Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):455-460 | DOI: 10.5507/bp.2013.045

Neuroendocrine neoplasms of the stomach

Oldrich Louthan
4th Internal Department, General University Hospital, Prague, Czech Republic

Background: Gastric neuroendocrine neoplasms of type 1 and type 3 are different entities and as such require different therapeutical strategies. The aim of this study was to define and distinguish these two tumour subtypes with clearly different biological properties and patient survival. As shown, serum gastrin is an important diagnostic tool for differentiating the less malignant type 1 "hypergastrinemia non-related" tumor from malignant type 3, along with other parameters of malignant potential such as proliferation index and depth of invasion.

Methods: The biological behaviour, tumour marker status, symptomatology, survival and therapeutical strategy were assessed and compared in 18 consecutive patients with type 1 and 7 with type 3 gastric neuroendocrine tumours.

Results: All 18 patients with type 1 gastric carcinoids survived long-term. 17/18 patients were treated with endoscopic tumour removal. The prognosis for patients with generalized type 3 neuroendocrine neoplasms was poor, with short-term survival. No statistically significant differences between the types were found in urine 5-hydroxyindolacetic acid concentration or serum chromogranin A concentration. Significant differences were found in serum gastrin with high levels even in localized type 1 tumors and normal levels in generalized type 3 neoplasm. Further, high neuron-specific enolase levels were found in type 3.

Conclusions: Type 1 tumour should be preferably treated with endoscopic tumour removal. Recently, favourable tumoristatic effects have been reported in somatostatin analogs. Surgery is a treatment option for type 3 neuroendocrine carcinoma with normal gastrinemia. Serum gastrin is suitable for assessment of the biological properties of both neuroendocrine neoplasm types. It serves, among other factors, as a predictor of prognosis and an indicator for the selection of optimal therapeutical strategy.

Keywords: gastric carcinoid, neuroendocrine carcinoma, gastrin, chromogranin A, neuronspecific enolase

Received: November 3, 2012; Accepted: June 5, 2013; Prepublished online: June 27, 2013; Published: September 30, 2014  Show citation

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Louthan, O. (2014). Neuroendocrine neoplasms of the stomach. Biomedical papers, 158(3), 455-460. doi: 10.5507/bp.2013.045
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    References

    1. Delle Fave G, Kwekkeboom DJ, Van Cutsem E, Rindi G, Kos-Kudla B, Knigge U, Sasano H, Tomassetti P, Salazar R, Ruszniewski R. ENETS Consensus Guidelines for the Management of Patients with Gastroduodenal Neoplasms. Neuroendocrinology 2012;95:74-87. Go to original source... Go to PubMed...
    2. Klimstra DS, Modlin IR, Coppola D, Lloyd RV, Suster S. The Pathologic Classification of Neuroendocrine Tumors. A review of Nomenclature, Grading, and Staging Systems. Consensus Guidelines for the Diagnosis and Management of Neuroendocrine Tumors. NANETS Guidelines. Pancreas 2010;39:707-12. Go to original source... Go to PubMed...
    3. Kulke HM, Anthony LB, Bushnell DL, de Herder WW, Goldsmith SJ, Klimstra DS, Marx SJ, Pasieka JL, Pommier RF, Yao JC, Jensen RT. Well-Differentiated Neuroendocrine Tumors of the Stomach and Pancreas. NANETS Guidelines 2010;39(6):735-52. Go to original source...
    4. Solcia E, Kloppel G, Sobin LH. Histological typing of endocrine tumours; in Solcia E, Kloppel G, Sobin LH (eds): Histological Typing of Endocrine Tumours. International classification of Tumours, ed 2. Berlin, Springer, 2000. Go to original source...
    5. Rindi G, Luinetti O, Cornaggia M, Capella C, Solcia E. Three subtypes of gastric argyrophil carcinoid and the gastric neuroendocrine carcinoma: a clinicopathologic study. Gastroenterology 1993;104(4):994-1006. Go to original source... Go to PubMed...
    6. Nilsson O, Cutsem EV, Delle Fave G, Yao JC, Pavel ME, McNicol AM. Poorly Differentiated Carcinomas of the Foregut (Gastric, Duodenal and Pancreatic). ENETS Guidelines. Neuroendocrinology 2006;84:212-5. Go to original source... Go to PubMed...
    7. Bordi C, D“Adda T, Azzoni C. Hypergastrinemia and gastric enterochromaffin-like cells. Am J Surg 1995;19(Suppl 1):S8-19.
    8. Lehy T, Cadiot G, Mignon M, Ruszniewski P, Bonfils S. Influence of multiple endocrine neoplasm type 1 on gastric endocrine cells in patients with Zollinger-Ellison syndrome. Gut 1992;33:1275-9. Go to original source... Go to PubMed...
    9. Waldum HL, Sandvik AK, Idle JR. Gastrin is the most important factor in ECL tumorigenesis. Gastroenterology 1998;114:1113-5. Go to original source... Go to PubMed...
    10. Ruszniewski P, Delle Fave G, Cadiot G, Cadiot G, Komminoth P, Chung D, Kos-Kudla B, Kianmanesh R, Hochhauser D, Arnold R, Ahlman H, Pauwels S, Kwekkeboom DJ, Rindi G; Frascati Consensus Conference; European neuroendocrine Tumor Society. Well-Differentiated Gastric Tumors/Carcinomas. Neuroendocrinology 2009;84(3):158-64. Go to original source... Go to PubMed...
    11. Granberg D, Wilander E, Stridsberg M, Granerus G, Skogseid B, Öberg K. Clinical symptoms, hormone profiles, treatment, and prognosis in patients with gastric carcinoids. Gut 1998;43,223-8. Go to original source... Go to PubMed...
    12. Hirschowitz BI, Griffith J, Pellegrin D, Cummings OW. Rapid regression of enterochromaffin-like cell gastric carcinoids in pernicious anemia after antrectomy. Gastroenterology 1992;102:1409-18. Go to original source... Go to PubMed...
    13. Ferraro G, Annibale B, Marignani M, Azzoni C, D'Adda T, D'Ambra G, Bordi C, delle Fave G. Effectiveness of octreotide in controlling fasting hypergastrinemia and related enterochromaffin-like cell growth. J Clin Endocrinol Metab 1996;81(2):677-83. Go to original source...
    14. Fykse V, Sandvik AK, Qvigstad G, Falkmer GE, Syversen U, Waldum HL. Treatment of ECL cell carcinoids with octreotide LAR. Scandinavian Journal of Gastroenterology 2004;39(7):621-8. Go to original source... Go to PubMed...
    15. Grozinsky-Glasberg S, Kaltsas G, Gur C, Gal E, Thomas D, Fichman S, Alexandraki K, Barak D, Glaser B, Shimon I, Gross DJ. Long-acting somatostatin analogues are an effective treatment for type 1 gastric carcinoid tumours. Eur J Endocrinol 2008;159:475-82. Go to original source... Go to PubMed...
    16. Khuroo MS, Khuroo MS, Khuroo NS. Treatment of type I gastric neuroendocrine tumors with somatostatin analogs. J Gastroenterol Hepatol 2010;25(3):548-54. Go to original source... Go to PubMed...
    17. Hou W, Schubert ML. Treatment of gastric carcinoids. Curr Treat Options Gastroenterol 2007;10(2):123-33. Go to original source... Go to PubMed...
    18. Arnold R, Simon B, Wied M. Treatment of Neuroendocrine GEP Tumours with Somatostatin Analogues. Digestion 2000;62(Suppl.1):84-91. Go to original source... Go to PubMed...
    19. Kim BS, Oh ST, Yook JH, Kim KC, Kim MG, Jeong JW, Kim BS. Typical carcinoids and neuroendocrine carcinomas of the stomach: differing clinical courses and prognoses. Am J Surg 2010;3:328-33. Go to original source...
    20. Tomassetti P, Migliori M, Caletti GC, Fusaroli P, Corinaldesi R, Gullo L. Treatment of type II gastric carcinoid tumors with somatostatin analogues. N Eng J Med 2000;343:551-4. Go to original source... Go to PubMed...
    21. Gupta S, Yao JC, Ahrar K, Wallace MJ, Morello FA, Madoff DC, Murthy R, Hicks ME, Ajani JA. Hepatic artery embolization and chemoembolization for treatment of patients with metastatic carcinoid tumors: the M.D. Anderson experience. Cancer J 2003;9(4):261-7. Go to original source... Go to PubMed...
    22. Lewington VJ. Targeted radionuclide therapy for neuroendocrine tumour. Endocr Relat Cancer 2003;10,497-501. Go to original source... Go to PubMed...

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