Endocrine Abstracts

Introduction: Type 1 gastric endocrine tumors (T1-GET) incidence is increasing world while mainly due to widespread use of upper endoscopy. Autoimmune disease (AID) is the hallmark of T1-GET, pernicious anemia is often found at presentation. Association with lymphocytic thyroiditis (LT) has been described.

Aims: Retrospective evaluation of GET data from patients (pts) followed at IPO-Porto, including the presence of other AID with emphasis to LT.

Patients and methods: Retrospective data from 48 GET patients files followed at Endocrine Tumors Clinic of IPO-Porto was reviewed, 20 pts were excluded because of insufficient data or diagnosis before 2006, because at that time classification was not performed. Age, gender, normal gastric mucosa (NGM), classification, stage, treatment, presence of pernicious anemia (PA), LT and other AI diseases; parietal (p-ab), intrinsic factor (IF-ab) and thyroid antibodies (TPO-ab, TG-ab), thyroid function (TF) and survival were evaluated.

Results: Age 58.7±10.2 years; F/M: 3/1; T1=85.7%, T2=0%, T3=14.3%. Median gastrin=1107.6±842.7 pg/ml. Two of four T3 were metastatic. T1-NGM showed atrophic gastritis (85.7%), intestinal metaplasia (61.5%) and HP positivity (15.8%). 85.7% (100% T1-GET) were submitted to endoscopic treatment. AID was identified in 71.4%: PA 93.4%, vitiligo 1 pt, another has lupus erythematosus (LE) and Crohn’s disease(CD). Positive PC-ab 63.2% and FI-ab 5.6%. LT was identified in 33.3%. TPO and Tg-ab were positive 22.4 and 11.1% respectively. Insufficient data concerning other DAI was found in 28.6–31.4%. 21.1% pts had either clinical or subclinical hypothyroidism. Thyroid nodules (TN) were diagnosed in 50% of pts who were submitted to US neck (n=6). Three of four of T3 pts have died, 100% of T1 were alive.

Conclusion: As in other series, most of our GET pts are type1. In this group there was a high proportion of AID, including PA, vitiligo, LE and CD. One third of T1-GET had LT. Among these, one fifth had abnormal function tests and half of pts who were submitted to neck US had TN. All T1-GET must be evaluated in order to exclude association with other AIDs, especially LT. Prospective studies should be performed in other to increase our knowledge about this entity.