Development of type I gastric carcinoid in patients with chronic atrophic gastritis

Aliment Pharmacol Ther. 2011 Jun;33(12):1361-9. doi: 10.1111/j.1365-2036.2011.04659.x. Epub 2011 Apr 15.

Abstract

Background: Long-term observational studies assessing the incidence of type I gastric carcinoid (typeIGC) in patients with chronic atrophic gastritis are few.

Aim: To evaluate the occurrence of typeIGC at diagnosis and during follow-up and to identify patient features associated with the presence of typeIGC in a cohort of chronic atrophic gastritis patients.

Methods: Three hundred and sixty-seven chronic atrophic gastritis patients [245 women, age 54 (18-79) years] underwent regular follow-up by gastroscopy. The incidence of typeIGC was determined in chronic atrophic gastritis patients with at least 2 years of follow-up (n = 214). Baseline clinical and histological features were analysed as factors associated with the presence of typeIGC by univariate analysis.

Results: Type I gastric carcinoid was diagnosed in nine (2.4%) patients at the moment when chronic atrophic gastritis was diagnosed. After 1463 person-years, six patients developed typeIGC with an annual incidence rate (person-year) of 0.4%. Patients with typeIGC had significantly higher levels of gastrin, chromogranin A and more frequently the presence of body polyps and ECL-dysplasia compared with chronic atrophic gastritis patients without typeIGC.

Conclusions: This cohort study shows that typeIGC is a rare complication in patients with chronic atrophic gastritis, and the presence of body polyps and ECL-dysplasia at gastroscopic/histologic evaluation is strongly associated with the presence of typeIGC.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Carcinoid Tumor / classification
  • Carcinoid Tumor / pathology*
  • Cohort Studies
  • Female
  • Gastric Mucosa / pathology
  • Gastritis, Atrophic / pathology*
  • Gastroscopy / methods
  • Humans
  • Immunohistochemistry
  • Incidence
  • Male
  • Middle Aged
  • Precancerous Conditions / classification
  • Precancerous Conditions / pathology*
  • Stomach Neoplasms / pathology*
  • Young Adult