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©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Clinicopathological characteristics and prognosis of 77 cases with type 3 gastric neuroendocrine tumours
Yuan-Liang Li, Xu-Dong Qiu, Jie Chen, Yu Zhang, Jie Li, Jian-Ming Xu, Chao Wang, Zhi-Rong Qi, Jie Luo, Huang-Ying Tan
Yuan-Liang Li, Xu-Dong Qiu, Beijing University of Chinese Medicine, Beijing 100029, China
Yuan-Liang Li, Xu-Dong Qiu, Chao Wang, Zhi-Rong Qi, Huang-Ying Tan, Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing 100029, China
Jie Chen, Yu Zhang, Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China
Jie Li, Department of Gastrointestinal Oncology, Peking University Cancer Hospital and Beijing Cancer Hospital, Beijing 100037, China
Jian-Ming Xu, Department of Gastrointestinal Oncology, The Fifth Medical Center, Chinese PLA General Hospital, Beijing 100071, China
Jie Luo, Department of Pathology, China-Japan Friendship Hospital, Beijing 100029, China
Author contributions: Li YL and Qiu XD contributed equally to this work and should be considered as co-first authors; Li YL and Qiu XD wrote the paper; Li YL and Tan HY designed the research; Qiu XD, Chen J, Zhang Y, Li J, and Xu JM collected the data; Wang C and Qi ZR analysed the data; Luo J reviewed the pathology; Tan HY revised the paper.
Supported by National Natural Science Foundation of China, No. 81673763; Foundation of Guangzhou Science and Technology Plan, No. 201804010078.
Institutional review board statement: The study was reviewed and approved by the clinical research ethics committee of the China-Japan Friendship Hospital (No. 2019-24-K18-1).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that no competing interests exist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Noncommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Huang-Ying Tan, MD, PhD, Professor, Department of Integrative Oncology, China-Japan Friendship Hospital, No. 2 Yinghuadong Street, Beijing 100029, China. tanhuangying@263.net
Received: July 11, 2020
Peer-review started: July 11, 2020
First decision: September 17, 2020
Revised: September 28, 2020
Accepted: October 28, 2020
Article in press: October 28, 2020
Published online: December 15, 2020
ARTICLE HIGHLIGHTS
Research background
Given the rarity, type 3 gastric neuroendocrine tumours (g-NETs) have not been well described.
Research motivation
The pathological classification of gastroenteropancreatic neuroendocrine neoplasms was updated in 2019. Well-differentiated NET G3 was added, but its role has not been yet illustrated in type 3 g-NETs.
Research objectives
We dedicated to illustrate clinicopathological features and outcome of type 3 g-NETs. Also, we aimed to assess the role of the updated WHO pathological classification in type 3 g-NETs.
Research methods
Data of patients with type 3 g-NETs from four NET centres in China were collected and analysed retrospectively.
Research results
Seventy-seven patients with type 3 g-NETs were enrolled. Of these, there were 37 G1 tumours (48.1%), 31 G2 (40.3%), and 9 G3 (11.7%). Compared with G1 NETs, G2 NETs had a higher lymph node metastasis rate, and G3 NETs had a higher distant metastasis rate. In terms of treatment, 33 patients (29 G1 and 4 G2 ) with stage I/II disease underwent endoscopic treatment, and no one had tumour recurrence or tumour-related death with a median follow-up period of 36 mo. Additionally, grade and distant metastasis were independent risk factors for prognosis in multivariable analysis.
Research conclusions
Type 3 g-NETs is heterogeneous with unique clinicopathological features and the 2019 WHO pathological classification is effective to predict their biological behaviors and prognosis. Besides, endoscopic resection is safe and effective for G1 NETs with tumours under 2 cm and confined to the mucosa or submucosa.
Research perspectives
Having a better understanding of the clinicopathological characteristics and outcome of type 3 g-NETs based on the 2019 WHO pathological classification, clinicians could offer an optimal treatment for patients. Grade and stage are related to outcome and should be considered before treatment. In addition, endoscopic treatment is effective and should be considered for small, low grade, superficial tumours.
