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Comparison study of gastrinomas between gastric and non-gastric origins.

Huang SF, Kuo IM, Lee CW, Pan KT, Chen TC, Lin CJ, Hwang TL, Yu MC - World J Surg Oncol (2015)

Bottom Line: In our study, 21 tumors of the 20 cases were identified by pathologic proof, 11 (55 %) had resection or endoscopic mucosa resection, 9 of gastric origins, 9 of duodenal origins, 2 of pancreatic origins, and 1 of hepatic origins.One case had multiple lesions.The long-term outcome was probably better than non-gastric origin because of lower grading and less lymph node and liver involvement.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Chang Gung Memorial Hospital, 5, Fu-Shin Street, Kweishan, Taoyuan, 333, Taiwan. b9102059@cgmh.org.tw.

ABSTRACT

Background: Gastrinomas are one of the neuroendocrine tumors with potential distant metastasis. Most gastrinomas are originated from pancreas and duodenum, but those of gastric origin have been much less reported. The aim of the study is to compare gastrinomas of gastric and non-gastric origins.

Methods: Four hundred twenty-four patients with neuroendocrine tumor by histological proof in Chang Gung Memorial Hospital, Linkou branch in the past 10 years were included. A total of 109 (25.7 %) cases were identified of upper gastrointestinal origins, of which 20 (18.3 %) were proven gastrinomas. The clinical characteristics were collected and analyzed retrospectively.

Results: In our study, 21 tumors of the 20 cases were identified by pathologic proof, 11 (55 %) had resection or endoscopic mucosa resection, 9 of gastric origins, 9 of duodenal origins, 2 of pancreatic origins, and 1 of hepatic origins. One case had multiple lesions. Patients with gastric gastrinomas had older age, higher levels of gastrin, seemingly smaller tumor size (p = 0.024, 0.030, and 0.065, respectively), and usually lower grade in differentiation (p = 0.035). Though gastric gastrinomas had a high recurrent rate (80 %), the lymph node and liver involvement was less common. Gastrinomas with liver involvement/metastasis had a high mortality rate where 80 % died of liver dysfunction.

Conclusions: Gastrinomas originating from stomach had higher gastrin level and lower tumor grading and presented at older age. The long-term outcome was probably better than non-gastric origin because of lower grading and less lymph node and liver involvement.

No MeSH data available.


Related in: MedlinePlus

Histology and immunohistochemistry staining of gastrinomas. Upper panel represents high-grade non-gastric and lower panel is low-grade gastric gastrinoma. The image shows histology, Ki-67 staining, and chromogranin staining from left to right, (100× magnification)
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Fig2: Histology and immunohistochemistry staining of gastrinomas. Upper panel represents high-grade non-gastric and lower panel is low-grade gastric gastrinoma. The image shows histology, Ki-67 staining, and chromogranin staining from left to right, (100× magnification)

Mentions: The CT imaging was shown in Fig. 1, with an emphasis on the presentation of lymph node metastasis. Compared with those of non-gastric origin, patients with gastric gastrinomas had significantly elder age (56.3 ± 11.2 vs. 39.7 ± 17.4, p = 0.024) and higher gastrin level (512.3 ± 323.3 vs. 207.7 ± 234.7 mg/ml, p = 0.030), however, smaller tumor size (7.3 mm vs. 5.1 mm, P = 0.065). Four gastrinomas of high or moderate tumor-grade (G2, 3) all had non-gastric origins (p = 0.035). The histology, Ki-67 staining, and chromogranin A staining are shown in Fig. 2. Overall survival rate was showed in Fig. 3. Patients with low grade gastrinoma and with resection treatment had better survival outcome. Besides, of those patients with tumor of gastric origin, although most received local treatment, seems to have less distant metastasis and better long-term survival; no statistically significant difference was found due to small case numbers.Fig. 1


Comparison study of gastrinomas between gastric and non-gastric origins.

Huang SF, Kuo IM, Lee CW, Pan KT, Chen TC, Lin CJ, Hwang TL, Yu MC - World J Surg Oncol (2015)

Histology and immunohistochemistry staining of gastrinomas. Upper panel represents high-grade non-gastric and lower panel is low-grade gastric gastrinoma. The image shows histology, Ki-67 staining, and chromogranin staining from left to right, (100× magnification)
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4478711&req=5

Fig2: Histology and immunohistochemistry staining of gastrinomas. Upper panel represents high-grade non-gastric and lower panel is low-grade gastric gastrinoma. The image shows histology, Ki-67 staining, and chromogranin staining from left to right, (100× magnification)
Mentions: The CT imaging was shown in Fig. 1, with an emphasis on the presentation of lymph node metastasis. Compared with those of non-gastric origin, patients with gastric gastrinomas had significantly elder age (56.3 ± 11.2 vs. 39.7 ± 17.4, p = 0.024) and higher gastrin level (512.3 ± 323.3 vs. 207.7 ± 234.7 mg/ml, p = 0.030), however, smaller tumor size (7.3 mm vs. 5.1 mm, P = 0.065). Four gastrinomas of high or moderate tumor-grade (G2, 3) all had non-gastric origins (p = 0.035). The histology, Ki-67 staining, and chromogranin A staining are shown in Fig. 2. Overall survival rate was showed in Fig. 3. Patients with low grade gastrinoma and with resection treatment had better survival outcome. Besides, of those patients with tumor of gastric origin, although most received local treatment, seems to have less distant metastasis and better long-term survival; no statistically significant difference was found due to small case numbers.Fig. 1

Bottom Line: In our study, 21 tumors of the 20 cases were identified by pathologic proof, 11 (55 %) had resection or endoscopic mucosa resection, 9 of gastric origins, 9 of duodenal origins, 2 of pancreatic origins, and 1 of hepatic origins.One case had multiple lesions.The long-term outcome was probably better than non-gastric origin because of lower grading and less lymph node and liver involvement.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Chang Gung Memorial Hospital, 5, Fu-Shin Street, Kweishan, Taoyuan, 333, Taiwan. b9102059@cgmh.org.tw.

ABSTRACT

Background: Gastrinomas are one of the neuroendocrine tumors with potential distant metastasis. Most gastrinomas are originated from pancreas and duodenum, but those of gastric origin have been much less reported. The aim of the study is to compare gastrinomas of gastric and non-gastric origins.

Methods: Four hundred twenty-four patients with neuroendocrine tumor by histological proof in Chang Gung Memorial Hospital, Linkou branch in the past 10 years were included. A total of 109 (25.7 %) cases were identified of upper gastrointestinal origins, of which 20 (18.3 %) were proven gastrinomas. The clinical characteristics were collected and analyzed retrospectively.

Results: In our study, 21 tumors of the 20 cases were identified by pathologic proof, 11 (55 %) had resection or endoscopic mucosa resection, 9 of gastric origins, 9 of duodenal origins, 2 of pancreatic origins, and 1 of hepatic origins. One case had multiple lesions. Patients with gastric gastrinomas had older age, higher levels of gastrin, seemingly smaller tumor size (p = 0.024, 0.030, and 0.065, respectively), and usually lower grade in differentiation (p = 0.035). Though gastric gastrinomas had a high recurrent rate (80 %), the lymph node and liver involvement was less common. Gastrinomas with liver involvement/metastasis had a high mortality rate where 80 % died of liver dysfunction.

Conclusions: Gastrinomas originating from stomach had higher gastrin level and lower tumor grading and presented at older age. The long-term outcome was probably better than non-gastric origin because of lower grading and less lymph node and liver involvement.

No MeSH data available.


Related in: MedlinePlus