[Study on clinicopathologic grading system and prognosis of primary hepatic neuroendocrine neoplasms]
1Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Objective:
To study the clinicopathologic features, criteria for grading and prognostic factors of primary hepatic neuroendocrine neoplasms.
Methods:
Thirty-five cases of primary hepatic neuroendocrine neoplasm were retrieved from the archival files over a period of 11 years (with 32 cases having integrated data). According to the 2010 WHO classification of tumors of the digestive system, the cases were categorized into three groups: neuroendocrine tumor grade 1 (NET G1), neuroendocrine tumor grade 2 (NET G2) and neuroendocrine carcinoma (NEC). Statistical correlation between various histologic parameters and survival data was analyzed.
Results:
Statistical analysis showed significant difference between NET [G1 (1 case)/G2 (14 cases)] and NEC (17 cases) groups in terms of tumor differentiation, necrosis, nuclear atypia, mitotic count and Ki-67 proliferative index (P < 0.05). There was no statistically significant difference in tumor size, growth pattern and presence of vascular tumor emboli (P > 0.05). The survival rate of patients correlated with tumor differentiation, growth pattern, necrosis, nuclear atypia, mitotic count and proliferative index (P < 0.05). There was no statistically significant difference between patient survival and tumor size or presence of vascular tumor emboli (P > 0.05).
Conclusions:
The subdivision of primary hepatic neuroendocrine neoplasm according to the 2010 WHO classification of tumors of the digestive system helps to evaluate the malignant potential and prognosis of the tumors. Prognostically useful histologic parameters include tumor differentiation, growth pattern, necrosis, nuclear atypia, mitotic count and proliferative index.