Clinicopathological heterogeneity between primary and metastatic sites of gastroenteropancreatic neuroendocrine neoplasm
Abstract Background Chromogranin A (CgA), synaptophysin (Syn) and the Ki-67 index play significant roles in diagnosis or the evaluation of the proliferative activity of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs). However, little is known about whether these biological markers change...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-09-01
|
| Series: | Diagnostic Pathology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13000-020-01030-x |
| _version_ | 1818970353340252160 |
|---|---|
| author | Huiying Shi Chen Jiang Qin Zhang Cuihua Qi Hailing Yao Rong Lin |
| author_facet | Huiying Shi Chen Jiang Qin Zhang Cuihua Qi Hailing Yao Rong Lin |
| author_sort | Huiying Shi |
| collection | DOAJ |
| description | Abstract Background Chromogranin A (CgA), synaptophysin (Syn) and the Ki-67 index play significant roles in diagnosis or the evaluation of the proliferative activity of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs). However, little is known about whether these biological markers change during tumor metastasis and whether such changes have effect on prognosis. Methods We analyzed 35 specimens of both primary and metastatic tumor from 779 patients who had been diagnosed as GEP-NENs at Wuhan Union Hospital from August 2011 to October 2019. The heterogeneity of CgA, Syn and Ki-67 index was evaluated by immunohistochemical analysis. Results Among these 779 patients, the three most common sites of NENs in the digestive tract were the pancreas, rectum and stomach. Metastases were found in 311 (39.9%) patients. Among the 35 patients with both primary and metastatic pathological specimens, differences in the Ki-67 level were detected in 54.3% of the patients, while 37.1% showed a difference in CgA and only 11.4% showed a difference in Syn. Importantly, due to the difference in the Ki-67 index between primary and metastatic lesions, the WHO grade was changed in 8.6% of the patients. In addition, a Kaplan–Meier survival analysis showed that patients with Ki-67 index variation had a shorter overall survival (p = 0.0346), while neither Syn variation nor CgA variation was related to patient survival (p = 0.7194, p = 0.4829). Conclusions Our data indicate that primary and metastatic sites of GEP-NENs may exhibit pathological heterogeneity. Ki-67 index variation is closely related to the poor prognosis of patients with tumor metastasis, but neither Syn variation nor CgA variation is related to patient prognosis. Therefore, clinicopathologic evaluation of the primary tumor and metastatic sites could be helpful for predicting the prognosis. |
| first_indexed | 2024-12-20T14:35:08Z |
| format | Article |
| id | doaj.art-7b00fe6100bd44dfbe7c696144daabed |
| institution | Directory Open Access Journal |
| issn | 1746-1596 |
| language | English |
| last_indexed | 2024-12-20T14:35:08Z |
| publishDate | 2020-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Diagnostic Pathology |
| spelling | doaj.art-7b00fe6100bd44dfbe7c696144daabed2022-12-21T19:37:29ZengBMCDiagnostic Pathology1746-15962020-09-0115111010.1186/s13000-020-01030-xClinicopathological heterogeneity between primary and metastatic sites of gastroenteropancreatic neuroendocrine neoplasmHuiying Shi0Chen Jiang1Qin Zhang2Cuihua Qi3Hailing Yao4Rong Lin5Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyAbstract Background Chromogranin A (CgA), synaptophysin (Syn) and the Ki-67 index play significant roles in diagnosis or the evaluation of the proliferative activity of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs). However, little is known about whether these biological markers change during tumor metastasis and whether such changes have effect on prognosis. Methods We analyzed 35 specimens of both primary and metastatic tumor from 779 patients who had been diagnosed as GEP-NENs at Wuhan Union Hospital from August 2011 to October 2019. The heterogeneity of CgA, Syn and Ki-67 index was evaluated by immunohistochemical analysis. Results Among these 779 patients, the three most common sites of NENs in the digestive tract were the pancreas, rectum and stomach. Metastases were found in 311 (39.9%) patients. Among the 35 patients with both primary and metastatic pathological specimens, differences in the Ki-67 level were detected in 54.3% of the patients, while 37.1% showed a difference in CgA and only 11.4% showed a difference in Syn. Importantly, due to the difference in the Ki-67 index between primary and metastatic lesions, the WHO grade was changed in 8.6% of the patients. In addition, a Kaplan–Meier survival analysis showed that patients with Ki-67 index variation had a shorter overall survival (p = 0.0346), while neither Syn variation nor CgA variation was related to patient survival (p = 0.7194, p = 0.4829). Conclusions Our data indicate that primary and metastatic sites of GEP-NENs may exhibit pathological heterogeneity. Ki-67 index variation is closely related to the poor prognosis of patients with tumor metastasis, but neither Syn variation nor CgA variation is related to patient prognosis. Therefore, clinicopathologic evaluation of the primary tumor and metastatic sites could be helpful for predicting the prognosis.http://link.springer.com/article/10.1186/s13000-020-01030-xGastroenteropancreatic neuroendocrine neoplasms (GEP-NENs)Chromogranin (CgA)Synaptophysin (Syn)Ki-67 indexMetastasisHeterogeneity |
| spellingShingle | Huiying Shi Chen Jiang Qin Zhang Cuihua Qi Hailing Yao Rong Lin Clinicopathological heterogeneity between primary and metastatic sites of gastroenteropancreatic neuroendocrine neoplasm Diagnostic Pathology Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) Chromogranin (CgA) Synaptophysin (Syn) Ki-67 index Metastasis Heterogeneity |
| title | Clinicopathological heterogeneity between primary and metastatic sites of gastroenteropancreatic neuroendocrine neoplasm |
| title_full | Clinicopathological heterogeneity between primary and metastatic sites of gastroenteropancreatic neuroendocrine neoplasm |
| title_fullStr | Clinicopathological heterogeneity between primary and metastatic sites of gastroenteropancreatic neuroendocrine neoplasm |
| title_full_unstemmed | Clinicopathological heterogeneity between primary and metastatic sites of gastroenteropancreatic neuroendocrine neoplasm |
| title_short | Clinicopathological heterogeneity between primary and metastatic sites of gastroenteropancreatic neuroendocrine neoplasm |
| title_sort | clinicopathological heterogeneity between primary and metastatic sites of gastroenteropancreatic neuroendocrine neoplasm |
| topic | Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) Chromogranin (CgA) Synaptophysin (Syn) Ki-67 index Metastasis Heterogeneity |
| url | http://link.springer.com/article/10.1186/s13000-020-01030-x |
| work_keys_str_mv | AT huiyingshi clinicopathologicalheterogeneitybetweenprimaryandmetastaticsitesofgastroenteropancreaticneuroendocrineneoplasm AT chenjiang clinicopathologicalheterogeneitybetweenprimaryandmetastaticsitesofgastroenteropancreaticneuroendocrineneoplasm AT qinzhang clinicopathologicalheterogeneitybetweenprimaryandmetastaticsitesofgastroenteropancreaticneuroendocrineneoplasm AT cuihuaqi clinicopathologicalheterogeneitybetweenprimaryandmetastaticsitesofgastroenteropancreaticneuroendocrineneoplasm AT hailingyao clinicopathologicalheterogeneitybetweenprimaryandmetastaticsitesofgastroenteropancreaticneuroendocrineneoplasm AT ronglin clinicopathologicalheterogeneitybetweenprimaryandmetastaticsitesofgastroenteropancreaticneuroendocrineneoplasm |