Distinct patterns of chronic gastritis associated with carcinoid and cancer and their role in tumorigenesis.
A series of 60 gastric endocrine tumors comprised 44 body-fundus argyrophil carcinoids, of which 23 arose in a background of hypergastrinemia and type A chronic atrophic gastritis (A-CAG), mainly with histologic patterns suggestive of an autoimmune process. Only 22 percent (compared with 19 percent of 58 tumor-free A-CAG cases) of 36 carcinoids and 21 percent of 19 A-CAG carcinoids investigated had Helicobacter pylori (HP) colonization, against 50 percent of 14 CAG-associated neuroendocrine carcinomas or mixed endocrine-exocrine tumors, 84 percent of 150 cases with early gastric cancer (p < 0.001 versus carcinoids), mostly with B- or AB-type CAG, 76 percent of 97 tumor-free AB-CAG, and 95 percent of 151 tumor-free B-CAG cases. Secondary hypergastrinemia and local mechanisms activated by chronic autoimmune gastritis are among factors involved in the pathogenesis of relatively indolent CAG-associated carcinoids, whereas active HP gastritis in cooperation with environmental carcinogens may likely cause more severe epithelial transformation, leading to ordinary cancer and, possibly, to neuroendocrine carcinomas or mixed endocrine-exocrine tumors.
Solcia
E
E
Department of Human Pathology and Genetics, I Medical Faculty, University of Pavia, Italy.
Rindi
G
G
Fiocca
R
R
Villani
L
L
Buffa
R
R
Ambrosiani
L
L
Capella
C
C
D001327:Autoimmune Diseases / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D002276:Carcinoid Tumor / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D018278:Carcinoma, Neuroendocrine / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D002908:Chronic Disease; D004701:Endocrine Gland Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D005260:Female; D005755:Gastrins / Q000097:blood; D005756:Gastritis / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D016480:Helicobacter pylori / Q000302:isolation & purification / Q000502:physiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D013270:Stomach / Q000382:microbiology / Q000473:pathology; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology
D005755:Gastrins