A Prospective Study of Gastric Carcinoids and Enterochromaffin-Like Cell Changes in Multiple Endocrine Neoplasia Type 1 and Zollinger-Ellison Syndrome: Identification of Risk Factors

Berna, Marc J.; Annibale, Bruno; Marignani, Massimo; Luong, Tu Vinh; Corleto, Vito D.; Pace, Andrea; Ito, Tetsuhide; Liewehr, David J.; Venzon, David; Fave, Gianfranco Delle; Bordi, Cesare; Jensen, Robert T.

doi:10.1210/jc.2007-2279

Cited by 137 publications

(142 citation statements)

References 40 publications

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“…ABG diagnosis was based on hypergastrinemia and histological confirmation of gastric body atrophy on multiple biopsies performed in gastric antrum and body[30,31,32,33,34]. Gastritis was evaluated according to the updated Sydney System; gastric body atrophy was defined as focal or complete replacement of oxyntic glands by metaplastic pyloric or intestinal glands; this variable was graded on a four-grade scale represented by absence of replacement (score 0), replacement to a mild degree (score 1), moderate degree (score 2) or severe degree (score 3) [35].…”

Section: Methodsmentioning

confidence: 99%

Type I Gastric Carcinoids: A Prospective Study on Endoscopic Management and Recurrence Rate

et al. 2011

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Background: Type I gastric carcinoids (TIGCs) are neuroendocrine neoplasms arising from enterochromaffin-like cells in atrophic body gastritis. Data regarding their evolution in prospective series are scarce, thus treatment and follow-up are not codified. Our aim was to evaluate clinical outcome and recurrence in TIGCs managed by endoscopic approach. Methods: 33 patients (24 females; median age 65 years, range 23–81) were included and managed through endoscopic follow-up every 6–12 months, with lesion removal and multiple gastric biopsies. Baseline clinical and histological features were analyzed as risk factors by Cox regression. Results: At diagnosis, 7 tumors were intramucosal carcinoids and 26 were polyps (median diameter 5 mm, range 2–20), multiple in 17 patients. Associated severe atrophy was present in 21 cases (63.6%), while mild atrophy was found in 6 cases (18.2%). During a 46-month median follow-up, survival was 100% and no metastases occurred. One patient developed a less-differentiated carcinoid that was radically treated by surgery. 21 patients (63.6%) had recurrence after a median of 8 months, 14 of these (66.6%) had a second recurrence after a median of 8 months following the previous carcinoid removal. Median recurrence-free survival was 24 months. Neither clinical nor biochemical recurrence-predicting factors were found. Conclusions: Although about 60% of TIGCs had recurrence after endoscopic resection, endoscopic management may be considered safe and effective.

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Section: Methodsmentioning

confidence: 99%

Type I Gastric Carcinoids: A Prospective Study on Endoscopic Management and Recurrence Rate

et al. 2011

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“…Proliferative changes in gastric enterochromaffin-like cells (ECL) are very common in the context of hypergastrinemia and can progress to gastric NET (type 2 gastric ECL tumor). 3,92 Endoscopy frequently reveals gastric nodules and in one series ECL tumors were identified in 23% of cases. 92 A surveillance strategy for these tumors has not been universally adopted but should be considered in patients with a history of longstanding or uncontrolled hypergastrinemia.…”

Section: Other Tumorsmentioning

confidence: 96%

Multiple endocrine neoplasia type 1 (MEN1)

Carroll

2012

Asia-Pac J Clncl Oncology

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Multiple endocrine neoplasia type 1 (MEN1) is inherited in an autosomal dominant fashion and predisposes to the development of hyperplastic or neoplastic changes in the parathyroid and pituitary glands and the endocrine pancreas, along with numerous other characteristic tumors and features. The management of each entity differs to some degree from their sporadic counterparts, while the lack of a genotype-phenotype correlation requires lifelong clinical, biochemical and radiological screening for the development of new tumors. While the syndrome itself is relatively rare (a prevalence of 1-10/100 000), it is likely that health-care practitioners from numerous specialities will occasionally encounter a patient with MEN1 and therefore a basic knowledge of the syndrome is important. In addition, many of the associated tumors are seen commonly in sporadic form, and a judicious policy is therefore required in deciding how thoroughly patients who develop these tumors should be screened for MEN1. The current literature on MEN1 is reviewed and key learning points are suggested for the clinician.

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“…Risk factors for developing GCs in patients with MEN-1/ZES include elevated fasting serum gastrin (>490 pg/mL), gastric nodules (present in 44% of patients), severe ECL-cell changes and long disease duration (>7 years). 26 Type 2 GCs associated with ZES invariably show loss of heterozygosity at the MEN-1 gene locus 11q13.…”

Section: -25mentioning

confidence: 99%

Review article: the investigation and management of gastric neuroendocrine tumours

Basuroy

Haji

Ramage

et al. 2014

Aliment Pharmacol Ther

128

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Summary Background Gastric carcinoids (GCs) or neuroendocrine tumours (NETs) are increasingly identified at endoscopy, and account for 0.6–2% of all gastric polyps identified. The SEER database in the US has demonstrated a rising incidence of gastric NETs amongst all NETs; from 2.2% between 1950 and 1969 to 6.0% between 2000 and 2007. Aim To review the literature and assist clinicians in managing patients with GCs. Methods A literature search was conducted through MEDLINE using search terms: gastric, carcinoid, neuroendocrine tumour, therapy, endoscopy, mucosal resection, submucosal dissection. Relevant articles were identified through manual review. The reference lists of these articles were reviewed to include further appropriate articles. Results There are three types of GCs with important epidemiological, pathophysiological, histological and endoscopic differences that affect prognosis and management. Type 1 and 2 GCs develop in the context of hypergastrinaemia that originates from achlorhydria in atrophic gastritis and a gastrinoma, respectively. Type 3 GCs occur sporadically and independent of gastrin. The histological type, grade and Ki67 index are used to determine prognosis and direct clinical management. Type 1 GCs >1 cm in size and type 2 GCs should be assessed for invasion beyond the submucosa with EUS prior to endoscopic resection with EMR or ESD. Type 3 GCs should be managed as per recommendations for gastric adenocarcinoma. The treatment of advanced disease is multimodal. Conclusions Patients with gastric carcinoids should be discussed in a specialist neuroendocrine tumour multidisciplinary meeting to ensure all treatment options are explored in localised and advanced disease. Areas of controversy exist that need further research.

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A Prospective Study of Gastric Carcinoids and Enterochromaffin-Like Cell Changes in Multiple Endocrine Neoplasia Type 1 and Zollinger-Ellison Syndrome: Identification of Risk Factors

Cited by 137 publications

References 40 publications

Type I Gastric Carcinoids: A Prospective Study on Endoscopic Management and Recurrence Rate

Type I Gastric Carcinoids: A Prospective Study on Endoscopic Management and Recurrence Rate

Multiple endocrine neoplasia type 1 (MEN1)

Review article: the investigation and management of gastric neuroendocrine tumours

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