Gastric neuroendocrine carcinoma: Clinicopathologic review and immunohistochemical study of E-cadherin and Ki-67 as prognostic markers

Yoon-Jung Boo, Sungsoo Park, Jong Han Kim, Young Jae Mok, Seong Joo Kim, Chong Suk Kim

Research output: Contribution to journalReview article

28 Citations (Scopus)

Abstract

Background and Objectives: Gastric neuroendocrine carcinoma (NEC) is an uncommon cancer of the stomach. The classification of NEC and its clinical behavior remains controversial, and prognostic markers and their therapeutic guidelines have not been clearly defined. The aim of this study was to evaluate the clinicopathologic characteristics of these tumors and analyze the expression of E-cadherin and Ki-67 as prognostic markers in gastric NECs. Methods: We retrospectively reviewed 17 cases of gastric NECs. Tumor pathology was reviewed and the tumors were categorized as well-differentiated NEC (n = 5) and poorly differentiated NEC (n = 12) according to the WHO classification. With the aim of evaluating the expression of E-cadherin and Ki-67 and their prognostic role in gastric NEC, immunohistochemical analysis of the tumors was performed. Results: The median survival of patients was 20.0 months (95% confidence interval (CI), 13.2-28.8). There was a statistically significant difference in overall survival between well and poorly differentiated NECs (P = 0.021). However, there was no significant difference in overall survival between patients with poorly differentiated small cell and large cell NEC (P = 0.796). Loss of E-cadherin was correlated with lymph node metastasis (P = 0.044). A high Ki-67 proliferation index (PI) (>60%) was correlated with tumor recurrence (P = 0.013) and histologic differentiation (P = 0.028). Conclusions: Loss of E-cadherin may predict lymph node metastasis in gastric NECs. A high Ki-67 PI (>60%) could be used as a prognostic marker to predict aggressive gastric NECs in addition to standard pathologic classification.

Original languageEnglish
Pages (from-to)110-117
Number of pages8
JournalJournal of Surgical Oncology
Volume95
Issue number2
DOIs
Publication statusPublished - 2007 Feb 1

Fingerprint

Neuroendocrine Carcinoma
Cadherins
Stomach
Neoplasms
Survival
Lymph Nodes
Neoplasm Metastasis
Large Cell Carcinoma
Stomach Neoplasms
Guidelines
Confidence Intervals
Pathology
Recurrence

Keywords

  • E-cadherin
  • Ki-67
  • Neuroendocrine carcinoma
  • Stomach

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Gastric neuroendocrine carcinoma : Clinicopathologic review and immunohistochemical study of E-cadherin and Ki-67 as prognostic markers. / Boo, Yoon-Jung; Park, Sungsoo; Kim, Jong Han; Mok, Young Jae; Kim, Seong Joo; Kim, Chong Suk.

In: Journal of Surgical Oncology, Vol. 95, No. 2, 01.02.2007, p. 110-117.

Research output: Contribution to journalReview article

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abstract = "Background and Objectives: Gastric neuroendocrine carcinoma (NEC) is an uncommon cancer of the stomach. The classification of NEC and its clinical behavior remains controversial, and prognostic markers and their therapeutic guidelines have not been clearly defined. The aim of this study was to evaluate the clinicopathologic characteristics of these tumors and analyze the expression of E-cadherin and Ki-67 as prognostic markers in gastric NECs. Methods: We retrospectively reviewed 17 cases of gastric NECs. Tumor pathology was reviewed and the tumors were categorized as well-differentiated NEC (n = 5) and poorly differentiated NEC (n = 12) according to the WHO classification. With the aim of evaluating the expression of E-cadherin and Ki-67 and their prognostic role in gastric NEC, immunohistochemical analysis of the tumors was performed. Results: The median survival of patients was 20.0 months (95{\%} confidence interval (CI), 13.2-28.8). There was a statistically significant difference in overall survival between well and poorly differentiated NECs (P = 0.021). However, there was no significant difference in overall survival between patients with poorly differentiated small cell and large cell NEC (P = 0.796). Loss of E-cadherin was correlated with lymph node metastasis (P = 0.044). A high Ki-67 proliferation index (PI) (>60{\%}) was correlated with tumor recurrence (P = 0.013) and histologic differentiation (P = 0.028). Conclusions: Loss of E-cadherin may predict lymph node metastasis in gastric NECs. A high Ki-67 PI (>60{\%}) could be used as a prognostic marker to predict aggressive gastric NECs in addition to standard pathologic classification.",
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AU - Mok, Young Jae

AU - Kim, Seong Joo

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N2 - Background and Objectives: Gastric neuroendocrine carcinoma (NEC) is an uncommon cancer of the stomach. The classification of NEC and its clinical behavior remains controversial, and prognostic markers and their therapeutic guidelines have not been clearly defined. The aim of this study was to evaluate the clinicopathologic characteristics of these tumors and analyze the expression of E-cadherin and Ki-67 as prognostic markers in gastric NECs. Methods: We retrospectively reviewed 17 cases of gastric NECs. Tumor pathology was reviewed and the tumors were categorized as well-differentiated NEC (n = 5) and poorly differentiated NEC (n = 12) according to the WHO classification. With the aim of evaluating the expression of E-cadherin and Ki-67 and their prognostic role in gastric NEC, immunohistochemical analysis of the tumors was performed. Results: The median survival of patients was 20.0 months (95% confidence interval (CI), 13.2-28.8). There was a statistically significant difference in overall survival between well and poorly differentiated NECs (P = 0.021). However, there was no significant difference in overall survival between patients with poorly differentiated small cell and large cell NEC (P = 0.796). Loss of E-cadherin was correlated with lymph node metastasis (P = 0.044). A high Ki-67 proliferation index (PI) (>60%) was correlated with tumor recurrence (P = 0.013) and histologic differentiation (P = 0.028). Conclusions: Loss of E-cadherin may predict lymph node metastasis in gastric NECs. A high Ki-67 PI (>60%) could be used as a prognostic marker to predict aggressive gastric NECs in addition to standard pathologic classification.

AB - Background and Objectives: Gastric neuroendocrine carcinoma (NEC) is an uncommon cancer of the stomach. The classification of NEC and its clinical behavior remains controversial, and prognostic markers and their therapeutic guidelines have not been clearly defined. The aim of this study was to evaluate the clinicopathologic characteristics of these tumors and analyze the expression of E-cadherin and Ki-67 as prognostic markers in gastric NECs. Methods: We retrospectively reviewed 17 cases of gastric NECs. Tumor pathology was reviewed and the tumors were categorized as well-differentiated NEC (n = 5) and poorly differentiated NEC (n = 12) according to the WHO classification. With the aim of evaluating the expression of E-cadherin and Ki-67 and their prognostic role in gastric NEC, immunohistochemical analysis of the tumors was performed. Results: The median survival of patients was 20.0 months (95% confidence interval (CI), 13.2-28.8). There was a statistically significant difference in overall survival between well and poorly differentiated NECs (P = 0.021). However, there was no significant difference in overall survival between patients with poorly differentiated small cell and large cell NEC (P = 0.796). Loss of E-cadherin was correlated with lymph node metastasis (P = 0.044). A high Ki-67 proliferation index (PI) (>60%) was correlated with tumor recurrence (P = 0.013) and histologic differentiation (P = 0.028). Conclusions: Loss of E-cadherin may predict lymph node metastasis in gastric NECs. A high Ki-67 PI (>60%) could be used as a prognostic marker to predict aggressive gastric NECs in addition to standard pathologic classification.

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