Sjöblom S M, Sipponen P, Miettinen M, Karonen S L, Jrvinen H J
Second Department of Surgery, University Central Hospital, Helsinki, Finland.
Endoscopy. 1988 Mar;20(2):52-6. doi: 10.1055/s-2007-1018130.
Among 196 patients examined in 1972-1985 because of pernicious anemia (PA), 105 patients under the age of 76 years were invited for gastroscopic screening, and 71 patients (68%) participated. Gastroscopy revealed carcinoid tumor(s) in 5 patients (7%) but no case of carcinoma. In addition, one patient with gastric carcinoid, 5 patients with adenocarcinomas and one with a concomitant carcinoid and carcinoma had already been diagnosed earlier in the overall PA group on the basis of clinical symptoms. Thus, within a follow-up of 0-20 years (mean 7 years) the total frequency of gastric carcinoid tumors was 4% and that of carcinoma 3%. Patients with carcinoid tumors had a long duration of PA and young age of onset; these cases were not necessarily those with the highest serum gastrin levels. Even though most gastric carcinoids are small subclinical tumors of uncertain clinical significance, their unexpectedly high frequency, combined within the risk of carcinoma in PA, might indicate the need for gastroscopic follow-up, at least in cases of juvenile onset PA.
在1972年至1985年期间因恶性贫血（PA）接受检查的196例患者中，邀请了105例76岁以下的患者进行胃镜筛查，71例患者（68%）参与了筛查。胃镜检查发现5例患者（7%）患有类癌肿瘤，但未发现癌症病例。此外，在整个PA组中，已有1例胃类癌患者、5例腺癌患者和1例同时患有类癌和癌的患者根据临床症状在早期被诊断出来。因此，在0至20年（平均7年）的随访中，胃类癌肿瘤的总发生率为4%，癌症的总发生率为3%。类癌肿瘤患者的PA病程长且发病年龄小；这些病例不一定是血清胃泌素水平最高的病例。尽管大多数胃类癌是临床意义不确定的小亚临床肿瘤，但其意外的高发生率，加上PA患者患癌的风险，可能表明至少在青少年期发病的PA病例中需要进行胃镜随访。
