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©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Clinicopathological characteristics and prognosis of 77 cases with type 3 gastric neuroendocrine tumours
Yuan-Liang Li, Xu-Dong Qiu, Jie Chen, Yu Zhang, Jie Li, Jian-Ming Xu, Chao Wang, Zhi-Rong Qi, Jie Luo, Huang-Ying Tan
Yuan-Liang Li, Xu-Dong Qiu, Beijing University of Chinese Medicine, Beijing 100029, China
Yuan-Liang Li, Xu-Dong Qiu, Chao Wang, Zhi-Rong Qi, Huang-Ying Tan, Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing 100029, China
Jie Chen, Yu Zhang, Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China
Jie Li, Department of Gastrointestinal Oncology, Peking University Cancer Hospital and Beijing Cancer Hospital, Beijing 100037, China
Jian-Ming Xu, Department of Gastrointestinal Oncology, The Fifth Medical Center, Chinese PLA General Hospital, Beijing 100071, China
Jie Luo, Department of Pathology, China-Japan Friendship Hospital, Beijing 100029, China
Author contributions: Li YL and Qiu XD contributed equally to this work and should be considered as co-first authors; Li YL and Qiu XD wrote the paper; Li YL and Tan HY designed the research; Qiu XD, Chen J, Zhang Y, Li J, and Xu JM collected the data; Wang C and Qi ZR analysed the data; Luo J reviewed the pathology; Tan HY revised the paper.
Supported by National Natural Science Foundation of China, No. 81673763; Foundation of Guangzhou Science and Technology Plan, No. 201804010078.
Institutional review board statement: The study was reviewed and approved by the clinical research ethics committee of the China-Japan Friendship Hospital (No. 2019-24-K18-1).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that no competing interests exist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Noncommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Huang-Ying Tan, MD, PhD, Professor, Department of Integrative Oncology, China-Japan Friendship Hospital, No. 2 Yinghuadong Street, Beijing 100029, China. tanhuangying@263.net
Received: July 11, 2020
Peer-review started: July 11, 2020
First decision: September 17, 2020
Revised: September 28, 2020
Accepted: October 28, 2020
Article in press: October 28, 2020
Published online: December 15, 2020
Processing time: 152 Days and 9.3 Hours
BACKGROUND
For the rarity of type 3 gastric neuroendocrine tumours (g-NETs), their clinicopathological characteristics and prognosis are not well illustrated.
AIM
To describe the clinicopathological features and outcome of type 3 g-NETs in the Chinese population.
METHODS
Based on the 2019 WHO pathological classification, the clinicopathological characteristics and prognosis of patients with type 3 g-NETs in China were retrospectively analysed.
RESULTS
A total of 77 patients (55.8% of females) with type 3 g-NETs were analysed, with a median age of 48 years (range: 28-79 years). The tumours were mainly located in the gastric fundus/body (83.1%) and were mostly solitary (83.1%), with a median size of 1.5 cm (0.8-3.5 cm). Of these, there were 37 G1 tumours (48.1%), 31 G2 (40.3%), and 9 G3 (11.7%). Ten (13.0%) and 24 (31.2%) patients had lymph node and distant metastasis, respectively. In addition, type 3 g-NETs were heterogeneous. Compared with G1 NETs, G2 NETs had a higher lymph node metastasis rate, and G3 NETs had a higher distant metastasis rate. G1 and G2 NETs with stage I/II disease (33/68) received endoscopic treatment, and no tumour recurrence or tumour-related death was observed within a median follow-up time of 36 mo. Grade and distant metastasis were identified to be independent risk factors for prognosis in multivariable analysis.
CONCLUSION
Type 3 g-NETs are obviously heterogeneous, and the updated WHO 2019 pathological classification may be used to effectively evaluate their biological behaviors and prognosis. Also, endoscopic treatment should be considered for small (< 2 cm), low grade, superficial tumours.
Core Tip: Type 3 gastric neuroendocrine tumours (g-NETs) were heterogeneous based on the 2019 WHO pathological classification. Endoscopic treatment was safe and effective for patients with G1 NETs having tumours under 2 cm, confined to the mucosa or submucosa. The prognosis of type 3 g-NETs was related to stage and grade, which were its independent prognostic factors, and the 2019 WHO pathological classification was effective to predict the biological behaviors and prognosis of type 3 g-NETs.
