Natural history, clinicopathologic classification and prognosis of gastric ECL cell tumors.
A series of 50 gastric endocrine tumors classified according to Rindi et al. [1] comprised 12 small cell neuroendocrine carcinomas (NEC) and 38 ECL cell carcinoids, of which 22 associated with type A chronic atrophic gastritis (A-CAG), eight with hypertrophic gastropathy due to combined Multiple Endocrine Neoplasia and Zollinger/Ellison syndrome (MEN/ZES), and eight sporadic. Variables found to predict tumor malignancy were: size > 2 cm, > 2 mitoses and > 130 Ki67 positive cells/10 high power fields (HPF), grade 2 or 3 histology, angioinvasion, p53 protein nuclear accumulation, and the presence of a single tumor. None of these factors increased significantly the predicting ability of tumor classification itself, although grade 2 + 3 shows 100 percent negative predictive value and Ki67 and angioinvasion 100 percent positive predictive value. When the mostly non-malignant A-CAG and MEN-ZES tumors were analysed against the mostly malignant sporadic and NEC tumors, a positive predictive value of 90 percent and a negative predictive value of 93 percent was obtained. Investigation of a larger tumor series is under way with the aim to develop an optimal model for prognostic evaluation of gastric endocrine tumors.
Solcia
E
E
Department of Human Pathology, University of Pavia, Italy.
Rindi
G
G
Paolotti
D
D
Luinetti
O
O
Klersy
C
C
Zangrandi
A
A
La Rosa
S
S
Capella
C
C
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000473:pathology; D002454:Cell Differentiation; D002455:Cell Division; D019861:Enterochromaffin-like Cells / Q000378:metabolism / Q000473:pathology*; D005260:Female; D005755:Gastrins / Q000378:metabolism; D005757:Gastritis, Atrophic / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008938:Mitosis; D018358:Neuroendocrine Tumors / Q000145:classification / Q000473:pathology* / Q000556:secondary; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012701:Serotonin / Q000378:metabolism; D013004:Somatostatin / Q000378:metabolism; D013274:Stomach Neoplasms / Q000145:classification / Q000473:pathology* / Q000556:secondary
D005755:Gastrins; D012701:Serotonin; D013004:Somatostatin