Predictive tests for treatment with somatostatin analogues have been asked for by clinicians. In the remaining 10 patients, no sstr2 mRNA could be detected, and none of the patients responded to somatostatin analogue treatment. We conclude that in this group of carcinoid patients, there was complete agreement between the presence of mRNA for sstr2 detected by in situ hybridization and therapeutic outcome. AD - Dipartimento di Chirurgia, Universita degli Studi, Catania. In our experience there is no specific symptoms and diagnosis was based on postoperative histopathologic analysis.
Carcinoid tumour presents considerable problems of diagnosis because symptoms are aspecific.
Diagnosis is possible only in patients with high urinary levels of 5-HIAA, in presence of carcinoid syndrome and by endoscopic biopsy when tumour infiltrated gastrointestinal mucosa. C.T., ultrasonography and angiography play a primary role in the diagnosis of this tumour but octreotide scintigraphy is very important for tumour and metastases localization in consequence of its ability to demonstrate somatostatin receptor positive tumours. Radical surgery is the only treatment in very little carcinoids to prevent metastases risk. In patients with any of these risk factors, resection with regional lymphadenectomy is recommended. Other prognostic factors include histologic differentiation, the presence of macroscopic residual disease after initial surgery and level of 5-HIAA in urine.