Department of Biliary Surgery, West China Hospital, Sichuan University, Chengdu, China.
Department of Biliary Disease Research Center, West China Hospital of Sichuan University, Chengdu, China.
Front Endocrinol (Lausanne). 2024 Jul 22;15:1217250. doi: 10.3389/fendo.2024.1217250. eCollection 2024.
Gallbladder mixed neuroendocrine-non-neuroendocrine neoplasm generally consists of a gallbladder neuroendocrine tumor and a non-neuroendocrine component. The World Health Organization (WHO) in 2019 established a guideline requiring each component, both neuroendocrine and non-neuroendocrine, to account for a minimum of 30% of the tumor mass.
Patients after surgery resection and diagnosed at microscopy evaluation with pure gallbladder neuroendocrine carcinoma (GBNEC), gallbladder mixed adeno-neuroendocrine carcinoma (GBMANEC, GBNEC≥30%), and gallbladder carcinoma mixed with a small fraction of GBNEC (GBNEC <30%) between 2010 and 2022 at West China Hospital of Sichuan University were collated for the analyses. Demographic features, surgical variables, and tumor characteristics were evaluated for association with patients' overall and recurrence-free survival (OS and RFS).
The study included 26 GBNEC, 11 GBMANEC, 4 gallbladder squamous-cell carcinoma (GBSCC), and 7 gallbladder adenocarcinoma (GBADC) mixed with a small fraction of GBNEC. All patients had stage III or higher tumors (AJCC edition). The majority of included patients (79.17%) underwent curative surgical resection (R0), with only ten patients having tumoral resection margins. In the analysis comparing patients with GBNEC percentage (GBNEC≥30% vs. GBNEC<30%), the basic demographics and tumor characteristics of most patients were comparable. The prognosis of these patients was also comparable, with a median OS of 23.65 months versus 20.40 months (P=0.13) and a median RFS of 17.1 months versus 12.3 months (P=0.24). However, patients with GBADC or GBSCC mixed with GBNEC <30% had a statistically significant decreased OS and RFS (both P<0.0001)) compared with GBNEC and GBMANEC. Patients with GBNEC who exhibited advanced tumor stages and lymphovascular invasion had a higher risk of experiencing worse overall survival (OS) and recurrence-free survival (RFS). However, a 30% GBNEC component was not identified as an independent risk factor.
Patients with GBNEC were frequently diagnosed at advanced stages and their prognosis is poor. The 30% percentage of the GBNEC component is not related to the patient's survival.
胆囊混合神经内分泌-非神经内分泌肿瘤通常由胆囊神经内分泌肿瘤和非神经内分泌成分组成。世界卫生组织（WHO）于 2019 年制定了一项指南，要求每种成分（神经内分泌和非神经内分泌）至少占肿瘤质量的 30%。
对 2010 年至 2022 年在四川大学华西医院接受手术切除并通过显微镜评估诊断为单纯胆囊神经内分泌癌（GBNEC）、胆囊混合腺神经内分泌癌（GBMANEC，GBNEC≥30%）和胆囊癌伴少量 GBNEC（GBNEC<30%）的患者进行了整理分析。评估了人口统计学特征、手术变量和肿瘤特征与患者总生存（OS）和无复发生存（RFS）的关系。
本研究包括 26 例 GBNEC、11 例 GBMANEC、4 例胆囊鳞状细胞癌（GBSCC）和 7 例胆囊腺癌（GBADC）伴少量 GBNEC。所有患者均为 III 期或更高分期（AJCC 分期）。大多数纳入的患者（79.17%）接受了根治性手术切除（R0），仅有 10 例患者行肿瘤边缘切除术。在比较 GBNEC 百分比（GBNEC≥30%与 GBNEC<30%）的患者分析中，大多数患者的基本人口统计学和肿瘤特征相似。这些患者的预后也相似，中位 OS 分别为 23.65 个月和 20.40 个月（P=0.13），中位 RFS 分别为 17.1 个月和 12.3 个月（P=0.24）。然而，与 GBNEC 和 GBMANEC 相比，混合 GBNEC<30%的 GBSCC 或 GBADC 患者的 OS 和 RFS 均显著降低（均 P<0.0001）。患有晚期肿瘤和脉管侵犯的 GBNEC 患者的总生存（OS）和无复发生存（RFS）风险更高。然而，GBNEC 成分的 30%并未被确定为独立的危险因素。
GBNEC 患者常被诊断为晚期，预后较差。GBNEC 成分的 30%与患者的生存无关。
