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Åkerström, Göran
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Publications (10 of 106) Show all publications
Åkerström, G., Stålberg, P. & Skogseid, B. (2018). Multiple Endocrine Neoplasia type 2. In: Shane Y Morita, Charles M Balch, V. Suzanne Klimberg, Timothy M. Pawlik, Mitchell C. Posner, Kenneth K. Tanabe (Ed.), Textbook of Complex General Surgical Oncology: . McGraw-Hill
Open this publication in new window or tab >>Multiple Endocrine Neoplasia type 2
2018 (English)In: Textbook of Complex General Surgical Oncology / [ed] Shane Y Morita, Charles M Balch, V. Suzanne Klimberg, Timothy M. Pawlik, Mitchell C. Posner, Kenneth K. Tanabe, McGraw-Hill, 2018Chapter in book (Refereed)
Place, publisher, year, edition, pages
McGraw-Hill, 2018
National Category
Surgery
Identifiers
urn:nbn:se:uu:diva-308335 (URN)0071793313 (ISBN)
Available from: 2016-11-24 Created: 2016-11-24 Last updated: 2017-10-26Bibliographically approved
Grimelius, L. & Åkerström, G. (2017). Biographical item: "Henry Johansson in memoriam" in Upsala Journal Of Medical Sciences, vol 122, Issue: 4, pp 260-261. , 122(4)
Open this publication in new window or tab >>Biographical item: "Henry Johansson in memoriam" in Upsala Journal Of Medical Sciences, vol 122, Issue: 4, pp 260-261
2017 (English)Other (Other (popular science, discussion, etc.))
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-350222 (URN)10.1080/03009734.2017.1396271 (DOI)000423294800009 ()29338500 (PubMedID)
Note

Minnesord (Obituary)

WoS title: Henry Johansson in memoriam OBITUARY

Available from: 2018-05-18 Created: 2018-05-18 Last updated: 2018-05-18Bibliographically approved
Åkerström, G. (2016). Introduction to symposium: "New genetics with impact on treatment of endocrine tumour disease". Journal of Internal Medicine, 286(6), 536-539
Open this publication in new window or tab >>Introduction to symposium: "New genetics with impact on treatment of endocrine tumour disease"
2016 (English)In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 286, no 6, p. 536-539Article in journal, Editorial material (Other academic) Published
Abstract [en]

Read more articles from the symposium: Endocrine tumors - new generation sequencing with impact on therapy.

Place, publisher, year, edition, pages
Uppsala Univ, Dept Surg Sci, Uppsala, Sweden. [Akerstrom, G.] Uppsala Univ, Dept Surg Sci, Uppsala, Sweden.: , 2016
Keywords
Molecular genetics, endocrine tumor, diagnosis, treatment
National Category
Surgery
Identifiers
urn:nbn:se:uu:diva-311766 (URN)10.1111/joim.12518 (DOI)000388573300001 ()
Available from: 2017-01-02 Created: 2017-01-02 Last updated: 2017-11-29Bibliographically approved
Åkerström, G., Stålberg, P. & Hellman, P. (2016). Natural History of untreated primary hyperparathyroidism (3ed.). In: Dr. Orlo H Clark MD, Dr. Quan-Yang Duh MD, Dr. Electron Kebebew MD, Dr. Jessica E Gosnell MD and Dr. Wen T Shen MA MD (Ed.), Textbook of Endocrine Surgery: . Jaypee Brothers Medical Publishers
Open this publication in new window or tab >>Natural History of untreated primary hyperparathyroidism
2016 (English)In: Textbook of Endocrine Surgery: / [ed] Dr. Orlo H Clark MD, Dr. Quan-Yang Duh MD, Dr. Electron Kebebew MD, Dr. Jessica E Gosnell MD and Dr. Wen T Shen MA MD, Jaypee Brothers Medical Publishers , 2016, 3Chapter in book (Refereed)
Place, publisher, year, edition, pages
Jaypee Brothers Medical Publishers, 2016 Edition: 3
National Category
Surgery
Identifiers
urn:nbn:se:uu:diva-308337 (URN)9789351528067 (ISBN)
Available from: 2016-11-24 Created: 2016-11-24 Last updated: 2017-10-26Bibliographically approved
Åkerström, G., Stålberg, P. & Hellman, P. (2016). Resection of Small intestinal neuroendocrine tumors. In: Sally E Carty (Ed.), Atlas of endocrine surgical techniques: . Jaypee Brothers Medical Publishers
Open this publication in new window or tab >>Resection of Small intestinal neuroendocrine tumors
2016 (English)In: Atlas of endocrine surgical techniques / [ed] Sally E Carty, Jaypee Brothers Medical Publishers , 2016Chapter in book (Refereed)
Place, publisher, year, edition, pages
Jaypee Brothers Medical Publishers, 2016
National Category
Surgery
Identifiers
urn:nbn:se:uu:diva-308338 (URN)9351525295 (ISBN)
Available from: 2016-11-24 Created: 2016-11-24 Last updated: 2017-10-26Bibliographically approved
Herrera, M. F., Åkerström, G., Angelos, P., Grant, C. S., Hoff, A. O., Pantoja, J. P., . . . Randolph, G. (2015). AACE/ACE DISEASE STATE CLINICAL REVIEW: PANCREATIC NEUROENDOCRINE INCIDENTALOMAS. Endocrine Practice, 21(5), 546-553
Open this publication in new window or tab >>AACE/ACE DISEASE STATE CLINICAL REVIEW: PANCREATIC NEUROENDOCRINE INCIDENTALOMAS
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2015 (English)In: Endocrine Practice, ISSN 1530-891X, E-ISSN 1934-2403, Vol. 21, no 5, p. 546-553Article, review/survey (Refereed) Published
Abstract [en]

Incidental detection of pancreatic neuroendocrine tumors (PNETs) has substantially increased over the last decade due to widespread use of advanced imaging studies. Reliable initial imaging-based characterization is crucial for the differential diagnosis from other exocrine neoplasms and to determine the appropriate management plan. Measurements of chromogranin A, pancreatic polypeptide, and calcitonin are recommended for the biochemical evaluation. A thorough medical history needs to be performed to rule out multiple endocrine neoplasia (MEN) type 1. The European Neuroendocrine Tumor Society (ENETS)/Tumor Node Metastasis (TNM) staging system together with a grading based on the Ki-67 proliferation index and mitotic counts has proven to give more appropriate prognostic information than the World Health Organization (WHO)/American Joint Committee on Cancer (AJCC) TNM staging but may still fail to safely differentiate benign from malignant lesions. Poorly differentiated PNETs generally present with metastases and are rarely amenable for resection. Well-or intermediately differentiated tumors >= 2 cm with imaging evidence of malignancy or with a Ki-67 > 2% should be resected. It has been suggested that non-MEN related, nonfunctioning, and asymptomatic PNETs < 2 cm with a Ki-67 index >= 2% carry a low risk of metastasis and may be observed in the absence of clinical or radiologic criteria of malignancy or progression, especially in older patients. However, because metastases may occur with long delay with smaller PNETS, physicians should consider patient age, lesion location, and the risks of operation, and patients not undergoing surgery need to be closely followed closely.

National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:uu:diva-260972 (URN)10.4158/EP14465.DSC (DOI)000357731800011 ()25962093 (PubMedID)
Available from: 2015-08-28 Created: 2015-08-27 Last updated: 2017-12-04Bibliographically approved
Cromer, M. K., Choi, M., Nelson-Williams, C., Fonseca, A. L., Kunstman, J. W., Korah, R. M., . . . Lifton, R. P. (2015). Neomorphic effects of recurrent somatic mutations in Yin Yang 1 in insulin-producing adenomas. Proceedings of the National Academy of Sciences of the United States of America, 112(13), 4062-4067
Open this publication in new window or tab >>Neomorphic effects of recurrent somatic mutations in Yin Yang 1 in insulin-producing adenomas
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2015 (English)In: Proceedings of the National Academy of Sciences of the United States of America, ISSN 0027-8424, E-ISSN 1091-6490, Vol. 112, no 13, p. 4062-4067Article in journal (Refereed) Published
Abstract [en]

Insulinomas are pancreatic islet tumors that inappropriately secrete insulin, producing hypoglycemia. Exome and targeted sequencing revealed that 14 of 43 insulinomas harbored the identical somatic mutation in the DNA-binding zinc finger of the transcription factor Yin Yang 1 (YY1). Chromatin immunoprecipitation sequencing (ChIP-Seq) showed that this T372R substitution changes the DNA motif bound by YY1. Global analysis of gene expression demonstrated distinct clustering of tumors with and without YY1(T372R) mutations. Genes showing large increases in expression in YY1(T372R) tumors included ADCY1 (an adenylyl cyclase) and CACNA2D2 (a Ca2+ channel); both are expressed at very low levels in normal beta-cells and show mutation-specific YY1 binding sites. Both gene products are involved in key pathways regulating insulin secretion. Expression of these genes in rat INS-1 cells demonstrated markedly increased insulin secretion. These findings indicate that YY1(T372R) mutations are neomorphic, resulting in constitutive activation of cAMP and Ca2+ signaling pathways involved in insulin secretion.

Keywords
exome sequencing, insulinoma, YY1, cAMP, adenylyl cyclase
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:uu:diva-251996 (URN)10.1073/pnas.1503696112 (DOI)000351914500068 ()25787250 (PubMedID)
Available from: 2015-05-08 Created: 2015-04-28 Last updated: 2017-12-04
Delgado Verdugo, A., Crona, J., Starker, L. F., Stålberg, P., Åkerström, G., Westin, G., . . . Björklund, P. (2014). Global DNA methylation patterns in small intestinal neuroendocrine tumors (SI-NETs). Endocrine-Related Cancer, 21(1), L5-L7
Open this publication in new window or tab >>Global DNA methylation patterns in small intestinal neuroendocrine tumors (SI-NETs)
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2014 (English)In: Endocrine-Related Cancer, ISSN 1351-0088, E-ISSN 1479-6821, Vol. 21, no 1, p. L5-L7Article in journal (Refereed) Published
Abstract [en]

Small intestinal neuroendocrine tumors (SI-NETs) are rare hormone producing tumors and are often diagnosed at advanced stage. The genetic and epigenetic background of SI-NETs are poorly understood, but several reports have indicated chromosomal losses at 18.21-qter and 11q22-q23. The aim of this study was to characterize CpG DNA methylation status of primary SI-NETs and the corresponding lymph node metastases. We used the commercially available HumanMethylation27 Beadchip array (Illumina), which covers 27578 CpG sites spanning over 14495 genes, and analyzed a discovery cohort of 10 primary SI-NETs with matched metastases. Messenger- mRNA, were determined for selected genes in a 47 tumors. In comparison to the primary tumors, the metastases showed 2697 statistically significant differentially genes. Metastases were generally less methylated than primary tumors. The relative mRNA expression level of the differentially methylated genes AXL, CRMP1, FGF5, and APOBEC3C largely reflected the methylation status. MAPK4, RUNX3, TP73, CCND1, CHFR, AHRR, and Rb1 known to be hypermethylated in other cancer types, displayed overall high methylation level (β-value ≥ 0.9). Methylation (β -value >0,7) at 18q21-qter and 11q22-q23 were detected in genes SETBP1, ELAC1, MBD1, MAPK4, TCEB3C and ARVC1, MMP8, BTG4, APOA1, FAM89B, HSPB1, respectively. Furthermore unsupervised clustering of the tumors identified three distinct clusters, one with a highly malignant behavior. Our data supports involvement of CpG DNA methylation in metastatic progression of SI-NETs and this could present a possibility to identify more aggressive tumors based on DNA methylation.

National Category
Surgery
Identifiers
urn:nbn:se:uu:diva-212142 (URN)10.1530/ERC-13-0481 (DOI)000334279600002 ()24192231 (PubMedID)
Available from: 2013-12-06 Created: 2013-12-06 Last updated: 2017-12-06
Norlén, O., Daskalakis, K., Öberg, K., Åkerström, G., Stålberg, P. & Hellman, P. (2014). Indication for Liver Transplantation in Young Patients with Small Intestinal NETs Is Rare?. World Journal of Surgery, 38(3), 742-747
Open this publication in new window or tab >>Indication for Liver Transplantation in Young Patients with Small Intestinal NETs Is Rare?
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2014 (English)In: World Journal of Surgery, ISSN 0364-2313, E-ISSN 1432-2323, Vol. 38, no 3, p. 742-747Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

A majority of patients with small intestinal neuroendocrine tumors (SI-NETs) present with or develop liver metastases (LM). A number of treatments for LM are used clinically, including liver transplantation (LTx). Indications for LTx are under debate; young age (<65 years), absence of extrahepatic disease, resected primary tumor and limited extent of LM have been suggested as inclusion criteria for LTx with the aim to optimize outcome.

MATERIALS AND METHODS:

From our series of 672 patients with SI-NET treated at the University Hospital in Uppsala between 1985 and 2012, we identified 78 patients according to the following criteria: <65 years of age, locoregional surgery (LRS) of the primary tumor and mesenteric metastases successfully performed, LM present but no extrahepatic disease. Baseline was chosen as the first date the following points were met: First visit to our center, LRS performed, LM present. The patients underwent treatment according to the standard clinical protocols at our center, and during this time period we did not perform or refer any SI-NET patients for LTx. Kaplan-Meier survival analyses were performed in three different groups based on hypothetical criteria for LTx.

RESULTS:

Five-year overall survival rates for patients <65 years (n = 78) and <55 years (n = 36) of age were 84 ± 8 and 92 ± 9 %, respectively. For patients fulfilling the Milan criteria (n = 33) the 5-year survival was 97 ± 6 %.

CONCLUSIONS:

Most young patients (<65 years) with SI-NET and LM have a favorable survival with standardized multimodality treatment. Indeed, most survival figures reported after LTx of NET do not surpass these figures.

National Category
Surgery
Identifiers
urn:nbn:se:uu:diva-212143 (URN)10.1007/s00268-013-2331-z (DOI)000333151700032 ()24233660 (PubMedID)
Available from: 2013-12-06 Created: 2013-12-06 Last updated: 2018-02-20Bibliographically approved
Norlén, O., Edfeldt, K., Åkerström, G., Westin, G., Hellman, P., Björklund, P. & Stålberg, P. (2014). Peritoneal carcinomatosis from small intestinal neuroendocrine tumors: Clinical course and genetic profiling. Surgery, 156(6), 1512-1522
Open this publication in new window or tab >>Peritoneal carcinomatosis from small intestinal neuroendocrine tumors: Clinical course and genetic profiling
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2014 (English)In: Surgery, ISSN 0039-6060, E-ISSN 1532-7361, Vol. 156, no 6, p. 1512-1522Article in journal (Refereed) Published
Abstract [en]

Background. One-fifth of all patients with small-intestinal neuroendocrine tumors (SI-NETs) present with or develop peritoneal carcinomatosis (PC). Our aim was to determine the prognosis and genetic profiles of tumors in patients with PC compared with tumors in patients without PC. Methods. We included SI-NET patients (cases with PC, n = 73, and controls without PC, n = 468) who underwent operation between 1985 and 2012. The Lyon prognostic index was used to correlate the amount of PC to survival. DNA samples from patients with (n = 8) and without (n = 7) PC were analyzed with a single-nucleotide polymorphism array (HumanOmni2.5 BeadChip, Illumina) to investigate genetic disparities between groups. Results. Patients with PC had poorer survival (median 5.1 years) than controls (11.1 years). An advanced postoperative Lyon prognostic index was a negative prognostic marker for survival by multivariable analysis (P = .042). Patients with and without PC clustered differently based on loss of heterozygosity and copy number variation data from single-nucleotide polymorphism array of the primary tumors (P = .042). Conclusion. SI-NET patients with PC have poor survival, which diminishes with increasing PC load after surgery. Clustering based on copy number variation and loss of heterozygosity data suggests different genotypes in primary tumors comparing patients with and without PC.

National Category
Surgery
Identifiers
urn:nbn:se:uu:diva-185070 (URN)10.1016/j.surg.2014.08.090 (DOI)000345255700031 ()25456945 (PubMedID)
Available from: 2012-11-19 Created: 2012-11-19 Last updated: 2017-12-07
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