Current Trends in Diagnosis, Treatment and Prognosis of Canine Insulinoma
Abstract
:Simple Summary
Abstract
1. Introduction
2. Pathophysiology
3. Clinical Features
4. Clinical Pathology
5. Biochemical Diagnosis
6. Tumour Localisation
7. Treatment
7.1. Medical Therapy
7.1.1. Emergency Treatment
7.1.2. Long-Term Management
7.2. Surgical Therapy
7.2.1. Preoperative Considerations and Anaesthesia
7.2.2. Surgical Techniques
7.2.3. Postoperative Complications
8. Prognosis
9. Future Directions
- Insulinoma cancer stem cells can be identified using the cell surface marker CD90, which is also known as Thy-1, which is a potential therapeutic target. A zebrafish embryo insulinoma xenograft model was treated with anti-CD90 monoclonal antibodies, which resulted in the decreased viability of the injected insulinoma cells. Immunohistochemistry tests confirmed the expression of CD90 in clinical insulinoma samples, with there being positive staining in insulinoma cells, intra-tumoural fibroblasts and vascular endothelium. Consequently, anti-CD90 monoclonals are a promising new adjuvant therapy modality that either targets insulinoma cells directly or targets the insulinoma microenvironment [66].
- Another subpopulation of canine and human insulinoma cancer stem cells, which is characterised by the expression of OCT4, SOX2, SOX9, CD133 and CD34, exhibited the overexpression of Notch-signalling related genes. Cancer stem cells were more sensitive to 5-fluorouracil (5-FU) in vitro, and in an in vivo chicken chorioallantoic membrane tumour model, when the Notch pathway was inhibited with a gamma secretase inhibitor. By inhibiting Notch-signalling and targeting 5-FU synergistically, these findings demonstrated the synergetic attenuation of enriched INS cancer stem cell populations, which may be exploitable as a therapy in the future [67].
- An RNA sequencing study of canine insulinomas showed that early clinical stage insulinomas and the normal pancreas had similar genetic profiles, while late clinical stage insulinomas genetically resembled metastatic lymph nodes. Therefore, it appears that that markers of malignant behaviour can be found at the primary site of the disease [68].
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Primary Tumour (T) |
T0—no evidence of primary insulinoma |
T1—insulinoma present in pancreas |
Abdominal Lymph Nodes (N) |
N0—negative nodes |
N1—positive nodes |
Distant Metastasis (M) |
M0—no distant metastasis |
M1—distant metastasis |
Clinical Signs | Number of Dogs (Percentage) |
---|---|
Seizures | 167 (52%) |
Weakness | 134 (42%) |
Posterior paresis | 106 (33%) |
Collapse | 89 (28%) |
Muscle fasciculations | 60 (19%) |
Ataxia | 59 (18%) |
Polyphagia | 22 (7%) |
Polyuria and polydipsia | 18 (6%) |
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Buishand, F.O. Current Trends in Diagnosis, Treatment and Prognosis of Canine Insulinoma. Vet. Sci. 2022, 9, 540. https://doi.org/10.3390/vetsci9100540
Buishand FO. Current Trends in Diagnosis, Treatment and Prognosis of Canine Insulinoma. Veterinary Sciences. 2022; 9(10):540. https://doi.org/10.3390/vetsci9100540
Chicago/Turabian StyleBuishand, Floryne O. 2022. "Current Trends in Diagnosis, Treatment and Prognosis of Canine Insulinoma" Veterinary Sciences 9, no. 10: 540. https://doi.org/10.3390/vetsci9100540