{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T20:16:53Z","timestamp":1776716213660,"version":"3.51.2"},"reference-count":55,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:p>Mixed adenoneuroendocrine carcinoma (MANEC) is a rare and histologically complex malignancy. Due to its low incidence, data on gastric MANEC (G-MANEC) are limited, and its clinicopathological characteristics and prognosis remain poorly defined. In this study, we performed a retrospective analysis of 168 G-MANEC patients and identified a median age of 64.7 years at diagnosis. Cases were classified into adenocarcinoma (AC)-predominant and neuroendocrine carcinoma (NEC)-predominant subtypes based on histological composition, with large-cell NEC accounting for 69.9% of NEC-predominant tumors. Patterns of lymph node metastasis (LNM) included involvement of either a single component (AC or NEC) or both components. Survival analysis revealed a median overall survival (OS) of 24 months, with 1-, 3-, and 5-year survival rates of 72.6%, 39.5%, and 29.7%, respectively. Univariate and multivariate analyses identified tumor size, LNM, and histological subtype as independent prognostic factors. Compared with a cohort of 328 patients with pure gastric adenocarcinoma, G-MANEC cases exhibited distinct clinicopathological features\u2014particularly in terms of tumor size, Ki-67 index, and LNM. Collectively, these findings underscore that G-MANEC is associated with significantly poorer overall survival than that of conventional gastric adenocarcinoma.<\/jats:p>","DOI":"10.3389\/fendo.2025.1650314","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T04:11:13Z","timestamp":1759205473000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Insights into gastric mixed adenoneuroendocrine carcinoma: a novel comparative study of clinicopathological features and survival 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