Gao R, Chen X Y, Jin L
Provincial Clinical Medical College of Fujian Medical University; Department of Pathology, Fujian Provincial Hospital, Fuzhou 350001, China.
Zhonghua Bing Li Xue Za Zhi. 2019 Oct 8;48(10):767-771. doi: 10.3760/cma.j.issn.0529-5807.2019.10.004.
To investigate the clinicopathological characteristics of gastric mixed adenoneuroendocrine carcinoma (MANEC). The clinical and pathologic data of 36 cases of gastric MANEC collected from January 2011 to December 2018 in the Department of Pathology, Fujian Provincial Hospital were retrospectively analyzed. Light microscopy and EnVision immunohistochemical (IHC) staining were used in the study. The results were compared with 40 cases of gastric neuroendocrine carcinoma collected within the same period. The 36 cases were collected, there were 29 males and 7 females. The patients' age ranged from 43 to 87 years (mean 66 years). The tumor diameter ranged from 1.0 to 9.0 cm (mean 5.0 cm). Clinical staging showed that four cases were at T1+T2 stages and 32 cases were at T3+T4 stages. The main clinical manifestations were upper abdominal pain, abdominal distension and dysphagia. Complete follow-up data were obtained in 20 (eleven living and nine dead) patients. Pathologic analysis showed that all tumors were composed of neuroendocrine carcinoma and adenocarcinoma and each of the components was more than 30%. IHC staining showed that CK was expressed in adenocarcinoma; whereas the neuroendocrine carcinoma mainly expressed CD56 and Syn. There was no significant difference in age, sex, T stage and prognosis between gastric MANEC and gastric neuroendocrine carcinoma(>0.05). Gastric neuroendocrine carcinoma predominantly occurred in the esophagogastric junction and the gastric body but only rarely in the gastric antrum; gastric MANEC mainly occurred in the esophagogastric junction and the gastric antrum but rarely in the gastric body. Gastric MANEC was more prone to lymph node metastasis than gastric neuroendocrine cancer(0.05). Most of the gastric MANEC patients are middle-aged and elderly males, and the tumors predominantly occur in the esophagogastric junction and the gastric antrum. Most of the patients are found to have higher stages, and most of them have lymph node metastases and poor prognosis.
探讨胃混合性腺神经内分泌癌（MANEC）的临床病理特征。回顾性分析2011年1月至2018年12月福建省立医院病理科收集的36例胃MANEC的临床和病理资料。本研究采用光学显微镜和EnVision免疫组织化学（IHC）染色。将结果与同期收集的40例胃神经内分泌癌进行比较。收集的36例患者中，男性29例，女性7例。患者年龄范围为43至87岁（平均66岁）。肿瘤直径范围为1.0至9.0 cm（平均5.0 cm）。临床分期显示，4例为T1 + T2期，32例为T3 + T4期。主要临床表现为上腹部疼痛、腹胀和吞咽困难。20例患者（11例存活，9例死亡）获得了完整的随访数据。病理分析显示，所有肿瘤均由神经内分泌癌和腺癌组成，且各成分均超过30%。IHC染色显示，CK在腺癌中表达；而神经内分泌癌主要表达CD56和Syn。胃MANEC与胃神经内分泌癌在年龄、性别、T分期和预后方面无显著差异（>0.05）。胃神经内分泌癌主要发生于食管胃交界部和胃体部，而胃窦部少见；胃MANEC主要发生于食管胃交界部和胃窦部，胃体部少见。胃MANEC比胃神经内分泌癌更容易发生淋巴结转移（P<0.05）。大多数胃MANEC患者为中老年男性，肿瘤主要发生于食管胃交界部和胃窦部。大多数患者分期较高，多数有淋巴结转移，预后较差。
