Copyright ©The Author(s) 2022.
World J Gastroenterol. Feb 28, 2022; 28(8): 794-810
Published online Feb 28, 2022. doi: 10.3748/wjg.v28.i8.794
Table 1 Discrimination among mixed neuroendocrine-nonneuroendocrine neoplasms, neuroendocrine tumors, and carcinomas according to pathological parameters
Dual differentiation present
Dual differentiation absent
Neuroendocrine markers(-)(+)(+)(+)(-)Few (+) cells1
Nonneuroendocrine markers(+)Few (+) cells(+)(+)(+)(+)
DiagnosisCarcinoma NENMiNENAmphicrine tumorCarcinomaCarcinoma
Table 2 Classification of mixed neuroendocrine-nonneuroendocrine neoplasms depending on the grade of malignancy[15]
Grade of MiNEN
Nonneuroendocrine component
Endocrine component
High-grade AdenocarcinomaPDNEC, NET G31
Squamous cell carcinoma
Ductal and acinar cell carcinoma
Ductal adenocarcinoma
High-gradeAcinar cell carcinomaNET, G1 or G21
Ductal adenocarcinoma
Acinar cell carcinoma
Intermediate gradeAdenocarcinomaNET, G1 or G21
Low-grade2Adenoma NET, G1 or G2
Table 3 Summary of the therapy protocols applied to localized mixed neuroendocrine-nonneuroendocrine neoplasms
Complete resection is possible
Complete resection is not possible
MiNEN gradeHighIntermediateLowHigh IntermediateLow
ChemotherapyPDNEC-likeADC-likeNRPDNEC-likeADC- likeNET-like
Table 4 Summary of the therapy protocols applied to metastatic mixed neuroendocrine-nonneuroendocrine neoplasms
Metastatic component
Not defined
One componentTwo components
Chemotherapy targetThe metastatic componentThe most aggressive componentThe most aggressive component in the primary tumor