title: Progression of gastric enterochromaffin-like cells growth in Zollinger-Ellison syndrome and atrophic body gastritis patients.
abstract: BACKGROUND
  Enterochromaffin-like cell hyperplasia of the gastric body mucosa occurs in hypergastrinaemic conditions such as atrophic body gastritis and Zollinger-Ellison syndrome. However, the time course of change or factors involved are not known.
  
  
  OBJECTIVE
  To compare the rate of change of enterochromaffin-like cell proliferation in patients with atrophic body gastritis and Zollinger-Ellison syndrome.
  
  
  METHODS
  From a consecutive series of atrophic body gastritis and Zollinger-Ellison syndrome patients, studied at the time of first diagnosis, 10 atrophic body gastritis (4 with pernicious anaemia) and 14 Zollinger-Ellison syndrome (4 with multiple endocrine neoplasia type 1) patients were followed-up for a median time of 48 months.
  
  
  METHODS
  At entry and during follow-up patients underwent: plasma gastrin determination, endoscopic sampling of body mucosa for qualitative assessment of enterochromaffin-like cell hyperplasia pattern and degree of glandular atrophy, qualitative and morphometric analyses of body mucosa endocrine cells.
  
  
  RESULTS
  At time of diagnosis, enterochromaffin-like cell lesions were more severe in atrophic body gastritis than in Zollinger-Ellison syndrome. During follow-up, no significant variations were observed in gastrin values, enterochromaffin-like cell patterns and grade of body mucosa atrophy in atrophic body gastritis. In contrast, gastrin levels were significantly increased [median 1200 (235-2625) vs 1947 (225-5200) pg/ml; p<0.001)] as was total volume density of enterochromaffin-like cells [median 1.60 (0.53-4.06) vs 3.18 (1.35-21.13)% of mucosal epithelial component; (p<0.005)] in Zollinger-Ellison syndrome. Micronodular hyperplasia of enterochromaffin-like cells, present in only one patient at diagnosis, was observed in 8 Zollinger-Ellison syndrome patients at follow-up.
  
  
  CONCLUSIONS
  These data suggest that the progression of enterochromaffin-like cell growth in human gastric mucosa requires an increase of and/or a prolonged exposure to severe hypergastrinaemia.
authors.affiliation: Division of Digestive and Liver Diseases, 2nd School of Medicine, University La Sapienza, Rome, Italy. gianfranco.dellefave@uniroma1.it
authors.forename: G
authors.initials: G
authors.lastname: Delle Fave
authors.forename: M
authors.initials: M
authors.lastname: Marignani
authors.forename: V D
authors.initials: VD
authors.lastname: Corleto
authors.forename: S
authors.initials: S
authors.lastname: Angeletti
authors.forename: G
authors.initials: G
authors.lastname: D'Ambra
authors.forename: G
authors.initials: G
authors.lastname: Ferraro
authors.forename: T
authors.initials: T
authors.lastname: D'Adda
authors.forename: C
authors.initials: C
authors.lastname: Azzoni
authors.forename: R T
authors.initials: RT
authors.lastname: Jensen
authors.forename: B
authors.initials: B
authors.lastname: Annibale
authors.forename: C
authors.initials: C
authors.lastname: Bordi
mesh_terms: D000328:Adult; D000368:Aged; D018450:Disease Progression; D019861:Enterochromaffin-like Cells / Q000473:pathology*; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D005755:Gastrins / Q000097:blood; D005757:Gastritis, Atrophic / Q000473:pathology*; D006801:Humans; D006965:Hyperplasia; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015043:Zollinger-Ellison Syndrome / Q000473:pathology*
chemical_list: D005755:Gastrins