years are more senior. In most cases small-celled lung cancer develops. The forecast is extremely adverse. Five-year survival of patients makes less than 8%. Smoking is the reason of the vast majority of carcinoids of lungs.

Stomach carcinoid

Carcinoids of a stomach happen three types. The type A is combined with chronic atrophic gastritis, type B – with Zollingera-Ellison's syndrome, the type C meets independently. At carcinoid of type A secretion of hydrochloric acid in a stomach decreases, increases gastrin level, anemia also often comes to light. Carcinoids of a stomach of this type often happen multiple, their sizes do not exceed 1 cm. The age of patients is usually more senior than 60 years. The course of a disease is considered favorable: the remote metastasises arise in 3-5% of cases, the lethality is minimum, there are practically no clinical manifestations. Carcinoid of type B most often meets within Vermer's syndrome when there are also other tumors of closed glands. The carcinoid syndrome does not form, the forecast rather favorable. Carcinoids of type C it is tumors more than 1 cm in the diameter. These new growths early metastasize, high mortality of patients is characteristic.

Carcinoid treatment

Preference is given to radical ways in treatment of carcinoid. Even in the presence of the remote metastasises it is necessary to consider the possibility of operation. The technique of intervention depends on location of a tumor and its origin. Even when full removal of a new growth and its metastasises is impossible, sometimes apply a surgical method to elimination of symptoms of a disease. Conservative treatment by medicines includes first of all analogs of somatostatin and an interferona. These drugs reduce secretion of hormones, promote the termination of growth of a new growth and its metastasises. Also chemotherapeutic methods, including treatment temzirolimusy, temozolomidy are used. Now new approaches to treatment of carcinoids are developed. Drugs of the directed action are created (targetny). The angiogenesis inhibitors stopping growth of vessels of a tumor concern to them, for example.