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Biochemistry Markers of Neuroendocrine Tumours

Ewang-Emukowhate, Mfon; (2021) Biochemistry Markers of Neuroendocrine Tumours. Doctoral thesis (M.D(Res)), UCL (University College London).

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Abstract

Neuroendocrine tumours (NET) are a diverse group of neoplasms originating from cells within the diffuse endocrine system. Urine 5-hydroxyindole acetic acid (5-HIAA), a metabolite of serotonin is commonly used in the diagnosis and monitoring of patients with NET in particular small intestinal neuroendocrine tumour with carcinoid syndrome. The collection of urine 5- HIAA over a 24 hour period, and exposure to the acid preservative in the sample container are limitations in the use of urine 5-HIAA. In this thesis, I have developed a liquid chromatography tandem mass spectrometry assay for plasma and serum 5-HIAA with acceptable analytical performance. I have also demonstrated that it compares well with the currently used urine 5-HIAA assay. I compared plasma and serum 5-HIAA with serotonin, chromogranin A (CgA) and N-terminal prohormone of brain natriuretic peptide (NT-proBNP). A significant correlation was observed. Somatostatin analogues (SSA) are often used as first line treatment in patients with metastatic NET. Diarrhoea and steatorrhoea are adverse effects reported with SSA use, which can lead to malabsorption of fat-soluble vitamins (FSV) and trace elements (TE). I have therefore investigated the prevalence of deficiencies in fat-soluble vitamins and trace elements. Deficiencies especially in vitamin K1 and zinc were observed I have shown in this thesis that the measurement of 5-HIAA in plasma or serum is a suitable alternative to urine, and it addresses the inconvenience associated with the timing and collection of the urine. In patients with NET on SSA, monitoring and supplementation of FSV and TE should be considered

Type: Thesis (Doctoral)
Qualification: M.D(Res)
Title: Biochemistry Markers of Neuroendocrine Tumours
Language: English
Additional information: Copyright © The Author 2021. Original content in this thesis is licensed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10118796
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