Lymph node metastatic patterns of gastric carcinoma with a combination of adenocarcinoma and neuroendocrine carcinoma components

doi:10.3748/wjg.v31.i8.102347

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Cohort Study

World J Gastroenterol. Feb 28, 2025; 31(8): 102347
Published online Feb 28, 2025. doi: 10.3748/wjg.v31.i8.102347

Lymph node metastatic patterns of gastric carcinoma with a combination of adenocarcinoma and neuroendocrine carcinoma components

Kai Zhou, Zhong-Wu Li, Yan Wu, Zhi-Jie Wang, Ling-Qian Wang, Li-Xin Zhou, Ling Jia, Ke Ji, Xue-Song Yang, Ji Zhang, Xiao-Jiang Wu, An-Qiang Wang, Zhao-De Bu

Kai Zhou, Zhi-Jie Wang, Ling-Qian Wang, Ke Ji, Xue-Song Yang, Ji Zhang, Xiao-Jiang Wu, An-Qiang Wang, Zhao-De Bu, Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Beijing 100142, China

Zhong-Wu Li, Yan Wu, Li-Xin Zhou, Ling Jia, Department of Pathology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing 100142, China

Co-first authors: Kai Zhou and Zhong-Wu Li.

Co-corresponding authors: An-Qiang Wang and Zhao-De Bu.

Author contributions: Wang AQ and Bu ZD contributed to conceptualization, funding acquisition, project administration; Zhou K, Wu Y, Li ZW, Wang ZJ, Wang LQ, Zhou LX, Jia L, Ji K, Yang XS contributed to data curation; Zhou K contributed to formal analysis, software and writing original draft; Zhou K, Wu Y, Li ZW contributed to validation, visualization and investigation; Zhou K, Wang AQ contributed to methodology; Bu ZD, Li ZW , Zhang J, Wu XJ contributed to resources; Wang AQ, Bu ZD, Li ZW contributed to supervision; Wang AQ, Wu Y, Bu ZD contributed to writing, review and editing.

Supported by the National Key Research and Development Program of China, No. 2023YFF1204702; the National Natural Science Foundation of China, No. 82173151; Capital’s Funds for Health Improvement and Research, No. CFH 2022-4-1025; Beijing Hospitals Authority Clinical Medicine Development of Special Funding, No. XMLX202119; and Science Foundation of Peking University Cancer Hospital, No. PY202329.

Institutional review board statement: The study was reviewed and approved by the Medical Ethics Committee of Beijing Cancer Hospital, Institutional Review Board (Approval No. 2022KT04).

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 they have no conflict of interest.

STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.

Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at buzhaode@cjcrcn.org.

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: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Zhao-De Bu, PhD, Professor, Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, No. 52 Fucheng Road, Haidian District, Beijing 100142, China. buzhaode@cjcrcn.org

Received: October 16, 2024
Revised: December 14, 2024
Accepted: January 7, 2025
Published online: February 28, 2025
Processing time: 98 Days and 20.9 Hours

Core Tip

Core Tip: Rare individual studies on the lymph node metastasis components and treatment issues of adenoneuroendocrine mixed gastric cancer (G-ANEC). For G-ANEC, even if the neuroendocrine carcinoma (NEC) or adenocarcinoma (AC) component is relatively small in the primary lesion, it may still metastasize to the lymph nodes (LNs). If the metastasis in the LNs consists only of AC components, treatment of G-ANEC should primarily be based on fluoropyrimidine drugs. If the metastasis in the LNs includes NEC components, treatment should primarily be based on the etoposide and cisplatin/irinotecan and cisplatin regimen.