High-grade progression confers poor survival in pancreatic neuroendocrine tumors
Authors
Botling, J.Lamarca, Angela
Bajic, D.
Norlen, O.
Lonngren, V.
Kjaer, J.
Eriksson, B.
Welin, S.
Hellman, P.
Rindi, G.
Skogseid, B.
Crona, J.
Affiliation
Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.Issue Date
2020
Metadata
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Introduction: Little is known about how pancreatic neuroendocrine tumors (PanNETs) evolve over time and if changes toward a more aggressive biology correlate with prognosis. The purpose of this study was to characterize changes in PanNET differentiation and proliferation over time and to correlate findings to overall survival (OS). Patients and methods: In this retrospective cohort study, we screened 475 PanNET patients treated at Uppsala University Hospital, Sweden. Sporadic patients with baseline and follow-up tumor samples were included. Pathology reports and available tissue sections were reevaluated with regard to tumor histopathology and Ki-67 index. Results: Forty-six patients with 106 tumor samples (56 available for pathology reevaluation) were included. Median Ki-67 index at diagnosis was 7% (range 1-38%), grade 1 n = 8, grade 2 n = 36, and grade 3 n = 2. The median change in Ki-67 index (absolute value; follow-up - baseline) was +14% (range -11 to +80%). Increase in tumor grade occurred in 28 patients (63.6%), the majority from grade 1/2 to grade 3 (n = 24, 54.5%). The patients with a high-grade progression had a median OS of 50.2 months compared to 115.1 months in patients without such progression (hazard ratio 3.89, 95% CI 1.91-7.94, p < 0.001). Conclusions: A longitudinal increase in Ki-67 index and increase in tumor grade were observed in a majority of PanNETs included in this study. We propose that increase in Ki-67 index and high-grade progression should be investigated further as important biomarkers in PanNET.Citation
Botling J, Lamarca A, Bajic D, Norlen O, Lonngren V, Kjaer J, et al. High-Grade Progression Confers Poor Survival in Pancreatic Neuroendocrine Tumors. Neuroendocrinology. 2020;110(11-12):891-8.Journal
NeuroendocrinologyDOI
10.1159/000504392PubMed ID
31658459Additional Links
https://dx.doi.org/10.1159/000504392Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.1159/000504392
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