Lymph node metastatic patterns of gastric carcinoma with a combination of adenocarcinoma and neuroendocrine carcinoma components  

作　　者：Kai Zhou Zhong-Wu Li Yan Wu Zhi-Jie Wang Ling-Qian Wang Li-Xin Zhou Ling Jia Ke Ji Xue-Song Yang Ji Zhang Xiao-Jiang Wu An-Qiang Wang Zhao-De Bu 

机构地区：[1]Department of Gastrointestinal Surgery,Peking University Cancer Hospital and Institute,Beijing 100142,China [2]Department of Pathology,Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education),Peking University Cancer Hospital and Institute,Beijing 100142,China

出　　处：《World Journal of Gastroenterology》2025年第8期24-37,共14页世界胃肠病学杂志(英文)

基　　金：Supported by the National Key Research and Development Program of China,No.2023YFF1204702;the National Natural Science Foundation of China,No.82173151;Capital’s Funds for Health Improvement and Research,No.CFH 2022-4-1025;Beijing Hospitals Authority Clinical Medicine Development of Special Funding,No.XMLX202119;Science Foundation of Peking University Cancer Hospital,No.PY202329.

摘　　要：BACKGROUND Gastric mixed-adenoneuroendocrine carcinoma(G-MANEC)is a subtype of gastric cancer.Building upon prior research findings,we propose that tumours containing both neuroendocrine carcinoma(NEC)and adenocarcinoma(AC)components,with each component ranging from 1%to 99%of the tumour,be classified as a distinct entity.We hereby term this adenoneuroendocrine mixed gastric cancer(G-ANEC).Research on lymph node(LN)involvement in GMANEC has focused mainly on metastasis status,with limited studies on metastatic composition.AIM To investigate the LN metastasis patterns of G-ANEC,the clinicopathological features associated with these metastasis patterns,and to explore adjuvant chemotherapy regimens for G-ANEC.METHODS We analyzed 68 G-ANEC cases treated with radical surgery and confirmed LN metastasis at Peking University Cancer Hospital between August 2012 and June 2022.Utilizingχ2 tests in IBM statistical product and service solutions statistics and R software.RESULTS We identified three distinct LN metastasis patterns in G-ANEC that were significantly associated with the NEC proportion,tumour invasion depth,Lauren classification,and tumour location(P values:0.008,0.015,0.01,and 0.004,respectively).When the SOX/XELOX regimen was applied for adjuvant chemotherapy,patients with LN metastasis comprising only AC exhibited better overall survival(OS)(94.25±11.07 months vs 54.36±11.36 months)than did those with NEC.When LN metastasis components contained NEC,there was a trend towards improved OS(64±10.77 months vs 54.35±11.36 months)and disease-free survival(71.28±9.92 months vs 66.28±11.93 months)in patients treated with the etoposide and cisplatin compared to those receiving the SOX/XELOX regimen.CONCLUSION We found a significant correlation between the NEC percentage,tumour invasion depth,Lauren classification,and tumour location and LN metastasis patterns in G-ANEC.For G-ANEC,a lower proportion of NEC or AC in the primary lesion does not preclude the possibility of these components metastasizing to the LNs.Dif

关 键 词：Gastric mixed-adenoneuroendocrine carcinoma Lymph node metastatic patteren Clinicopathological features Adjuvant chemotherapy regimens Prognosis 

分 类 号：R73[医药卫生—肿瘤]