The results indicated that The univariate analysis identified tumor size ≥5 cm (OR=9.03, 95% CI: 4.44–18.36, P<0.01), Ki-67 index≥60% (OR=3.36, 95% CI: 1.77–6.40, P<0.01), NEC-dominant histology (OR=8.85, 95% CI: 4.37–17.96, P<0.01), LNM(OR=5.62, 95% CI: 2.87–10.99, P<0.01), and lower tumor location (OR=0.33, 95% CI: 0.13–0.85, P=0.02) as significant risk factors for G-MANEC. This evidence concerns the gene MKI67 and neoplasm.