1
|
Guo X, Zhao X, Huang G, Yu Y. Advances in Endoscopic Diagnosis and Treatment of Gastric Neuroendocrine Neoplasms. Dig Dis Sci 2024; 69:27-35. [PMID: 37971578 DOI: 10.1007/s10620-023-08180-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023]
Abstract
Gastric neuroendocrine neoplasms refer to a group of diseases that are relatively rare. They can be classified into three subtypes based on their clinical and histopathological features, and there are significant differences in diagnosis, treatment, and prognosis among the different subtypes. The incidence of gastric neuroendocrine neoplasms has been increasing globally in recent years with the localized disease being particularly evident. Gastrointestinal endoscopy is of irreplaceable importance for the diagnosis and management of g-NENs. Endoscopy with biopsy is the gold standard for the diagnosis of g-NENs. Ultrasound endoscopy can assess the depth of tumor invasion and the presence of lymphatic metastases, which is important for the development of treatment strategies. Meanwhile, for some small and low-risk lesions, endoscopic surveillance or endoscopic resection has satisfactory therapeutic results and prognosis. This means that even though the incidence has increased, advances in endoscopic techniques have allowed more patients to adopt a relatively conservative treatment strategy. However, the criteria for patients suitable for endoscopic surveillance or endoscopic resection remain controversial.
Collapse
Affiliation(s)
- Xinrui Guo
- Department of Gastroenterology, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong, People's Republic of China
- Shandong Provincial Clinical Research Center for Digestive Disease, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China
| | - Xiaohan Zhao
- Department of Gastroenterology, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong, People's Republic of China
- Shandong Provincial Clinical Research Center for Digestive Disease, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China
| | - Gang Huang
- Department of Gastroenterology, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong, People's Republic of China
- Shandong Provincial Clinical Research Center for Digestive Disease, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China
| | - Yanbo Yu
- Department of Gastroenterology, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong, People's Republic of China.
- Shandong Provincial Clinical Research Center for Digestive Disease, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China.
| |
Collapse
|
2
|
Matsueda K, Uedo N, Kitamura M, Shichijo S, Maekawa A, Kanesaka T, Takeuchi Y, Higashino K, Ishihara R, Michida T, Kawano S, Kawahara Y. Endoscopic features of gastric neuroendocrine carcinoma. J Gastroenterol Hepatol 2023; 38:1808-1817. [PMID: 37527834 DOI: 10.1111/jgh.16309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 07/06/2023] [Accepted: 07/10/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND AND AIM The endoscopic features of gastric neuroendocrine carcinoma (G-NEC) have not been clarified; therefore, they were investigated in relation to clinicopathological findings. METHODS Consecutive patients with G-NECs who had undergone endoscopic or surgical resection at our institution between January 2005 and March 2022 were included in this retrospective study. The endoscopic and clinicopathological findings of the lesions were analyzed to provide information of diagnostic value. In addition, cases of gastric neuroendocrine tumor (G-NET) and common-type gastric adenocarcinoma treated in the same study period were identified to compare the endoscopic findings between each G-NEC versus G-NET, and G-NEC versus common-type gastric adenocarcinoma. Patients with common-type gastric adenocarcinoma were matched for age, sex, tumor size, and depth of tumor invasion in 1:3 ratio. RESULTS Among 15 patients with 15 G-NECs, submucosal tumor-like marginal elevation (87%), adherent white coat (67%), and ulceration with a distinct border (60%) were characteristic endoscopic findings in white-light images. Magnifying narrow-band imaging endoscopy revealed an absent microsurface (MS) pattern plus disrupted irregular microvessel (MV) in five (71%) of seven cases with evaluable MS and MV patterns. The area with an absent MS pattern plus disrupted irregular MV corresponded to the histological finding of NEC component in all five cases. These endoscopic features were all significantly more frequent in G-NECs than G-NETs (n = 22) or common-type gastric adenocarcinomas (n = 45). CONCLUSIONS These endoscopic features should be taken into consideration to increase the index of suspicion and to improve the accuracy of target biopsies for G-NEC.
Collapse
Affiliation(s)
- Katsunori Matsueda
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
- Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
| | - Noriya Uedo
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Masanori Kitamura
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan
| | - Satoki Shichijo
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Akira Maekawa
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Takashi Kanesaka
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Yoji Takeuchi
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Koji Higashino
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Ryu Ishihara
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Tomoki Michida
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Seiji Kawano
- Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
| | - Yoshiro Kawahara
- Department of Practical Gastrointestinal Endoscopy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| |
Collapse
|
3
|
Cheng Y, Zhang X, Zhou X, Xu K, Lin M, Huang Q. Differences in clinicopathology and prognosis between gastroesophageal junctional and gastric non-cardiac neuroendocrine carcinomas: a retrospective comparison study of consecutive 56 cases from a single institution in China. Am J Cancer Res 2022; 12:4737-4750. [PMID: 36381336 PMCID: PMC9641387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023] Open
Abstract
Gastric neuroendocrine carcinoma (NEC), including mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN), is uncommon and differences in clinicopathological features and outcomes of NEC arising in various gastric regions remain elusive. We investigated 56 consecutive NECs identified among 3961 gastrectomies performed at our center between 2005 and 2021. We then compared clinicopathological characteristics and prognosis between gastroesophageal junctional (GEJ) NECs (N=39) and gastric non-cardiac NECs (N=17). No significant difference was found between the two groups in age, gender, tumor size, mixed non-neuroendocrine carcinoma component, MiNEN, NEC type, metastatic NEC component in lymph nodes, tumor infiltrating lymphocyte, lymph node metastasis, lymphovascular or perineural invasion, intestinal metaplasia in adjacent non-neoplastic mucosa, and expression of P53, PD-L1, TTF-1, HER2, and Ki-67. However, compared to gastric non-cardiac NECs, GEJ NECs displayed a significantly higher frequency of prevalence (2.79% versus 0.66%), pT3-T4 (92.3% versus 64.7%), advanced pathological stage (IIb-IV) (76.9% versus 47.1%), and a significantly lower 5-year overall survival rate (46.1% versus 73.1%) (P<0.05). The GEJ location was the only independent risk factor for overall survival. In stage-stratified comparisons, patients with stage II GEJ NEC demonstrated a significantly lower 5-year survival rate than those with gastric non-cardiac NEC at the same stage. Compared to non-NECs matched for age, gender, tumor location, and pathological summary stage, GEJ NEC was associated with significantly worse prognosis. In conclusion, GEJ NEC showed deeper invasion, more advanced pathological stages, and worse prognosis than gastric non-cardiac NEC. The findings provide pathologic evidence for individualized management strategies for patients with GEJ NEC. Future studies with larger samples are needed.
Collapse
Affiliation(s)
- Yuqing Cheng
- Department of Pathology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical UniversityChangzhou, Jiangsu, China
| | - Xinwen Zhang
- Department of Pathology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical UniversityChangzhou, Jiangsu, China
- Graduate School of Dalian Medical UniversityDalian, Liaoning, China
| | - Xiaoli Zhou
- Department of Pathology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical UniversityChangzhou, Jiangsu, China
| | - Kequn Xu
- Department of Oncology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical UniversityChangzhou, Jiangsu, China
| | - Min Lin
- Department of Gastroenterology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical UniversityChangzhou, Jiangsu, China
| | - Qin Huang
- Department of Pathology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical UniversityChangzhou, Jiangsu, China
- Department of Pathology and Laboratory Medicine, Veterans Affairs Boston Healthcare System, Harvard Medical School and Brigham and Women’s HospitalBoston, Massachusetts, USA
| |
Collapse
|
4
|
Li L, Huang S, Qiu L, Jiang W, Chen Z, Kang D, Tu H, Chen J, Zhou Y. Label-free identification of early gastrointestinal neuroendocrine tumors via biomedical multiphoton microscopy and automatic image analysis. IEEE ACCESS : PRACTICAL INNOVATIONS, OPEN SOLUTIONS 2020; 8:105681-105689. [PMID: 37197612 PMCID: PMC10187769 DOI: 10.1109/access.2020.3000289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
At present, early diagnosis and treatment is the most effective way to treat early gastrointestinal neuroendocrine tumors. Therefore, we attempted to carry out multiphoton imaging of early neuroendocrine tumors because of its ability to label-free image tissue microstructure at the cellular level. Imaging results show that this imaging technique can quickly identify the histopathological changes in mucosa and submucosa caused by tumor invasion. Furthermore, we performed automatic image analysis on SHG images and extracted two optical diagnostic features-collagen density and average intensity, and also found obvious differences in the density as well as average intensity of collagen fibers in tumor microenvironment using a series of quantitative analysis. These findings may further facilitate the development of multiphoton microscopic imaging technique for clinical use.
Collapse
Affiliation(s)
- Lianhuang Li
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou 350007, P. R. China
| | - Shenghui Huang
- Department of Colorectal Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, P. R. China
| | - Lida Qiu
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou 350007, P. R. China
- College of Physics and Electronic Information Engineering, Minjiang University, Fuzhou 350108, P. R. China
| | - Weizhong Jiang
- Department of Colorectal Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, P. R. China
| | - Zhifen Chen
- Department of Colorectal Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, P. R. China
| | - Deyong Kang
- Department of Pathology, Fujian Medical University Union Hospital, Fuzhou 350001, P. R. China
| | - Haohua Tu
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Jianxin Chen
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou 350007, P. R. China
| | - Yongjian Zhou
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, P. R. China
| |
Collapse
|