Relations between Circulating Gastrin and Endocrine Cell Proliferation in the Atrophic Gastric Fundic Mucosa

Abstract

It has been suggested that gastrin may be a causative factor in the proliferation of gastric fundic mucosal endocrine cells, as seen in the Zollinger-Ellison syndrome and in atrophic gastritis with hypergastrinemia of antral origin. In the present study, morphometrically determined densities of endocrine cells in fundic mucosal biopsy specimens were related to basal levels of serum gastrin in 10 normal controls and 60 patients with achlorhydric fundic atrophic gastritis, of which 45 had pernicious anemia (5 with fundic mucosal carcinoid) and 15 had atrophic gastritis without pernicious anemia. The densities of fundic mucosal endocrine cells were positively related to the levels of serum gastrin (atrophic gastritis, rs = 0.65; atrophic gastritis and normal controls, rs = 0.72). The highest levels of serum gastrin were found in patients with carcinoid tumors (mean, 1659.3 pmol/l), followed by those in patients with focal hyperplasias (cluster formation) of endocrine cells (mean, 503.2 pmol/l) and those in patients without focal hyperplasias (mean, 304.4 pmol/l) (p = 0.03 and p = 0.04, respectively).

Chromogranin A in patients with acid hypersecretion and/or hypergastrinaemia

“…Multicentric ECL cell carcinoids occur predominantly in two conditions, PA 20,28,29 and ZE with MEN-1 30 but are rare in sporadic ZE, 17 despite high gastrin and modest ECL cell proliferation. 12,16,17,30 There are several potential sources for elevated serum CgA in ZE, principally G cells comprising the tumour and the gastric ECL cells that proliferate in response to the tumour-related hypergastrinaemia.…”

Well-Differentiated Gastric Tumors/Carcinomas

“…In these patients, basal serum gastrin levels should be determined and are always elevated [11, 28, 29], as well as serum chromogranin A levels [30]. Further tests should be performed depending on the clinical context.…”

Gastrin: growth enhancing effects on human gastric and colonic tumour cells

“…Naturally occurring gastrins (G171, G1711, G3411) were several times more potent than pentagastrin in their trophic effects on normal mucosa (Johnson, 1977). More recently it was shown that the density of fundic mucosal endocrine cells was positively related to levels of serum gastrin (Borch et al, 1986).…”