AB14. A retrospective study on clinicopathological characteristics and treatment analysis of gastric neuroendocrine carcinoma

Objectives: To analyze the clinicopathological characteristics and treatment of gastric neuroendocrine carcinoma.

Methods: The clinicopathological and follow-up data of the patients with gastric neuroendocrine carcinoma, who were diagnosed by pathology from 2011 to 2013, were analyzed retrospectively.

Results: The tumor occurs more often in older patients (the average age was 60.5 years old). The major clinical manifestation was epigastric pain. Main body sign was epigastrium tenderness. Inspection methods include ultrasound, PET-CT, upper gastrointestinal gastroscope, biopsy under gastroscope and immunohistochemistry. Endoscopy revealed: ulcerative type 1 case, nodular type with ulcer 1 case, a mass 1.2 cm ×1.2 cm in diameter 1 case and a diameter 1 cm ×1.5 cm mass with centre ulcer 1 case. Pathology result: infiltration beyond the serosa occurred in all the 4 patients with neurologic invasion, regional lymph node metastasis in 1 patient, liver metastasis in 2 patients. Treatment: two patients treated with radical gastrectomy of gastric cancer. One of the two received the adjuvant chemotherapy after the operation. Specific surgical treatment: radical gastrectomy of gastric cancer (total gastrectomy, Roux-en-Y), resection of liver tumors. The adjuvant chemotherapy after surgery is Oxaliplatin, Etoposide, Fluorouracil and Bevacizumab. The choice of specific surgical treatment made by the other case is radical gastrectomy of gastric cancer (R₀ distal gastrectomy, D1+8a, 9, 11p, Billroth I).

Conclusions: Gastric neuroendocrine carcinoma with unique biologic behavior is rare. The rate of misdiagnosis is high. MRI, CT and ultrasound hold great significance to the diagnosis and clinical stage of primary locations and metastases. PET-CT may be used to evaluate the invasion and distant metastasis of tumors. And it is the basis of clinical staging. But all these image examinations are impossible to determine the nature of tumors. Diagnosis of gastric neuroendocrine tumor is mainly based on gastroscope and pathologic biopsy. In addition, the application of immunohistochemical method may raise the diagnostic rate of neuroendocrine tumors. Operation is the first choice for gastric neuroendocrine tumor at present. Radical gastrectomy is an effective way to prolong the postoperative survival in patients with gastric neuroendocrine carcinoma.

Keywords: Gastric neuroendocrine tumor; pathology; diagnosis; radical gastrectomy