Development of type I gastric carcinoid in patients with chronic atrophic gastritis

Authors


Dr B. Annibale, Dipartimento Medico-Chirurgico di Scienze Cliniche, Tecnobiomediche e Medicina Traslazionale, Sant’Andrea Hospital, School of Medicine, University Sapienza, Via di Grottarossa 1035, Rome 00189, Italy.
E-mail: bruno.annibale@uniroma1.it

Summary

Background  Long-term observational studies assessing the incidence of type I gastric carcinoid (typeIGC) in patients with chronic atrophic gastritis are few.

Aim  To evaluate the occurrence of typeIGC at diagnosis and during follow-up and to identify patient features associated with the presence of typeIGC in a cohort of chronic atrophic gastritis patients.

Methods  Three hundred and sixty-seven chronic atrophic gastritis patients [245 women, age 54 (18–79) years] underwent regular follow-up by gastroscopy. The incidence of typeIGC was determined in chronic atrophic gastritis patients with at least 2 years of follow-up (= 214). Baseline clinical and histological features were analysed as factors associated with the presence of typeIGC by univariate analysis.

Results  Type I gastric carcinoid was diagnosed in nine (2.4%) patients at the moment when chronic atrophic gastritis was diagnosed. After 1463 person-years, six patients developed typeIGC with an annual incidence rate (person-year) of 0.4%. Patients with typeIGC had significantly higher levels of gastrin, chromogranin A and more frequently the presence of body polyps and ECL-dysplasia compared with chronic atrophic gastritis patients without typeIGC.

Conclusions  This cohort study shows that typeIGC is a rare complication in patients with chronic atrophic gastritis, and the presence of body polyps and ECL-dysplasia at gastroscopic/histologic evaluation is strongly associated with the presence of typeIGC.

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