Publication: Clinicopathological features and lymph node metastatic patterns of gastric mixed adenoneuroendocrine carcinoma
Authors
Chen, Hanrui ; Shu, Man ; Chen, Sile ; Xue, Ling ; Linn, Yua
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Publisher
Universidad de Murcia. Departamento de BiologĂa Celular e HistologĂa
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DOI
DOI: 10.14670/HH-18-045
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info:eu-repo/semantics/article
Description
Abstract
Aims. Mixed adenoneuroendocrine
carcinoma (MANEC), also known as high- grade mixed
neuroendocrine-non-neuroendocrine neoplasm (MiNEN)
in the World Health Organization (WHO) classification
of tumors of the endocrine organs (2017), is a rare
gastric malignancy. Here, we present 10 cases of gastric
MANEC and analyse their clinicopathological features
and lymph node metastatic patterns.
Methods and results. Six patients were male, and
four were female. The mean age of the patients was 67.9
years. Grossly, most tumors presented as ulcerative
mass, located in gastric fundus or/and cardia.
Microscopically, the neuroendocrine component, large
cell neuroendocrine carcinoma in most cases (8/10),
constituted 30-70% of the whole tumor. It was diffusely
positive for CD56 or/and synaptophysin in all cases, but
negative for chromogranin A in 9 cases. Ki-67 index was
50-80% in neuroendocrine component. The glandular
component was moderately (6/10) or poorly (4/10)
differentiated adenocarcinoma. Nine of 10 cases were
positive for lymph node metastasis, with pure
neuroendocrine component (6/9), or pure glandular
component (1/9), or mixed components (2/9). The
patients were treated with surgery, combining with
chemotherapy (4/10), radiotherapy (2/10) and
immunotherapy (1/10). Five patients died from tumor
progress, with an average survival time of 18.6 months.
The dead cases had predominant neuroendocrine
component in primary tumor or in metastatic lymph
nodes.
Conclusions. Neuroendocrine component may
determine the clinical behavior and outcome in gastric
MANEC. Different metastatic component makes the
selection of chemotherapy protocol more challenging.
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Citation
Histology and Histopathology, Vol.34, nÂş4, (2019)
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