Авторы: Пачуашвили Н. В., Тертычный А. С., Проценко Д. Д., Лернер Ю. В., Цой Л. В., Нагорная Д. П.
DOI: https://doi.org/10.17650/2618‑7019‑2023‑6‑1-2-39‑49
PDF: https://journal.oncopathology.ru/article/OP_2023_1-2-41-51.pdf
Смешанные нейроэндокринные-ненейроэндокринные новообразования желудочно-кишечного тракта представляют собой редкую гетерогенную группу опухолей. На протяжении многих лет диагностические критерии, классификация и клиническое поведение этих опухолей были предметом постоянных дискуссий, что привело к путанице как среди патологов, так и среди клиницистов. Цель данного обзора – описать эпидемиологические, клинические и патологические характеристики и прогноз смешанных нейроэндокринных-ненейроэндокринных новообразований желудочно-кишечного тракта, а также сфокусироваться на последних опубликованных данных, в том числе генетических, чтобы дать некоторые представления о биологии и патогенезе этого редкого заболевания. В качестве иллюстрации смешанных нейроэндокринных-ненейроэндокринных новообразований желудочно-кишечного тракта в данной работе приводятся несколько собственных клинических наблюдений.
Пачуашвили Н. В., Тертычный А. С., Проценко Д. Д., Лернер Ю. В., Цой Л. В., Нагорная Д. П.
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И. М. Сеченова» Минздрава России (Сеченовский Университет); Россия, 119991 Москва, ул. Трубецкая, 8, стр. 2
1. Brathwaite S.A., Smith S.M., Wai L. et al. Mixed adenoneuroendocrine carcinoma: A review of pathologic characteristics. Hum Pathol 2018;73:184–91. DOI: 10.1016/j.humpath.2017.12.009
2. Lewin K. Carcinoid tumors and the mixed (composite) glandularendocrine cell carcinomas. Am J Surg Pathol 1987;11(1):71–86. DOI: 10.1097/00000478-198700111-00007
3. Capella C., La Rosa S., Uccella S. et al. Mixed endocrine-exocrine tumors of the gastrointestinal tract. Semin Diagn Pathol 2000;17(2):91–103.
4. La Rosa S., Sessa F., Uccella S. Mixed neuroendocrinenonneuroendocrine neoplasms (MiNENs): unifying the concept of a heterogeneous group of neoplasms. Endocr Pathol 2016;27(4):284–311. DOI: 10.1007/s12022-016-9432-9
5. Frizziero M., Chakrabarty B., Nagy B. et al. Mixed neuroendocrine non-neuroendocrine neoplasms: a systematic review of a controversial and underestimated diagnosis. J Clin Med 2020;9(1). DOI: 10.3390/jcm9010273
6. Woischke C., Schaaf C.W., Yang H.-M. et al. In-depth mutational analyses of colorectal neuroendocrine carcinomas with adenoma or adenocarcinoma components. Mod Pathol An Off J United States Can Acad Pathol Inc 2017;30(1):95–103. DOI: 10.1038/ modpathol.2016.150
7. Jesinghaus M., Konukiewitz B., Keller G. et al. Colorectal mixed adenoneuroendocrine carcinomas and neuroendocrine carcinomas are genetically closely related to colorectal adenocarcinomas. Mod Pathol An Off J United States Can Acad Pathol Inc 2017;30(4):610–9. DOI: 10.1038/modpathol.2016.220
8. Sahnane N., Furlan D., Monti M. et al. Microsatellite unstable gastrointestinal neuroendocrine carcinomas: a new clinicopathologic entity. Endocr Relat Cancer 2015;22(1):35–45. DOI: 10.1530/ERC-14-0410
9. La Rosa S., Marando A., Furlan D. et al. Colorectal poorly differentiated neuroendocrine carcinomas and mixed adenoneuroendocrine carcinomas: insights into the diagnostic immunophenotype, assessment of methylation profile, and search for prognostic markers. Am J Surg Pathol 2012;36(4):601–11. DOI: 10.1097/PAS.0b013e318242e21c
10. Furlan D., Bernasconi B., Uccella S. et al. Allelotypes and fluorescence in situ hybridization profiles of poorly differentiated endocrine carcinomas of different sites. Clin Cancer Res An Off J Am Assoc Cancer Res 2005;11(5):1765–75. DOI: 10.1158/1078- 0432.CCR-04-1732
11. Sinha N., Gaston D., Manders D. et al. Characterization of genome-wide copy number aberrations in colonic mixed adenoneuroendocrine carcinoma and neuroendocrine carcinoma reveals recurrent amplification of PTGER4 and MYC genes. Hum Pathol 2018;73:16–25. DOI: 10.1016/j.humpath.2017.08.036
12. Vanacker L., Smeets D., Hoorens A. et al. Mixed adenoneuroendocrine carcinoma of the colon: molecular pathogenesis and treatment. Anticancer Res 2014;34(10):5517–21. 13. Farooq F., Zarrabi K., Sweeney K. et al. multiregion comprehensive genomic profiling of a gastric mixed neuroendocrinenonneuroendocrine neoplasm with trilineage differentiation. J Gastric Cancer 2018;18(2):200–7. DOI: 10.5230/jgc.2018.18.e16
14. Scardoni M., Vittoria E., Volante M. et al. Mixed adenoneuroendocrine carcinomas of the gastrointestinal tract: targeted next-generation sequencing suggests a monoclonal origin of the two components. Neuroendocrinology 2014;100(4):310–6. DOI: 10.1159/000369071
15. Fujita Y., Uesugi N., Sugimoto R. et al. Gastric mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) with pancreatic acinar differentiation: a case report. Diagn Pathol 2019;14(1):38. DOI: 10.1186/s13000-019-0815-3
16. La Rosa S., Uccella S., Molinari F. et al. Mixed adenoma welldifferentiated neuroendocrine tumor (MANET) of the digestive system: An indolent subtype of mixed neuroendocrinenonneuroendocrine neoplasm (MiNEN). Am J Surg Pathol 2018;42(11):1503–12. DOI: 10.1097/PAS.0000000000001123
17. Gastroenterol W.J. Frizziero-2019-Retrospective-study-on-mixedne. 2019;9327(39).
18. Uccella S., Sessa F., La Rosa S. Diagnostic approach to neuroendocrine neoplasms of the gastrointestinal tract and pancreas. Turk Patoloji Derg 2015;31(1):113–27. DOI: 10.5146/tjpath.2015.01319
19. Milione M., Maisonneuve P., Pellegrinelli A. et al. Ki-67 proliferative index of the neuroendocrine component drives MANEC prognosis. Endocr Relat Cancer 2018;25(5):583–93. DOI: 10.1530/ERC-17-0557
20. Nagtegaal I.D., Odze R.D., Klimstra D. et al. The 2019 WHO classification of tumours of the digestive system. Histopathology 2020;76(2):182–8. DOI: 10.1111/his.13975
21. Uccella S., La Rosa S., Volante M. et al. Immunohistochemical biomarkers of gastrointestinal, pancreatic, pulmonary, and thymic neuroendocrine neoplasms. Endocr Pathol 2018;29(2):150–68. DOI: 10.1007/s12022-018-9522-y
22. Huang D., Ren F., Ni S. et al. Amphicrine carcinoma of the stomach and intestine: a clinicopathologic and pan-cancer transcriptome analysis of a distinct entity. Cancer Cell Int 2019;19:310. DOI: 10.1186/s12935-019-1031-7
23. Sun L., Wang C., Zhang J. et al. Genetic alterations in gastric amphicrine carcinomas and comparison with gastric mixed neuroendocrine-non-neuroendocrine neoplasms. Mod Pathol An Off J United States Can Acad Pathol Inc 2022;35(6):808–15. DOI: 10.1038/s41379-021-00978-5
24. Kleist B., Poetsch M. Neuroendocrine differentiation: The mysterious fellow of colorectal cancer. World J Gastroenterol 2015;21(41):11740–7. DOI: 10.3748/wjg.v21.i41.11740
25. Wang K.L., Yang Q., Cleary K.R et al. The significance of neuroendocrine differentiation in adenocarcinoma of the esophagus and esophagogastric junction after preoperative chemoradiation. Cancer 2006;107(7):1467–74. DOI: 10.1002/cncr.22179
26. Oneda E., Liserre B., Bianchi D. et al. Diagnosis of mixed adenoneuroendocrine carcinoma (MANEC) after neoadjuvant chemotherapy for pancreatic and gastric adenocarcinoma: two case reports and a review of the literature. Case Rep Oncol 2019;12(2):434–42. DOI: 10.1159/000501200
27. Rindi G., Bordi C., La Rosa S. et al. Gastroenteropancreatic (neuro)endocrine neoplasms: the histology report. Dig Liver Dis Off J Ital Soc Gastroenterol Ital Assoc Study Liver 2011;43(4):S356–60. DOI: 10.1016/S1590-8658(11)60591-4
28. Sorbye H., Baudin E., Borbath I. et al. Unmet needs in high-grade gastroenteropancreatic neuroendocrine neoplasms (WHO G3). Neuroendocrinology 2019;108(1):54–62. DOI: 10.1159/000493318
29. Jiang C., Yao H., Zhang Q. et al. Clinicopathological characteristics of mixed neuroendocrine-non-neuroendocrine neoplasms in gastrointestinal tract. Pathol Res Pract 2023;243:154373. DOI: 10.1016/j.prp.2023.154373
30. Frizziero M., Wang X., Chakrabarty B. et al. Retrospective study on mixed neuroendocrine non-neuroendocrine neoplasms from five European centres. World J Gastroenterol 2019;25(39):5991–6005. DOI: 10.3748/wjg.v25.i39.5991
31. Yuan W., Liu Z., Lei W. et al. Mutation landscape and intra-tumor heterogeneity of two MANECs of the esophagus revealed by multiregion sequencing. Oncotarget 2017;8(41):69610–21. DOI: 10.18632/oncotarget.18678
32. Kawazoe T., Saeki H., Edahiro K. et al. A case of mixed adenoneuroendocrine carcinoma (MANEC) arising in Barrett’s esophagus: literature and review. Surg Case Rep 2018;4(1):45. DOI: 10.1186/ s40792-018-0454-z
33. Lim J.S., Kurtz J., Borscheid R. et al. Mixed neuroendocrinenonneuroendocrine neoplasms (MiNENs) of the esophagus. Am Surg 2020;86(2):e101–3.
34. Sciarra A., Missiaglia E., Trimech M. et al. Gallbladder mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) arising in intracholecystic papillary neoplasm: Clinicopathologic and molecular analysis of a case and review of the literature. Endocr Pathol 2020;31(1):84–93. DOI: 10.1007/s12022-020-09605-6
35. Maru D.M., Khurana H., Rashid A. et al. Retrospective study of clinicopathologic features and prognosis of high-grade neuroendocrine carcinoma of the esophagus. Am J Surg Pathol 2008;32(9):1404–11. DOI: 10.1097/PAS.0b013e31816bf41f
36. La Rosa S., Marando A., Sessa F. et al. Mixed adenoneuroendocrine carcinomas (manecs) of the gastrointestinal tract: An update. Cancers (Basel) 2012;4(1):11–30. DOI: 10.3390/ cancers4010011
37. Yoshimachi S., Ohtsuka H., Aoki T. et al. Mixed adenoneuroendocrine carcinoma of the ampulla of Vater: a case report and literature review. Clin J Gastroenterol 2020;13(1):37–45.
38. Zhang L., DeMay R.M. Cytological features of mixed adenoneuroendocrine carcinoma of the ampulla: two case reports with review of literature. Diagn Cytopathol 2014;42(12):1075–84. DOI: 10.1002/dc.23107
39. Nassar H., Albores-Saavedra J., Klimstra D.S. High-grade neuroendocrine carcinoma of the ampulla of vater: a clinicopathologic and immunohistochemical analysis of 14 cases. Am J Surg Pathol 2005;29(5):588–94. DOI: 10.1097/01.pas.0000157974.05397.4f
40. Uccella S., La Rosa S. Looking into digestive mixed neuroendocrine-nonneuroendocrine neoplasms: subtypes, prognosis, and predictive factors. Histopathology 2020;77(5):700– 17. DOI: 10.1111/his.14178
41. Watanabe J., Suwa Y., Ota M. et al. Clinicopathological and prognostic evaluations of mixed adenoneuroendocrine carcinoma of the colon and rectum: A case-matched study. Dis Colon Rectum 2016;59(12):1160–7. DOI: 10.1097/DCR.0000000000000702
42. Hock Y.L., Scott K.W., Grace R.H. Mixed adenocarcinoma/ carcinoid tumour of large bowel in a patient with Crohn’s disease. J Clin Pathol 1993;46(2):183–5. DOI: 10.1136/jcp.46.2.183
43. Lyss A.P., Thompson J.J., Glick J.H. Adenocarcinoid tumor of the colon arising in preexisting ulcerative colitis. Cancer 1981;48(3):833–9. DOI: 10.1002/1097-0142(19810801)48:3<833::aidcncr2820480328> 3.0.co;2-z
44. Bolzacchini E., Chini C., Cortelezzi C.C. et al. Poorly differentiated neuroendocrine carcinoma of the sigmoid tract in long-standing ulcerative colitis: Report of a case and review of the literature. Int J Surg Pathol 2018;26(5):479–83. DOI: 10.1177/1066896917752443
45. Brathwaite S., Rock J., Yearsley M.M. et al. Mixed adenoneuroendocrine carcinoma: An aggressive clinical entity. Ann Surg Oncol 2016;23(7):2281–6. DOI: 10.1245/s10434-016- 5179-2
46. Brathwaite S., Yearsley M.M., Bekaii-Saab T. et al. Appendiceal mixed adeno-neuroendocrine carcinoma: A population-based study of the surveillance, epidemiology, and end results registry. Front Oncol 2016;6:148. DOI: 10.3389/fonc.2016.00148
Авторы заявляют об отсутствии конфликта интересов.
Работа выполнена без спонсорской поддержки.
Пачуашвили Н. В., Тертычный А. С., Проценко Д. Д. и др. Смешанные нейроэндокринные-ненейроэндокринные новообразования желудочно-кишечного тракта. Онкопатология 2023;1–2(6):39–49. DOI: https://doi.org/10.17650/2618‑7019‑2023‑6‑1-2-39‑49
![]() |
2026 №1 (Том 9) Скачать>> |