Incidence and prevalence of gastric neuroendocrine tumors in patients with chronic atrophic autoimmune gastritis

Aims The incidence of type I gastric neuroendocrine neoplasms (gNEN) has increased substantially over the past 50 years, although studies evaluating the association with chronic autoimmune atrophic gastritis (CAAG) in the long term have been inconsistent. The main aim was to evaluate the incidence of type I gNENs in a cohort of CAAG patients with a long follow-up.

Methods From October 2020 to May 2022, patients with a histologic diagnosis of CAAG were enrolled; circulating levels of chromogranin A (CgA) and gastrin were assessed at enrollment. Included patients underwent regular endoscopic follow-up, to assess for gastric neoplastic lesions, enterochromaffin-like (ECL) cell hyperplasia, and the development of gNEN.

Results We included 176 patients [142 women, median age 64 years (51-41)], diagnosed with CAAG from January 1990 to June 2022. At enrollment, 116 patients (65.9%) had ECL hyperplasia, of which 29.5% had simple/linear, 30.7% had micronodular, and 5.7% had macronodular. The median follow-up was 5 years (3-7.5). After 1032 person-years, 33 patients developed a total of 33 gNEN type I, with an incidence rate of 0.032 person-years, corresponding to an annual cumulative incidence of 3.2%. Circulating gastrin levels ​​were significantly higher in CAAG patients who developed gNENs [median 992 pg/mL IQR=449-1500 vs 688 pg/mL IQR =423-1200, p=0.03]; similarly, circulating CgA levels were significantly higher in patients with gNENs [median 227 ng/mL IQR=124-421 vs 174 ng/mL IQR= 77-265, p=0.01].

Conclusions Type I gNENs represent a non-negligible complication in patients with CAAG, due to hypergastrinemia. Circulating CgA levels are associated with the presence of gNENs.

 

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Conflicts of interest

Authors do not have any conflict of interest to disclose.

Publication History

Article published online:
14 April 2023