背景:根据2019年世界卫生组织(WHO)对胃神经内分泌肿瘤的分类,胃神经内分泌癌(GNEC)又可分为胃大细胞神经内分泌癌(GLNEC)和胃小细胞神经内分泌癌(GSNEC)。这两种类型的预测是否存在差异长期以来一直存在争议。
方法:我们收集了2000年1月至2020年12月在中国国家癌症中心诊断为GLNEC或GSNEC的患者。比较两组患者的特点和生存结局。我们使用SEER数据集进一步验证了我们的结论。
结果:共有114名GNEC患者,包括82例GLNEC患者和32例GSNEC患者,已经在我们医院完成治疗。在性别方面,GSNEC和GLNEC患者之间未观察到临床病理差异,年龄,身体质量指数,Charlson合并症指数,肿瘤位置,肿瘤大小,舞台,接受治疗,神经内分泌标志物(CD56,嗜铬粒蛋白A,突触素),Ki-67指数得分。1年,3年,GLNEC和GSNEC的5年总生存率为89.0%,60.5%,52.4%,和93.8%,56.3%,52.7%,差异无统计学意义。通过在治疗加权的逆概率之后使用SEER数据集进一步证实了该结果。
结论:尽管细胞形态不同,GLNEC与GSNEC的预后比较差异无统计学意义。
BACKGROUND: According to the 2019 World Health Organization (WHO) classification of gastric neuroendocrine neoplasms, gastric neuroendocrine carcinoma (GNEC) can be further divided into gastric large-cell neuroendocrine carcinoma (GLNEC) and gastric small-cell neuroendocrine carcinoma (GSNEC). Whether the prognoses of the two types have a discrepancy has long been disputed.
METHODS: We collected patients diagnosed with GLNEC or GSNEC in the National Cancer Center of China between January 2000 and December 2020. The characteristics and survival outcomes were compared between the two groups. We further verified our conclusion using the SEER dataset.
RESULTS: A total of 114 GNEC patients, including 82 patients with GLNEC and 32 patients with GSNEC, have completed treatment in our hospital. Clinicopathologic differences were not observed between patients with GSNEC and GLNEC concerning the sex, age, body mass index, Charlson Comorbidity Index, tumor location, tumor size, stage, treatment received, the expression of neuroendocrine markers (CD56, Chromogranin A, synaptophysin), and score on the Ki-67 index. The 1-year, 3-year, and 5-year overall survival rates of GLNEC and GSNEC were 89.0%, 60.5%, and 52.4%, and 93.8%, 56.3%, and 52.7%, which showed no statistically significant differences. This result was confirmed further by using the SEER dataset after the inverse probability of treatment weighting.
CONCLUSIONS: Although with different cell morphology, the comparison of prognosis between the GLNEC and GSNEC has no significant statistical difference.