Gastric neuroendocrine tumors: Biology and management
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Christopoulos, E. Papavassiliou2, C.
Neoplasms may originate from any of the endocrine cells
of the gastric wall, most commonly the enterochromaffinlike
(ECL) cells of the oxyntic mucosa. In recent years, the
increasing number of screening gastroscopies and biopsies,
and the widespread application of sophisticated immunohistochemical
stains for neuroendocrine markers, have resulted
in the frequent detection of ECL tumors. The latter
are regarded as a separate clinicopathological entity seen
in the setting of hypergastrinemic states, and their pathogenesis
follows the sequence hyperplasia dysplasia
neoplasia. According to the most recent WHO classification,
gastric neuroendocrine tumors (NETs) are generally
divided into well-differentiated NETs (class 1a), welldifferentiated
neuroendocrine carcinomas (NECs) (class
1b) and poorly differentiated NECs (class 2). Well-differentiated
tumors (NETs and NECs), for which the historic
term carcinoid is still in use, include three subgroups:
Type I (70-80%), associated with chronic atrophic
gastritis, which are benign (class 1a) ECL cell tumors in
the vast majority of cases; Type II (
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