Prognostic significance of neuroendocrine components in gastric carcinomas |
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| Affiliation: | 1. Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul 138-736, Republic of Korea;2. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul 138-736, Republic of Korea;3. Department of Surgery, Hanyang University Guri Hospital, 153, Gyeongchun-ro, Guri, Gyeonggi-do 471-701, Republic of Korea;4. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul 138-736, Republic of Korea;1. Department of Obstetrics and Gynecology, Kunming General Hospital of Chengdu Military Command, Kunming, Yunnan, China;2. Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA;3. Department of Cardiology, Kunming General Hospital of Chengdu Military Command, Kunming, Yunnan, China;1. Department of General Surgery, People’s hospital of Rizhao, Shandong, P.R. China;2. Department of Gynaecology and obstetrics, People’s hospital of Zhangqiu, Shandong, P.R. China;3. Department of Neurology, People’s hospital of Zhangqiu, Shandong, P.R. China;4. Department of Clinical laboratory, People’s hospital of Zhangqiu, Shandong, P.R. China;1. Department of Biological Engineering, University of Missouri-Columbia, Columbia, MO 65211, USA;2. Department of Electrical and Computer Engineering, University of Missouri-Columbia, Columbia, MO 65211, USA;1. Servicio de Física Médica y Protección Radiológica. Hospital Universitario Araba – Sede Txagorritxu, C/ Jose Atxotegui, s/n, 01009 Vitoria-Gasteiz, Spain;2. Servicio de Medicina Nuclear, Hospital Universitario Araba – Sede Santiago, C/ Olaguibel, 29, 01004 Vitoria-Gasteiz, Spain |
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| Abstract: | BackgroundGastric neuroendocrine carcinomas (NECs) and mixed adenoneuroendocrine carcinomas (MANECs) are aggressive tumours but the prognostic significance of a neuroendocrine component in <30% of the tumour remains unclear. Here, the implication of neuroendocrine components in gastric carcinomas was assessed according to proportion.MethodsSurgically resected primary gastric carcinomas with neuroendocrine morphology (NEM; n = 88) from 2000 to 2012 at Asan Medical Center were retrospectively reviewed. Neuroendocrine differentiation (NED) was defined as immunopositivity for one of three neuroendocrine markers (synaptophysin, chromogranin or CD56) within the NEM area. To validate the prognostic significance of NED, these cases were compared with 650 randomly selected gastric adenocarcinomas without NEM from the same time period.ResultsGastric carcinomas with NEM were reclassified as NEC (⩾70% NED, n = 47), MANEC (30–70% NED, n = 10), gastric carcinoma with 10–30% NED (GCNED, n = 8) and carcinoma with <10% NED (n = 23). The survival rates of patients with ⩾10% NED were significantly poorer than those with <10% NED but no survival difference was observed between NEC and MANEC. In univariate analyses, older age (⩾60 years), larger tumour size (⩾4 cm), advanced stage group, ⩾10% NED and lymphovascular or perineural invasion were indicative of a poor prognosis. Stage group and ⩾10% NED remained as independent prognostic factors by multivariate analysis.ConclusionsA minor proportion (10–30%) of NED should not be overlooked in gastric carcinomas with NEM. NED should be carefully evaluated to predict patient outcomes and plan optimal additional therapies. |
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| Keywords: | Gastric carcinoma Neuroendocrine Component Proportion Prognosis |
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