Gastric neuroendocrine carcinoma: Clinicopathologic review and immunohistochemical study of E‐cadherin and Ki‐67 as prognostic markers

Boo, Yoon Jung; Kim, Jong Han; Mok, Young Jae; Kim, Seong Joo; Kim, Chong Suk

doi:10.1002/jso.20616

Cited by 37 publications

(32 citation statements)

References 15 publications

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“…In a review of the literature, the 5-year survival rate of gastric EC was reported to be 30-40% [3,9,13,[16][17][18][19]. Our 5-year survival of 43.8% was similar to the results of some of these previous reports (Table 4).…”

Section: Discussionsupporting

confidence: 87%

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

et al. 2012

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Background Gastric endocrine carcinoma (EC) is an uncommon tumor of the stomach and the clinical features are not well known. Additionally, the classification and staging systems of this tumor are not yet unified worldwide. In this study, we reviewed 27 patients with gastric EC to evaluate the clinicopathological characteristics of this tumor. Methods We retrospectively reviewed 27 patients with gastric EC among 6466 patients who had undergone gastrectomy between 1986 and 2008 at our institute. Clinicopathological features including immunohistochemistry of Ki-67 were investigated to evaluate the malignant potential of the tumor. Furthermore, survivals were compared between the 7th edition of the International Union Against Cancer (UICC)-TNM (7th TNM) classification for gastric cancer (GC) and the new TNM classification for foregut neuroendocrine tumors (NET). Results The median survival of the patients was 19.0 months. The 5-year survival rate was 100% in pathological stage (pStage) I, 40% in pStage II, 38% in pStage III, and 11% in pStage IV according to the 7th TNM classification for GC. Survivals by stage showed great difference between the 7th TNM classification for GC and the new TNM classification for foregut NET, but each system correlated with survival. The Ki-67 labeling index was more than 20% in most of the patients. Univariate analysis revealed that maximum tumor diameter, tumor depth, lymph node metastasis, lymphatic invasion, pStage, and curability had significant correlations with survival. Conclusion Early detection and curative operations are essential for improving the prognosis of gastric EC. However, some adjuvant chemotherapies are required for advanced-stage tumors. Classification and staging systems may need to be unified worldwide for further analysis.

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Section: Discussionsupporting

confidence: 87%

“…A high Ki-67 proliferation index could be used as a prognostic marker to predict aggressive gastric EC [17] and the ENETS grading system accepts a Ki-67 labeling index of more than 20% as grade 3 [7]. On the other hand, it is well known that p53 mutations are the most common genetic alterations in ordinary GC [29][30][31].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2012

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“…Previous researches have indicated that higher Ki-67 index showed worse prognosis in GEP-NENs [28,29]. Some studies with small sample sizes of colorectal NENs also presented similar results.…”

Section: Discussionsupporting

confidence: 52%

Clinicopathological features and prognostic factors of colorectal neuroendocrine neoplasms.

Jiang

Yuan

2017

JCO

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Background. Limited research is available regarding colorectal NENs and the prognostic factors remain controversial. Materials and Methods. A total of 68 patients with colorectal NENs were studied retrospectively. Clinical characteristics and prognosis between colonic and rectal NENs were compared. The Cox regression models were used to evaluate the predictive capacity. Results. Of the 68 colorectal NENs patients, 43 (63.2%) had rectal NENs, and 25 (36.8%) had colonic NENs. Compared with rectal NENs, colonic NENs more frequently exhibited larger tumor size ( < 0.0001) and distant metastasis ( < 0.0001). Colonic NENs had a worse prognosis ( = 0.027), with 5-year overall survival rates of 66.7% versus 88.1%. NET, NEC, and MANEC were noted in 61.8%, 23.5%, and 14.7% of patients, respectively. Multivariate analyses revealed that tumor location was not an independent prognostic factor ( = 0.081), but tumor size ( = 0.037) and pathological classification ( = 0.012) were independent prognostic factors. Conclusion. Significant differences exist between colonic and rectal NENs. Multivariate analysis indicated that tumor size and pathological classification were associated with prognosis. Tumor location was not an independent factor. The worse outcome of colonic NENs observed in clinical practice might be due not only to the biological differences, but also to larger tumor size in colonic NENs caused by the delayed diagnosis.

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“…Loss of E-cadherin expression and function has been associated with disruption of E-cadherin junctions and gain of cell motility and invasiveness in several tumour types. Moreover, E-cadherin loss was identified in 13 out of 17 (76.5%) gastric neuroendocrine carcinomas (NECs) and was significantly associated with lymph node metastasis; however, it did not correlate with invasion to adjacent organs or distant metastasis (Boo et al 2007). Additionally, progressive loss of E-cadherin in tumour cells with nuclear b-catenin accumulation indicates that they have undergone an epithelial-mesenchymal transition -a developmental regulatory programme resulting in invasion, resistance to apoptosis and dissemination (Hanahan & Weinberg 2011).…”

Section: Activating Invasion and Metastasismentioning

confidence: 99%

Hallmarks of gastrointestinal neuroendocrine tumours: implications for treatment

Walenkamp¹,

Crespo²,

Maya³

et al. 2014

Endocrine-Related Cancer

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In the past few years, there have been advances in the treatment of neuroendocrine tumours (NETs) and improvements in our understanding of NET biology. However, the benefits to patients have been relatively modest and much remains yet to be done. The 'Hallmarks of Cancer', as defined by Hanahan and Weinberg, provide a conceptual framework for understanding the aberrations that underlie tumourigenesis and to help identify potential targets for therapy. In this study, our objective is to review the major molecular characteristics of NETs, based on the recently modified 'Hallmarks of Cancer', and highlight areas that require further research.

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Gastric neuroendocrine carcinoma: Clinicopathologic review and immunohistochemical study of E‐cadherin and Ki‐67 as prognostic markers

Abstract: Loss of E-cadherin may predict lymph node metastasis in gastric NECs. A high Ki-67 PI (>60%) could be used as a prognostic marker to predict aggressive gastric NECs in addition to standard pathologic classification.

Cited by 37 publications

References 15 publications

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

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

Clinicopathological features and prognostic factors of colorectal neuroendocrine neoplasms.

Hallmarks of gastrointestinal neuroendocrine tumours: implications for treatment

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