Abstract
BackgroundMixed adenoneuroendocrine carcinoma is a rare clinical manifestation, especially in the gastric and ampullary. The purpose of this study was to investigate the clinicopathological features and prognosis of mixed adenoneuroendocrine carcinoma in the gastric and ampullary and summarize related treatment suggestions.MethodsIn all, 32 cases of mixed adenoneuroendocrine carcinoma in the gastric and ampullary that were diagnosed from resected specimens were analyzed from 2009 to 2015. The corresponding demographic, clinicopathological and survival data were retrospectively reviewed.ResultsThe 1-year, 3-year and 5-year survival rates were 78.1%, 28.1 and 9.4%, respectively, and the median overall survival was 28.0 months. In all, 75.0% (24/32) had lymph node metastasis at the time of initial diagnosis. A multivariate analysis revealed that TNM stage (HR 6.444 95%CI 1.477–28.121 P = 0.013), lymph nodes metastasis (HR10.617 95%CI 1.409–79.997 P = 0.022), vascular invasion (HR 5.855 95%CI 1.719–19.940 P = 0.005), grade of the adenocarcinoma component (HR 3.876 95%CI 1.451–10.357 P = 0.007) and CD56 positivity (HR 0.265 95%CI 0.100–0.705 P = 0.008) were independent predictors of overall survival.ConclusionsMixed adenoneuroendocrine carcinoma is an aggressive clinical entity with a poor prognosis. Taking both the neuroendocrine component and the adenocarcinoma component into consideration of optimal treatment is strongly recommended.
Highlights
Mixed adenoneuroendocrine carcinoma is a rare clinical manifestation, especially in the gastric and ampullary
We choosed “adenocarcinoma” and “neuroendocrine carcinoma” as key words to do a search on our pathological database of resected specimens from 2009 to 2015, we went through the qualified pathological reports, only the sites of tumor were in stomach or in the ampulla of Vater did the patients are involved in the step
Immunohistochemical staining was positive for chromogranin (81.3%), synaptophysin (96.9%) and CD56 (56.3%), and the positivity rates for pancytokeratin (PCK), epithelial membrane antigen (EMA), and CK7 were 56.3%, 34.4 and 25.0%, respectively
Summary
Mixed adenoneuroendocrine carcinoma is a rare clinical manifestation, especially in the gastric and ampullary. The purpose of this study was to investigate the clinicopathological features and prognosis of mixed adenoneuroendocrine carcinoma in the gastric and ampullary and summarize related treatment suggestions. According to the recent WHO classification from 2010, mixed adenoneuroendocrine carcinomas (MANEC) are composed of both malignant neuroendocrine and exocrine components, and each of them must exceed 30% of the entire tumor cell population [1]. We analyzed the clinicopathological features and prognosis of patients with MANEC in the gastric and ampullary and summarized related treatment suggestions according to other recently published literatures
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