Gastric cancer in patients with type I gastric carcinoids

• Published in: Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 2015-07, Vol.18 (3), p.564-570
• Main Authors: Lahner, Edith, Esposito, Gianluca, Pilozzi, Emanuela, Galli, Gloria, Corleto, Vito D., Di Giulio, Emilio, Annibale, Bruno
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Adult; Aged; Cancer Research; Carcinoid Tumor - etiology; Carcinoid Tumor - pathology; Female; Follow-Up Studies; Gastric cancer; Gastritis, Atrophic - complications; Gastritis, Atrophic - pathology; Gastroenterology; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Oncology; Original Article; Retrospective Studies; Stomach Neoplasms - etiology; Stomach Neoplasms - pathology; Surgical Oncology
• ISSN: 1436-3291; 1436-3305
• DOI: 10.1007/s10120-014-0393-8

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. 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 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.