The importance of grading and staging small intestinal neuroendocrine tumors

• Published in: International journal of endocrine oncology Vol. 4; no. 3; pp. 117 - 120
• Main Authors: Gonzalez, Raul S, Shi, Chanjuan
• Format: Journal Article
• Language: English
• Published: London Future Medicine Ltd 01.08.2017
• Subjects: Amputation; Biopsy; Cancer; Classification; grading; Labeling; Liver; liver metastasis; Lymphatic system; Medical prognosis; mesenteric tumor deposits; Metastasis; Neuroendocrine tumors; Patients; small intestinal neuroendocrine tumors; Small intestine; staging; United States > US
• DOI: 10.2217/ije-2017-0009
• ISSN: 2045-0869

Grade 3 poorly differentiated NECs and grade 3 well-differentiated NETs are very different in terms of their genetic basis, biologic behavior and response to platinum-based chemotherapy (3). [...]it is very important to differentiate grade 3 well-differentiated NETs from NEC. [...]assessment of Ki67 index should be done on biopsies from liver metastases even when the Ki67 index is available for the primary tumor. Additionally, Ki67 intratumoral heterogeneity is frequently present in liver metastases from SI-NET, especially in large metastases (4,7). [...]Ki67 labeling performed on liver biopsies may not represent the whole tumor. Liver metastasis is common in patients with SI-NET, and the grade of primary SI-NETs does not always predict that of liver metastasis, though the latter is correlated with prognosis. [...]tumor grade of liver metastasis by Ki67 staining should be assessed when tissue is available for pathologic examination.