title: Gastric cancer in patients with type I gastric carcinoids.
abstract: BACKGROUND
  Atrophic body gastritis (ABG) is associated with both type I gastric carcinoids (T1-GCs) and intestinal-type gastric cancer. The occurrence of gastric cancer in ABG patients with type I gastric carcinoids has not yet been described.
  
  
  OBJECTIVE
  To describe the occurrence at follow-up of gastric cancer in ABG patients with type I gastric carcinoid in a retrospective case series in a single tertiary referral center.
  
  
  METHODS
  Between 1994 and 2012, 17 new cases of T1-GCs were diagnosed among a cohort of ABG patients in a single tertiary referral center for ABG. The clinical charts of these 17 T1-GC patients were retrospectively evaluated for the occurrence of gastric cancer at follow-up (median 4.2 years, range 0.5-13).
  
  
  RESULTS
  In 4 (23.5 %)/17 T1-GCs patients (3 females, age 40-78 years), gastric cancer occurred (median follow-up 5.9 years, range 5.1-13). Three cases were intestinal-type adenocarcinomas and one a signet-ring cell diffuse gastric cancer, localized in three cases in the antrum. In two patients, it was detected on random biopsies during follow-up gastroscopy; in the other two, gastroscopy was performed because of new symptoms. All patients with gastric cancer had associated autoimmune features (pernicious anemia, autoimmune thyroid disease and a spared antrum) compared to 77, 46 and 54 % of those without gastric cancer, although statistical significance was not reached.
  
  
  CONCLUSIONS
  This case series shows that in patients with T1-GCs, gastric cancer may frequently occur at long-term follow-up. Thus, these patients should be monitored by a long-term surveillance program, including an accurate bioptic sampling of the antral mucosa.
authors.affiliation: Department of Digestive and Liver Disease, Sant'Andrea Hospital, Medical School, Sapienza University Rome, Via di Grottarossa 1035-1039, 00189, Rome, Italy.
authors.forename: Edith
authors.initials: E
authors.lastname: Lahner
authors.forename: Gianluca
authors.initials: G
authors.lastname: Esposito
authors.forename: Emanuela
authors.initials: E
authors.lastname: Pilozzi
authors.forename: Gloria
authors.initials: G
authors.lastname: Galli
authors.forename: Vito D
authors.initials: VD
authors.lastname: Corleto
authors.forename: Emilio
authors.initials: E
authors.lastname: Di Giulio
authors.forename: Bruno
authors.initials: B
authors.lastname: Annibale
mesh_terms: D000328:Adult; D000368:Aged; D002276:Carcinoid Tumor / Q000209:etiology* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005757:Gastritis, Atrophic / Q000150:complications* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000209:etiology* / Q000473:pathology