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M Renga
a Istituto di Ematologia e Oncologia Medica "L. e A. Serágnoli", Policlinico S. Orsola, University of Bologna, via
Massarenti 9, I-40138 Bologna, Italy, b Istituto di Radiologia III, c Istituto di Dermatologia, d Dipartimento di Medicina Interna e
Gastroenterologia
Correspondence to: Dr G
Biasco. Accepted for publication 25 March 1997 Background Keywords:
gastrin;
cell kinetics;
colon cancer;
chronic
autoimmune gastritis;
Zollinger-Ellison syndrome
The influence of gastrin on the colonic
mucosa is still uncertain. Some authors have suggested a stimulating
effect on the growth of normal and malignant colonic epithelium, while others have shown no association between gastrin and neoplastic development.
AimsTo evaluate the effect of gastrin on
colorectal cell proliferation, patients with chronic endogenous
hypergastrinaemia underwent proctoscopy. Biopsy specimens were taken in
order to study rectal cell kinetics.
Patients and controlsTen patients with chronic
autoimmune gastritis (CAG), six patients with Zollinger-Ellison
syndrome (ZES), and 16 hospital controls took part in this study.
Patients with CAG and ZES had basal serum gastrin concentrations
significantly higher than controls (p<0.001).
MethodsImmunohistochemistry was performed on 3 µm sections of rectal biopsy specimens incubated with
5'-bromodeoxyuridine.
ResultsThe percentage of proliferating cells in
the entire crypts (overall labelling index) was similar in all the
groups. However, the labelling frequency in the upper two fifths of the glands (
h value) was significantly higher in patients with CAG or
ZES compared with controls (p<0.01 in both patient groups versus controls).
ConclusionsEndogenous hypergastrinaemia is
associated with rectal cell proliferation defects, similar to those
observed in conditions at high risk for colon cancer. The effect of the
increased serum concentrations of gastrin on the colorectal mucosa
after treatment with drugs inhibiting gastric acid secretion should be investigated.
(GUT 1997;41:330-332)
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