Variability of Ki67 labeling index in multiple neuroendocrine tumors specimens over the course of the disease
Variability of Ki67 labeling index in multiple neuroendocrine tumors specimens over the course of the disease
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DOI：
10.1016/j.ejso.2014.06.016
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发表时间：
2014-11-01
期刊：
影响因子：
3.8
通讯作者：
Law, C. H. L.
中科院分区：
文献类型：
--
作者：
Singh, S.;Hallet, J.;Law, C. H. L.
背景资料：Ki 67-LI是神经内分泌肿瘤（NET）生物学行为的有效替代物，其水平较高与攻击性行为相关。世界卫生组织（WHO）根据Ki 67-LI（G1：20%）对NET进行分类。关于NETs在疾病过程中的组织学特征的演变知之甚少。我们试图评估Ki 67-LI在整个NETs疾病course.Methods的变化：我们回顾性地审查了Sunnybrook Odette癌症中心NET数据库中的多个病理标本的患者。主要结局是每个标本基于Ki 67-LI的WHO NET分类。我们评估了标本之间WHO分类的变化。结果：检索到43例患者，其中39例标本来自原发肿瘤和转移灶，4例标本来自多个转移灶。16例（37.0%）在不同的活检中被鉴定为Ki 67-LI属于不同的WHO类别。了12在这16例患者中，Ki 67-LI显示出足够的变异性以使WHO分级升高：5例（31%）从G1到G2，2例（13%）从G2到G3，5例（31%）从G1到G3。当有多个病理学标本时，Ki 67-LI在整个NET疾病过程中变化，大多数病例升级到更高的WHO级别。如果得到证实，这一发现可能会对如何监测和治疗神经内分泌肿瘤产生影响。需要进一步研究来证实这些发现，更好地了解Ki 67变异的潜在机制，并确定其与预后的关系。(C)2014爱思唯尔有限公司版权所有。
Background: The Ki67-LI is a valid surrogate for biologic behavior of neuroendocrine tumors (NETs), with higher levels associated with aggressive behavior. The World Health Organization (WHO) classifies NETs according to Ki67-LI (G1: 20%). Little is known about the evolution of NETs histologic characteristics over the disease course. We sought to evaluate variations in Ki67-LI throughout NETs disease course.Methods: We retrospectively reviewed the Sunnybrook Odette Cancer Center NET database for patients with multiple pathology specimens. Primary outcome was the WHO NET class based on Ki67-LI for each specimen. We assessed change in WHO class between specimens.Results: Forty-three patients were retrieved, of which 39 had specimens from the primary tumor and a metastatic focus, and 4 had specimens from multiple metastatic foci. Sixteen (37.0%) were identified with Ki67-LI falling in different WHO classes on distinct biopsies. For 12 (75.0%) of those 16 patients, Ki67-LI showed enough variability for WHO class to be upstaged: 5 (31%) from G1 to G2, 2 (13%) from G2 to G3, and 5 (31%) from G1 to G3.Conclusion: When multiple pathology specimens were available, Ki67-LI varied throughout NETs disease course, with a majority of cases upgraded to a higher WHO class. If confirmed, this finding may have implications in how neuroendocrine tumors are monitored and treated. Further research is warranted to confirm these findings, understand better the underlying mechanisms of Ki67 variability, and define its relationship to prognosis. (C) 2014 Elsevier Ltd. All rights reserved.