Department of Gastric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350001, Fujian Province, China.
Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
BMC Cancer. 2018 Oct 22;18(1):1021. doi: 10.1186/s12885-018-4943-z.
To assess the prognostic factors and investigate the optimal treatment of gastric mixed adenoneuroendocrine tumors.
We retrospectively analyzed clinical data from 80 patients with gastric mixed adenoneuroendocrine carcinoma that received radical resection in our department from January 2007 to December 2016. Risk factors for relapse and survival were analyzed using a multivariate Cox proportional hazards regression model. Gastric mixed adenoneuroendocrine carcinoma was divided into neuroendocrine carcinoma and adenocarcinoma based on the predominant type in the tumor.
The 3-year overall survival was 40% in the neuroendocrine carcinoma group and 75% in the adenocarcinoma group (P = 0.006). The neuroendocrine carcinoma (NEC)-dominant tumors and a Ki-67-positive index ≥60% were independent risk factors for worse overall survival. The 3-year recurrence-free survival was 33% in the neuroendocrine carcinoma group and 68% in the adenocarcinoma group. NEC-dominant tumors and a Ki-67-positive index ≥60% were independent risk factors for gastric mixed adenoneuroendocrine carcinoma recurrence. Patients in the adenocarcinoma group that received adjuvant chemotherapy exhibited significantly better overall survival than patients that did not receive chemotherapy (median survival time 43 months vs. 13 months, P = 0.026).
The NEC-dominant tumors and a Ki-67-positive index ≥60% were significantly associated with worse survival and a higher recurrence rate for gastric mixed adenoneuroendocrine carcinoma patients. Patients in the adenocarcinoma group may benefit from gastric adenocarcinoma treatments.
评估胃混合性腺神经内分泌肿瘤的预后因素并探讨其最佳治疗方法。
回顾性分析 2007 年 1 月至 2016 年 12 月在我院接受根治性切除术的 80 例胃混合性腺神经内分泌癌患者的临床资料。采用多因素 Cox 比例风险回归模型分析复发和生存的危险因素。根据肿瘤中的主要类型，胃混合性腺神经内分泌癌分为神经内分泌癌和腺癌。
神经内分泌癌组 3 年总生存率为 40%，腺癌组为 75%（P=0.006）。神经内分泌癌（NEC）优势肿瘤和 Ki-67 阳性指数≥60%是总生存较差的独立危险因素。神经内分泌癌组 3 年无复发生存率为 33%，腺癌组为 68%。NEC 优势肿瘤和 Ki-67 阳性指数≥60%是胃混合性腺神经内分泌癌复发的独立危险因素。接受辅助化疗的腺癌组患者总生存率明显优于未接受化疗的患者（中位生存时间 43 个月比 13 个月，P=0.026）。
NEC 优势肿瘤和 Ki-67 阳性指数≥60%与胃混合性腺神经内分泌癌患者的生存和复发率较差显著相关。腺癌组患者可能受益于胃腺癌的治疗。
