Tsolakis Apostolos V, Stridsberg Mats, Grimelius Lars, Portela-Gomes Guida M, Falkmer Sture E, Waldum Helge L, Janson Eva T
Department of Medical Sciences, Section of Endocrine Oncology, Uppsala University Hospital, Uppsala, Sweden.
J Clin Gastroenterol. 2008 Apr;42(4):381-8. doi: 10.1097/MCG.0b013e318032338c.
Our aim was to elucidate the incidence and distribution pattern of ghrelin-immunoreactive (IR) cells in various types of human gastric endocrine tumors, and their surrounding mucosa, and relate the findings to total ghrelin concentrations in plasma.
It has been demonstrated previously, that ghrelin-IR cells are present not only in normal human gastric oxyntic mucosa, but also in all types of enterochromaffinlike (ECL) cell carcinoids (ECL-CCs), and in mucosal regions affected by ECL cell hyperplasia.
Forty-eight gastric endocrine tumors were included in the study: 32 type I ECL-CCs, 3 type II, 9 type III, 1 non-ECL-CC, and 3 poorly differentiated endocrine carcinomas. The tumors were analyzed immunohistochemically with antibodies raised versus chromogranin A, synaptophysin, serotonin, somatostatin, vesicular monoamine transporter 2 and ghrelin. Total ghrelin in plasma was measured in 20 patients, using a commercial radioimmunoassay kit.
Ghrelin-IR cells were found in all types I and II ECL-CCs but in only a few cases of the other tumors. Ghrelin-IR cells were also found among the hyperplastic endocrine cells in the mucosa surrounding types I and II, where they showed diffuse, linear, nodular and adenomatoid hyperplasia patterns. In type III ECL-CCs and poorly differentiated endocrine carcinomas, only diffuse and linear ghrelin-IR cell hyperplasia was present in the oxyntic mucosa in about half of the cases, whereas the mucosa of the non-ECL-CC did not show this feature.
Despite the frequent occurrence of ghrelin-IR cells in both the neoplastic parenchyma and the oxyntic mucosa, plasma total ghrelin concentrations remained within the reference range and can therefore not be used as a clinical marker to identify ghrelin expressing ECL-CCs or ghrelin cell hyperplasia.
我们的目的是阐明生长激素释放肽免疫反应性（IR）细胞在各种类型人类胃内分泌肿瘤及其周围黏膜中的发生率和分布模式，并将这些发现与血浆中生长激素释放肽的总浓度相关联。
先前已证明，生长激素释放肽-IR细胞不仅存在于正常人类胃泌酸黏膜中，还存在于所有类型的肠嗜铬样（ECL）细胞类癌（ECL-CCs）以及受ECL细胞增生影响的黏膜区域中。
本研究纳入了48例胃内分泌肿瘤：32例I型ECL-CCs、3例II型、9例III型、1例非ECL-CC和3例低分化内分泌癌。使用针对嗜铬粒蛋白A、突触素、5-羟色胺、生长抑素、囊泡单胺转运体2和生长激素释放肽的抗体对肿瘤进行免疫组织化学分析。使用商用放射免疫分析试剂盒对20例患者的血浆总生长激素释放肽进行了测量。
在所有I型和II型ECL-CCs中均发现了生长激素释放肽-IR细胞，但在其他肿瘤中仅在少数病例中发现。在I型和II型周围黏膜的增生内分泌细胞中也发现了生长激素释放肽-IR细胞，它们呈现弥漫性、线性、结节状和腺瘤样增生模式。在III型ECL-CCs和低分化内分泌癌中，约一半病例的泌酸黏膜中仅存在弥漫性和线性生长激素释放肽-IR细胞增生，而非ECL-CC的黏膜未显示此特征。
尽管在肿瘤实质和泌酸黏膜中生长激素释放肽-IR细胞频繁出现，但血浆总生长激素释放肽浓度仍在参考范围内，因此不能用作识别表达生长激素释放肽的ECL-CCs或生长激素释放肽细胞增生的临床标志物。
