Clinical and morphological characteristics of tumors in patients with ACTH ectopic syndrome

The aim of this investigation was to study the clinical and morphological characteristics of tumors at various sites in patients with A CTH-ectopic syndrome (ACTH-ES) in order to assess surgical results, to determine the hormonal activity of tumor cells, to establish a possible association between the level of proliferation, the expression of neoangiogenesis factors, cell adhesion, the size of tumor size, with its malignancy potential on the basis of the signs of invasive tumor growth and dissemination, and to explore the receptor expression of somatostatin tumors associated with ACTH-ES. Eleven patients with ACTH-ES surgically treated at the Endocrinology Research Center, Russian Agency for Medical Technologies, and the N. I. Pirogov National Medical Surgical Center for carcinoid tumors of the lung and bronchus, kidney, and thymus, and small-cell carcinoma of the lung. The development of secondary adrenal insufficiency was considered to be a criterion for adequate ACTH-ectopic tumor removal. The expression of ACTН and/or cortico-trophin-releasing hormone was revealed in the cells of ACTH-ES-assoclated tumors at various sites. No association was found between the proliferative activity (Ki-67), the expression of a marker of angiogenesis (CD31), proangiogenic growth factor (VEGF), cell ad-hesion (galectin-3), the size of tumors, and the morphological signs of tumor progression. The expression of different subtypes of somatostatin receptors suggests that somatostatin analogues should be used in recurrence or continued growth of ACTH-ectopic tumors.