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 intestinaltype gastric cancer. The occurrence of gastric cancer in ABG patients with type I gastric carcinoids has not yet been described. Aim 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 followup 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.

Gastric hyperplastic polyps coexisting with early gastric cancers, adenoma and neuroendocrine cell hyperplasia

“…In 2004, Lahner et al published the first study regarding the occurrence of gastric cancer and type 1 carcinoid in patients with atrophic body gastritis [28]. In case 2 of our study, the presence of adenoma/HGD and NET G1 in the stomach was found.…”

Gastric neuroendocrine neoplasias: manifestations and comparative outcomes

“…So far, the presented data constrain that repeated local resections by short and mid-term endoscopic follow-up is a pragmatic and cost-effective approach which leads to a very good clinical outcome of gNEN-1, even in cases of recurrence or progression due to ongoing HG caused by CAG. However, follow-up intervals are part of ongoing controversy, probably because of inconsistent reports on the adenocancerogenic potential of CAG and intestinal metaplasia itself (Chen et al 2015, Lahner et al 2015, Xie et al 2017). Neither adenocarcinoma nor a life-threatening progression of gNEN-1 was documented during follow-up in our cohort.…”

Synchronous Early Gastric Cancer/Neuroendocrine Tumor Associated with Autoimmune Gastritis Completely Resected with Endoscopic Submucosal Dissection

“…Gastric cancer and NET lesions are reportedly observed in 0.9-9% and 4-9% of patients with autoimmune gastritis, respectively (14). The pathogenesis of gastric cancer is attributed to atrophic gastritis resulting in intestinal metaplasia (2) or long-term hypergastrinemia (15), leading to the development of adenocarcinoma, while that of type I gastric NET is attributed to elevated gastrin secretion in response to the loss of negative feedback by parietal cells, wherein hypo-/achlorhydria-induced hypergastrinemia results in enterochromaffin-like (ECL) cell hyperplasia and dysplasia, thus leading to type I gastric NET (16, 17). In our case, the patient was shown to be positive for anti-parietal cells, anti-intrinsic factor antibodies, and hypergastrinemia (gastrin, up to 1,440 pg/mL) but negative for serum H. pylori IgG antibody.…”