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

Détails

ID Serval
serval:BIB_74719D9C24F1
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
The Clinicopathologic Heterogeneity of Grade 3 Gastroenteropancreatic Neuroendocrine Neoplasms: Morphological Differentiation and Proliferation Identify Different Prognostic Categories.
Périodique
Neuroendocrinology
Auteur(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
Statut éditorial
Publié
Date de publication
2017
Peer-reviewed
Oui
Volume
104
Numéro
1
Pages
85-93
Langue
anglais
Notes
Publication types: ArticlePublication Status: ppublish
Résumé
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
Oui
Création de la notice
06/09/2016 13:54
Dernière modification de la notice
08/05/2019 20:27
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