Uppin Megha S, Uppin Shantveer G, Sunil Chittiboyina Shiva Prasada Venkata, Hui Monalisa, Paul Tara Roshni, Bheerappa Nagari
Department of Pathology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana 500082, India.
Department of Surgical Gastroenterology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana 500082, India.
J Gastrointest Oncol. 2017 Feb;8(1):139-147. doi: 10.21037/jgo.2016.12.08.
The gastroenteropancreatic neuroendocrine tumors (GEPNET) have a characteristic histologic appearance unrelated of the exact site of origin. However the behavior of these tumors are different in each of these sites. In this article we study the clinicopathological features of GEPNET. These tumors were classified and graded according to WHO 2010 criteria. The immunohistochemical (IHC) features were evaluated and the grade of the tumor was correlated with Ki67.
A total of 40 cases of GEPNET diagnosed on biopsies as well as resected specimens were analyzed from January 2012 to June 2015.
There were 28 resected specimens and 12 biopsies. Majority of the gastric neuroendocrine tumors (NET) showed classic morphology of cells arranged in islands. There were 3 cases each of grade 1 and grade 2 and one was diagnosed as mixed adenoneuroendocrine carcinoma (MANEC). All the duodenal NET were well differentiated (grade 1). There were 8 cases in colon and rectum, of which 4 cases were grade 3 and 3 cases were grade 2. Majority of the pancreatic tumors were grade 1. The mean mitotic count along with ki67 had good correlation in NET of stomach, duodenum colon and rectum.
The most common site was small intestine followed by pancreas. Majority of the tumors were NET G1. Tumors from colorectal region were mostly NEC G3. There was a strong correlation by spearman correlation analysis between Ki67 and mitotic count and moderate correlation between ki67 and tumor grade as well as mitotic rate and tumor grade. Ki67 was helpful in grading these tumors.
胃肠胰神经内分泌肿瘤（GEPNET）具有独特的组织学表现，与确切的起源部位无关。然而，这些肿瘤在每个部位的行为有所不同。在本文中，我们研究了GEPNET的临床病理特征。这些肿瘤根据世界卫生组织2010年标准进行分类和分级。评估了免疫组化（IHC）特征，并将肿瘤分级与Ki67进行了关联分析。
分析了2012年1月至2015年6月间经活检及手术切除标本确诊的40例GEPNET病例。
有28例手术切除标本和12例活检标本。大多数胃神经内分泌肿瘤（NET）表现出典型的细胞呈岛状排列的形态。1级和2级各有3例，1例被诊断为混合性腺神经内分泌癌（MANEC）。所有十二指肠NET均为高分化（1级）。结肠和直肠有8例，其中4例为3级，3例为2级。大多数胰腺肿瘤为1级。胃、十二指肠、结肠和直肠NET的平均有丝分裂计数与Ki67具有良好的相关性。
最常见的部位是小肠，其次是胰腺。大多数肿瘤为NET G1。结直肠区域的肿瘤大多为NEC G3。Spearman相关性分析显示，Ki67与有丝分裂计数之间存在强相关性，Ki67与肿瘤分级以及有丝分裂率与肿瘤分级之间存在中度相关性。Ki67有助于这些肿瘤的分级。
