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Biomed Res Int. 2018 Mar 27;2018:1013640. doi: 10.1155/2018/1013640. eCollection 2018.

Identification of Phosphohistone H3 Cutoff Values Corresponding to Original WHO Grades but Distinguishable in Well-Differentiated Gastrointestinal Neuroendocrine Tumors.

Author information

1
Department of Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 150 Seongan-ro, Gangdong-gu, Seoul 05355, Republic of Korea.
2
Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 170beon-gil, 22 Gwanpyeong-ro, Dongan-gu, Anyang-si, Gyeonggi-do 14068, Republic of Korea.
3
Research Institute for Complementary & Alternative Medicine, Hallym University, 40 Seokwoo-Dong, Hwaseong, Gyeonggi-do 445-170, Republic of Korea.
4
Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 170beon-gil, 22 Gwanpyeong-ro, Dongan-gu, Anyang-si, Gyeonggi-do 14068, Republic of Korea.
5
Department of Pathology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea.
6
Department of Pathology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 150 Seongan-ro, Gangdong-gu, Seoul 05355, Republic of Korea.
7
Department of Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 170beon-gil, 22 Gwanpyeong-ro, Dongan-gu, Anyang-si, Gyeonggi-do 14068, Republic of Korea.

Abstract

Mitotic counts in the World Health Organization (WHO) grading system have narrow cutoff values. True mitotic figures, however, are not always distinguishable from apoptotic bodies and darkly stained nuclei, complicating the ability of the WHO grading system to diagnose well-differentiated neuroendocrine tumors (NETs). The mitosis-specific marker phosphohistone H3 (PHH3) can identify true mitoses and grade tumors reliably. The aim of this study was to investigate the correspondence of tumor grades, as determined by PHH3 mitotic index (MI) and mitotic counts according to WHO criteria, and to determine the clinically relevant cutoffs of PHH3 MI in rectal and nonrectal gastrointestinal NETs. Mitotic counts correlated with both the Ki-67 labeling index and PHH3 MI, but the correlation with PHH3 MI was slightly higher. The PHH3 MI cutoff ≥4 correlated most closely with original WHO grades for both rectal NETs. A PHH3 MI cutoff ≥4, which could distinguish between G1 and G2 tumors, was associated with disease-free survival in patients with rectal NETs, whereas that cutoff value showed marginal significance for overall survival in patient with rectal NETs. In conclusion, the use of PHH3 ≥4 correlated most closely with original WHO grades.

PMID:
29780816
PMCID:
PMC5892266
DOI:
10.1155/2018/1013640
[Indexed for MEDLINE]
Free PMC Article

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