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BMC Cancer. 2017 Aug 4;17(1):521. doi: 10.1186/s12885-017-3490-3.

Clinicopathological features and prognostic validity of WHO grading classification of SI-NENs.

Author information

1
Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan II Road, Yuexiu District, Guangzhou, 510080, China.
2
Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
3
Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong University, No.324 Jingwu Road, Huaiyin District, Jinan, 250021, China.
4
Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis & Translational Research under Ministry of Education, Peking University Cancer Hospital & Beijing Cancer Hospital, No.52 Fucheng Road, Haidian District, Beijing, 100142, China.
5
Department of Gastric Surgery, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
6
Department of Gastroenterology, Peking Union Medical College Hospital, Beijing, China.
7
Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing, China.
8
Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, China.
9
Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.
10
Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
11
Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
12
Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
13
Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis & Translational Research under Ministry of Education, Peking University Cancer Hospital & Beijing Cancer Hospital, No.52 Fucheng Road, Haidian District, Beijing, 100142, China. xiaotong10241@sina.com.
14
Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong University, No.324 Jingwu Road, Huaiyin District, Jinan, 250021, China. lileping@medmail.com.cn.
15
Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan II Road, Yuexiu District, Guangzhou, 510080, China. chen0jie@hotmail.com.

Abstract

BACKGROUND:

The clinicopathological characteristics of small intestinal neuroendocrine neoplasms (SI-NENs) and the prognostic validity of WHO grading classification for SI-NENs are still unknown in Asian patients.

METHODS:

277 patients and 8315 patients with SI-NENs were retrieved respectively from eleven Chinese hospitals and Surveillance, Epidemiology, and End Results (SEER) cancer registry. Overall survival was used as the major study outcome. Survival analysis using Kaplan-Meier analysis with log-rank test and cox regression analysis were applied.

RESULTS:

Clinicopathological characteristics of SI-NENs were quite different among different races. Duodenum was the predominant tumor site in Chinese patients and Asian/Pacific Islander patients but not in white patients from SEER database. Patients with duodenal NENs tended to have more localized disease than patients with jejunal/ileal NENs which were confirmed by patients from SEER database. Grade 3 or poorly differentiated/undifferentiated tumor were more common and tumor size was significantly larger in ampullary NENs compared with that in non-ampullary duodenal NENs. As for the prognostic validity of WHO grading classification, survival between patients with grade 1 and grade 2 disease was not significantly different. Ki-67 index of 5% might be a better threshold between grade 1 and grade 2 than Ki-67 index of 2% in SI-NENs.

CONCLUSIONS:

Our study revealed that the clinicopathological characteristics of SI-NENs among different races were quite different. This might because duodenal NENs was much more common in Chinese patients and Asian/Pacific Islander patients. Duodenal NENs and jejunal/ileal NENs, ampullary and non-ampullary duodenal NENs shared different characteristics. Ki-67 index of 5% might be a better threshold between grade 1 and grade 2 in SI-NENs.

KEYWORDS:

Clinicopathological characteristics; Neuroendocrine neoplasms; Small intestine; Tumor grade

PMID:
28778195
PMCID:
PMC5543548
DOI:
10.1186/s12885-017-3490-3
[Indexed for MEDLINE]
Free PMC Article

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