Gastric Neuroendocrine Neoplasias: Literature Review

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Abstract


A brief retrospective journey into the history of neouroendocrine neoplasias serves to remind the histology and distribution of neuroendocrine cells in the gastric mucosa, followed by chronological review of NEN discovery and theory development up to the present moment. The morphological classification of gastric NET consisting of 4 possible types is highlighted: the correct interpretation of the pathological findings, taking into account not only the histological features of the tumor itself, but also of the adjacent mucosa, allows to suggest the appropriate managment, which fundamentally affects patient survival.

The review provides other current classifications of the gastric neuroendocrine neoplasia depending on its location, embryogenesis, functional activity, histological grade (with a focus on the Ki-67 labeling index counting, and ways to improve the interobserver reliability in routine practice). Moreover, the differences in the gastric NET and NEC TNM classification are emphasized. The drawbacks of all classifications are discussed and the possibilities for their further development are considered. An important part of the review is the description of a possible immunohistochemical markers, since immunohistochemistry is widely used to confirm the diagnosis. In addition, INSM1 (insulinomaassociatedprotein 1), the new immunohistochemical and molecular marker for NEN is discussed: according to the literature, it contributes to more accurate assessment of the tumor malignant potential and the metastatic risk.

Furthermore, modern methods of endoscopic and PET/CT imaging (68-gallium DOTATATE PET/CT, molecular imaging using SSTR (somatostatin receptor) PET/CT or GLP-1R (Glucagon-like peptide-1 receptor) SPECT (single photon emission computed tomography)/CT), which allows the clinician to suspect a NEN even before morphological analysis of the resected specimen and adequately select the extent of surgical intervention are shown.

In conclusion, we would like to reiterate the importance of further research on the gastric NET subtype pathogenesis and their clinical behavior, also of the correlation of the endoscopic, morphological, and immunohistochemical picture with the patient prognosis to improve managment tactics.


Liudmila M. Mikhaleva

Research Institute of Human Morphology;
State Budgetary Health Care Institution “City Clinical Hospital No. 31 of the Moscow City Health Department”

Email: mikhalevalm@yandex.ru
SPIN-code: 2086-7513
Scopus Author ID: 6701472396

Russian Federation, 117418, 3, Tsyurupy str., Moscow, Russia; 119415, 42, Lobachevskogo street, Moscow, Russia

Doct. of Med. Sci., Professor, Director of the Research Institute of Human Morphology, the Head of the Laboratory of Clinical Morphology, the Head of the Pathology Department in the City Clinical Hospital No. 31

Olesya A. Vasyukova

Research Institute of Human Morphology; State Budgetary Health Care Institution “City Clinical Hospital No. 31 of the Moscow City Health Department”

Author for correspondence.
Email: o.vas.93@gmail.com
SPIN-code: 2242-0958
Scopus Author ID: 57195514112

Russian Federation, 117418, 3, Tsyurupy str., Moscow, Russia; 119415, 42, Lobachevskogo street, Moscow, Russia

Junior Researcher, Laboratory of Clincal Morphology, Research Institute of Human Morphology; pathologist in the City Clinical Hospital No. 31

Andrey E. Birukov

Research Institute of Human Morphology; State Budgetary Health Care Institution “City Clinical Hospital No. 31 of the Moscow City Health Department”

Email: bervost@rambler.ru

Russian Federation, 117418, 3, Tsyurupy str., Moscow, Russia; 119415, 42, Lobachevskogo street, Moscow, Russia

Cand. of Med. Sci.; Senior Researcher, Clinical Morphology Laboratory; pathologist in the City Clinical Hospital No. 31

Mikhail Yu. Guschin

Research Institute of Human Morphology

Email: guschin.michail@yandex.ru

Russian Federation, 117418, 3, Tsyurupy str., Moscow, Russia

Cand. of Med. Sci.; Senior Researcher, Clinical Morphology Laboratory

Konstantin Yu. Midiber

Research Institute of Human Morphology; State Budgetary Health Care Institution “City Clinical Hospital No. 31 of the Moscow City Health Department”

Email: midiberkonst@gmail.com

Russian Federation, 117418, 3, Tsyurupy str., Moscow, Russia; 119415, 42, Lobachevskogo street, Moscow, Russia

Researcher, Clinical Morphology Laboratory; pathologist in the City Clinical Hospital No. 31

Emma P. Akopyan

Research Institute of Human Morphology

Email: vanilsheep@yandex.ru
117418, 3, Tsyurupy str., Moscow, Russia

Resident

Tatyana N. Khovanskaya

Research Institute of Human Morphology; State Budgetary Health Care Institution “City Clinical Hospital No. 31 of the Moscow City Health Department”

Email: zimavnebe@mail.ru
117418, 3, Tsyurupy str., Moscow, Russia; 119415, 42, Lobachevskogo street, Moscow, Russia

Junior Researcher, Clinical Morphology Laboratory; pathologist in the City Clinical Hospital No. 31

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