Correlation of metastasis characteristics with prognosis in gastric mixed adenoneuroendocrine carcinoma

Tang, Qiang; Zhou, Zili; Chen, Jinhuang; Di, Maojun; Ji, Jintong; Yuan, Wenzheng; Liu, Zhengyi; Wu, Liang; Zhang, Xudan; Li, Kang; Shu, Xuefeng

doi:10.1097/md.0000000000009189

Cited by 8 publications

(7 citation statements)

References 25 publications

(34 reference statements)

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“…The quantitative composition of the primary tumour was described in 36 studies (n = 294) [12,15,17,19,21,[23][24][25]27,29,30,34,36,[39][40][41]45,46,[48][49][50][52][53][54]56,57,59,65,73,74,80,82,[84][85][86]92]; the two components were present in equal proportion in 27.9% (n = 82) of cases, whereas in the remaining 72.1% one of the two histologies was predominant; the neuroendocrine component in 42.2% (n = 124), the non-neuroendocrine component in 29.9% (n = 88).…”

Section: Clinical-pathological Characteristics Treatment Modalitiesmentioning

confidence: 99%

“…Among 69 studies (n = 667) reporting the grade of differentiation of the neuroendocrine component [11][12][13][14][15][16][17][18][19][21][22][23][24][25][26][27][28][29][54][55][56][57][58][59][60][61][62]68,71,[73][74][75]79,80,82,[84][85][86][87]89,[91][92][93]96,97,100,101], a large proportion of MiNENs (92.5%; n = 617) had a grade 3 neuroendocrine component, whereas 4.3% (n = 29) and 3.1% (n = 21) had a grade 1 and a grade 2 neuroendocrine component, respectively. Among MiNENs with a grade 3 neuroendocrine component, the morphological subtype (large cell or small cell) was reported in 25 studies (n = 241) [11,…”

Section: Clinical-pathological Characteristics Treatment Modalitiesmentioning

confidence: 99%

“…Interestingly, in 43 studies (n = 61) where more than one diagnostic sample was available [11,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]30,[32][33][34][36][37][38][39][41][42][43][44][45][46][47]49,50,53,55,[59][60][61][62]64,65,96], the initial diagnosis from the first sample collected (either cytological or histological) was in keeping with MiNEN or suspicion of MiNEN in 36.1% (n = 22) of cases, adenocarcinoma in 36.1% (n = 22), poorly differentiated neuroendocrine carcinoma in 21.3% (n = 13), and well differentiated neuroendocrine tumour in 6.6% (n = 4).…”

Section: Clinical-pathological Characteristics Treatment Modalitiesmentioning

confidence: 99%

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Mixed Neuroendocrine Non-Neuroendocrine Neoplasms: A Systematic Review of a Controversial and Underestimated Diagnosis

Frizziero

Chakrabarty

Nagy

et al. 2020

JCM

122

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Mixed neuroendocrine non-neuroendocrine neoplasms (MiNENs) represent a rare diagnosis of the gastro-entero-pancreatic tract. Evidence from the current literature regarding their epidemiology, biology, and management is of variable quality and conflicting. Based on available data, the MiNEN has an aggressive biological behaviour, mostly driven by its (often high-grade) neuroendocrine component, and a dismal prognosis. In most cases, the non-neuroendocrine component is of adenocarcinoma histology. Due to limitations in diagnostic methods and poor awareness within the scientific community, the incidence of MiNENs may be underestimated. In the absence of data from clinical trials, MiNENs are commonly treated according to the standard of care for pure neuroendocrine carcinomas or adenocarcinomas from the same sites of origin, based on the assumption of a biological similarity to their pure counterparts. However, little is known about the molecular aberrations of MiNENs, and their pathogenesis remains controversial; molecular/genetic studies conducted so far point towards a common monoclonal origin of the two components. In addition, mutations in tumour-associated genes, including TP53, BRAF, and KRAS, and microsatellite instability have emerged as potential drivers of MiNENs. This systematic review (91 full manuscripts or abstracts in English language) summarises the current reported literature on clinical, pathological, survival, and molecular/genetic data on MiNENs.

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Section: Clinical-pathological Characteristics Treatment Modalitiesmentioning

confidence: 99%

Section: Clinical-pathological Characteristics Treatment Modalitiesmentioning

confidence: 99%

Section: Clinical-pathological Characteristics Treatment Modalitiesmentioning

confidence: 99%

See 1 more Smart Citation

Mixed Neuroendocrine Non-Neuroendocrine Neoplasms: A Systematic Review of a Controversial and Underestimated Diagnosis

Frizziero

Chakrabarty

Nagy

et al. 2020

JCM

122

View full text Add to dashboard Cite

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“…On morphology, it has both adenocarcinoma and neuroendocrine carcinoma, and each component accounts for at least 30%. [ 3 , 18 ] MANEC gastric cancer is extremely rare and the histological origin is still unclear. [ 16 ] MANEC that is different from NED has definite diagnostic criteria.…”

Section: Discussionmentioning

confidence: 99%

Α-fetoprotein producing hepatoid gastric adenocarcinoma with neuroendocrine differentiation

Liu²,

Wang³

et al. 2018

Medicine

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Rationale:Hepatoid gastric adenocarcinoma is a rare type of gastric cancer. The phenomenon of neuroendocrine differentiation (NED) in gastrointestinal tumor needs further research. Both hepatoid adenocarcinoma and neuroendocrine differentiation are the factors leading to a poor prognosis of gastric cancer. However, there is still no specific treatment.Patient Concerns:A 60-year-old man who had a pain and distention in his upper abdomen presented melena. Gastroscopy and pathology revealed a gastric cancer.Diagnoses:Postoperative pathology revealed a hepatoid gastric adenocarcinoma. Immunohistochemical analysis showed a-fetoprotein (AFP), hepatocyte, synaptophysin (Syn), and chromogranin A (CgA) positive, and Ki67 60% positive. A-fetoprotein producing hepatoid gastric adenocarcinoma with NED is diagnosed.Interventions:The patient was treated with an R2 radical gastrectomy, but refused chemotherapy.Outcomes:The AFP level was >2000 ng/mL (0–8.78) half a year after the surgery. There was no obvious abnormality from computed tomography (CT). The patient refused positron emission tomography computed tomography (PET-CT) and left the hospital.Lessons:Hepatoid adenocarcinoma and neuroendocrine differentiation are the factors leading to a poor prognosis of gastric cancer. It relapses easily. Long-term follow-up and regular examinations are necessary to detect relapses.

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“…[ 3 ] The epidemiology of gastric MANEC (gMANEC) has not yet been described due to its rarity, while gMANECs account for about 20% of all digestive MANECs. [ 3 ] Based on a small series of patients and case reports, most gMANECs are diagnosed at an advanced stage [ 1 , 4 ] and have a worse prognosis than gastric adenocarcinoma, with survival time usually measured in months. [ 2 – 4 ] In order to improve the prognosis, the diagnosis of gMANEC at an early stage is needed; however, early-stage gMANECs in which invasion is limited to the submucosa are less frequently identified because of the low diagnostic ability of endoscopic biopsy.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic findings of gastric mixed adenoneuroendocrine carcinoma

et al. 2020

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Rationale: Gastric mixed adenoneuroendocrine carcinoma (gMANEC) is a rare malignant tumor. Most gMANECs are diagnosed at an advanced stage and have a worse prognosis than gastric adenocarcinoma. In order to improve the prognosis, it is necessary to diagnose gMANEC at an early stage. However, the endoscopic features of early gMANECs are unclear. We, herein, report a case of early gMANEC that showed characteristic magnifying endoscopic findings. Patient concerns: A 78-year-old man was referred to our institution for endoscopic resection of a gastric lesion. He had a medical history of distal gastrectomy due to early gastric cancer with negative surgical margins 9 years previously. Diagnosis: Esophagogastroduodenoscopy showed a reddish depressed lesion on the suture line of the gastric remnant, which was classified as type 0-IIc according to the Paris classification. ME-NBI at the oral side of the lesion revealed the absence of the microsurface pattern (MSP) and scattered microvessels with dilation and caliber variation, while ME-NBI at the anal side showed an irregularly tubular MSP. An endoscopic forceps biopsy showed a well- to moderately differentiated adenocarcinoma. Interventions: We performed endoscopic submucosal dissection, and en bloc resection of the tumor was successfully achieved. Outcomes: The histological findings showed two distinct components: neuroendocrine carcinoma (NEC) and well-differentiated adenocarcinoma, which comprised ∼60% and 40% of the tumor, respectively. The NEC component corresponded to the site with the absence of an MSP and scattered microvessels on ME-NBI, while the well-differentiated adenocarcinoma component corresponded to the site with an irregularly tubular MSP. The pathological diagnosis was mixed adenoneuroendocrine carcinoma, infiltrating into the deep submucosal layer. Lessons: We propose that the absence of an MSP plus an irregular MSP is characteristics of gMANEC, which was useful for the diagnosis of gMANEC before treatment.

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Correlation of metastasis characteristics with prognosis in gastric mixed adenoneuroendocrine carcinoma

Cited by 8 publications

References 25 publications

Mixed Neuroendocrine Non-Neuroendocrine Neoplasms: A Systematic Review of a Controversial and Underestimated Diagnosis

Mixed Neuroendocrine Non-Neuroendocrine Neoplasms: A Systematic Review of a Controversial and Underestimated Diagnosis

Α-fetoprotein producing hepatoid gastric adenocarcinoma with neuroendocrine differentiation

Endoscopic findings of gastric mixed adenoneuroendocrine carcinoma

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