The Clinicopathologic Heterogeneity of Grade 3 Gastroenteropancreatic Neuroendocrine Neoplasms: Morphological Differentiation and Proliferation Identify Different Prognostic Categories.

Details

Serval ID
serval:BIB_74719D9C24F1
Type
Article: article from journal or magazin.
Collection
Publications
Title
The Clinicopathologic Heterogeneity of Grade 3 Gastroenteropancreatic Neuroendocrine Neoplasms: Morphological Differentiation and Proliferation Identify Different Prognostic Categories.
Journal
Neuroendocrinology
Author(s)
Milione M., Maisonneuve P., Spada F., Pellegrinelli A., Spaggiari P., Albarello L., Pisa E., Barberis M., Vanoli A., Buzzoni R., Pusceddu S., Concas L., Sessa F., Solcia E., Capella C., Fazio N., La Rosa S.
ISSN
1423-0194 (Electronic)
ISSN-L
0028-3835
Publication state
Published
Issued date
2017
Peer-reviewed
Oui
Volume
104
Number
1
Pages
85-93
Language
english
Notes
Publication types: ArticlePublication Status: ppublish
Abstract
BACKGROUND/AIMS: Gastroenteropancreatic (GEP) neuroendocrine carcinomas (NECs) are defined as neuroendocrine neoplasms (NENs) with a Ki-67 index >20% according to the 2010 WHO classification. Some reports suggest that this category is heterogeneous. We retrospectively studied a series of 136 patients affected by grade 3 GEP-NECs with the aim to clarify the prognostic role of tumor morphological differentiation, proliferation, defect in mismatch repair proteins (MMRd), CD117 expression, and site of origin. The primary endpoint was the correlation between these parameters and the overall survival (OS).
METHODS: Univariate and multivariable Cox proportional hazards regression analyses were used to assess the prognostic significance of various clinical and histopathologic features.
RESULTS: With a median follow-up of 81 months, the median OS was 12.9 months. At multivariate analysis, morphological differentiation, Ki-67 index, MMRd, stage, and CD117 expression were independent prognostic markers in NECs. Three different prognostic categories of NECs were identified according to the degree of morphologic differentiation (well vs. poorly differentiated) and Ki-67 index (<55% vs. ≥55%). On this basis, median OS was 43.6 months in well-differentiated neoplasms with a Ki-67 index 20-55% (named type A), 24.5 months in poorly differentiated neoplasms with a Ki-67 index 20-55% (type B), and 5.3 months (p < 0.0001) in poorly differentiated neoplasms with a Ki-67 index ≥55% (type C).
CONCLUSIONS: The present study suggests that GEP-NECs represent a heterogeneous group of neoplasms which can be better classified in different prognostic categories using both tumor morphology and Ki-67 index.
Pubmed
Web of science
Open Access
Yes
Create date
06/09/2016 13:54
Last modification date
20/08/2019 15:32
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