title: Gastric type I carcinoid: a pilot study with human G17DT immunogen vaccination.
abstract: BACKGROUND
  Gastric type I carcinoid is a rare neoplasm, deriving from enterochromaffin-like cells (ECL), mainly affecting women with autoimmune gastritis. The approach to treatment, either endoscopic, medical or surgical, is not well defined, particularly in multifocal tumours or carcinoids with rapid growth/frequent recurrence.
  
  
  OBJECTIVE
  To determine whether an anti-G17 vaccination might interfere on the natural history of gastric type I carcinoid.
  
  
  METHODS
  Padua teaching Hospital, outpatient clinic.
  
  
  METHODS
  Three patients with type I gastric carcinoid in autoimmune gastritis were administered, after informed consent and ethic committee approval, with a vaccine against gastrin 17 (G17), a synthetic peptide that stimulates specific and high-affinity anti-G17 antibodies, and followed up endoscopically and clinically for a mean of 36 months.
  
  
  METHODS
  Gastric histology and specifically carcinoid growth/recurrence and trend in time in gastrin, G17, pepsinogens, chromogranin A and clinical parameters.
  
  
  RESULTS
  Following vaccination, carcinoid regression was observed in 2/3 patients and, in one of the patients, even the disappearance of ECL hyperplasia, with a reduced ECL cells stimulation, confirmed by a significant reduction in chromogranin A levels. Regression was observed in the two patients that showed a more clear local response to the vaccine. Increased autoantibody titre was observed, but no appearance of new autoimmune diseases.
  
  
  CONCLUSIONS
  Anti-G17 vaccination induced regression of type I gastric carcinoid and could be considered for the treatment of this tumour, when endoscopic removal is not indicated.
authors: Department of Surgical and Gastroenterological Sciences, Policlinico Universitario, Via Giustiniani 2, Padua, Italy.
authors: Chiara
authors: C
authors: Tieppo
authors: Corrado
authors: C
authors: Betterle
authors: Daniela
authors: D
authors: Basso
authors: Claudia
authors: C
authors: Mescoli
authors: Massimo
authors: M
authors: Rugge
authors: Chiara
authors: C
authors: Martini
authors: Valerio
authors: V
authors: Zorzetto
authors: Gemma
authors: G
authors: Maddalo
authors: Nora
authors: N
authors: Cazzagon
authors: Donato
authors: D
authors: Nitti
authors: Fabio
authors: F
authors: Farinati
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