Rapid regression of enterochromaffinlike cell gastric carcinoids in pernicious anemia after antrectomy
In rats, hypergastrinemia due to achlorhydria produced by antisecretory drugs or resection of the gastric fundus leads to enterochromaffinlike (ECL) cell hyperplasia and gastric carcinoids. In humans, achlorhydria due to pernicious anemia may also lead to ECL cell hyperplasia and multicentric gastri...
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| Veröffentlicht in: | Gastroenterology (New York, N.Y. 1943) N.Y. 1943), 1992-04, Vol.102 (4), p.1409-1418 |
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| container_title | Gastroenterology (New York, N.Y. 1943) |
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| creator | Hirschowitz, Basil I. Griffith, James Pellegrin, David Cummings, Oscar William |
| description | In rats, hypergastrinemia due to achlorhydria produced by antisecretory drugs or resection of the gastric fundus leads to enterochromaffinlike (ECL) cell hyperplasia and gastric carcinoids. In humans, achlorhydria due to pernicious anemia may also lead to ECL cell hyperplasia and multicentric gastric carcinoids in as many as 5% of cases. To examine the apparent gastrin dependence of gastric ECL carcinoids, three patients were studied (2 men aged 59 and 73 years; 1 woman aged 45 years) who had pernicious anemia, serum gastrin concentrations of >1000 ng/L (>1000 pg/mL), and multicentric gastric carcinoids. Antrectomy resulted in normalization of serum gastrin levels within 8 hours and disappearance of carcinoids in 6–16 weeks. In each of the three patients, a focus of microcarcinoid was found at 12–18 months. Further follow-up in each of the three patients 21–30 months after antrectomy again showed no carcinoids or ECL cell hyperplasia. It is concluded that multicentric ECL gastric carcinoids in patients with pernicious anemia and achlorhydria appear to be gastrin dependent and disappear after normalization of serum gastrin by antrectomy. Antrectomy rather than total gastrectomy may be the most appropriate treatment for this condition. |
| doi_str_mv | 10.1016/0016-5085(92)90787-Y |
| format | Article |
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In humans, achlorhydria due to pernicious anemia may also lead to ECL cell hyperplasia and multicentric gastric carcinoids in as many as 5% of cases. To examine the apparent gastrin dependence of gastric ECL carcinoids, three patients were studied (2 men aged 59 and 73 years; 1 woman aged 45 years) who had pernicious anemia, serum gastrin concentrations of >1000 ng/L (>1000 pg/mL), and multicentric gastric carcinoids. Antrectomy resulted in normalization of serum gastrin levels within 8 hours and disappearance of carcinoids in 6–16 weeks. In each of the three patients, a focus of microcarcinoid was found at 12–18 months. Further follow-up in each of the three patients 21–30 months after antrectomy again showed no carcinoids or ECL cell hyperplasia. It is concluded that multicentric ECL gastric carcinoids in patients with pernicious anemia and achlorhydria appear to be gastrin dependent and disappear after normalization of serum gastrin by antrectomy. Antrectomy rather than total gastrectomy may be the most appropriate treatment for this condition.</description><identifier>ISSN: 0016-5085</identifier><identifier>EISSN: 1528-0012</identifier><identifier>DOI: 10.1016/0016-5085(92)90787-Y</identifier><identifier>PMID: 1551550</identifier><identifier>CODEN: GASTAB</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Anemia, Pernicious - pathology ; Biological and medical sciences ; Carcinoid Tumor - pathology ; Carcinoid Tumor - surgery ; Enterochromaffin Cells - pathology ; Female ; Gastrins - blood ; Gastroscopy ; Hematologic and hematopoietic diseases ; Humans ; Hyperplasia ; Male ; Medical sciences ; Middle Aged ; Pyloric Antrum - surgery ; Stomach Neoplasms - pathology ; Stomach Neoplasms - surgery</subject><ispartof>Gastroenterology (New York, N.Y. 1943), 1992-04, Vol.102 (4), p.1409-1418</ispartof><rights>1992</rights><rights>1993 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c279y-c5d0a2fee051c3334be8c5aaa05a4bda0188e486481faeeec56acacfbbad25bb3</citedby><cites>FETCH-LOGICAL-c279y-c5d0a2fee051c3334be8c5aaa05a4bda0188e486481faeeec56acacfbbad25bb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/0016-5085(92)90787-Y$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=4355617$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1551550$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hirschowitz, Basil I.</creatorcontrib><creatorcontrib>Griffith, James</creatorcontrib><creatorcontrib>Pellegrin, David</creatorcontrib><creatorcontrib>Cummings, Oscar William</creatorcontrib><title>Rapid regression of enterochromaffinlike cell gastric carcinoids in pernicious anemia after antrectomy</title><title>Gastroenterology (New York, N.Y. 1943)</title><addtitle>Gastroenterology</addtitle><description>In rats, hypergastrinemia due to achlorhydria produced by antisecretory drugs or resection of the gastric fundus leads to enterochromaffinlike (ECL) cell hyperplasia and gastric carcinoids. In humans, achlorhydria due to pernicious anemia may also lead to ECL cell hyperplasia and multicentric gastric carcinoids in as many as 5% of cases. To examine the apparent gastrin dependence of gastric ECL carcinoids, three patients were studied (2 men aged 59 and 73 years; 1 woman aged 45 years) who had pernicious anemia, serum gastrin concentrations of >1000 ng/L (>1000 pg/mL), and multicentric gastric carcinoids. Antrectomy resulted in normalization of serum gastrin levels within 8 hours and disappearance of carcinoids in 6–16 weeks. In each of the three patients, a focus of microcarcinoid was found at 12–18 months. Further follow-up in each of the three patients 21–30 months after antrectomy again showed no carcinoids or ECL cell hyperplasia. It is concluded that multicentric ECL gastric carcinoids in patients with pernicious anemia and achlorhydria appear to be gastrin dependent and disappear after normalization of serum gastrin by antrectomy. Antrectomy rather than total gastrectomy may be the most appropriate treatment for this condition.</description><subject>Aged</subject><subject>Anemia, Pernicious - pathology</subject><subject>Biological and medical sciences</subject><subject>Carcinoid Tumor - pathology</subject><subject>Carcinoid Tumor - surgery</subject><subject>Enterochromaffin Cells - pathology</subject><subject>Female</subject><subject>Gastrins - blood</subject><subject>Gastroscopy</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Humans</subject><subject>Hyperplasia</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pyloric Antrum - surgery</subject><subject>Stomach Neoplasms - pathology</subject><subject>Stomach Neoplasms - surgery</subject><issn>0016-5085</issn><issn>1528-0012</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1992</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1rFTEUhoMo9bb6DxSyEKmLqUlmMpPZFKT4USgIRRddhTNnTmp0Jrkmc4X77814L3VXCAnhPOfl5WHslRQXUsj2vShXpYXR571614vOdNXdE7aRWpmqzNRTtnlAnrPTnH8KIfrayBN2IrUuR2yYu4WtH3mi-0Q5-xh4dJzCQinijxRncM6Hyf8ijjRN_B7ykjxyhIQ-RD9m7gPfUgoefdxlDoFmDxxcSSifJREucd6_YM8cTJleHt8z9v3Tx29XX6qbr5-vrz7cVKi6fl-hHgUoRyS0xLqum4EMagAQGpphBCGNoca0jZEOiAh1CwjohgFGpYehPmNvD7nbFH_vKC929nltXnqVerZTRtdtqwrYHEBMMedEzm6TnyHtrRR21WtXd3Z1Z3tl_-m1d2Xt9TF_N8w0_l86-CzzN8c5ZITJJQjo8wPW1Fq3sivY5QGj4uKPp2QzegpIo1-F2TH6x3v8BeJDmkE</recordid><startdate>199204</startdate><enddate>199204</enddate><creator>Hirschowitz, Basil I.</creator><creator>Griffith, James</creator><creator>Pellegrin, David</creator><creator>Cummings, Oscar William</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199204</creationdate><title>Rapid regression of enterochromaffinlike cell gastric carcinoids in pernicious anemia after antrectomy</title><author>Hirschowitz, Basil I. ; Griffith, James ; Pellegrin, David ; Cummings, Oscar William</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c279y-c5d0a2fee051c3334be8c5aaa05a4bda0188e486481faeeec56acacfbbad25bb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1992</creationdate><topic>Aged</topic><topic>Anemia, Pernicious - pathology</topic><topic>Biological and medical sciences</topic><topic>Carcinoid Tumor - pathology</topic><topic>Carcinoid Tumor - surgery</topic><topic>Enterochromaffin Cells - pathology</topic><topic>Female</topic><topic>Gastrins - blood</topic><topic>Gastroscopy</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Humans</topic><topic>Hyperplasia</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pyloric Antrum - surgery</topic><topic>Stomach Neoplasms - pathology</topic><topic>Stomach Neoplasms - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hirschowitz, Basil I.</creatorcontrib><creatorcontrib>Griffith, James</creatorcontrib><creatorcontrib>Pellegrin, David</creatorcontrib><creatorcontrib>Cummings, Oscar William</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gastroenterology (New York, N.Y. 1943)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hirschowitz, Basil I.</au><au>Griffith, James</au><au>Pellegrin, David</au><au>Cummings, Oscar William</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Rapid regression of enterochromaffinlike cell gastric carcinoids in pernicious anemia after antrectomy</atitle><jtitle>Gastroenterology (New York, N.Y. 1943)</jtitle><addtitle>Gastroenterology</addtitle><date>1992-04</date><risdate>1992</risdate><volume>102</volume><issue>4</issue><spage>1409</spage><epage>1418</epage><pages>1409-1418</pages><issn>0016-5085</issn><eissn>1528-0012</eissn><coden>GASTAB</coden><abstract>In rats, hypergastrinemia due to achlorhydria produced by antisecretory drugs or resection of the gastric fundus leads to enterochromaffinlike (ECL) cell hyperplasia and gastric carcinoids. In humans, achlorhydria due to pernicious anemia may also lead to ECL cell hyperplasia and multicentric gastric carcinoids in as many as 5% of cases. To examine the apparent gastrin dependence of gastric ECL carcinoids, three patients were studied (2 men aged 59 and 73 years; 1 woman aged 45 years) who had pernicious anemia, serum gastrin concentrations of >1000 ng/L (>1000 pg/mL), and multicentric gastric carcinoids. Antrectomy resulted in normalization of serum gastrin levels within 8 hours and disappearance of carcinoids in 6–16 weeks. In each of the three patients, a focus of microcarcinoid was found at 12–18 months. Further follow-up in each of the three patients 21–30 months after antrectomy again showed no carcinoids or ECL cell hyperplasia. It is concluded that multicentric ECL gastric carcinoids in patients with pernicious anemia and achlorhydria appear to be gastrin dependent and disappear after normalization of serum gastrin by antrectomy. 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| subjects | Aged Anemia, Pernicious - pathology Biological and medical sciences Carcinoid Tumor - pathology Carcinoid Tumor - surgery Enterochromaffin Cells - pathology Female Gastrins - blood Gastroscopy Hematologic and hematopoietic diseases Humans Hyperplasia Male Medical sciences Middle Aged Pyloric Antrum - surgery Stomach Neoplasms - pathology Stomach Neoplasms - surgery |
| title | Rapid regression of enterochromaffinlike cell gastric carcinoids in pernicious anemia after antrectomy |
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