Endocrine carcinoma of the stomach: clinicopathological analysis of 27 surgically treated cases in a single institute

Kubota, Takeshi; Ohyama, Shigekazu; Hiki, Naoki; Nunobe, Souya; Yamamoto, Norio; Yamaguchi, Toshiharu

doi:10.1007/s10120-011-0122-5

Cited by 44 publications

(56 citation statements)

References 21 publications

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“…Our results showed that a higher Ki-67 PI was associated with more advanced disease such as larger tumor size, deeper tumor invasion, and lymph node or distant metastasis in gastric WDNET, which is consistent with previous studies [10][11][12]. Prognostic value of WHO 2010 grading system based on Ki-67 PI has been validated in GI neuroendocrine neoplasms by others [6,7].…”

Section: Discussionsupporting

confidence: 93%

“…However, Ki-67 PI in the clinical subtypes of gastric WDNET has not been evaluated in detail. Also, only a few studies have reported correlation between Ki-67 PI and clinicopathologic factors of gastric WDNET [10][11][12]. We aimed to evaluate clinicopathologic characteristics and Ki-67 PI status in the clinical subtypes of gastric WDNET in detail.…”

Section: Introductionmentioning

confidence: 99%

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Sporadic Gastric Well-Differentiated Neuroendocrine Tumors Have a Higher Ki-67 Proliferative Index

et al. 2016

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Well-differentiated neuroendocrine tumor (WDNET) of the stomach can arise in three distinct clinical settings: (1) in association with autoimmune atrophic gastritis, (2) in association with multiple neuroendocrine neoplasia type I (MEN I) or Zollinger-Ellison syndrome (ZES), or (3) sporadic. The Ki-67 proliferative index (PI) in gastric WDNETs in these three distinct clinical settings has not been evaluated in detail. Forty-five gastric WNETs underwent polypectomy (n = 4), endoscopic mucosal resection (n = 12), and surgical resection (n = 29) between 1994 and 2015 were included. H&E slides from each case were reviewed, and Ki-67 immunostain was performed on one representative tumor block. Ki-67 PI was determined by quantitative Aperio image analysis software in areas of strongest nuclear labeling ("hot spots"), and correlated with underlying clinical and pathological features. Twenty-one patients were male and 24 female with a median age of 57 years (range, 30-80 years). Tumors were classified as type I (n = 17), type II (n = 6), and type III (n = 22) WDNETs. Types II and III showed more advanced TNM stage compared to type I (p = 0.02, overall). WHO grade based on Ki-67 PI was higher in type III WDNETs [grade 1 (G1), n = 3; grade 2 (G2), n = 15; and grade 3 (G3), n = 4] than in type I WDNETs [G1, n = 5; G2, n = 12] and in type II WDNETs [G1, n = 2; G2, n = 4] (p = 0.050, overall). Ki-67 PI was significantly higher in type III WDNETs (mean ± SD = 13.0 ± 13.3 %) than in non-sporadic (type I and II) WDNETs (mean ± SD = 5.3 ± 3.3 %; p = 0.015). There was no difference in Ki-67 PI between type I WDNETs (mean ± SD = 5.2 ± 3.5 %) and type II WDNETs (mean ± SD = 5.6 ± 3.1%; p = 0.817). Higher Ki-67 PI was associated with higher tumor T stage (p = 0.003) and also tended to be associated with lymph node metastasis (p = 0.071). In the Kaplan-Meier survival analysis, type I was associated with a significantly longer disease-free survival (DFS) time compared to type II (p = 0.018) or III (0.010). Also, the WHO G3 group had a significantly shorter DFS time than the WHO G1 (p = 0.020) or G2 (p = 0.007) group. Gastric WDNET is a heterogeneous disease entity encompassing three clinical subtypes-type I, type II, and type III-having their own distinct clinicopathologic characteristics and prognosis. Our results showed that sporadic (type III) WDNET had a significantly higher Ki-67 PI than non-sporadic cases (type I or II); increased PI was associated with higher tumor stage. We also described four type III cases of morphologically WD gastric NET with WHO grade 3 on the basis of Ki-67 PI.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Sporadic Gastric Well-Differentiated Neuroendocrine Tumors Have a Higher Ki-67 Proliferative Index

et al. 2016

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“…Although NEC is categorized as a neuroendocrine neoplasm, it is clearly differentiated from other neuroendocrine tumors by its highly malignant biological behavior (24). In addition, gastric NEC is considered to have a poorer prognosis than gastric adenocarcinoma (GAD), with a high incidence of metastasis to the lymph nodes or liver in the early stages of the disease (12,16). However, as gastric NEC is morphologically similar to poorly differentiated adenocarcinoma with a predominantly solid growth pattern (12), it is difficult to distinguish using hematoxylin and eosin staining only.…”

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confidence: 99%

<b>Comprehensive analysis of gene mutation and expression profiles in neuroendocrine carcinomas of the </b><b>stomach </b>

et al. 2017

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The gene mutation and expression profiles of gastric neuroendocrine carcinoma (NEC) have not been comprehensively determined. Here, we examined the gene mutation and expression profiles of NEC using whole exome sequencing (WES) and microarray analysis. Six patients with gastric NEC and 13 with gastric adenocarcinoma (GAD) were included in this study. Single nucleotide variants were compared and multivariate statistical investigation with orthogonal partial least squares discriminant analysis (OPLS-DA) was performed to compare the difference in expression profiles between NEC and GAD. NEC showed a significantly higher mutation rate than GAD and the percentage difference in the mutation pattern of NEC compared with GAD was 92.8%. OPLS-DA clearly discriminated between NEC and GAD. We identified 35 genes, including CPLX2 (Complexin 2), which were expressed more strongly in NEC than in GAD, of which 14 were neural-related. Immunohistochemical analysis showed the strong expression of CPLX2 in all NECs, versus expression in only 2 of 13 GADs. Gastric NEC had a specific mutation pattern with a significantly higher gene mutation rate than GAD, and completely differed from GAD on the basis of gene expression profile. CPLX2 might be a potential novel biomarker for the diagnosis of NEC.

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“…Early diagnosis is an important factor for avoiding extensive resection like in the case reported in this study. 14 The prognosis for patients with MANECs is not well-defined. 15,16 The data available suggest that high grade MANECs appear to lead to better overall survival than do pure neuroendocrine carcinomas.…”

Section: Discussionmentioning

confidence: 99%

Mixed adenoneuroendocrine carcinoma of the gastric stump following Billroth II gastrectomy: case report and review of the literature

Cazzo

Saito

2015

Sao Paulo Med. J.

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CONTEXT: Gastric stump cancer after gastric resection is a well-known disease. It may be a newly developed cancer after resection due to benign disease, or recurrent or residual disease after oncological surgery. The predominant histological type is usually adenocarcinoma. This study aimed to report on a rare occurrence of a mixed adenoneuroendocrine carcinoma (MANEC) on the gastric stump. CASE REPORT: The case of an 83-year-old female who presented a locally aggressive gastric stump MANEC, 35 years after Billroth II gastrectomy to treat a peptic ulcer, is reported. The patient underwent resection and adjuvant therapy. She has been followed up for one year without signs of recurrence. CONCLUSION: MANEC is a rare type of gastrointestinal neoplasm. The classification, histopathology, clinical features, treatment issues and prognosis are discussed along with a brief review of the literature.RESUMO CONTEXTO: O câncer de coto gástrico após gastrectomia é uma condição extensamente documentada. Pode se tratar de doença desenvolvida após a ressecção por doença benigna, ou ainda doença recorrente ou residual após cirurgia oncológica. Geralmente, o tipo histológico predominante é o adenocarcinoma. Este estudo tem como propósito relatar a rara ocorrência de um adenocarcinoma neuroendócrino misto (MANEC) no coto gástrico. RELATO DE CASO: É relatado o caso de uma mulher de 83 anos que apresentou um MANEC localmente agressivo 35 anos após uma gastrectomia à Billroth II devido a úlcera péptica. Foi submetida a ressecção e terapia adjuvante e foi seguida por 12 meses sem sinais de recorrência. CONCLUSÃO: Os MANECs constituem raro tipo de neoplasia gastrointestinal. Sua classificação, histopatologia, aspectos clínicos, tratamento e prognóstico são discutidos junto com uma breve revisão de literatura.

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Endocrine carcinoma of the stomach: clinicopathological analysis of 27 surgically treated cases in a single institute

Cited by 44 publications

References 21 publications

Sporadic Gastric Well-Differentiated Neuroendocrine Tumors Have a Higher Ki-67 Proliferative Index

Sporadic Gastric Well-Differentiated Neuroendocrine Tumors Have a Higher Ki-67 Proliferative Index

<b>Comprehensive analysis of gene mutation and expression profiles in neuroendocrine carcinomas of the </b><b>stomach </b>

Mixed adenoneuroendocrine carcinoma of the gastric stump following Billroth II gastrectomy: case report and review of the literature

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