BMC Cancer (Aug 2017)

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

  • Luohai Chen,
  • Lin Zhou,
  • Meng Zhang,
  • Liang Shang,
  • Panpan Zhang,
  • Wei Wang,
  • Cheng Fang,
  • Jingnan Li,
  • Tianming Xu,
  • Huangying Tan,
  • Pan Zhang,
  • Meng Qiu,
  • Xianjun Yu,
  • Kaizhou Jin,
  • Ye Chen,
  • Huishan Chen,
  • Rong Lin,
  • Qin Zhang,
  • Lin Shen,
  • Minhu Chen,
  • Jie Li,
  • Leping Li,
  • Jie Chen

DOI
https://doi.org/10.1186/s12885-017-3490-3
Journal volume & issue
Vol. 17, no. 1
pp. 1 – 11

Abstract

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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.

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