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Neuroendokrine Neoplasien des Magens

Was ist neu?

Neuroendocrine neoplasia of the stomach

What is new?

  • Schwerpunkt: Tumoren und Tumorvorstufen des Magens
  • Published:
Der Pathologe Aims and scope Submit manuscript

Zusammenfassung

Einleitung

Neuroendokrine Neoplasien (NEN) werden in 3 Subgruppen unterteilt, die mit unterschiedlichem biologischem Verhalten assoziiert sind: 1. Gut differenzierte neuroendokrine Tumoren G1 (NET G1, Ki67 ≤2 oder Mitosen <2), 2. Gut differenzierte neuroendokrine Tumoren G2 (NET G2, Ki67 3–20 oder Mitosen 2–20) sowie 3. Schlecht differenzierte neuroendokrine Karzinome G3 (NEC G3, Ki67 >20 oder Mitosen >20).

Material und Methoden

In dieser Arbeit sind 310 gastroenteropankreatische(GEP)-NEN der Ludwig-Maximilians-Universität nach der neuen WHO-Klassifikation reklassifiziert worden.

Ergebnisse

Sieben Prozent zeigten sich als NEN des Magens. Dabei sind 3 unterschiedliche Typen erkannt worden: Typ 1, assoziiert mit einer autoimmunen chronisch atrophen Korpusgastritis (A-CAG), Typ 2, assoziiert mit einer multiplen endokrinen Neoplasie Typ 1 (MEN1) und Zollinger-Ellison-Syndrom (ZES) und Typ 3, sporadische Tumoren (nicht assoziiert mit den oben beschriebenen Veränderungen A‑CAG oder MEN/ZES).

Diskussion

Als Vorläuferläsionen liegen bei NET Typ 1 und 2 des Magens Hyperplasien der enterochromaffinähnlichen(ECL)-Zellen vor. Kausal zugrunde liegend ist hier die Hypergastrinämie. Dieser Artikel soll zur standardisierten Diagnosestellung der NEN im Magen beitragen und auch auf aktuelle neue Gesichtspunkte eingehen.

Abstract

Introduction

Neuroendocrine Neoplasms are classified according to the new WHO classification in (1.) well differentiated neuroendocrine tumors G1 (NET G1, Ki67 ≤ 2 or mitosis count <2) and (2.) well differentiated neuroendocrine tumors G2 (NET G2, Ki67 3–20 or mitosis count 2–20) and (3.) poorly differentiated neuroendocrine carcinomas G3 (NEC G3, Ki67 > 20 or mitosis count >20).

Material and Methods

In this study 310 NENs of the Ludwig-Maximilians-University in Munich were reevaluated according to the new WHO classification.

Results

7% of the analyzed NENs were presented as neoplasias of the stomach. In NENs of the stomach three distinct subtypes are recognized: (1) type 1 associated with autoimmune chronic atrophic gastritis (2) type 2, associated with multiple endocrine neoplasia (MEN1) and Zollinger-Ellison Syndrom; and (3) type 3, sporadic tumors.

Discussion

Precursor lesions (i. e. hyperplasia of the ECL cells) are found in patients with hypergastrinaemia (type 1 and 2). This article should provide insights into the diagnosis of NENs of the stomach with emphasis on the new international standard.

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Authors and Affiliations

  1. Pathologisches Institut, Ludwig-Maximilians-Universität (LMU), Thalkirchnerstr. 36, 80337, München, Deutschland

    T. Knösel, C. Reiter & T. Kirchner

  2. Abteilung für Allgemein-, Viszeral- und Gefäßchirurgie, Friedrich-Schiller-Universität, Jena, Deutschland

    A. Altendorf-Hofmann

  3. Tumorregister München (TRM) des Tumorzentrums München (TZM), Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität (LMU), München, Deutschland

    G. Schubert-Fritschle

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  1. T. Knösel
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  4. A. Altendorf-Hofmann
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  5. T. Kirchner
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Correspondence to T. Knösel.

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Interessenkonflikt

T. Knösel, C. Reiter, G. Schubert-Fritschle, A. Altendorf-Hofmann und T. Kirchner geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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G. Baretton, Dresden

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Knösel, T., Reiter, C., Schubert-Fritschle, G. et al. Neuroendokrine Neoplasien des Magens. Pathologe 38, 98–104 (2017). https://doi.org/10.1007/s00292-017-0269-x

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