Distinct patterns of chronic gastritis associated with carcinoid and cancer and their role in tumorigenesis

Yale J Biol Med. 1992 Nov-Dec;65(6):793-804; discussion 827-9.

Abstract

A series of 60 gastric endocrine tumors comprised 44 body-fundus argyrophil carcinoids, of which 23 arose in a background of hypergastrinemia and type A chronic atrophic gastritis (A-CAG), mainly with histologic patterns suggestive of an autoimmune process. Only 22 percent (compared with 19 percent of 58 tumor-free A-CAG cases) of 36 carcinoids and 21 percent of 19 A-CAG carcinoids investigated had Helicobacter pylori (HP) colonization, against 50 percent of 14 CAG-associated neuroendocrine carcinomas or mixed endocrine-exocrine tumors, 84 percent of 150 cases with early gastric cancer (p < 0.001 versus carcinoids), mostly with B- or AB-type CAG, 76 percent of 97 tumor-free AB-CAG, and 95 percent of 151 tumor-free B-CAG cases. Secondary hypergastrinemia and local mechanisms activated by chronic autoimmune gastritis are among factors involved in the pathogenesis of relatively indolent CAG-associated carcinoids, whereas active HP gastritis in cooperation with environmental carcinogens may likely cause more severe epithelial transformation, leading to ordinary cancer and, possibly, to neuroendocrine carcinomas or mixed endocrine-exocrine tumors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autoimmune Diseases / complications
  • Autoimmune Diseases / epidemiology
  • Autoimmune Diseases / pathology
  • Carcinoid Tumor / epidemiology
  • Carcinoid Tumor / etiology*
  • Carcinoid Tumor / pathology
  • Carcinoma, Neuroendocrine / epidemiology
  • Carcinoma, Neuroendocrine / etiology*
  • Carcinoma, Neuroendocrine / pathology
  • Cell Transformation, Neoplastic / pathology
  • Chronic Disease
  • Endocrine Gland Neoplasms / epidemiology
  • Endocrine Gland Neoplasms / etiology*
  • Endocrine Gland Neoplasms / pathology
  • Female
  • Gastrins / blood
  • Gastritis / complications*
  • Gastritis / epidemiology
  • Gastritis / pathology
  • Helicobacter Infections / complications
  • Helicobacter Infections / epidemiology
  • Helicobacter Infections / pathology
  • Helicobacter pylori / isolation & purification
  • Helicobacter pylori / physiology
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Stomach / microbiology
  • Stomach / pathology
  • Stomach Neoplasms / epidemiology
  • Stomach Neoplasms / etiology*
  • Stomach Neoplasms / pathology

Substances

  • Gastrins