Gastric carcinoids:Between underestimation and overtreatment  

作　　者：Sara Massironi Valentina Sciola Matilde Pia Spampatti Maddalena Peracchi Dario Conte 

机构地区：[1]Gastroenterology UnitⅡ,Fondazione IRCCS Ospedale Maggiore Policlinico,Mangiagalli e Regina Elena,and Postgraduate School of Gastroenterology,University of Milan,20122 Milan,Italy

出　　处：《World Journal of Gastroenterology》2009年第18期2177-2183,共7页世界胃肠病学杂志（英文版）

摘　　要：Gastric carcinoids(GCs),which originate from gastric enterochromaffin-like(ECL) mucosal cells and account for 2.4% of all carcinoids,are found increasingly in the course of upper gastrointestinal tract endoscopy.Current nosography includes those occurring in chronic conditions with hypergastrinemia,as the type 1 associated with chronic atrophic gastritis,and the type 2 associated with Zollinger-Ellison syndrome in multiple endocrine neoplasia type 1,and type 3,which is unrelated to hypergastrinemia and is frequently malignant,with distant metastases.The optimal clinical approach to GCs remains to be elucidated,depending upon type,size and number of carcinoids.While there is agreement concerning the treatment of type 3 carcinoids,for types 1 and 2,current possibilities include simple surveillance,endoscopic polypectomy,surgical excision,associated or not with surgical antrectomy,or total gastrectomy.Moreover,the recent introduction of somatostatin analogues represents a therapeutic option of possibly outstanding relevance.Gastric carcinoids （GCs）, which originate from gastric enterochromaffin-like （ECL） mucosal cells and account for 2.4% of all carcinoids, are found increasingly in the course of upper gastrointestinal tract endoscopy. Current nosography includes those occurring in chronic conditions with hypergastrinemia, as the type 1 associated with chronic atrophic gastritis, and the type 2 associated with Zollinger-Ellison syndrome in multiple endocrine neoplasia type 1, and type 3, which is unrelated to hypergastrinemia and is frequently malignant, with distant metastases. The optimal clinical approach to GCs remains to be elucidated, depending upon type, size and number of carcinoids. While there is agreement concerning the treatment of type 3 carcinoids, for types 1 and 2, current possibilities include simple surveillance, endoscopic polypectomy, surgical excision, associated or not with surgical antrectomy, or total gastrectomy. Moreover, the recent introduction of somatostatin analogues represents a therapeutic option of possibly outstanding relevance.

关 键 词：Gastric carcinoids Endocrine tumors Well-differentiated tumors HYPERGASTRINEMIA Chronicatrophic gastritis Zollinger-Ellison syndrome Multipleendocrine neoplasia tupe 1 Enterochromaffin-like cells 

分 类 号：R735.2[医药卫生—肿瘤] R736[医药卫生—临床医学]