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Abstract
Background: Patients with chronic atrophic gastritis (CAG) and hypergastrinaemia are at risk of developing hyperplasia of the enterochromaffin‐like (ECL) cells and ECL‐cell‐derived tumours. The effect of the somatostatin analogue octreotide on ECL cell carcinoids is examined. Methods: Five patients with hypergastrinaemia and ECL cell carcinoids were enrolled in a 1‐year study of octreotide LAR (long‐acting release) 20 mg given at monthly intervals. Biopsies from tumours and from flat oxyntic mucosa were done at the start and 3, 6 and 12 months thereafter. Sections were stained with haematoxylin‐erythrosin, immunostained with chromogranin A (CgA) and doublestained with CgA and Ki‐67. Serum gastrin and CgA were measured. Results: The number of visible tumours was reduced by more than 50 %. Sections from both tumours and flat mucosa showed a reduced number of CgA immunoreactive cells. Mean serum gastrin decreased from 421 to 186 pM (normal <40 pM); P > 0.05, and serum CgA from 73 to 25 ng/ml (normal <30 ng/ml); P < 0.001. Conclusions: During treatment the patients were still markedly hypergastrinaemic, whereas the serum CgA showed normalization. A diminished tumour load and reduced ECL cell density were found, indicating an antiproliferative effect of octreotide directly on the ECL cells.