Tracht Jessica, Zhang Kui, Peker Deniz
Department of Pathology, The University of Alabama at Birmingham School of Medicine, Birmingham, Alabama (JT, DP).
Department of Biostatistics, The University of Alabama at Birmingham School of Public Health, Birmingham, Alabama (KZ).
J Histochem Cytochem. 2017 Jul;65(7):399-405. doi: 10.1369/0022155417708186. Epub 2017 May 22.
Grading of pancreatic neuroendocrine tumors (pNETs) is currently based on mitotic rate and Ki67 proliferation index. Phosphohistone-H3 (PHH3) is an effective marker for mitosis that has been proposed to use in grading various NETs. It remains unclear which method more accurately predicts grade and clinical outcome. Cases of pNET were evaluated using immunohistochemical stains for Ki67 and PHH3. In addition, each case was evaluated for necrosis, lymphovascular invasion, and perineural invasion and compared with stage. R project statistical analysis was used for comparisons. Sixty-three cases were included in the study including 29 males and 34 females (M:F 0.9) with a median age of 59 years (ranging 34-84). There was not a significant discrepancy in the stratification of tumor grades for Ki67 and PHH3. PHH3 significantly predicted lymph node metastasis ( p=0.041). Necrosis correlated with overall survival ( p=0.017). The results suggest that PHH3 is an effective marker for determining mitotic activity and can be used alternative to Ki67. In addition, necrosis may be included in the reporting of pNET as it may play a prognostic role. Larger scale studies are warranted to understand the biology and behavior of these tumors.
胰腺神经内分泌肿瘤（pNETs）的分级目前基于有丝分裂率和Ki67增殖指数。磷酸化组蛋白H3（PHH3）是一种用于有丝分裂的有效标志物，已被提议用于各种神经内分泌肿瘤的分级。目前尚不清楚哪种方法能更准确地预测分级和临床结果。使用Ki67和PHH3的免疫组织化学染色对pNET病例进行评估。此外，对每个病例评估坏死、淋巴管侵犯和神经周围侵犯情况，并与分期进行比较。采用R项目统计分析进行比较。该研究纳入了63例病例，包括29例男性和34例女性（男：女为0.9），中位年龄为59岁（范围34 - 84岁）。Ki67和PHH3在肿瘤分级分层方面无显著差异。PHH3能显著预测淋巴结转移（p = 0.041）。坏死与总生存期相关（p = 0.017）。结果表明，PHH3是确定有丝分裂活性的有效标志物，可替代Ki67使用。此外，坏死情况可纳入pNET的报告中，因为它可能具有预后作用。有必要开展更大规模的研究以了解这些肿瘤的生物学特性和行为。
