Endocrine cell tumor of the gastrointestinal tract : characteristics and racial differences

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1.Novel endocrine cells "ghrelin cells" and carcinoid tumor of the stomach(1)Ghrelin and ECL cells were distributed most densely in the gastric fundic mucosa without intestinal metaplasia of ordinary chronic gastritis, and were the major endocrine cell type there. Their increase and decrease were related to the mucosal condition and endocrinological factors such as gastrin.(2)Both ECL and ghrelin cells showed intra-and extra-glandular endocrine cell byperplasia and carcinoid tumor formation in the fimdic mucosa of auto-immune chronic gastritis. The main cell type forming carcinoid tumor was ECL cells.(3)Carcinoid tumors in the ordinary chronic gastritis and in autoimmune chronic gastritis were composed commonly of ECL cells and ghrelin cells. However, carcinoid tumors in the latter were formed with association of endocrine cell hyperplasia, and those in the former were formed without association of endocrine cell hyperplasia.2.Endocrine cell carcinoma of the stomach and large intestine(1)Endocrine cell carcinomas showed diversity in kinds of endocrine cell markers. They frequently showed co-expression of gastric and intestinal mucin phenotypes (67%), expression of musashi-1 protein (67%), over-expression of p53 protein (75%), and high incidence of Ki 67 positive cells (50-60%).(2)Endocrine cell carcinomas were characterized by multi-differentiation both to endocrine nature and mucin core protein expression, self-replication, and high proliferation.(3)The nature of "multi-differentiated, poorly differentiated carcinoma cells" was related to the high malignancy of the endocrine cell carcinomas of the gastrointestinal tract.3.Difference between Japanese and Western classification systems for endocrine cell tumors of the gastrointestinal tract(1)The detail differences of both classification systems and their problems for settling were first demonstrated in this study.