Predicting Prognosis in Gastroentero-Pancreatic Neuroendocrine Tumors: An Overview and the Value of Ki-67 Immunostaining
- PDF / 233,493 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 42 Downloads / 197 Views
Predicting Prognosis in Gastroentero-Pancreatic Neuroendocrine Tumors: An Overview and the Value of Ki-67 Immunostaining Mina Jamali & Runjan Chetty
Published online: 18 October 2008 # Humana Press Inc. 2008
Abstract Gastroenteropancreatic neuroendocrine tumors (GEP-NETS) are unusual and rare neoplasms for which prognostic assessment and the diagnosis of malignancy, on the basis of histology alone, represent considerable challenges for the pathologist. To date, many molecular markers have been identified with a view to providing accurate and timely prediction of response to treatment and long-term survival. Proliferation remains a key feature of tumor progression, which has been widely estimated by the immunohistochemical use of the Ki-67 nuclear antigen. Given the continued difficulties inherent in prediction of malignancy in pancreatic neuroendocrine tumors (PETs) in particular, it has become unclear whether Ki-67 is truly a reliable prognostication marker. This review seeks to better establish what the consensus is on the role of the Ki-67 proliferation index as a prognostic indicator of long-term outcome in pancreatic neuroendocrine tumors. We conclude that most studies favor the utility of the Ki-67 proliferation index despite different critical percentages and in concert with other pathological parameters in the routine work-up of PETs.
being a heterogeneous somewhat disparate, disseminated group of tumors to a more finely delineated and characterized class of neoplasms. Due to morphological, histogenetic, and immunophenotypical and molecular advances, we have and continue to expand upon the multi-faceted knowledge accrued on GEP-NETs. However, current classification schemes may need revision where biological behavior and prognostic significance of these tumors is concerned as more and more studies are investigating the utility of currently employed molecular variables as useful predictors of malignant behavior. One such variable has been the Ki-67 protein, which has been widely embraced and accepted as a proliferation marker in diagnostic surgical pathology. In this present review, we briefly present GEPNETs and discuss the role of Ki-67 as an established prognostic marker specifically in pancreatic neuroendocrine tumors as well as present data which may suggest the potential predictive role of, as of yet, investigational molecular markers in patients with these tumors.
GEP-NETS: Overview Keywords pancreas . neuroendocrine tumors . Ki-67
Introduction Much work has been dedicated to transform gastroenteropancreatic neuroendocrine tumors (GEP-NETs) from M. Jamali : R. Chetty (*) Department of Pathology, University Health Network, The Toronto General Hospital, 200 Elizabeth Street, 11th Floor, Eaton Wing, Toronto, ON M5G 2C4, Canada e-mail: [email protected]
GEP-NETs belong to a heterogeneous family of rare, benign, or malignant epithelial neoplasms (carcinoids), originating from either the pancreas (PETs) or gastrointestinal tract (GI-NETs). Despite great behavioral differences between the two, PETs
Data Loading...
