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Gastric carcinoids in patients with hypergastrinemia.
J Am Coll Surg 2004; 199(4):552-5JA

Abstract

BACKGROUND

Hypergastrinemia in patients with pernicious anemia is a major regulator contributing to enterochromaffin-cell hyperplasia and, ultimately, to gastric carcinoids.

STUDY DESIGN

Between 1990 and 2003, we studied 8 women and 10 men with pernicious anemia and gastric carcinoids; their mean age was 50 years. Serum gastrin levels ranged from 740 to 4,000 pg/mL (mean 1,000 pg/mL). Six patients underwent antrectomy, four total gastrectomy, and eight endoscopic resection or biopsy. During the same period, 22 patients with Zollinger-Ellison tumors and hypergastrinemia (20 men and 2 women, mean age 49 years) had no gastric carcinoids, but 1 of 7 patients with Zollinger-Ellison and multiple endocrine neoplasia (MEN1) tumors had hypergastrinemia and gastric carcinoids.

RESULTS

Mean followup for pernicious anemia patients was 6 years after antrectomy and 1 to 10 years after endoscopic resection or biopsy. Tumor regression was observed in one patient after antrectomy and one patient after biopsy. There were no deaths in this group in spite of lymph node metastasis in two patients. The patient with Zollinger-Ellison and MEN1 syndrome has been followed 3 years after diagnosis and 2 years after total gastrectomy.

CONCLUSIONS

Gastric carcinoids are indolent tumors occurring with increasing frequency in patients with pernicious anemia. Antrectomy or biopsy and observation are preferred methods of treatment. Total gastrectomy is reserved for patients with extensive tumor involvement of the gastric wall or for emergency bleeding.

Authors+Show Affiliations

Department of Surgery, Baylor College of Medicine, The Methodist Hospital, Houston, TX, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15454137

Citation

Jordan, Paul H., et al. "Gastric Carcinoids in Patients With Hypergastrinemia." Journal of the American College of Surgeons, vol. 199, no. 4, 2004, pp. 552-5.
Jordan PH, Barroso A, Sweeney J. Gastric carcinoids in patients with hypergastrinemia. J Am Coll Surg. 2004;199(4):552-5.
Jordan, P. H., Barroso, A., & Sweeney, J. (2004). Gastric carcinoids in patients with hypergastrinemia. Journal of the American College of Surgeons, 199(4), pp. 552-5.
Jordan PH, Barroso A, Sweeney J. Gastric Carcinoids in Patients With Hypergastrinemia. J Am Coll Surg. 2004;199(4):552-5. PubMed PMID: 15454137.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gastric carcinoids in patients with hypergastrinemia. AU - Jordan,Paul H,Jr AU - Barroso,Alberto, AU - Sweeney,John, PY - 2004/05/19/received PY - 2004/06/09/revised PY - 2004/06/10/accepted PY - 2004/9/30/pubmed PY - 2004/11/4/medline PY - 2004/9/30/entrez SP - 552 EP - 5 JF - Journal of the American College of Surgeons JO - J. Am. Coll. Surg. VL - 199 IS - 4 N2 - BACKGROUND: Hypergastrinemia in patients with pernicious anemia is a major regulator contributing to enterochromaffin-cell hyperplasia and, ultimately, to gastric carcinoids. STUDY DESIGN: Between 1990 and 2003, we studied 8 women and 10 men with pernicious anemia and gastric carcinoids; their mean age was 50 years. Serum gastrin levels ranged from 740 to 4,000 pg/mL (mean 1,000 pg/mL). Six patients underwent antrectomy, four total gastrectomy, and eight endoscopic resection or biopsy. During the same period, 22 patients with Zollinger-Ellison tumors and hypergastrinemia (20 men and 2 women, mean age 49 years) had no gastric carcinoids, but 1 of 7 patients with Zollinger-Ellison and multiple endocrine neoplasia (MEN1) tumors had hypergastrinemia and gastric carcinoids. RESULTS: Mean followup for pernicious anemia patients was 6 years after antrectomy and 1 to 10 years after endoscopic resection or biopsy. Tumor regression was observed in one patient after antrectomy and one patient after biopsy. There were no deaths in this group in spite of lymph node metastasis in two patients. The patient with Zollinger-Ellison and MEN1 syndrome has been followed 3 years after diagnosis and 2 years after total gastrectomy. CONCLUSIONS: Gastric carcinoids are indolent tumors occurring with increasing frequency in patients with pernicious anemia. Antrectomy or biopsy and observation are preferred methods of treatment. Total gastrectomy is reserved for patients with extensive tumor involvement of the gastric wall or for emergency bleeding. SN - 1072-7515 UR - https://www.unboundmedicine.com/medline/citation/15454137/Gastric_carcinoids_in_patients_with_hypergastrinemia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1072-7515(04)00932-9 DB - PRIME DP - Unbound Medicine ER -