PMID- 18270260
OWN - NLM
STAT- MEDLINE
DCOM- 20080617
LR  - 20211020
IS  - 0021-972X (Print)
IS  - 1945-7197 (Electronic)
IS  - 0021-972X (Linking)
VI  - 93
IP  - 5
DP  - 2008 May
TI  - A prospective study of gastric carcinoids and enterochromaffin-like cell changes 
      in multiple endocrine neoplasia type 1 and Zollinger-Ellison syndrome: 
      identification of risk factors.
PG  - 1582-91
LID - 10.1210/jc.2007-2279 [doi]
AB  - CONTEXT: Multiple endocrine neoplasia type 1 (MEN1) patients frequently develop 
      Zollinger-Ellison syndrome (ZES). These patients can develop proliferative 
      changes of gastric enterochromaffin-like (ECL) cells and gastric carcinoids 
      (ECL-cell tumors). ECL-cell changes have been extensively studied in sporadic ZES 
      patients and can be precursor lesions of gastric carcinoids, but little is known 
      about factors influencing their severity or development of carcinoids in MEN1/ZES 
      patients. OBJECTIVES: Our objective was to prospectively analyze ECL-cell changes 
      and gastric carcinoids (ECL-cell tumors) in a large series of MEN1/ZES patients 
      to detect risk factors and deduct clinical guidelines. SETTING AND PATIENTS: 
      Fifty-seven consecutive MEN1/ZES patients participated in this prospective study 
      at two tertiary-care research centers. INTERVENTIONS AND OUTCOME MEASURES: 
      Assessment of MEN1, gastric hypersecretion, and gastroscopy with multiple 
      biopsies was done according to a fixed protocol and tumor status. ECL-cell 
      changes and alpha-human chorionic gonadotropin staining were assessed in each 
      biopsy and correlated with clinical, laboratory, and MEN1 features. RESULTS: 
      ECL-cell proliferative changes were universally present, advanced changes in 53% 
      and carcinoids in 23%. Gastric nodules are common and are frequently associated 
      with carcinoids. Patients with high fasting serum gastrin levels, long disease 
      duration, or a strong alpha-human chorionic gonadotropin staining in a biopsy are 
      at higher risk for an advanced ECL-cell lesion and/or gastric carcinoid. 
      CONCLUSIONS: Gastric carcinoids and/or advanced ECL-cell changes are frequent in 
      MEN1/ZES patients, and therefore, regular surveillance gastroscopy with multiple 
      routine biopsies and biopsies of all mucosal lesions are essential. 
      Clinical/laboratory data and biopsy results can be used to identify a subgroup of 
      MEN1/ZES patients with a significantly increased risk for developing gastric 
      carcinoids, allowing development of better surveillance strategies.
FAU - Berna, Marc J
AU  - Berna MJ
AD  - Digestive Diseases Branch, National Institute of Diabetes and Digestive and 
      Kidney Diseases, National Institutes of Health, 10 Center Drive, Bethesda, MD 
      20892-1804, USA.
FAU - Annibale, Bruno
AU  - Annibale B
FAU - Marignani, Massimo
AU  - Marignani M
FAU - Luong, Tu Vinh
AU  - Luong TV
FAU - Corleto, Vito
AU  - Corleto V
FAU - Pace, Andrea
AU  - Pace A
FAU - Ito, Tetsuhide
AU  - Ito T
FAU - Liewehr, David
AU  - Liewehr D
FAU - Venzon, David J
AU  - Venzon DJ
FAU - Delle Fave, Gianfranco
AU  - Delle Fave G
FAU - Bordi, Cesare
AU  - Bordi C
FAU - Jensen, Robert T
AU  - Jensen RT
LA  - eng
GR  - Intramural NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Intramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20080212
PL  - United States
TA  - J Clin Endocrinol Metab
JT  - The Journal of clinical endocrinology and metabolism
JID - 0375362
RN  - 0 (Gastrins)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Carcinoid Tumor/blood/*etiology/pathology
MH  - Enterochromaffin-like Cells/*pathology
MH  - Female
MH  - Gastrins/blood
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multiple Endocrine Neoplasia Type 1/*pathology
MH  - Prospective Studies
MH  - Risk Factors
MH  - Stomach Neoplasms/blood/*etiology/pathology
MH  - Zollinger-Ellison Syndrome/*pathology
PMC - PMC2386679
EDAT- 2008/02/14 09:00
MHDA- 2008/06/18 09:00
PMCR- 2009/05/01
CRDT- 2008/02/14 09:00
PHST- 2008/02/14 09:00 [pubmed]
PHST- 2008/06/18 09:00 [medline]
PHST- 2008/02/14 09:00 [entrez]
PHST- 2009/05/01 00:00 [pmc-release]
AID - jc.2007-2279 [pii]
AID - 5736 [pii]
AID - 10.1210/jc.2007-2279 [doi]
PST - ppublish
SO  - J Clin Endocrinol Metab. 2008 May;93(5):1582-91. doi: 10.1210/jc.2007-2279. Epub 
      2008 Feb 12.