T. Dadda et al., GASTRIC CARCINOID-TUMOR AND ITS PRECURSOR LESIONS - ULTRASTRUCTURAL-STUDY OF A CASE BEFORE AND AFTER ANTRECTOMY, Archives of pathology and laboratory medicine, 118(6), 1994, pp. 658-663
Citations number
28
Categorie Soggetti
Pathology,"Medical Laboratory Technology","Medicine, Research & Experimental
Antrectomy has been proposed as the preferential treatment of hypergas
trinemic patients with nonantral gastric carcinoids since it removes t
he main growth factor for the tumors and their precursor lesions, ie,
hypergastrinemia. To investigate the cellular basis of the mechanism f
or postantrectomy regression in nonantral endocrine cells, a light and
electron microscopic morphometric study was performed in a case of en
terochromaffinlike-cell gastric carcinoid associated with hypergastrin
emia before and 4 and 10 months after antrectomy. The withdrawal of su
stained hypergastrinemia obtained by antrectomy was associated with a
progressive reduction of the volume density, cross-sectional area, and
number of profiles of endocrine cells in the remaining nonantral muco
sa, in which gastrin-dependent proliferations were regarded as the car
cinoid precursor lesions. Ultrastructural morphometry demonstrated tha
t the changes selectively involved the enterochromaffinlike cells, ie,
the specific cell target for the trophic action of gastrin and the us
ual component of gastric carcinoids. The volume fractions of enterochr
omaffin and X cells (producing serotonin and endothelin, respectively)
were increased 10 months after antrectomy. Persistence of a modest el
evation of gastrin levels, likely due to the occurrence of gastrin cel
ls in areas of pyloric metaplasia of the nonantral mucosa, did not pre
vent the hypotrophic effects of antrectomy.