Alimentary TractECL cell tumor and poorly differentiated endocrine carcinoma of the stomach: Prognostic evaluation by pathological analysis☆,☆☆
Section snippets
Materials and methods
In the last three decades, 258 cases of gastric endocrine tumors were identified in the Departments of Pathology of Bayreuth, Parma, Pavia, and Varese. Of the 258 cases, 217 (84.1%) had been diagnosed as ECL cell tumors, 3 as pyloric gastrin cell tumors, 1 as a pyloric somatostatin cell tumor, 1 as a corpus serotonin cell microtumor, 20 (7.8%) as PDEC, 13 (5.0%) as associations of gastric endocrine tumor and nonendocrine carcinoma in a background of chronic atrophic gastritis (10 ECL cell
Overall description
The 102 patients selected for study had approximately equal sex distribution (55 female, 47 male), with a mean age of 59 years (SD, 13.7); 52% of patients (n = 53) were older than 58 years. However, 13 of 16 PDECs and 11 of 17 type III ECL cell tumors were in men, and 32 of 58 type I and 7 of 11 type II ECL cell tumors were in women.
Tumor features
The main pathological findings of the 102 tumors are outlined in Table 1 and Figures 1 and 2.
Discussion
Extensive investigation of 102 gastric endocrine tumors allowed identification of 11 variables (tumor size, site, number, histological grade, mitotic index, Ki67 or P53 protein expression, angioinvasion, lymphoinvasion, clinicopathologic type, and patient's sex) that, upon univariate analysis, proved to be significant predictors of malignancy as defined by metastases and/or deep gastric wall invasion. Mitotic index, Ki67 index, histological grade, size, and clinicopathologic type were found to
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Address requests for reprints to: Enrico Solcia, M.D., Department of Human Pathology, via Forlanini 16, 27100 Pavia, Italy. Fax: (39) 382-525866; e-mail: [email protected].
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Supported by grants from the Italian Ministry of Health (to IRCCS Policlinico San Matteo), from Ministero dell'Universita e Ricerca Scientifica e Tecnologica (MURST) and University of Pavia (to G.R. and E.S.), and from MURST, University of Parma, and Associazione Italiana per la Ricerca sul Cancro (to C.B.). S.L.R. is supported by an Anna Villa Rusconi Foundation Fellowship.