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Clinical Trial
. 2015 Jun 16:13:202.
doi: 10.1186/s12957-015-0614-6.

Comparison study of gastrinomas between gastric and non-gastric origins

Song-Fong Huang  1 , I-Ming Kuo  2 , Chao-Wei Lee  3 , Kuang-Tse Pan  4 , Tse-Ching Chen  5 , Chun-Jung Lin  6 , Tsann-Long Hwang  7 , Ming-Chin Yu  8
Affiliations
Clinical Trial

Comparison study of gastrinomas between gastric and non-gastric origins

Song-Fong Huang et al. World J Surg Oncol. .

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.

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Figures

Fig. 1
Fig. 1
Axial contrast enhanced CT scan of upper abdomen (arterial phase) shows a two enhanced polypoid mass (black arrow) at high gastric body along lesser curvature side. b Coronal multiplanar reformation image. (1) Axial dynamic fat-saturated T1-weighted image with gadolinium enhancement shows enlarged lymph node (*) at peripancreatic area (c). (2) Ga-68 DOTATOC-scan shows strong uptake at medial aspect of uncinate process of pancreas (d). (3) Infiltrative tumor at pancreatic head with diffuse liver metastases (white arrow) e Axial dynamic fat-saturated T2-weighted image with gadolinium enhancement. f Axial contrast CT scan in arterial phase
Fig. 2
Fig. 2
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)
Fig. 3
Fig. 3
The Kaplan-Meier overall survival rate between a gastric origin (solid line) and non-gastric origin (dotted line), b low and high grading gastrinoma (G1 vs. G2, G3 solid line vs. dotted line), and c with/without resection (solid line/dotted line). P = 0.063, 0.001, and 0.041, respectively. WHO grading was most important for prognosis, but gastric gastrinomas got better survival rate
See this image and copyright information in PMC

References

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