Gastroenteropancreatic neuroendocrine neoplasms: Historical context and current issues Journal Article
| Authors: | Yang, Z.; Tang, L. H.; Klimstra, D. S. |
| Article Title: | Gastroenteropancreatic neuroendocrine neoplasms: Historical context and current issues |
| Abstract: | The digestive organs contain a large number of neuroendocrine cells as part of the diffuse neuroendocrine system. Neuroendocrine tumors can occur in every digestive organ. It has long been recognized that this is a diverse group of tumors with very different clinical outcomes; however, well-recognized prognostic parameters had been elusive until recently. Over the years, there have been several different classification schemes, each with different strengths and weaknesses. In an effort to standardize the classification and grading criteria for gastroenteropancreatic neuroendocrine tumors, the current World Health Organization classification includes a histologic grade based on proliferative rate (mitotic rate and Ki67 index) and a TNM stage that varies from organ to organ. The prognostic value of both the grade and stage has been validated in multiple studies. However, several issues remain, including the lack of standardized methods to assess proliferative rate, potential discrepancies between the mitotic count and the Ki67 index; intratumoral heterogeneity in proliferative rate; and the need for refinement in proliferative cut-points to define the grades. More studies are needed to further improve the classification of neuroendocrine tumors, thus guiding optimal treatment for these tumors. © 2013 Elsevier Inc. |
| Keywords: | protein expression; histopathology; pancreatic neoplasms; cancer staging; neoplasm staging; cancer grading; ki 67 antigen; image analysis; tumor volume; standardization; cellular distribution; mitosis rate; nomenclature; carcinoid tumor; neuroendocrine tumors; history of medicine; synaptophysin; reference value; digital imaging; chromogranin a; tumor necrosis; neurosecretory cell; tumor invasion; gastroenteropancreatic neuroendocrine tumor; cancer prognosis; neoplasm grading; ki67 antigen; vesicular monoamine transporter 2; poorly differentiated neuroendocrine carcinoma |
| Journal Title: | Seminars in Diagnostic Pathology |
| Volume: | 30 |
| Issue: | 3 |
| ISSN: | 0740-2570 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2013-08-01 |
| Start Page: | 186 |
| End Page: | 196 |
| Language: | English |
| DOI: | 10.1053/j.semdp.2013.06.005 |
| PROVIDER: | scopus |
| PUBMED: | 24144288 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 2 December 2013" - "CODEN: SDPAE" - "Source: Scopus" |
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