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Because gastric endoscopic biopsies are common in referral and community hospitals, accurate morphologic, immunophenotypic, and—when needed—molecular assessment is essential for proper entity identification and recognition of precursor lesions. The review also proposes a simplified prognostic classification for enterochromaffin-like (ECL)-cell NETs using gastrin serum levels and gastric acid secretion status.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/neuroendocrine-neoplasms-of-the-stomach-update-on-diagnostic-criteria-classification-and-prognostic-markers/374998/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/neuroendocrine-neoplasms-of-the-stomach-update-on-diagnostic-criteria-classification-and-prognostic-markers/374998.png","ImageObject",300,407,{"name":92,"@type":93},"acoobca","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What types of gastric neuroendocrine neoplasms are included in the gNEN spectrum?","Question",{"text":112,"@type":113},"gNENs include neuroendocrine carcinomas (gNECs), mixed neuroendocrine/non-neuroendocrine neoplasms (gMiNENs), and neuroendocrine tumors (gNETs).","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Why is correct classification of gastric neuroendocrine neoplasms crucial for patient management?",{"text":117,"@type":113},"Accurate diagnosis enables appropriate management strategies that can range from endoscopic monitoring to surgery or chemotherapy. It also helps clinicians identify relevant entities and precursor lesions.",{"name":119,"@type":110,"acceptedAnswer":120},"How does the proposed prognostic classification for ECL-cell NETs work?",{"text":121,"@type":113},"The review proposes a simplified prognostic schema for enterochromaffin-like (ECL)-cell NETs based on gastrin serum levels and the status of gastric acid secretion.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},374998,1790240832,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":36},3985747870733,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Virchows Archiv (2025) 488:79–94  \n[https://doi.org/10.1007/s00428-025-04340-x](https://doi.org/10.1007/s00428-025-04340-x)  \nNeuroendocrine neoplasms of the stomach. Update on diagnostic criteria, classification, and prognostic markers  \nSilvia Uccella1,2 · Stefano La Rosa3,4,5  \nReceived: 11 August 2025 / Revised: 9 October 2025 / Accepted: 4 November 2025 / Published online: 22 November 2025 © The Author(s) 2025  \nAbstract  \nGastric neuroendocrine neoplasms (gNENs) encompass all the spectrum of NENs including neuroendocrine carcinomas (gNECs), mixed neuroendocrine/non-neuroendocrine neoplasms (gMiNENs) and neuroendocrine tumors (gNETs) . Differently from other digestive sites, gNETs are subclassified according to the clinicopathologic setting in which they arise, with important prognostic implications. Since gastric endoscopic biopsies represent a high-volume daily activity in both referral and community hospitals, pathologists should be increasingly aware of this disease. This will allow to correctly identify the different entities and, when present, their precursor lesions, giving useful information to clinicians for the best patient management. This review paper aims to provide morphologic, immunophenotypic, and, when necessary, molecular criteria for the correct diagnosis and subtyping of gNENs. In addition, a simplified prognostic classification schema of enterochromaffin-like (ECL)-cell NETs is proposed, based on gastrin serum levels and the status of gastric acid secretion.  \nKeywords Stomach · Neuroendocrine tumor · Neuroendocrine carcinoma · MiNEN · Classification · Prognosis  \nIntroduction  \nThe incidence of gastric neuroendocrine neoplasms (gNENs) has been increasing over the last 30 years [1–4] and their classification has evolved to encompass a wide clinicopathologic spectrum [5] . The correct diagnosis is crucial for appropriate patient management that may include radically different strategies from simple endoscopic monitoring to surgery or chemotherapy [6, 7] .  \n* Stefano La Rosa [stefano.larosa@uninsubria.it](stefano.larosa@uninsubria.it)  \n1 Department of Biomedical Sciences, Humanitas University, Milan, Italy  \n2 Pathology Service, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy  \n3 Unit of Pathology, Department of Medicine and Technological Innovation, University of Insubria, Via Guicciardini 9, 21100 Varese, Italy  \n4 Hereditary Cancer Research Center, Department of Medicine and Technological Innovation, University of Insubria, Varese, Italy  \n5 Unit of Pathology, ASST dei Sette Laghi, Varese, Italy  \nGiven these premises and considering the widespread use of gastric endoscopy in both referral and community hospitals, it is essential that pathologists are aware of the diversity of gNENs and can accurately distinguish among the different entities in order to provide relevant information for optimal patient management.  \nThis review aims to provide the morphologic, immunophenotypic, and, where appropriate, molecular criteria necessary for the accurate diagnosis of gNENs. In addition, a simplified prognostic classification of enterochromaffinlike (ECL)-cell NETs is proposed, based on gastrin serum levels and the status of gastric acid secretion.  \nClassification of gastric NENs (gNENs)  \nAccording to the last WHO classification of digestive tumors [5], gNENs are classified into three different categories including neuroendocrine tumors (gNETs), neuroendocrine carcinomas (gNECs) and mixed neuroendocrine-nonneuroendocrine neoplasms (gMiNENs) (Table 1) . Notably, gNETs are peculiar—if not unique—among NETs, as they exhibit specific site-related features that must be considered to provide a clinically meaningful classification. For this reason, the WHO classification of NETs into three proliferative  \nTable 1 WHO classification of digestive neuroendocrine neoplasms  \n\n| Tumor category | Morphology | Mitotic index (mitoses/2 mm2) | Ki67 index |\n| --- | --- ","cbCaibJ6CRktN6pI","https://ap.wps.com/l/cbCaibJ6CRktN6pI","pdf",6018715,16,"English","# Abstract\n# Introduction\n# Classification of gastric NENs (gNENs)\n## WHO classification of digestive neuroendocrine neoplasms\n# Gastric NETs (gNETs)","[{\"question\":\"What types of gastric neuroendocrine neoplasms are included in the gNEN spectrum?\",\"answer\":\"gNENs include neuroendocrine carcinomas (gNECs), mixed neuroendocrine/non-neuroendocrine neoplasms (gMiNENs), and neuroendocrine tumors (gNETs).\"},{\"question\":\"Why is correct classification of gastric neuroendocrine neoplasms crucial for patient management?\",\"answer\":\"Accurate diagnosis enables appropriate management strategies that can range from endoscopic monitoring to surgery or chemotherapy. It also helps clinicians identify relevant entities and precursor lesions.\"},{\"question\":\"How does the proposed prognostic classification for ECL-cell NETs work?\",\"answer\":\"The review proposes a simplified prognostic schema for enterochromaffin-like (ECL)-cell NETs based on gastrin serum levels and the status of gastric acid secretion.\"}]","Neuroendocrine neoplasms of the stomach - Update on diagnostic criteria, classification, and prognostic markers | PDF",1790202952]