双分泌瘤（Amphicrine neoplasms，简称ANs）是由同时具有外分泌和神经内分泌特征的上皮恶性肿瘤，其机制尚不明确。本文报道了一例复发性粘液产生型胃双分泌瘤，其同时表达神经内分泌标志物（chromogranin-A、synaptophysin和CD56）和胰腺腺泡细胞标志物（BCL10和胰蛋白酶），该病例发生在一名64岁女性在接受黑色素瘤辅助免疫治疗期间。Ki-67水平＜2%。胃组织背景为萎缩性胃炎。下一代测序显示MEN1基因突变（p.P71fs*42）伴有等位基因丢失。研究得出以下关键结论：（1）胃ANs可能同时存在具有外分泌粘液产生元素、神经内分泌和胰腺腺泡分化特征；（2）它们可能是在萎缩性胃炎和免疫治疗期间发生的新实体；（3）胃神经内分泌肿瘤的诊断工作中应该考虑ANs；（4）它们的分子特征与良性神经内分泌肿瘤存在明显相似性。这些发现有助于提高对ANs的了解和生物分类学。© 2023年该作者（作者们），独家授权给Springer-Verlag GmbH Germany，Springer Nature的一部分。

Amphicrine neoplasms (ANs) are poorly understood epithelial malignancies composed of cells with co-existing exocrine-neuroendocrine features. Here, we report a recurrent mucin-producing gastric amphicrine tumor co-expressing neuroendocrine (chromogranin-A, synaptophysin, and CD56) and pancreatic acinar cell (BCL10 and trypsin) markers, arisen in a 64-year-old woman during adjuvant immunotherapy for melanoma. Ki-67 was < 2%. The gastric background context was atrophic gastritis. Next-generation sequencing showed MEN1 mutation (p.P71fs*42) coupled with loss of heterozygosity. The key lessons were as follows: (1) gastric ANs can show the co-existence of exocrine mucin-producing elements with neuroendocrine and pancreatic acinar differentiation; (2) they may represent a new entity arising in the context of atrophic gastritis and during immunotherapy; (3) they should be considered in the diagnostic workup of gastric neuroendocrine tumors; and (4) their molecular profile can show striking similarities with well-differentiated neuroendocrine tumors. These findings may be of help to improve the knowledge and the biological taxonomy of ANs.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.