title: A clinical perspective on gastric neuroendocrine neoplasia.
abstract: The incidence of gastric neuroendocrine tumors (NETs) has increased exponentially based on widespread use of endoscopy and a greater pathological awareness of the condition. A key concern is the potential association with hypergastrinemia induced by proton pump inhibitor administration. Previous confusion regarding diagnosis and therapy has been diminished by a series of international consensus statements defining the biology and management strategies for the disease. Overall, gastric NETs are categorized as well-differentiated or poorly differentiated neoplasms. Well-differentiated gastric NETs are enterochromaffin-like (ECL) cell tumors subclassified into three types based on their relationship to gastrin, a key regulator of ECL cell neoplastic transformation. The treatment of type 1 and type 2 tumors depends on the size and invasiveness of the tumor, whereas type 3 tumors and poorly differentiated neuroendocrine carcinomas warrant aggressive surgical resection. The disease-specific 5-year survival ranges from about 95% in type 1 gastric carcinoids to about 25% in poorly differentiated gastric NECs. Elucidation of the precise biology of a gastric NET is critical to diagnosis and delineation of a type-specific management strategy.
authors.affiliation: Yale University School of Medicine, New Haven, CT 06520, USA. benjamin.lawrence@yale.edu
authors.forename: Ben
authors.initials: B
authors.lastname: Lawrence
authors.forename: Mark
authors.initials: M
authors.lastname: Kidd
authors.forename: Bernhard
authors.initials: B
authors.lastname: Svejda
authors.forename: Irvin
authors.initials: I
authors.lastname: Modlin
mesh_terms: D002276:Carcinoid Tumor / Q000145:classification / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D018278:Carcinoma, Neuroendocrine / Q000145:classification / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D002471:Cell Transformation, Neoplastic; D019861:Enterochromaffin-like Cells / Q000473:pathology / Q000502:physiology; D005773:Gastroscopy; D006801:Humans; D015994:Incidence; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D018358:Neuroendocrine Tumors / Q000145:classification / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy*; D011379:Prognosis; D013274:Stomach Neoplasms / Q000145:classification / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy*