Department of Pathology, Division of Anatomic Pathology, University of Maryland Medical Center, 22 S. Greene Street, Baltimore, MD 21201-1595, USA.
Diagn Pathol. 2007 Aug 8;2:28. doi: 10.1186/1746-1596-2-28.
Gastrointestinal and pancreatic (GIP) endocrine tumors (ETs) have been regarded as slow growing neoplasms with distinct morphologic characteristics that behave less aggressively than carcinomas. The malignant potential of these tumors is difficult to predict.
To evaluate prognostic parameters, namely tumor size, tumor grade, and Ki-67 index in relationship to metastatic behavior of GIP ETs.
Biopsies and surgical specimens from 38 patients with GIP ETs were selected. The study group comprised 16 males and 22 females (mean age 62.6 years; range 24-91). Formalin-fixed, paraffin-embedded tissue sections were stained with H&E, synaptophysin, chromogranin A, and Ki-67. Ki-67 index was evaluated using ChromaVision Automated Assisted Image Analysis software. Proliferative index was compared to tumor grade, and the degree of associations between tumor size, tumor grade, Ki-67 index and metastatic behavior of GIP ETs were evaluated.
Fifteen of the twenty-two (68.18%) surgically staged neoplasms presented with peritoneal dissemination, lymphogenous, and/or hematogenous metastases. Nine of the metastatic tumors were G1 (9/13, or 69.23%), 5 were G2 (5/7, or 71.42%), and 1 - G3 (1/2, or 50%). Overall, 10/15 (66.66%) metastatic tumors showed < 2% Ki-67 immunoreactivity. Four ileal ETs had a synchronous malignancy. No significant correlation was found to exist between tumor grade and Ki-67 index as well as between tumor size, tumor grade, Ki-67 index and metastatic behavior.
The findings suggest that tumor size, tumor grade and Ki-67 index do not accurately predict malignant behavior of GIP ETs.
胃肠胰（GIP）内分泌肿瘤（ET）被认为是生长缓慢的肿瘤，具有独特的形态学特征，其行为比癌性肿瘤侵袭性小。这些肿瘤的恶性潜能难以预测。
评估肿瘤大小、肿瘤分级和 Ki-67 指数等预后参数与 GIP ET 转移行为的关系。
选择 38 例 GIP ET 患者的活检和手术标本。研究组包括 16 名男性和 22 名女性（平均年龄 62.6 岁；范围 24-91 岁）。福尔马林固定、石蜡包埋组织切片用 H&E、突触素、嗜铬粒蛋白 A 和 Ki-67 染色。使用 ChromaVision 自动辅助图像分析软件评估 Ki-67 指数。将增殖指数与肿瘤分级进行比较，并评估肿瘤大小、肿瘤分级、Ki-67 指数与 GIP ET 转移行为之间的相关性。
22 例手术分期肿瘤中有 15 例（68.18%）出现腹膜播散、淋巴和/或血行转移。9 例转移瘤为 G1（9/13，或 69.23%），5 例为 G2（5/7，或 71.42%），1 例为 G3（1/2，或 50%）。总体而言，15 例转移瘤中有 10 例（66.66%）Ki-67 免疫反应性<2%。4 例回肠 ET 存在同步恶性肿瘤。肿瘤分级和 Ki-67 指数之间以及肿瘤大小、肿瘤分级、Ki-67 指数和转移行为之间均未发现显著相关性。
研究结果表明，肿瘤大小、肿瘤分级和 Ki-67 指数不能准确预测 GIP ET 的恶性行为。
