Department of Endocrinology and Neuroendocrine Tumors, Department of Pathophysiology and Endocrinology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-514 Katowice, Poland.
Department of Medical and Molecular Biology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-808 Katowice, Poland.
Int J Mol Sci. 2024 Sep 11;25(18):9820. doi: 10.3390/ijms25189820.
Neuroendocrine tumors (NETs) are a heterogeneous group of tumors that are characteristically different from other malignancies. The difference is not only in the prognosis, which is usually more favorable in such patients, but also in the high clinical progression of the disease, where NET patients do not experience the cachexia typical of other malignancies. The purposes of this study were to evaluate the ghrelin and leptin levels in a group of patients diagnosed with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) and bronchopulmonary neuroendocrine tumors (BP-NETs) and to analyze the relationship between the body mass index (BMI), cachexia and selected NET markers. The study group comprised 52 patients with GEP-NETs and BP-NETs, while the controls comprised 67 healthy volunteers. The ghrelin and leptin concentrations were determined in both groups. The concentrations of chromogranin A, serotonin, 5-hydroxyindoleacetic acid (5-HIAA), total cholesterol, triglycerides and glucose were determined in the study group. Characteristics of the study group and of the controls were defined by age, sex and BMI, and the effects of these factors on the ghrelin and leptin concentrations were assessed. The data obtained were subject to statistical analysis. The study cohort showed higher levels of ghrelin as compared to the controls (142.31 ± 26.00 vs. 121.49 ± 35.45, = 0.016), and no statistical difference in the levels of leptin (11.15 ± 9.6 vs. 12.94 ± 20.30, = 0.439) were observed. Significantly lower levels of leptin were found in patients with the small intestine primary location, as compared to individuals with primary locations in the lungs and the pancreas (4.9 ± 6.49 vs. 16.97 ± 15.76, = 0.045, and 4.9 ± 6.49 vs. 12.89 ± 8.56, = 0.016, respectively). A positive correlation was observed between the leptin levels and the BMIs in both the study group (r = 0.33, = 0.016) and the controls (r = 0.41, = 0.001). The study group showed a negative correlation between the leptin levels and 5-HIAA (r = -0.32, = 0.026) and a negative correlation between the leptin levels and Ki-67 (r = -0.33, = 0.018). The control group showed negative correlations between the ghrelin and the volunteer age (r = -0.41, = 0.008), the leptin and the volunteer age (r = -0.44, < 0.001), the leptin and total cholesterol (r = -0.24, < 0.049) as well as the leptin and triglycerides (r = -0.33, < 0.006). The current study emphasized the importance of the markers' determination, where ghrelin appears as a valuable diagnostic biomarker in NETs, probably responsible for maintaining a normal BMI, despite the progression of the disease.
神经内分泌肿瘤 (NETs) 是一组具有显著特征的异质性肿瘤，与其他恶性肿瘤明显不同。这种差异不仅表现在预后通常更为有利，还表现在疾病的高临床进展性上，NET 患者不会出现其他恶性肿瘤典型的恶病质。本研究旨在评估一组诊断为胃肠胰神经内分泌肿瘤 (GEP-NETs) 和肺神经内分泌肿瘤 (BP-NETs) 的患者的 ghrelin 和 leptin 水平，并分析 NET 标志物与体质量指数 (BMI)、恶病质之间的关系。研究组包括 52 名 GEP-NETs 和 BP-NETs 患者，对照组包括 67 名健康志愿者。在两组中均测定了 ghrelin 和 leptin 浓度。研究组还测定了嗜铬粒蛋白 A、血清素、5-羟吲哚乙酸 (5-HIAA)、总胆固醇、甘油三酯和葡萄糖的浓度。通过年龄、性别和 BMI 定义了研究组和对照组的特征，并评估了这些因素对 ghrelin 和 leptin 浓度的影响。对获得的数据进行了统计分析。与对照组相比，研究组的 ghrelin 水平更高 (142.31 ± 26.00 比 121.49 ± 35.45， = 0.016)，而 leptin 水平无统计学差异 (11.15 ± 9.6 比 12.94 ± 20.30， = 0.439)。与肺和胰腺原发灶患者相比，小肠原发灶患者的 leptin 水平显著较低 (4.9 ± 6.49 比 16.97 ± 15.76， = 0.045，和 4.9 ± 6.49 比 12.89 ± 8.56， = 0.016)。研究组和对照组的 leptin 水平与 BMI 呈正相关(r = 0.33， = 0.016 和 r = 0.41， = 0.001)。研究组的 leptin 水平与 5-HIAA 呈负相关(r = -0.32， = 0.026)，与 Ki-67 呈负相关(r = -0.33， = 0.018)。对照组的 ghrelin 与志愿者年龄呈负相关(r = -0.41， = 0.008)，leptin 与志愿者年龄呈负相关(r = -0.44， < 0.001)，leptin 与总胆固醇呈负相关(r = -0.24， < 0.049)，leptin 与甘油三酯呈负相关(r = -0.33， < 0.006)。本研究强调了确定这些标志物的重要性，其中 ghrelin 似乎是 NETs 的一种有价值的诊断生物标志物，可能有助于维持正常的 BMI，尽管疾病在进展。
