GASTRIC CARCINOIDS AND NEUROENDOCRINE CARCINOMAS - PATHOGENESIS, PATHOLOGY, AND BEHAVIOR

The goal of this study was to provide information of prognostic value fur gastric endocrine tumors. A total of 205 gastric endocrine tumors have been studied: 193 well differentiated tumors [2 gastrin cell tumo rs, 191 enterochromaffin-like (ECL) cell tumors] and 12 poorly differe ntiated carcinomas. Subtyping of ECL cell tumors (carcinoids) resulted in 152 associated with chronic atrophic gastritis (GAG) (type 1); 12 associated with hypertrophic gastropathy (HG) due to Zollinger-Ellison syndrome with multiple endocrine neoplasia type I (type 2), and 27 wi th no specific association (type 3, sporadic). Type 1 cases occurred m ost often in female (108 of 152), elderly (mean 63 years) patients, wi th no tumor-related death at an overall mean follow-up of 53 months. T he 12 type 2 cases were equally distributed between the sexes (six of each), with a mean age of 45 years; there was one tumor-related death (49 months after diagnosis) and an overall mean survival of 84 months. Type 3 cases were mostly in men (20 of 27), with a mean age of 55 yea rs; there were seven tumor-related deaths at a mean follow-up of 28 mo nths. Poorly differentiated neuroendocrine carcinomas were observed in elderly patients (mean 63 years, range 41-76 years) of both sexes, wi th nine tumor-related deaths and a mean survival of 7 months. It was c oncluded that correct clinicopathologic subtyping may predict the clin ical behavior of gastric endocrine tumors.