【摘要】 目的 探讨胃混合性腺神经内分泌癌（mixed adenoneuroendocrine carcinoma,MANEC）的临床病理特征及预后分析。方法 回顾性分析2012年3月至2021年10月福建医科大学附属第二医院收治的21例胃MANEC患者、31例胃腺癌患者和20例胃神经内分泌癌（neuroendocrine carcinoma,NEC）患者的临床资料。对比分析胃MANEC与腺癌、NEC的临床病理特点，使用Kaplan–Meier法比较三者的生存曲线，Log–Rank法分析胃MANEC临床病理特征与预后的关系，并采用多因素Cox回归分析评估影响胃MANEC患者预后的独立危险因素。结果 胃MANEC分别与胃腺癌、NEC比较，肿瘤发生部位及肿瘤分级、分期均存在差异。胃MANEC患者的生存曲线介于胃腺癌与NEC之间。单因素分析结果显示，嗜铬粒素A(chromogranin A,CgA)是否阳性、神经侵犯、脉管侵犯、浸润深度及是否化疗均是影响患者预后的因素（P<0.05）。多因素Cox回归分析结果显示，CgA是否阳性、是否化疗及腺癌成分WHO分级均是影响患者预后的独立危险因素（P<0.05）。结论 胃MANEC具有介于经典腺癌与NEC之间的形态特征及预后，CgA是否阳性、是否化疗及腺癌成分WHO分级均是影响MANEC预后的独立危险因素。更多还原

【Abstract】 Objective To investigate clinicopathological features and prognostic factors of gastric mixed adenoneuroendocrine carcinoma(MANEC). Methods The case data of 21 patients with gastric MANEC, 31 patients with gastric adenocarcinoma and 20 patients with gastric neuroendocrine carcinoma(NEC) admitted to the Second Affiliated Hospital of Fujian Medical University from March 2012 to October 2021 were retrospectively analyzed. Comparative analysis of clinicopathological features of gastric MANEC, adenocarcinoma and NEC. Kaplan–Meier method was used for survival analysis. Log–rank test was used to analyze the relationship between clinicopathological characteristics and prognosis of MANEC. Multivariate Cox regression analysis was used to evaluate the independent risk factors affecting the prognosis of gastric MANEC. Results Compared with NEC and adenocarcinoma, the MANEC had different occurrence site, grading and staging. The survival curve of gastric MANEC was between adenocarcinoma and NEC. Univariate analysis showed that positive expression of chrogranin A(CgA), nerve invasion, vascular invasion, depth of infiltration and chemotherapy were all factors affecting prognosis(P<0.05). Multivariate Cox regression analysis showed that whether CgA positive, chemotherapy and WHO grade of adenocarcinoma were independent risk factors that affect the prognosis of patients(P<0.05). Conclusion The morphological characteristics and prognosis of gastric MANEC were between classical adenocarcinoma and NEC. Positive expression of CgA, chemotherapy and WHO grade of adenocarcinoma components were independent risk factors affecting the prognosis of MANEC.更多还原