[Gastric neuroendocrine tumors]

Autoimmune gastritis and stomach cancer: assessing the risks

The purpose of this publication is to systematize available data on the risks of developing stomach cancer in patients with a chronic autoimmune gastritis with a demonstration of the clinical case of a patient with a chronic autoimmune gastritis and a neuroendocrine gastric tumor of the type 1. Discussion: the article discusses the risks of stomach cancer in patients with chronic autoimmune gastritis. A mechanism for the formation of a neuroendocrine gastric tumor of the type 1, associated with autoimmune gastritis, is given. A clinical example of a patient with a long history of dyspepsia, the presence of concomitant changes in the results of laboratory tests, describes an algorithm for diagnosis of autoimmune gastritis and associated neuroendocrine tumors. The risks of the development in patients with autoimmune gastritis of formidable complications as an adenocarcinoma of the stomach are considered. Conclusion: Chronic autoimmune gastritis is a precancerous diseases of the stomach, with the progressive atrophy of the gastric body mucosa, and associated with an increased risk of developing neuroendocrine gastric tumor of the type 1 and adenocarcinoma of the stomach. Patients with autoimmune gastritis need dynamic outpatient observation, with endoscopic control and assessment of the degree and stage of gastritis in OLGA system, with immunogistochemistry to evaluate the risks of stomach cancer and timely implementation of the necessary measures of carcinoprection.

Hyperplasia of enterochromaffin-like (ECL) cells as a precursor of neuroendocrine gastric tumors in autoimmune gastritis

The purpose of this publication is to update knowledge about chronic autoimmune gastritis and about cases of hyperplasia of enterochromaffin-like (ECL) cells as precursors of the development of neuroendocrine gastric tumor type 1 due to clinical example’s demonstration. Discussion: the types and main characteristics of neuroendocrine tumors of the stomach were discussed, in particular tumors type 1 associated with autoimmune gastritis. The mechanisms of formation of neuroendocrine tumors in the stomach against the background of an autoimmune process were presented, two clinical examples presenting the algorithm of diagnosis of autoimmune gastritis and associated neuroendocrine tumors were presented. Both clinical examples demonstrated the presence of subepithelial formations of the stomach body according to FGDS, which have not been morphologically identified. Timely repeated FGDS with sampling of biopsies according to the OLGA standard made it possible to verify the formations, and the serological markers helped in clarifying the diagnosis and morphological nature of tumors. Conclusion: analysis of clinical data, anamnesis and esophagoduodenoscopy with morphological evaluation of the gastric mucosa biopsy may help to find out the cause and nature of chronic inflammation in the gastric mucosa. Atrophy of the glands in the stomach body, pseudopiloric metaplasia, hyperplasia of enterochromaffin (ECL) cells are sufficient morphological criteria for autoimmune gastritis. The study of the level of chromogranin A in blood serum can be considered as a marker of the development of type 1 neuroendocrine gastric tumor in patients with autoimmune gastritis and the presence of polyps in the stomach body.