Τίτλος:
Distinctive features of pancreatic neuroendocrine neoplasms exhibiting an increment in proliferative activity during the course of the disease
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Purpose: Neuroendocrine neoplasms (NENs) differ in their biological behavior and growth potential in a way that can be predicted using histological classification and grading systems. A subset of pancreatic NENs (pNENs) may develop a more aggressive phenotype during the course of the disease, associated with an increase in the Ki-67 proliferation index (PI). The purpose of the study was to present the clinical characteristics of these patients. Methods: Using re-biopsy of growing lesions, we investigated the increase in Ki-67 PI sufficient to change initial grading (G). Results: Of 264 patients with well differentiated (WD) pNENs who showed progressive disease during follow-up, 15 (6%) exhibited an increase in Ki-67 PI at a median time 36.8 (9.3–255.8) months. All neoplasms had WD-morphology: five had G1 (Ki-67 median value 1%), nine G2 (median value 5%), one G3 (25%) grades. Upon change of Ki-67 PI, 3 patients had G2 (8%) and 12 G3 (57.5%) NENs, while all retained their WD-morphology. At last follow-up, eight patients were alive with a median overall survival (OS) of 52.5 (9.5–264.3) months. Μedian OS was shorter in patients who had a change in Ki-67 PI before 36 months compared to those who had a change of Ki-67 PI at a later stage (27.5 95%CI: 11.88–43.06 vs. 120.87 95%CI: 96.05–145.69; log-rank p = 0.018). Conclusions: During the course of their disease, 6% patients with progressive pNENs develop an increase in Ki-67 PI resulting in an increase in grading status while maintaining their morphology. This process is associated with worse OS when it occurs at an early stage. © 2020, Springer Science+Business Media, LLC, part of Springer Nature.
Συγγραφείς:
Alexandraki, K.I.
Kaltsatou, M.
Kyriakopoulos, G.
Mavroeidi, V.
Kostopoulou, A.
Atlan, K.
Theocharis, S.
Rindi, G.
Grossman, A.B.
Grozinsky-Glasberg, S.
Kaltsas, G.A.
Περιοδικό:
Endocrine Development
Λέξεις-κλειδιά:
everolimus; protein p53; Ki 67 antigen, adult; aged; Article; cancer grading; cancer surgery; cell structure; clinical feature; cohort analysis; disease course; disease exacerbation; female; follow up; histopathology; human; human tissue; immunohistochemistry; major clinical study; male; middle aged; morphology; neuroendocrine tumor; overall survival; pancreas tumor; priority journal; proliferation index; protein expression; retrospective study; survival time; tumor biopsy; very elderly; cancer staging; diagnostic test; neuroendocrine tumor; pancreas tumor; pathology; prognosis, Diagnostic Tests, Routine; Humans; Ki-67 Antigen; Neoplasm Grading; Neoplasm Staging; Neuroendocrine Tumors; Pancreatic Neoplasms; Prognosis
DOI:
10.1007/s12020-020-02540-w
