Gastric carcinoids and neuroendocrine carcinomas: pathogenesis, pathology, and behavior.
The goal of this study was to provide information of prognostic value for gastric endocrine tumors. A total of 205 gastric endocrine tumors have been studied: 193 well differentiated tumors [2 gastrin cell tumors, 191 enterochromaffin-like (ECL) cell tumors] and 12 poorly differentiated carcinomas. Subtyping of ECL cell tumors (carcinoids) resulted in 152 associated with chronic atrophic gastritis (CAG) (type 1); 12 associated with hypertrophic gastropathy (HG) due to Zollinger-Ellison syndrome with multiple endocrine neoplasia type I (type 2), and 27 with no specific association (type 3, sporadic). Type 1 cases occurred most often in female (108 of 152), elderly (mean 63 years) patients, with no tumor-related death at an overall mean follow-up of 53 months. The 12 type 2 cases were equally distributed between the sexes (six of each), with a mean age of 45 years; there was one tumor-related death (49 months after diagnosis) and an overall mean survival of 84 months. Type 3 cases were mostly in men (20 of 27), with a mean age of 55 years; there were seven tumor-related deaths at a mean follow-up of 28 months. Poorly differentiated neuroendocrine carcinomas were observed in elderly patients (mean 63 years, range 41-76 years) of both sexes, with nine tumor-related deaths and a mean survival of 7 months. It was concluded that correct clinicopathologic subtyping may predict the clinical behavior of gastric endocrine tumors.
Rindi
G
G
Department of Human Pathology and Heredity, University of Pavia, Via Forlanini 16, 27100 Pavia, Italy.
Bordi
C
C
Rappel
S
S
La Rosa
S
S
Stolte
M
M
Solcia
E
E
D000328:Adult; D000367:Age Factors; D000368:Aged; D002276:Carcinoid Tumor / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D018278:Carcinoma, Neuroendocrine / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D005753:Gastric Mucosa / Q000473:pathology; D015408:Gastrinoma / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D005757:Gastritis, Atrophic / Q000473:pathology; D006801:Humans; D006984:Hypertrophy; D008297:Male; D008875:Middle Aged; D018761:Multiple Endocrine Neoplasia Type 1 / Q000473:pathology; D011379:Prognosis; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D015996:Survival Rate; D015043:Zollinger-Ellison Syndrome / Q000473:pathology