Gastric carcinoids(GCs) are classified as: type Ⅰ,related to hypergastrinemia due to chronic atrophic gastritis(CAG), type Ⅱ, associated with Zollinger-Ellison syndrome in multiple endocrine neoplasia type 1, and ty...Gastric carcinoids(GCs) are classified as: type Ⅰ,related to hypergastrinemia due to chronic atrophic gastritis(CAG), type Ⅱ, associated with Zollinger-Ellison syndrome in multiple endocrine neoplasia type 1, and type Ⅲ, which is normogastrinemic. The management of type-Ⅰ gastric carcinoids(GC1s) is still debated,because of their relatively benign course. According to the European Neuroendocrine Tumor Society guidelines endoscopic resection is indicated whenever possible;however, it is not often feasible because of the presence of a multifocal disease, large lesions, submucosal invasion or, rarely, lymph node involvement. Therefore,somatostatin analogs(SSAs) have been proposed as treatment for GC1 s in view of their antisecretive,antiproliferative and antiangiogenic effects. However,in view of the high cost of this therapy, its possible side effects and the relatively benign course of the disease,SSAs should be reserved to specific subsets of "high risk patients", i.e., those patients with multifocal or recurrent GCs. Indeed, it is reasonable that, after the development of a gastric neuroendocrine neoplasm in patients with a chronic predisposing condition(such as CAG), other enterochromaffin-like cells can undergo neoplastic proliferation, being chronically stimulated by hypergastrinemia. Therefore, definite indications to SSAs treatment should be established in order to avoid the undertreatment or overtreatment of GCs.展开更多
Gastric neuroendocrine tumors (gNETs) are a rare entity that is increasing in incidence.Different pathophysiological processes can lead to the development of these tumors,appropriate histological analysis is necessary...Gastric neuroendocrine tumors (gNETs) are a rare entity that is increasing in incidence.Different pathophysiological processes can lead to the development of these tumors,appropriate histological analysis is necessary to differentiate between grade 1 (G1) and grade 2 (G2) tumors as this will impact the management of these patients based on their increased risk of lymph node and distant metastases.To provide a comprehensive clinicopathologic review of multifocal gastric neuroendocrine tumors,with particular emphasis on G1 and G2 tumors and differentiating between types I,II and II and risk stratification based upon immunohistochemical profile.This review is based on peer-reviewed literature and the authors’ experience.gNETs are a heterogenous group of tumors that is rising in incidence.These lesions while arise from the same cell type,they have different etiologies.Identifying the type of gNETs is a collective effort of clinical and pathologic correlation.The correct grading and staging of these lesions are of paramount significance,due its impact on patient management and prognosis.展开更多
文摘Gastric carcinoids(GCs) are classified as: type Ⅰ,related to hypergastrinemia due to chronic atrophic gastritis(CAG), type Ⅱ, associated with Zollinger-Ellison syndrome in multiple endocrine neoplasia type 1, and type Ⅲ, which is normogastrinemic. The management of type-Ⅰ gastric carcinoids(GC1s) is still debated,because of their relatively benign course. According to the European Neuroendocrine Tumor Society guidelines endoscopic resection is indicated whenever possible;however, it is not often feasible because of the presence of a multifocal disease, large lesions, submucosal invasion or, rarely, lymph node involvement. Therefore,somatostatin analogs(SSAs) have been proposed as treatment for GC1 s in view of their antisecretive,antiproliferative and antiangiogenic effects. However,in view of the high cost of this therapy, its possible side effects and the relatively benign course of the disease,SSAs should be reserved to specific subsets of "high risk patients", i.e., those patients with multifocal or recurrent GCs. Indeed, it is reasonable that, after the development of a gastric neuroendocrine neoplasm in patients with a chronic predisposing condition(such as CAG), other enterochromaffin-like cells can undergo neoplastic proliferation, being chronically stimulated by hypergastrinemia. Therefore, definite indications to SSAs treatment should be established in order to avoid the undertreatment or overtreatment of GCs.
文摘Gastric neuroendocrine tumors (gNETs) are a rare entity that is increasing in incidence.Different pathophysiological processes can lead to the development of these tumors,appropriate histological analysis is necessary to differentiate between grade 1 (G1) and grade 2 (G2) tumors as this will impact the management of these patients based on their increased risk of lymph node and distant metastases.To provide a comprehensive clinicopathologic review of multifocal gastric neuroendocrine tumors,with particular emphasis on G1 and G2 tumors and differentiating between types I,II and II and risk stratification based upon immunohistochemical profile.This review is based on peer-reviewed literature and the authors’ experience.gNETs are a heterogenous group of tumors that is rising in incidence.These lesions while arise from the same cell type,they have different etiologies.Identifying the type of gNETs is a collective effort of clinical and pathologic correlation.The correct grading and staging of these lesions are of paramount significance,due its impact on patient management and prognosis.
