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Abstract：
BACKGROUND: Gastric mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN), which consists of neuroendocrine and non-neuroendocrine components, is quite rare. Until now, most data on gastric MiNEN come from clinical cases, without large-scale retrospective studies or controlled clinical trials. Consequently, no consensus regarding the origin, molecular characteristics, or appropriate treatment of MiNEN has been reached so far. We conducted chemotherapy of irinotecan plus cisplatin (IP regimen) and surgery in two patients with gastric MiNEN, which had never been used in treating this kind of tumor, leading to their long-term survival for more than 3 and 7 years, respectively.
METHODS: We present two patients (one male and one female) with gastric MiNEN, with the primary manifestation of recurrent upper abdominal pain. After they were referred to our hospital, a diagnosis of gastric MiNEN was defined with the help of CT scan, and histopathological and immunohistochemical examinations on the samples of gastrointestinal endoscopy or radical surgery. The male patient (case 1) were found to have metastases in the reginal lymph nodes and the left liver. He received four cycles of IP regimens first, then the gastrectomy and partial left liver resection, followed by additional two cycles of IP chemotherapy. The female patient (case 2) underwent a laparoscopic gastrectomy, and received six cycles of IP regimen. She was found to have metastatic lesions in the right lung 2 years after that, and underwent video-assisted thoracoscopic surgery (VATS) of the lower lobe of the right lung. The two patients have now survived for more than 3 years and 7 years, respectively, without any evidence of recurrence or metastases.
CONCLUSIONS: IP regimen, combined with curative-intent surgery if feasible, could be considered as the priority in the choice of front-line chemotherapy for gastric MiNEN.
METHODS: We present two patients (one male and one female) with gastric MiNEN, with the primary manifestation of recurrent upper abdominal pain. After they were referred to our hospital, a diagnosis of gastric MiNEN was defined with the help of CT scan, and histopathological and immunohistochemical examinations on the samples of gastrointestinal endoscopy or radical surgery. The male patient (case 1) were found to have metastases in the reginal lymph nodes and the left liver. He received four cycles of IP regimens first, then the gastrectomy and partial left liver resection, followed by additional two cycles of IP chemotherapy. The female patient (case 2) underwent a laparoscopic gastrectomy, and received six cycles of IP regimen. She was found to have metastatic lesions in the right lung 2 years after that, and underwent video-assisted thoracoscopic surgery (VATS) of the lower lobe of the right lung. The two patients have now survived for more than 3 years and 7 years, respectively, without any evidence of recurrence or metastases.
CONCLUSIONS: IP regimen, combined with curative-intent surgery if feasible, could be considered as the priority in the choice of front-line chemotherapy for gastric MiNEN.
摘要：
背景：胃混合性神经内分泌-非神经内分泌肿瘤（MiNEN），由神经内分泌和非神经内分泌成分组成，相当罕见。直到现在,大多数关于胃部MINEN的数据来自临床病例，没有大规模的回顾性研究或对照临床试验。因此,关于起源没有共识，分子特征，或到目前为止已对MiNEN进行了适当的治疗。我们对两名胃MiNEN患者进行了伊立替康加顺铂（IP方案）的化疗和手术，从未用于治疗这种肿瘤，导致他们的长期生存超过3年和7年，分别。
方法：我们介绍了两名患有胃MiNEN的患者（一名男性和一名女性），主要表现为复发性上腹痛。他们被转诊到我们医院后，在CT扫描的帮助下定义了胃部MiNEN的诊断，以及对胃肠内镜或根治性手术样本的组织病理学和免疫组织化学检查。发现男性患者（病例1）在区域淋巴结和左肝有转移。他首先接受了四个周期的IP疗法，然后是胃切除术和左肝部分切除术,随后是另外两个周期的IP化疗。女性患者（病例2）接受了腹腔镜胃切除术，并接受6个周期的IP方案。两年后，她被发现右肺有转移性病变，并接受了右肺下叶的电视胸腔镜手术（VATS）。这两个病人现在已经存活了3年多,7年多,分别,没有任何复发或转移的证据。
结论：IP方案，如果可行，结合治愈性手术，可被认为是选择胃MiNEN一线化疗的优先事项。
方法：我们介绍了两名患有胃MiNEN的患者（一名男性和一名女性），主要表现为复发性上腹痛。他们被转诊到我们医院后，在CT扫描的帮助下定义了胃部MiNEN的诊断，以及对胃肠内镜或根治性手术样本的组织病理学和免疫组织化学检查。发现男性患者（病例1）在区域淋巴结和左肝有转移。他首先接受了四个周期的IP疗法，然后是胃切除术和左肝部分切除术,随后是另外两个周期的IP化疗。女性患者（病例2）接受了腹腔镜胃切除术，并接受6个周期的IP方案。两年后，她被发现右肺有转移性病变，并接受了右肺下叶的电视胸腔镜手术（VATS）。这两个病人现在已经存活了3年多,7年多,分别,没有任何复发或转移的证据。
结论：IP方案，如果可行，结合治愈性手术，可被认为是选择胃MiNEN一线化疗的优先事项。
