Article: article from journal or magazin.
Natural history, clinicopathologic classification and prognosis of gastric ECL cell tumors.
Yale Journal of Biology and Medicine
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
A series of 50 gastric endocrine tumors classified according to Rindi et al.  comprised 12 small cell neuroendocrine carcinomas (NEC) and 38 ECL cell carcinoids, of which 22 associated with type A chronic atrophic gastritis (A-CAG), eight with hypertrophic gastropathy due to combined Multiple Endocrine Neoplasia and Zollinger/Ellison syndrome (MEN/ZES), and eight sporadic. Variables found to predict tumor malignancy were: size > 2 cm, > 2 mitoses and > 130 Ki67 positive cells/10 high power fields (HPF), grade 2 or 3 histology, angioinvasion, p53 protein nuclear accumulation, and the presence of a single tumor. None of these factors increased significantly the predicting ability of tumor classification itself, although grade 2 + 3 shows 100 percent negative predictive value and Ki67 and angioinvasion 100 percent positive predictive value. When the mostly non-malignant A-CAG and MEN-ZES tumors were analysed against the mostly malignant sporadic and NEC tumors, a positive predictive value of 90 percent and a negative predictive value of 93 percent was obtained. Investigation of a larger tumor series is under way with the aim to develop an optimal model for prognostic evaluation of gastric endocrine tumors.
Adult, Aged, Carcinoma/pathology, Cell Differentiation, Cell Division, Enterochromaffin-like Cells/metabolism, Enterochromaffin-like Cells/pathology, Female, Gastrins/metabolism, Gastritis, Atrophic/pathology, Humans, Male, Middle Aged, Mitosis, Neuroendocrine Tumors/classification, Neuroendocrine Tumors/pathology, Predictive Value of Tests, Regression Analysis, Serotonin/metabolism, Somatostatin/metabolism, Stomach Neoplasms/classification, Stomach Neoplasms/pathology
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