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Epidemiological study of gastroenteropancreatic neuroendocrine tumors in Japan |
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| Authors: | Tetsuhide Ito Hironobu Sasano Masao Tanaka R. Yoshiyuki Osamura Iwao Sasaki Wataru Kimura Koji Takano Takao Obara Miyuki Ishibashi Kazuwa Nakao Ryuichiro Doi Akira Shimatsu Toshirou Nishida Izumi Komoto Yukio Hirata Kazuhiko Nakamura Hisato Igarashi Robert T. Jensen Bertram Wiedenmann Masayuki Imamura |
| Affiliation: | 1. Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan 2. Department of Pathology, Tohoku University School of Medicine, Sendai, Japan 3. Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan 4. Department of Pathology, Tokai University School of Medicine, Kanagawa, Japan 5. Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan 6. Course of Organ Functions and Controls, Department of Gastroenterological and General Surgery, Yamagata University School of Medicine, Yamagata, Japan 7. Department of Nephrology and Endocrinology, University of Tokyo Faculty of Medicine, Tokyo, Japan 8. Department of Endocrine Surgery, Tokyo Women’s Medical University, Tokyo, Japan 9. Department of Medicine, Takatsu General Hospital, Kawasaki, Japan 10. Division of Endocrinology and Metabolism, Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, Kyoto, Japan 11. Department of Surgery, Kyoto University, Kyoto, Japan 12. Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan 13. Department of Surgery, Osaka University Graduate School of Medicine, Osaka, Japan 14. Department of Surgery, Osaka Saiseikai Noe Hospital, Osaka, Japan 15. Department of Clinical and Molecular Endocrinology, Tokyo Medical and Dental University Graduate School, Tokyo, Japan 16. Digestive Diseases Branch, National Institutes of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA 17. Department of Hepatology and Gastroenterology, University Medicine Berlin, Charité, Campus Virchow Klinikum, Berlin, Germany |
| Abstract: | BackgroundThere have been few epidemiological studies on gastroenteropancreatic neuroendocrine tumors (GEP-NETs) in Japan.MethodsWe examined the epidemiology of GEP-NETs [pancreatic endocrine tumors (PETs) and gastrointestinal neuroendocrine tumors (GI-NETs)] in Japan in 2005 using a nationwide stratified random sampling method.ResultsA total of 2,845 individuals received treatment for PETs. Prevalence was estimated as 2.23/100,000 with an annual onset incidence of 1.01/100,000. Non-functioning tumor (NF)-PET constituted 47.4%, followed by insulinoma (38.2%) and gastrinoma (7.9%). Distant metastases were reported in 21% patients with NF-PETs and occurred more frequently as tumor size increased (>2 cm). Multiple endocrine neoplasia type 1 (MEN-1) was detected in 10% of PETs but only in 6.1% of NF-PETs. NF-PETs were detected incidentally by physical examination in 24% patients. In 2005, an estimated 4,406 patients received treatment for GI-NETs. Prevalence was estimated as 3.45/100,000, with an annual onset incidence of 2.10/100,000. The locations of GI-NETs varied: foregut, 30.4%; midgut, 9.6%; and hindgut, 60.0%. Distant metastases were observed in 6%. Lymph node metastases occurred more frequently as tumor size increased (>1 cm). The frequency of MEN-1 complications was 1%. Physical examination revealed GI-NETs in 44% patients. The frequency of symptomatic GI-NETs was 3.4%. Interestingly, 77.1% of patients with foregut GI-NETs had type A gastritis.ConclusionOur results show there are large differences in GEP-NETs between Japan and Western nations, primarily due to differences in the presence of MEN-1 in NF-PETs and the location, symptomatic status, and prevalence of malignancy in GI-NETs. |
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