Clinicopathological Characteristics And Prognosis Of Gastric Cancer Patients With Neuroendocrine Differentiation

ObjectiveTo compare the differences in clinicopathological characteristics and prognosis between gastric cancer patients with or without neuroendocrine differentiation(NED),to explore the risk factors affecting prognosis of two groups patients,and to analyze the correlations between clinicopathological characteristics and the positive expression of CgA and Syn in gastric cancer patients with NED.MethodsClinicopathological data of 98 gastric cancer with NED patients and 338 gastric cancer without NED patients at Nanjing Drum Tower Hospital from January 2010 to August 2017 were analyzed retrospectively.The clinicopathological characteristics between the two groups of patients were compared by chi-square test.The overall survival rate was calculated by Kaplan-Meier curve,and univariate or multivariate prognostic risk factors were analyzed by Log-rank test or COX regression model respectively.ResultsThe gastric cancer patients with or without NED have the same characteristics,such as the onset symptoms,the operation methods,more younger than 65 year old,more bigger than or equal to 4 cm tumor size,high proportion of nerve invasion,and the rates of lymph node and distant metastasis.However,there were also some significant diferences in gender,histological types,T stage,tumor TNM staging and vascular invasion between this two groups(P <0.05).The positive expression rates of CgA and Syn in gastric cancer patients with NED were 70.4% and 75.5%,both expression rate was 45.9%,and Syn was more easily expressed in patients with III or IV tumor staging.Survival analysis showed the 1-year,3-years and 5-years overall survival rates were significantly lower in gastric cancer patients with NED than in those without NED(P<0.05),especially in patients with I and II tumor staging.Univariate analysis showed that the patient age,tumor size,differentiation,TNM staging,vascular and nerve invasion were associated with prognosis of gastric cancer with NED(P<0.05),and the patient age,tumor size,TNM staging,vascular and nerve invasion were associated with prognosis of gastric cancer without NED(P<0.05).Multivariate analysis showed that the patient age and TNM staging were independent risk factors affecting the prognosis of gastric cancer with NED(P <0.05),and the tumor size and TNM staging were independent risk factors affecting the prognosis of gastric cancer without NED(P <0.05).ConclusionImmunohistochemistry is the main method to diagnose gastric cancer with NED.Our study shows that NED may be one of the factors for the poor prognosis of gastric cancer patients,especially in patients with earlier tumor staging,and TNM staging is the independent risk factor of gastric cancer with or without NED,so it is essential to diagnose and treat early to improve the prognosis of patients with gastric cancer.