Investigation of clinical, laboratory and imaging findings and histopathological characteristics of cases with neuroendocrine cell hyperplasia

Objectives: This is the research of demographic, clinical, laboratory, imaging and histopathological factors that may play a role in the relationship between neuroendocrine cell hyperplasia (NECH) and neuroendocrine tumor (NET). It is aimed to raise awareness about NECH, which is considered a precancerous and reversible lesion, and to contribute to a limited number of studies in the literature. Material and Method: The study was followed up in the Department of Gastroenterology at Dokuz Eylul University Hospital, and upper GIS endoscopy was performed between October 2010 and October 2019, and a total of 196 patients, years of age 18 and over was included in the pathological examination of gastric biopsy materials (118 women, 78 men, mean age 61.2 ± 13.0). Patients were divided into two groups as those with and without NET during the follow-up period. Some demographic, clinical, laboratory, imaging, and histopathological parameters were investigated. In addition, patients with control endoscopy were divided into two subgroups as NECH decline and non-decline, and the same factors were evaluated between these two groups. Results: The most common NECH histological subtype is linear+micronodular (62.8%), while the most common subtype in patients with NET is the simple/diffuse type (41.6%) and is significant between the groups with and without NET (p<0.01). NET development rate on the NEHH ground is 5.6% (11/196) and the average time taken for NET development is 40 months (3 months-11 years). Demographic findings, cigarette-alcohol use, medication use, baseline symptom, laboratory findings (hemoglobin (HGB), hemotocrit (HCT), leukocyte (WBC), neutrophil (NEU), lymphocyte (LYM), platelet (PLT), lactate dehydrogenase (LDH), sedimentation, C reactive protein (CRP), carcinoembryonic antigen (CEA) and cancer antigen 19-9 (Ca19-9), neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR)], there was no difference between the groups in terms of imaging findings and histopathological features [presence of atrophy, intestinal metaplasia (IM), Helicobacter pylori (H. pylori)], while the presence of polyp in endoscopy and the presence of dysplasia in the histopathological examination showed a significant difference in favor of the group with NET (p=0.01 and p<0.01, respectively). Conclusion: Two factors that predict the move from NECH to NET; the presence of polyp in endoscopy and the presence of dysplasia in histopathological examination. Keywords: Chronic atrophic gastritis, Neuroendocrine cell hyperplasia, Neuroendocrine tumor