Clinicopathologic features and prognostic analysis of 104 patients with gastric neuroendocrine neoplasms

Objective To investigate the clinicopathologic features and prognostic factors of gastric neuroendocrine neoplasms (gNENs). Methods Clinicopathologic data of 104 patients with gastric neuroendocrine neoplasms admitted in Chinese PLA General Hospital between January 2000 and December 2014 were analyzed retrospectively. Tumor proliferation activity classification (G1, G2 and G3)and TNM staging were observed. The clinicopathologic features of the whole group were collected and the univariate and multivariate analysis were determined by Log-rank and Cox proportional hazard model to detect the prognosis-determining features. Results Of all the patients, 66 cases (63.5%)were neuroendocrine carcinoma, 25 cases (24.0%)were mixed adenoendocrine carcinoma and 12 cases (11.5%)were neuroendocrine tumor. For G grades, 92 cases (88.5%)were G3 grade, 8 cases (7.7%)were G2 grade and 4 cases (3.8%)were G1 grade. TNM staging results showed that stageⅠwas found in 6 cases (5.8%), stage ⅡA in 6 cases (5.8%), stageⅡB in 9 cases (8.7%), stage ⅢA in 8 cases (7.7%), stage ⅢB in 55 cases (52.9%)and stage Ⅳ in 20 cases (19.2%). For T stage, 7 cases (6.7%)were T1, 12 cases (11.5%)were T2, 24 cases (23.1%)were T3, and 61 cases (58.7%)were T4. Lymph node metastasis occurred in 73 cases (70.2%)and distant metastasis occurred in 20 cases (19.2%). Eighty-six patients were followed up for 6 to 186 months. The median survival was 33.0 months (95% CI: 28.3 to 36.6), and 1-, 3-, and 5-year survival rates were 80% , 49% and 31%. Clinicopathologic features which were considered statistically significant on univariate analysis were selected to Cox proportional hazard model. Univariate analysis showed that risk factors of reducing survival rate included tumor size, pathological type, proliferation activity grades, and depth of invasion (all P < 0.05), as well as chromogranin A expression, tumor staging, lymph node metastasis and distant metastasis (all P < 0.01). The multivariate analysis showed that the stage of gNEN was the independent risk factor of the prognosis (RR = 14.213, 95% CI: 1.316 to 153.524, P = 0.029). Conclusion Late staging is the main clinical feature and a prognostic factor for gNENs. Key words: Neuroendocrine neoplasms; Stomach neoplasms; Pathology; Prognosis