Objectives. Mixed neuroendocrine–non-neuroendocrine neoplasms (MiNENs) are rare gallbladder neuroendocrine neoplasms (GB-NENs). This study is aimed at investigating the clinicopathological features of GB-NENs and identifying prognostic factors related to overall survival (OS) of GB-MiNENs. Methods. The clinical data and pathological features of 13 patients with GB-NENs in our hospital were retrospectively reviewed. Additionally, 41 GB-MiNENs cases reported in English literature were reviewed and survival analysis was performed. Results. The mean age of thirteen patients (6 males and 7 females) with GB-NENs was 57.2 years (range: 35-75 years). Two patients were diagnosed with NET grade 1 (G1), two patients with NEC (), and nine patients with MiNENs. Of these 9 patients with MiNENs, 8 had composite tumors and 1 had amphicrine carcinoma. Microscopically, the adenocarcinoma component was located in the surface mucosa, and the neuroendocrine component was in the area of deep invasion, liver infiltration, and lymph node metastasis. Total analysis of 41 GB-MiNENs showed that patients were mainly elderly women (female/male ratio, 2.4 : 1.0; median age, 60 years). Kaplan-Meier’s analysis demonstrated that liver metastasis and TNM stage III-IV were associated with decreased OS (), whereas age, sex, tumor size, grade of the neuroendocrine component, lymph node metastasis, and adjuvant chemotherapy were not significantly prognostic indicators of OS. Multivariate analysis identified liver metastasis (, , ) as an independent unfavorable prognostic factor. Conclusions. GB-MiNENs were the most common type of GB-NENs in our case series, and neuroendocrine components exhibited more aggressive lymph node metastasis and local invasion than adenocarcinoma. Liver metastasis was a poor prognostic indicator in GB-MiNENs patients.

中文翻译：

---

胆囊神经内分泌肿瘤13例临床病理分析并文献复习


目标。混合性神经内分泌-非神经内分泌肿瘤（MiNEN）是罕见的胆囊神经内分泌肿瘤（GB-NEN）。本研究旨在调查 GB-NEN 的临床病理特征并确定与 GB-MiNEN 总生存期 (OS) 相关的预后因素。方法。回顾性分析我院收治的13例GB-NENs患者的临床资料及病理特征。此外，还回顾了英文文献中报道的 41 例 GB-MiNEN 病例并进行了生存分析。结果。 13 名 GB-NEN 患者（6 名男性和 7 名女性）的平均年龄为 57.2 岁（范围：35-75 岁）。两名患者被诊断为 NET 1 级（G1），两名患者被诊断为 NEC（ ）和 9 名 MiNEN 患者。在这 9 名 MiNEN 患者中，8 名患有复合肿瘤，1 名患有双泌癌。镜下腺癌成分位于粘膜表面，神经内分泌成分位于深部浸润、肝浸润、淋巴结转移区域。 对 41 例 GB-MiNEN 的总体分析显示，患者主要为老年女性（男女比例为 2.4 : 1.0；中位年龄 60 岁）。 Kaplan-Meier 的分析表明，肝转移和 TNM III-IV 期与 OS 降低相关（ ），而年龄、性别、肿瘤大小、神经内分泌成分的分级、淋巴结转移和辅助化疗并不是 OS 的显着预后指标。多变量分析发现肝转移（ , , ）作为 独立的不良预后因素。结论。 GB-MiNEN 是我们病例系列中最常见的 GB-NEN 类型，神经内分泌成分表现出比腺癌更具侵袭性的淋巴结转移和局部侵袭。肝转移是 GB-MiNENs 患者的不良预后指标。