Histological characterisation and prognostic evaluation of 62 gastric neuroendocrine carcinomas.
OBJECTIVE
To determine the significance of expression of synaptophysin, chromogranin A, and Ki-67 and their association with clinicopathological parameters, and to find out the possible prognostic factors in gastric neuroendocrine carcinoma (G-NEC).


METHODS
We investigated the immunohistochemical features and prognosis of 62 G-NECs, and evaluated the association among expressions of synaptophysin, chromogranin A, and Ki-67, clinicopathological variables, and outcome.


RESULTS
Chromogranin A expression was found more commonly in small-cell NECs (9/9, 100%) than in large-cell NECs (27/53, 51%) (p = 0.008). No statistical significance was found in Ki-67 (p = 0.494) or synaptophysin (p > 0.1) expression between NEC cell types. Correlation analyses revealed that Ki-67 expression was significantly associated with mid-third disease of stomach (p = 0.005) and vascular involvement (p = 0.006), and had a trend of significant correlation with tumour relapse (p = 0.078). High expression of chromogranin A was significantly associated with histology of small-cell NECs (p = 0.008) and lesser tumour greatest dimension (p = 0.038). The prognostic significance was determined by means of Kaplan-Meier survival estimates and log-rank tests, and as a result, early TNM staging and postoperative chemotherapy were found to be correlated with longer overall survival (p < 0.05). Univariate analysis revealed associations between poor prognosis in NECs and several factors, including high TNM staging (p = 0.048), vascular involvement (p = 0.023), relapse (p = 0.004), and microscopic/macroscopic residual tumour (R1/2, p < 0.001). In a multivariate analysis, relapse was identified as the sole independent prognostic factor.


CONCLUSIONS
No significant correlation between survival and expression of synaptophysin, chromogranin A, or Ki-67 has been determined in G-NECs. Our study indicated that early diagnosis, no-residual-tumour resection, and postoperative chemotherapy were possible prognostic factors.
Department of Chemotherapy, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, PR China; These two authors contributed equally to this paper.
Yujie
Y
Deng
Division of Oncological Surgery, Fujian Provincial Cancer Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, PR China; These two authors contributed equally to this paper.
Xiaohui
X
Chen
Department of Pathology, The First Affiliated Hospital of Fujian Medical University, PR China.
Yuhong
Y
Ye
Department of Chemotherapy, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, PR China.
Xi
X
Shi
Division of Oncological Surgery, Fujian Provincial Cancer Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, PR China.
Kunshou
K
Zhu
Department of Chemotherapy, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, PR China.
Liming
L
Huang
Department of Pathology, The First Affiliated Hospital of Fujian Medical University, PR China.
Sheng
S
Zhang
Division of Oncological Surgery, Fujian Provincial Cancer Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, PR China.
Mingang
M
Ying
Department of Chemotherapy, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, PR China.
Xuede
X
Lin
Ki-67; chromogranin A; neuroendocrine carcinoma; prognosis; stomach
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