Open AccessTumor size and perineural invasion predict outcome of gastric high-grade neuroendocrine neoplasms
Author(s) -
Qi Zhang,
Hongshan Wang,
Yue Xie,
Shao Min Huang,
Ke Chen,
Botian Ye,
Yupeng Yang,
Jie Sun,
Hongyong He,
Fenglin Liu,
Zhongliang Shen,
Weidong Chen,
Kuntang Shen,
Yuan Ji,
Yihong Sun
Publication year - 2021
Publication title -
endocrine connections
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.941
H-Index - 23
ISSN - 2049-3614
DOI - 10.1530/ec-21-0017
Subject(s) - medicine , neuroendocrine tumors , grading (engineering) , perineural invasion , lymphovascular invasion , stage (stratigraphy) , pathology , mitotic index , neuroendocrine carcinoma , oncology , gastroenterology , cancer , immunohistochemistry , metastasis , paleontology , mitosis , civil engineering , engineering , biology , microbiology and biotechnology
A new subcategory, grade 3 neuroendocrine tumors, is incorporated into the grading system of pancreatic neuroendocrine neoplasms in the 2017 WHO classification in order to differentiate grade 3 neuroendocrine tumors from neuroendocrine carcinomas. The 2019 WHO classification extends the concept of grade 3 neuroendocrine tumors to gastrointestinal high-grade neuroendocrine neoplasms. However, there is still limited study focusing on the gastric grade 3 neuroendocrine tumors and gastric neuroendocrine carcinomas. We retrospectively enrolled 151 gastric high-grade neuroendocrine neoplasms patients, who underwent radical resection from January 2007 to December 2015. Clinicopathologic and prognostic features were studied. The Surveillance, Epidemiology, and End Results (SEER) database was used to verify the prognostic determinants found in the Zhongshan cohort. Neuroendocrine carcinomas showed a higher Ki67 index and higher mitotic count than grade 3 neuroendocrine tumors. We identified 109 (72.2%) patients with neuroendocrine carcinomas, 12 (7.9%) patients with grade 3 neuroendocrine tumors, and 30 (19.9%) patients with mixed neuroendocrine-non-neuroendocrine neoplasms. Although neuroendocrine carcinomas demonstrated higher Ki67 index (P = 0.004) and mitoses (P = 0.001) than grade 3 neuroendocrine tumors, their prognosis after radical resection did not demonstrate significant differences (P = 0.709). Tumor size, perineural invasion, and TNM stage were independent prognostic factors of gastric high-grade neuroendocrine neoplasms.