Details

Autor(en) / Beteiligte

• Hasegawa, Toshiyuki
• Yamao, Kenji
• Hijioka, Susumu
• Bhatia, Vikram
• Mizuno, Nobumasa
• Hara, Kazuo
• Imaoka, Hiroshi
• Niwa, Yasumasa
• Tajika, Masahiro
• Kondo, Shinya
• Tanaka, Tutomu
• Shimizu, Yasuhiro
• Kinoshita, Taira
• Kohsaki, Takuhiro
• Nishimori, Isao
• Iwasaki, Shinji
• Saibara, Toshiji
• Hosoda, Waki
• Yatabe, Yasushi

Titel

Evaluation of Ki-67 index in EUS-FNA specimens for the assessment of malignancy risk in pancreatic neuroendocrine tumors

Ist Teil von

• Endoscopy, 2014-01, Vol.46 (1), p.32

Ort / Verlag

Germany

Erscheinungsjahr

2014

Quelle

MEDLINE

Beschreibungen/Notizen

• Malignancy in pancreatic neuroendocrine tumors (PNETs) is graded by assessing the resected specimens according to the World Health Organization (WHO) 2010 criteria. The feasibility of such grading using endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) specimens remains unclear. The aim of this study was to ascertain the optimal method of measuring the Ki-67 index in EUS-FNA specimens, using resected specimens as the criterion standard. A total of 58 consecutive patients diagnosed with PNETs between March 1998 and May 2011 were included. The study measured intratumoral Ki-67 index heterogeneity, concordance rates of PNET grading by EUS-FNA with grade of the resected tumor, optimal method of measuring the Ki-67 index in EUS-FNA specimens, and survival analysis based on EUS-FNA specimen grading. Intratumoral dispersion of Ki-67 index in resected specimens was 0.033 for Grade 1 and 0.782 for Grade 2 tumors (P<0.001). Concordance rates for WHO classification between EUS-FNA and resected specimens were 74.0% using the mean Ki-67 index in EUS-FNA specimens and 77.8% using the highest Ki-67 index. The concordance rate rose to 90% when EUS-FNA samples with less than 2000 tumor cells were excluded (26% of EUS-FNA cases). The Kaplan-Meier survival curves were significantly stratified by the EUS-FNA grading of PNETs with 5-year survival rates of 100%, 58.3%, and 0%, for Grade 1, Grade 2, and neuroendocrine carcinoma (NEC) tumors, respectively. Grading of PNETs by the highest Ki-67 index in EUS-FNA specimens with adequate cellularity has a high concordance with grading of resected specimens, and can predict long term patient survival with high accuracy.