Shi Huiying, Qi Cuihua, Meng Lingjun, Yao Hailing, Jiang Chen, Fan Mengke, Pang Suya, Zhang Qin, Lin Rong
Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Ther Adv Endocrinol Metab. 2020 Jul 6;11:2042018820938304. doi: 10.1177/2042018820938304. eCollection 2020.
Neuroendocrine carcinomas (NECs) and mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) in the gastrointestinal (GI) tract are both rare and malignant; however, it is unclear whether their prognosis is the same.
In this cross-sectional study, a total of 12,878 patients with NEC or MiNEN in the GI tract were reviewed retrospectively by searching the () program database. Next, we compared the characteristics and survival between patients with NEC or MiNEN and further analyzed the prognostic factors for the patients.
The data showed that patients with MiNEN had a worse prognosis as compared with patients with pure NEC in the small intestine (SI) and appendix, whereas there was no significant survival difference between NEC and MiNEN in the other parts of the GI system. On the whole, age ⩾55 years ( < 0.0001), male ( 0.002), being diagnosed at TNM Stage II-IV ( < 0.0001) or not receiving surgical treatment ( < 0.0001) were the independent negative prognostic factors for NEC patients, whereas age ⩾55 years ( = 0.003), being diagnosed at TNM Stage III-IV ( < 0.001) or not receiving surgical treatment ( < 0.001) were identified as the independent negative prognostic factors for the MiNEN patients. Furthermore, when NECs or MiNENs were classified based on the primary tumor site, the results showed that the prognostic factors for NEC and MiNEN varied between the tumor sites.
The prognostic differences between NECs and MiNENs in the GI tract are heterogeneous and site-related. Patients with appendiceal or SI MiNEN have a poorer prognosis than patients with pure appendiceal or SI NEC. Therefore, we should pay more attention to patients with MiNEN in the SI and appendix and monitor them more closely.
胃肠道神经内分泌癌（NECs）和神经内分泌-非神经内分泌混合性肿瘤（MiNEN）均罕见且具有恶性，但它们的预后是否相同尚不清楚。
在这项横断面研究中，通过检索（）程序数据库，对总共12878例胃肠道NEC或MiNEN患者进行了回顾性分析。接下来，我们比较了NEC或MiNEN患者的特征和生存率，并进一步分析了患者的预后因素。
数据显示，在小肠（SI）和阑尾中，MiNEN患者的预后比单纯NEC患者更差，而在胃肠道系统的其他部位，NEC和MiNEN之间的生存差异无统计学意义。总体而言，年龄≥55岁（<0.0001）、男性（0.002）、诊断为TNM II-IV期（<0.0001）或未接受手术治疗（<0.0001）是NEC患者的独立负性预后因素，而年龄≥55岁（=0.003）、诊断为TNM III-IV期（<0.001）或未接受手术治疗（<0.001）被确定为MiNEN患者的独立负性预后因素。此外，当根据原发肿瘤部位对NEC或MiNEN进行分类时，结果表明NEC和MiNEN的预后因素在不同肿瘤部位有所不同。
胃肠道NEC和MiNEN之间的预后差异是异质性的且与部位相关。阑尾或SI MiNEN患者的预后比单纯阑尾或SI NEC患者更差。因此，我们应更加关注SI和阑尾MiNEN患者，并对其进行更密切监测。
