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      • PREPARATIONS FOR MEDICAL, DENTAL, OR TOILET PURPOSES (bringing into special physical form A61J [N: mechanical aspects]; chemical aspects of, or use of materials for deodorisation of air, for disinfection or sterilisation, or for bandages, dressings, absorbent pads or surgical articles A61L; compounds per se C01, C07, C08, C12N; soap compositions C11D; micro-organisms per se C12N) [C0203]
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Keywords
BRONCHIAL CARCINOIDS, GASTROENTEROPANCREATIC (GEP) NEUROENDOCRINE TUMORS, NEOANGIOGENESIS, SOMATOSTATIN RECEPTORS

Neuroendocrine Lung Tumors (Carcinoids) and Gastro-Entero-Pancreatic (GEP) Tumors: Clinical, Immunophenotypical and Molecular Characterization in Prognosis and Therapeutic Definition.

Università degli Studi di Padova
Abstract
Neuroendocrine tumors of the lung (carcinoid tumors) and of the gastro-entero-pancreatic (GEP)trait are rare neoplasms. The rarity and the clinical behaviour of these tumors make difficult their study and their clinical management, requiring a multidisciplinary approach. The two groups of tumors, although the same pathological origin, have important differences; therefore the factors determining the natural history and the prognosis are not well known. Two surgical operative units, recruitment centers for neuroendocrine lung (carcinoids) and GEP neoplasms, associated with clinical (internal medicine and endocrinology) and pathological anatomy units constitute our multicentric and multidisciplinary group.
Our study aims:
1. To share the clinical experiences of various centres: that could make easier to suggest clinical pathways for these patients and to optimize the scientific resources by the light of actual knowledge. A specific database for the collecting data will be carried out to share the information between groups.
2. To investigate the possible existence of correlations between clinical phenotype, radiological features and morphologic and biologic characteristics of neuroendocrine tumors of the lung and of the gastro-entero-pancreatic tract. These information could be of utility to predict the natural history of these tumors and to indicate the better management. In particular a specific field of investigation will be the study of neoplastic >>>

Principal Investigator
Federico Rea Università degli Studi di PADOVA
Research Objectives
The research programme joins local Divisions that have clinical activities (e.g. surgery, internal medicine) and diagnostic activities (e.g. radiologists,nuclear physicians). All these participants have a specific interest in neuroendocrine tumors. The requirement for a specific comparison between each experience is due to the awareness that a multidisciplinary approach represents the better instrument to face these tumors.
In summary, the objectives of our study are of clinical interest (diagnosis and therapy) and of research interest (pathological and molecular aspects).
For the better management of clinical data a dedicate database will be done and will be available for all équipes.
About the clinical management we will optimize clinical and diagnostic resources to improve the quality of assistance and the multidisciplinary management.
Another issue will be the definition of the role of PET-TC and Octreoscan for the treatment too.
In the field of molecular aspects we will evaluate the role of somatostatin receptors and other pathological markers like the angiogenetic pattern.
The analisis and correlation between several clinical, biological, pathological and molecular data will allow us to define:
-the role of neoangiogenetic processes to determine the natural history of neuroendocrine GEP tumors and bronchial carcinoids;
-the subgroup of patients who could have benefit from treatment with somatostatine analogs >>>

Timescale
24 months
National and international background
Neuroendocrine tumors are a heterogenous group of tumors originating from neuronal and endocrine cells, widely distributed throughout the body, sharing a common phenotype. These cells indeed express Chromogranin A (CgA), neuron-specific enolase (NSE) and synaptophysin, besides cell-specific hormonal secretory products. Neuroendocrine neoplasia can develop from neuroendocrine cells belonging to a defined organ, such as pancreas (insular neoplasia), thyroid (medullary carcinoma), adrenal gland (pheochromocytoma), or non endocrine tissues, such as the gastrointestinal tract, lung, thymus, etc...
Bronchial carcinoids are rare, well-differentiated neuroendocrine malignant tumors and account for 2 to 5% of all lung neoplasms. They are classified in two distinctive forms, typical (TC) and atypical (AC), with different histologic features, clinical course and prognosis. TC is a variant of neuroendocrine tumors with a low grade histological malignancy profile (rare mithosis, absence of necrosis…), because it rarely metastasizes (10%) and shows an excellent long term prognosis with a 5-year survival rate ranging from 87% to 97%. Patients with AC have a large tendency to have metastasis and show a 5-year survival rate ranging from 25 to 69%.
The extimated incidence of endocrine tumors of the digestive tract is ab. 2/100000/year, however autopsy prevalence is 1-2 %; 1/3 of these tumors occur in the pancreatico-duodenal area and they are generally "sporadic". Some >>>