Does the WHO 2010 classification of pancreatic neuroendocrine neoplasms accurately characterize pancreatic neuroendocrine carcinomas?
- VernacularTitle:ДЭМБ-ийн 2010 оны нойр булчирхайн нейроэндокрин хавдрын ангилал нь нойр булчирхайн нейроэндокрин хорт хавдрыг зөв тодорхойлж чадаж байна уу?
- Author:
Tsukasa Yoshida
;
Susumu Hijioko
;
Waki Hosoda
;
Nobumasa Mizuno
;
Kazuo Hara
;
Hiroshi Imaoka
;
Vikram Bhatia
;
Masahiro Tajika
;
Mohamed A Mekky
;
Makoto Ishihara
;
Tatsuji Yogi
;
Kenji Yamao
- Publication Type:journal article
- From:Innovation
2014;8(4):124-125
- CountryMongolia
- Language:English
-
Abstract:
Background: The WHO classified pancreatic neuroendocrine neoplasms (pNEN)
in 2010 as G1, G2, and neuroendocrine carcinoma (NEC), according to Ki67
labeling index (LI). However, the clinical behavior of NEC is still not fully studied.
We aimed to clarify the clinicopathological and molecular characteristics of
NECs.
Methods: We retrospectively evaluated the clinicopathological characteristics,
KRAS mutation status, treatment response, and the overall survival of eleven
pNEC patients diagnosed between 2001 and 2014 according to the WHO 2010.
We subclassified WHO-NECs into well-differentiated (WDNEC) and poorlydifferentiated
NEC (PDNEC), the latter further subdivided into large and small
cell type.
Results: The median Ki67 LI was 69.1% (range, 40% - 95%) and the median
tumor size was 35 mm. 11 WHO-NECs were subclassified 4 WDNEC and 7
PDNEC, and further separated PDNEC into 3 large cell and 4 small cell subtypes.
Comparisons of WDNEC vs. PDNEC revealed hypervascularity on CT, 50% (2/4)
vs. 0% (0/7) (P = 0.109); median Ki67 LI, 46.3% (40% - 53%) vs. 85% (54% -
95%) (P = 0.001); KRAS mutations, 0% (0/4) vs. 85.7% (6/7) (P = 0.015); response
rates to platinum-based chemotherapy, 0% (0/2) vs.100% (4/4) (P = 0.067) and
median survival, 227 vs. 186 days (P = 0.227).
Conclusions: The WHO-NEC category may be composed of heterogeneous
disease entities, namely WDNEC and PDNEC. These subgroups tended to exhibit
differing Ki67 and KRAS mutation profiles, and distinct response to chemotherapy.
Further studies for the re-evaluation of the current WHO 2010 classification is
warranted.
