Back to Search
Start Over
Ki-67 cytological index can distinguish well-differentiated from poorly differentiated pancreatic neuroendocrine tumors: A comparative cytohistological study of 53 cases
- Publication Year :
- 2014
-
Abstract
- The Ki-67 labeling index has been found to bear prognostic significance in gastrointestinal neuroendocrine tumors (NETs), and it was recently incorporated in NET histological grading. Nevertheless, a reliable preoperative determination of NET grading could be useful in clinical practice. The aim of this study is to compare the results of Ki-67 labeling index, as measured on cytological samples and on surgical specimens of patients with pancreatic NETs (P-NETs). We also investigated whether concordance might be improved, using a 5 % (instead of 2 %) cutoff value for defining G2 tumors. We retrospectively identified 48 consecutive patients with 53 P-NETs, from our five institutions, and we measured Ki-67 labeling index on their cytological samples and surgical specimens. The traditional 2 % and the alternative 5 % cutoff values were used to classify G2 tumors. The concordance rate between cytological and histological grading was 46/53 (86.8 %; weighted κ statistic 0.77; 95 % confidence interval (95 % CI) 0.60-0.94). No cases of cytological G1-G2 NETs were upgraded to G3 neuroendocrine carcinoma (NEC) at histological grading. Cytology was found to be highly specific in the diagnosis of both G2 (94.1 %; 95 % CI 80.3-99.3) and G3 tumors (100.0 %; 95 % CI 92.8-100), but the sensitivity was poor for G2 NETs (66.7 %; 95 % CI 38.4-88.2) and high for the prediction of G3 NECs (100 %; 95 % CI 39.8-100.0). When the 5 % cutoff value was adopted, concordance rate was 49/53 (92.4 %; weighted κ 0.82; 95 % CI 0.64-1.00). In conclusion, Ki-67 cytological expression can distinguish well-differentiated (both G1 and G2) from poorly differentiated P-NETs, and it may be useful for their preoperative classification. © 2014 Springer-Verlag.
- Subjects :
- Adult
Male
Pathology
medicine.medical_specialty
Concordance
Neuroendocrine tumors
Gastroenterology
Sensitivity and Specificity
Pathology and Forensic Medicine
Cytological grading
Internal medicine
Cytology
Carcinoma
medicine
Biomarkers, Tumor
Mitotic Index
Humans
Molecular Biology
Grading (tumors)
Pancreatic neuroendocrine tumors
Aged
Retrospective Studies
Aged, 80 and over
Neoplasm Grading
Endoscopic ultrasound-guided fine needle aspiration
biology
business.industry
Histocytochemistry
Cell Differentiation
Cell Biology
General Medicine
Middle Aged
medicine.disease
Prognosis
Confidence interval
Carcinoma, Neuroendocrine
Pancreatic Neoplasms
Neuroendocrine Tumors
Ki-67 Antigen
Ki-67
biology.protein
Female
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....63b51008423465072ee8b0e5f622024e