Rappel S, Altendorf-Hofmann A, Stolte M
Institute of Pathology Bayreuth, University of Erlangen-Nürnberg, Deutschland.
Digestion. 1995;56(6):455-62. doi: 10.1159/000201276.
With the aim of evaluating the prognosis of carcinoid tumours of the stomach, the tumours were classified into subtypes on the basis of the type of gastritis, and a comparison made of the type of treatment, metastasizing rate, and the survival rates of the various groups of patients involved. Of the patients with atrophic autoimmune gastritis (type A gastritis) (n = 88) who had multiple carcinoid tumours in the corpus or fundus, usually not more than 1 cm in diameter, 98% were followed up clinically or by endoscopy and biopsy. In these patients, the metastasizing rate was 0%, and the age-corrected Kaplan-Meier survival rate revealed normal life expectancy. 25% of the patients with sporadic carcinoid tumours (n = 12)--most of whom had a Helicobacter pylori-related gastritis and usually solitary tumours located within the corpus of fundus, 25% of which exceeding 1 cm in diameter--underwent surgical treatment. In these patients the metastasizing rate was 16.7% and the age-corrected survival rate 79%. On the basis of our results, we conclude that, depending upon the subtype involved, the prognosis of gastric carcinoid tumours varies, such that regular endoscopy/biopsy follow-up suffices for patients with type A gastritis, while for patients with sporadic carcinoid tumours, surgical treatment is indicated.
为了评估胃类癌肿瘤的预后,根据胃炎类型将肿瘤分为不同亚型,并对不同组患者的治疗类型、转移率和生存率进行了比较。在患有萎缩性自身免疫性胃炎(A型胃炎)(n = 88)且胃体或胃底有多个类癌肿瘤(通常直径不超过1 cm)的患者中,98%通过临床随访或内镜检查及活检进行跟踪。在这些患者中,转移率为0%,年龄校正后的Kaplan-Meier生存率显示预期寿命正常。25%的散发性类癌肿瘤患者(n = 12)——其中大多数患有幽门螺杆菌相关性胃炎,且通常为位于胃体的孤立性肿瘤,25%的肿瘤直径超过1 cm——接受了手术治疗。在这些患者中,转移率为16.7%,年龄校正后的生存率为79%。根据我们的结果,我们得出结论,根据所涉及的亚型不同,胃类癌肿瘤的预后有所不同,对于A型胃炎患者,定期内镜检查/活检随访就足够了,而对于散发性类癌肿瘤患者,则建议进行手术治疗。