Prognostic Significance of Defining L-Cell Type on the Biologic Behavior of Rectal Neuroendocrine Tumors in Relation with Pathological Parameters.
- Author:
Jin Hee SOHN
1
;
Mee Yon CHO
;
Yangsoon PARK
;
Hyunki KIM
;
Woo Ho KIM
;
Joon Mee KIM
;
Eun Sun JUNG
;
Kyoung Mee KIM
;
Jae Hyuk LEE
;
Hee Kyung CHAN
;
Do Youn PARK
;
Mee JOO
;
Sujin KIM
;
Woo Sung MOON
;
Mi Seon KANG
;
So Young JIN
;
Yun Kyung KANG
;
Sun Och YOON
;
Hyeseung HAN
;
Eunhee CHOI
Author Information
- Publication Type:Multicenter Study ; Original Article
- Keywords: Rectal neoplasms; Neuroendocrine tumors; L cells; Immunohistochemistry; Survival; International Classification of Diseases
- MeSH: Diagnosis; Glucagon; Immunohistochemistry; Immunophenotyping; International Classification of Diseases; Lymph Nodes; Multivariate Analysis; Neoplasm Metastasis; Neuroendocrine Tumors*; Phenotype; Prognosis; Rectal Neoplasms; World Health Organization
- From:Cancer Research and Treatment 2015;47(4):813-822
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: In 2010, the World Health Organization categorized L-cell type neuroendocrine tumors (NETs) as tumors of uncertain malignancy, while all others were classified as malignant. However, the diagnostic necessity of L-cell immunophenotyping is unclear, as are tumor stage and grade that may guide diagnosis and management. To clarify the predictive markers of rectal neuroendocrine neoplasms (NENs), 5- and 10-year overall survival (OS) was analyzed by pathological parameters including L-cell phenotype. MATERIALS AND METHODS: A total of 2,385 rectal NENs were analyzed from our previous multicenter study and a subset of 170 rectal NENs was immunophenotyped. RESULTS: In univariate survival analysis, tumor grade (p < 0.0001), extent (p < 0.0001), size (p < 0.0001), lymph node metastasis (p=0.0063), and L-cell phenotype (p < 0.0001) showed significant correlation with the prognosis of rectal NENs; however, none of these markers achieved independent significance in multivariate analysis. The 10-year OS of tumors of NET grade 1, < 10 mm, the mucosa/submucosa was 97.58%, 99.47%, and 99.03%, respectively. L-Cell marker, glucagon II (GLP-1&2), with a cut off score of > 10, is useful in defining L-Cell type. In this study, an L-cell immunophenotype was found in 83.5% of all rectal NENs and most, but not all L-cell type tumors were NET G1, small (< 10 mm) and confined to the mucosa/submucosa. CONCLUSION: From these results, the biological behavior of rectal NENs does not appear to be determined by L-cell type alone but instead by a combination of pathological parameters.
