DOI QR코드

DOI QR Code

Clinicopathologic Significance of Gastric Adenocarcinoma with Neuroendocrine Features

  • Received : 2011.08.19
  • Accepted : 2011.10.27
  • Published : 2011.12.30

Abstract

Purpose: Composite neuroendocrine-exocrine carcinomas are malignancies that have two distinct components residing within the same tumor: an adenocarcinomatous portion and a neuroendocrine portion. This is rare in gastric cancers; however, poorly differentiated adenocarcinomas can sometimes reveal evidence of neuroendocrine features (NEF) or be 'mixed endocrine and exocrine carcinomas'. This study aimed to review NEF in gastric adenocarcinoma and to evaluate its prognostic significance. Materials and Methods: We selected 29 patients who were diagnosed with gastric adenocarcinoma with NEF and received gastrectomies at the Department of Surgery, Ajou University Hospital between January 2001 and December 2009. We analyzed the clinicopathologic features of gastric cancer with NEF and the prognosis associated with such tumors. Results: The pathologic result with respect to TNM staging of the gastric cancers with NEF were as follows: 5 cases of T1, 5 cases of T2, 10 cases of T3, and 9 cases of T4. There were 7 cases of N0, 7 cases of N1, 8 cases of N2 and 7 cases of N3. The staging of patients with NEF was higher than that of patients without NEF. Especially tumor lymphovascular invasion rate was 82.8%. The overall survival of patients with gastric cancer characterized by NEF was 73.8 months. Conclusions: Positive NEF status might be correlated with clinicopathologic parameters such as a high stage and high frequency of regional lymph node metastasis.

Keywords

References

  1. Volante M, Righi L, Asioli S, Bussolati G, Papotti M. Goblet cell carcinoids and other mixed neuroendocrine/nonneuroendocrine neoplasms. Virchows Arch 2007;451 Suppl 1:S61-69.
  2. Rindi G, Arnold R, Bosman FT. Nomenclature and classification of neuroendocrine neoplasms of the digestive system. In: Bosman FT, Carneiro F, Hruban RH, Theise ND, et al., eds. WHO classification of tumors of the digestive system. Lyon: IARC, 2010.
  3. Lewin K. Carcinoid tumors and the mixed (composite) glandular-endocrine cell carcinomas. Am J Surg Pathol 1987;11 Suppl 1:71-86. https://doi.org/10.1097/00000478-198700111-00007
  4. Ooi A, Hayashi H, Katsuda S, Nakanishi I. Gastric carcinoma cells with endocrine differentiation show no evidence of proliferation. Hum Pathol 1992;23:736-741. https://doi.org/10.1016/0046-8177(92)90341-Y
  5. Park JM, Jang YJ, Kim JH, Park SS, Park SH, Kim SJ, et al. Gastric cancer histology: clinicopathologic characteristics and prognostic value. J Surg Oncol 2008;98:520-525. https://doi.org/10.1002/jso.21150
  6. Wanebo HJ, Kennedy BJ, Chmiel J, Steele G Jr, Winchester D, Osteen R. Cancer of the stomach. A patient care study by the American College of Surgeons. Ann Surg 1993;218:583-592. https://doi.org/10.1097/00000658-199321850-00002
  7. Sim YK, Kim CY, Jeong YJ, Kim JH, Hwang Y, Yang DH. Changes of the clinicopathological characteristics and survival rates of gastric cancer with gastrectomy: 1990s vs early 2000s. J Korean Gastric Cancer Assoc 2009;9:200-206. https://doi.org/10.5230/jkgca.2009.9.4.200
  8. Seo WH, Seo BJ, Yu HJ, Lee WY, Lee HK. Analysis of prognostic factors in 1,435 surgically treated patients with gastric cancer. J Korean Gastric Cancer Assoc 2009;9:143-151. https://doi.org/10.5230/jkgca.2009.9.3.143
  9. Jeong O, Park YK. Clinicopathological features and surgical treatment of gastric cancer in South Korea: the results of 2009 nationwide survey on surgically treated gastric cancer patients. J Gastric Cancer 2011;11:69-77. https://doi.org/10.5230/jgc.2011.11.2.69
  10. Kim KM, Kim MJ, Cho BK, Choi SW, Rhyu MG. Genetic evidence for the multi-step progression of mixed glandular-neuroendocrine gastric carcinomas. Virchows Arch 2002;440:85-93. https://doi.org/10.1007/s004280100540
  11. Eren F, Celikel C, Gulluoglu B. Neuroendocrine differentiation in gastric adenocarcinomas; correlation with tumor stage and expression of VEGF and p53. Pathol Oncol Res 2004;10:47-51. https://doi.org/10.1007/BF02893409
  12. Tamura T, Jobo T, Watanabe J, Kanai T, Kuramoto H. Neuroendocrine features in poorly differentiated endometrioid adenocarcinomas of the endometrium. Int J Gynecol Cancer 2006;16:821-826. https://doi.org/10.1111/j.1525-1438.2006.00419.x
  13. Allen FJ, Van Velden DJ, Heyns CF. Are neuroendocrine cells of practical value as an independent prognostic parameter in prostate cancer? Br J Urol 1995;75:751-754. https://doi.org/10.1111/j.1464-410X.1995.tb07385.x
  14. Wilson BS, Lloyd RV. Detection of chromogranin in neuroendocrine cells with a monoclonal antibody. Am J Pathol 1984;115:458-468.
  15. Gould VE, Wiedenmann B, Lee I, Schwechheimer K, Dockhorn-Dworniczak B, Radosevich JA, et al. Synaptophysin expression in neuroendocrine neoplasms as determined by immunocytochemistry. Am J Pathol 1987;126:243-257.
  16. Waldum HL, Aase S, Kvetnoi I, Brenna E, Sandvik AK, Syversen U, et al. Neuroendocrine differentiation in human gastric carcinoma. Cancer 1998;83:435-444. https://doi.org/10.1002/(SICI)1097-0142(19980801)83:3<435::AID-CNCR11>3.0.CO;2-X

Cited by

  1. Mixed Adenoneuroendocrine Gastric Carcinoma: A Case Report and Review of the Literature vol.14, pp.1, 2011, https://doi.org/10.5230/jgc.2014.14.1.63
  2. Mixed adenoneuroendocrine carcinoma of gastrointestinal tract: report of two cases. vol.21, pp.4, 2015, https://doi.org/10.3748/wjg.v21.i4.1329
  3. A resected case of neuroendocrine carcinoma of the stomach with unusual lymph node metastasis vol.49, pp.1, 2011, https://doi.org/10.1007/s00795-015-0100-9
  4. Mixed adenoneuroendocrine carcinoma (MANEC) of the gastroesophageal junction: a case report and review of the literature vol.109, pp.2, 2011, https://doi.org/10.17235/reed.2016.4315/2016
  5. Coexisting tubular adenoma with a neuroendocrine carcinoma of colon allowing early surgical intervention and implicating a shared stem cell origin vol.23, pp.6, 2011, https://doi.org/10.3748/wjg.v23.i6.1106
  6. Comparison of relapse-free survival in gastric neuroendocrine carcinoma (WHO grade 3) and gastric carcinoma vol.10, pp.5, 2011, https://doi.org/10.1177/1756283x17697870
  7. Mixed adenoneuroendocrine carcinoma in the stomach: a case report with a literature review vol.94, pp.5, 2018, https://doi.org/10.4174/astr.2018.94.5.270
  8. Gastric adenocarcinoma is concurrent with metastatic neuroendocrine cancer treated with nivolumab and chemotherapy: A case report vol.9, pp.6, 2018, https://doi.org/10.3892/mco.2018.1740
  9. Mixed Neuroendocrine-non-neuroendocrine Neoplasm of the Stomach that is Distributed in Depth on the Same Tumor: Inconsistent with the Definition of Mixed Adenoneuroendocrine Carcinoma in the 2010 Worl vol.74, pp.6, 2011, https://doi.org/10.4166/kjg.2019.74.6.349
  10. Prognostic Threshold of Neuroendocrine Differentiation in Gastric Carcinoma: a Clinicopathological Study of 945 Cases vol.19, pp.1, 2011, https://doi.org/10.5230/jgc.2019.19.e9
  11. Gastric Endocrine Carcinoma: A New Look at a Rare Tumor From Cases in Japan vol.104, pp.3, 2011, https://doi.org/10.9738/intsurg-d-19-00015.1
  12. Mixed adenoneuroendocrine carcinoma of the liver: A rare case report vol.12, pp.2, 2011, https://doi.org/10.3892/mco.2019.1962
  13. Laparoscopic treatment of mixed adenoneuroendocrine cancer of right colon: case report and review of literature vol.33, pp.3, 2011, https://doi.org/10.23736/s0394-9508.19.05003-4
  14. Gastric Mixed Adenoneuroendocrine Carcinoma with Revised Diagnosis after Retrospective Pathologic Review vol.21, pp.4, 2011, https://doi.org/10.7704/kjhugr.2021.0047