Top

Published in:

01-10-2014 | Clinical Review

Clinical features and management of type I gastric carcinoids

Author: Yuichi Sato

Published in: Clinical Journal of Gastroenterology | Issue 5/2014

Abstract

Type I gastric carcinoids (TIGCs) are related to chronic atrophic gastritis and are characterized by hypergastrinemia and hyperplasia of enterochromaffin-like cells. TIGCs are the most frequently diagnosed of all gastric carcinoids, accounting for about 70–80 %. Endoscopically, TIGCs are present as small (<10 mm), polypoid lesions or, more frequently, as smooth, rounded submucosal lesions. Histologically, TIGCs arise in the deep mucosa, with some invading the submucosa. Most TIGCs are well-differentiated tumors, with metastasis being rare. Therefore, patients with TIGCs generally have an excellent prognosis. Among the currently available treatment options are total gastrectomy, partial resection, antrectomy, endoscopic resection, and endoscopic surveillance, although no consensus has been reached on their optimal management. Further studies are needed to develop better management options for patients with TIGC.

Solcia E, Arnold R, Capella C, et al. Neuroendocrine neoplasms of the stomach. In: Bosman FT, Carneiro F, Hruban RH, Theise ND editors WHO classification of tumours of the digestive system. Lyon: IARC, 2010. p. 64–68.

Yao JC, Hassan M, Phan A, et al. One hundred years after “carcinoid”: epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol. 2008;26:3063–72.PubMedCrossRef

Ellis L, Shale MJ, Coleman MP. Carcinoid tumors of the gastrointestinal tract: trends in incidence in England since 1971. Am J Gastroenterol. 2010;105:2563–9.PubMedCrossRef

Modlin IM, Lye KD, Kidd M. A 50-year analysis of 562 gastric carcinoids: small tumor or larger problem? Am J Gastroenterol. 2004;99:23–32.PubMedCrossRef

Rindi G, Luinetti O, Cornaggia M, et al. Three subtypes of gastric argyrophil carcinoid and the gastric neuroendocrine carcinoma: a clinicopathological study. Gastroenterology. 1993;104:994–1006.PubMed

Nikou GC, Angelopoulos TP. Current concepts on gastric carcinoid tumors. Gastroenterol Res Pract. 2012; Article ID 287825.

Basuroy R, Srirajaskanthan R, Prachalias A, et al. Review article: the investigation and management of gastric neuroendocrine tumours. Aliment Pharmacol Ther. 2014;39:1071–84.PubMedCrossRef

Li TT, Qiu F, Qian ZR, et al. Classification, clinicopathologic features and treatment of gastric neuroendocrine tumors. World J Gastroenterol. 2014;20:118–25.PubMedCrossRefPubMedCentral

Massironi S, Sciola V, Spampatti MP, et al. Gastric carcinoids: between underestimation and overtreatment. World J Gastroenterol. 2009;15:2177–83.PubMedCrossRefPubMedCentral

10.

Zhang L, Ozao J, Warner R, Divino C. Review of the pathogenesis, diagnosis, and management of type I gastric carcinoid tumor. World J Surg. 2011;35:1879–86.PubMedCrossRef

11.

Kaltsas G, Grozinsky-Glasberg S, Alexandraki KI, et al. Current concepts in the diagnosis and management of type 1 gastric neuroendocrine neoplasms. Clin Endocrinol (Oxf). 2014;81:157–68.CrossRef

12.

Scherübl H, Cadiot G, Jensen RT, et al. Neuroendocrine tumors of the stomach (gastric carcinoids) are on the rise: small tumors, small problems? Endoscopy. 2010;42:664–71.PubMedCrossRef

13.

Sato Y, Iwafuchi M, Ueki J, et al. Gastric carcinoid tumors without autoimmune gastritis in Japan: a relationship with Helicobacter pylori infection. Dig Dis Sci. 2002;47:579–85.PubMedCrossRef

14.

Ito T, Sasano H, Tanaka M, et al. Epidemiological study of gastroenteropancreatic neuroendocrine tumors in Japan. J Gastroenterol. 2010;45:234–43.PubMedCrossRef

15.

Niederle MB, Hackl M, Kaserer K, Niederle B. Gastroenteropancreatic neuroendocrine tumours: the current incidence and staging based on the WHO and European Neuroendocrine Tumour Society classification: an analysis based on prospectively collected parameters. Endocr Relat Cancer. 2010;17:909–18.PubMedCrossRef

16.

Cho MY, Kim JM, Sohn JH, et al. Current trends of the incidence and pathological diagnosis of gastroenteropancreatic neuroendocrine tumors (gep-nets) in korea 2000–2009: multicenter study. Cancer Res Treat. 2012;44:157–65.PubMedCrossRefPubMedCentral

17.

Lawrence B, Gustafsson BI, Chan A, et al. The epidemiology of gastroenteropancreatic neuroendocrine tumors. Endocrinol Metab Clin North Am. 2011;40:1–18.PubMedCrossRef

18.

Soykan I, Yakut M, Keskin O, et al. Clinical profiles, endoscopic and laboratory features and associated factors in patients with autoimmune gastritis. Digestion. 2012;86:20–6.PubMedCrossRef

19.

Sato Y, Imamura H, Kaizaki Y, et al. Management and clinical outcomes of type I gastric carcinoid patients: retrospective, multicenter study in Japan. Dig Endosc. 2014;26:377–84.PubMedCrossRef

20.

Higham AD, Bishop LA, Dimaline R, et al. Mutations of RegI alpha are associated with enterochromaffin-like cell tumor development in patients with hypergastrinemia. Gastroenterology. 1999;116:1310–8.PubMedCrossRef

21.

Pritchard DM, Berry D, Przemeck SM, et al. Gastrin increases mcl-1 expression in type I gastric carcinoid tumors and a gastric epithelial cell line that expresses the CCK-2 receptor. Am J Physiol Gastrointest Liver Physiol. 2008;295:G798–805.PubMedCrossRefPubMedCentral

22.

D’Adda T, Keller G, Bordi C, Höfler H. Loss of heterozygosity in 11q13-14 regions in gastric neuroendocrine tumors not associated with multiple endocrine neoplasia type 1 syndrome. Lab Invest. 1999;79:671–7.PubMed

23.

Chittajulla RS, Ardill JES, McColl KEL. The degree of hypergastrinemia induced by Helicobacter pylori is the same in duodenal ulcer patients and asymptomatic volunteers. Eur J Gastroenterol. 1992;4:49–53.

24.

Smith JTL, Pounder RE, Nwokolo CU. Inappropriate hypergastrinemia in asymptomatic healthy subjects infected with Helicobacter pylori. Gut. 1990;31:522.PubMedCrossRefPubMedCentral

25.

El-Omar EM, Oien K, El-Nujumi A, et al. Helicobacter pylori infection and chronic gastric acid hyposecretion. Gastroenterology. 1997;113:15–24.PubMedCrossRef

26.

Faller G, Steininger H, Kra¨nzlein J, et al. Antigastric autoantibodies in Helicobacter pylori infection: implications of histological and clinical parameters of gastritis. Gut. 1997;41:619–23.PubMedCrossRefPubMedCentral

27.

Claeys D, Faller G, Appelmelk BJ, et al. The gastric H, K⁺–ATPase is a major autoantigen in chronic Helicobacter pylori gastritis with body mucosa atrophy. Gastroenterology. 1998;115:340–7.PubMedCrossRef

28.

Negrini R, Savio A, Poiesi C, et al. Antigenic mimicry between Helicobacter pylori and gastric mucosa in the pathogenesis of body atrophic gastritis. Gastroenterology. 1996;111:655–65.PubMedCrossRef

29.

Calam J, Gibbons A, Healey ZV, et al. How does Helicobacter pylori cause mucosal damage? Its effect on acid and gastrin physiology. Gastroenterology. 1997;113:S43–9.PubMedCrossRef

30.

Kidd M, Miu K, Tang LH, et al. Helicobacter pylori lipopolysaccharide stimulates histamine release and DNA synthesis in rat enterochromaffin- like cells. Gastroenterology. 1997;113:1110–7.PubMedCrossRef

31.

Solcia E, Rindi G, Fiocca R, et al. Distinct patterns of chronic gastritis associated with carcinoid and cancer and their role in tumorigenesis. Yale J Biol Med. 1992;65:793–804.PubMedPubMedCentral

32.

Ravizza D, Fiori G, Trovato C, et al. Long-term endoscopic and clinical follow-up of untreated type 1 gastric neuroendocrine tumours. Dig Liver Dis. 2007;39:537–43.PubMedCrossRef

33.

Borch K, Ahrén B, Ahlman H, et al. Gastric carcinoids: biologic behavior and prognosis after differentiated treatment in relation to type. Ann Surg. 2005;242:64–73.PubMedCrossRefPubMedCentral

34.

Granberg D, Wilander E, Stridsberg M, et al. Clinical symptoms, hormone profiles, treatment, and prognosis in patients with gastric carcinoids. Gut. 1998;43:223–8.PubMedCrossRefPubMedCentral

35.

Ichikawa J, Tanabe S, Koizumi W, et al. Endoscopic mucosal resection in the management of gastric carcinoid tumors. Endoscopy. 2003;35:203–6.PubMedCrossRef

36.

Singh R, Yao K, Anagnostopoulos G, et al. Microcarcinoid tumor diagnosed with high-resolution magnification endoscopy and narrow band imaging. Endoscopy. 2008;40(Suppl 2):E12.PubMedCrossRef

37.

Delle Fave G, Kwekkeboom DJ, Van Cutsem E, et al. ENETS Consensus Guidelines for the management of patients with gastroduodenal neoplasms. Neuroendocrinology. 2012;95:74–87.PubMedCrossRef

38.

La Rosa S, Vanoli A. Gastric neuroendocrine neoplasms and related precursor lesions. J Clin Pathol. 2014; 22 Jul. doi:10.1136/jclinpath-2014-202515.

39.

Solcia E, Bordi C, Creutzfeldt W, et al. Histopathological classification of nonantral gastric endocrine growths in man. Digestion. 1988;41:185–200.PubMedCrossRef

40.

Rindi G, Arnold R, Bosman FT, et al. Nomenclature and classification of neuroendocrine neoplasms of the digestive system. In: Bosman FT, Carneiro F, Hruban R, Theise ND, editors. WHO classification of tumours of the digestive system. Lyon: International Agency for Research on cancer (IARC); 2010. p. 13–14.

41.

Karaca C, Turner BG, Cizginer S, Forcione D, Brugge W. Accuracy of EUS in the evaluation of small gastric subepithelial lesions. Gastrointest Endosc. 2010;71:722–7.PubMedCrossRef

42.

Bushnell DL, Baum RP. Standard imaging techniques for neuroendocrine tumors. Endocrinol Metab Clin North Am. 2011;40:153–62.PubMedCrossRef

43.

Gibril F, Reynolds JC, Lubensky IA, et al. Ability of somatostatin receptor scintigraphy to identify patients with gastric carcinoids: a prospective study. J Nucl Med. 2000;41:1646–56.PubMed

44.

O’Toole D, Delle Fave G, Jensen RT. Gastric and duodenal neuroendocrine tumours. Best Pract Res Clin Gastroenterol. 2012;26:719–35.PubMedCrossRef

45.

La Rosa S, Inzani F, Vanoli A, et al. Histologic characterization and improved prognostic evaluation of 209 gastric neuroendocrine neoplasms. Hum Pathol. 2011;42:1373–84.PubMedCrossRef

46.

Saund MS, Al Natour RH, Sharma AM, et al. Tumor size and depth predict rate of lymph node metastasis and utilization of lymph node sampling in surgically managed gastric carcinoids. Ann Surg Oncol. 2011;18:2826–32.PubMedCrossRef

47.

Grozinsky-Glasberg S, Thomas D, Strosberg JR, et al. Metastatic type 1 gastric carcinoid: a real threat or just a myth? World J Gastroenterol. 2013;19:8687–95.PubMedCrossRefPubMedCentral

48.

Gilligan CJ, Lawton GP, Tang LH, et al. Gastric carcinoid tumors: the biology and therapy of an enigmatic and controversial lesion. Am J Gastroenterol. 1995;90:338–52.PubMed

49.

Hosokawa O, Kaizaki Y, Hattori M, et al. Long-term follow up of patients with multiple gastric carcinoids associated with type A gastritis. Gastric Cancer. 2005;8:42–6.PubMedCrossRef

50.

Kulke MH, Benson AB 3rd, Bergsland E, et al. National comprehensive cancer networks. neuroendocrine tumors. J Natl Compr Canc Netw. 2012;10:724–64.PubMed

51.

Sato Y, Takeuchi M, Hashimoto S, et al. Usefulness of endoscopic submucosal dissection for type I gastric carcinoid tumors compared with endoscopic mucosal resection. Hepatogastroenterology. 2013;60:1524–7.PubMed

52.

Kim HH, Kim GH, Kim JH, Choi MG, Song GA, Kim SE. The efficacy of endoscopic submucosal dissection of type I gastric carcinoid tumors compared with conventional endoscopic mucosal resection. Gastroenterol Res Pract. 2014; 253860. doi:10.1155/2014/253860. Epub 17 Feb 2014.

53.

Gladdy RA, Strong VE, Coit D, Allen PJ, et al. Defining surgical indications for type I gastric carcinoid tumor. Ann Surg Oncol. 2009;16:3154–60.PubMedCrossRef

54.

Thomas D, Tsolakis AV, Grozinsky-Glasberg S, et al. Long-term follow-up of a large series of patients with type 1 gastric carcinoid tumors: data from a multicenter study. Eur J Endocrinol. 2013;168:185–93.PubMedCrossRef

55.

Grozinsky-Glasberg S, Kaltsas G, Gur C, et al. Long-acting somatostatin analogues are an effective treatment for type 1 gastric carcinoid tumours. Eur J Endocrinol. 2008;159:475–82.PubMedCrossRef

56.

Campana D, Nori F, Pezzilli R, et al. Gastric endocrine tumors type I: treatment with long-acting somatostatin analogs. Endocr Relat Cancer. 2008;15:337–42.PubMedCrossRef

57.

Jianu CS, Fossmark R, Syversen U, et al. Five-year follow-up of patients treated for 1 year with octreotide long-acting release for enterochromaffin-like cell carcinoids. Scand J Gastroenterol. 2011;46:456–63.PubMedCrossRef

58.

Fossmark R, Sørdal Ø, Jianu CS, et al. Treatment of gastric carcinoids type 1 with the gastrin receptor antagonist netazepide (YF476) results in regression of tumours and normalisation of serum chromogranin A. Aliment Pharmacol Ther. 2012;36:1067–75.PubMedCrossRef

Title: Clinical features and management of type I gastric carcinoids
Author: Yuichi Sato
Publication date: 01-10-2014
Publisher: Springer Japan
Published in: Clinical Journal of Gastroenterology / Issue 5/2014
Print ISSN: 1865-7257
Electronic ISSN: 1865-7265
DOI: https://doi.org/10.1007/s12328-014-0528-9

ACC 2024 Congress Coverage

Heart Failure Video

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Clinical features and management of type I gastric carcinoids

Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 5/2014

Obscure gastrointestinal bleeding: resection of a pyogenic granuloma of the ileum via double-balloon enteroscopy

Severe liver injury associated with simeprevir plus pegylated interferon/ribavirin therapy in a patient with treatment-naïve genotype 1b hepatitis C virus: a case report

Spontaneous rupture of a hepatic angiomyolipoma: Report of a case

A case of anastrazole-related drug-induced autoimmune hepatitis

Collagenous gastroduodenitis coexisting repeated Dieulafoy ulcer: A case report and review of collagenous gastritis and gastroduodenitis without colonic involvement

A patient with esophageal cancer with bone metastasis who achieved pain relief with repetitive administration of strontium-89 chloride

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page