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[Gastroenteropancreatic neuroendocrine neoplasms: concepts and related issues]
Abstract:
The incidence of neuroendocrine neoplasms (NENs) has been gradually increasing and most of NENs are located in gastroenteropancreatic system. With the application of target therapeutic drugs in recent years, the precise pathological diagnosis is required critically for effective clinical treatment: target therapy needs targeted pathological diagnosis. In this article, the definition of NENs, and the century-long evolution of diagnostic terms and grades are reviewed. The eight steps of pathological diagnosis of NENs for clinical needs are described. Four inconsistent concepts in NENs diagnosis are also discussed, that is immunohistochemical biomarkers of pathological diagnosis, subpopulation of neuroendocrine neoplasms with high proliferative activity, general adenocarcinomas with neuroendocrine differentiation and molecular genetics characteristics. To correctly understand these issues would be of great value for diagnosis and treatment of NENs.
Insights
Neuroendocrine neoplasms (NENs) are increasing, requiring precise pathological diagnosis for targeted therapy. This review details NEN definitions, diagnostic evolution, and key challenges for improved patient care.
Area of Science:
- Oncology
- Pathology
- Gastroenterology
Background:
- Neuroendocrine neoplasms (NENs) incidence is rising, particularly in the gastroenteropancreatic system.
- Accurate pathological diagnosis is crucial for effective targeted therapy in NEN management.
- The evolution of diagnostic terms and grading systems for NENs necessitates a clear understanding.
Purpose of the Study:
- To review the definition and historical evolution of diagnostic terms and grades for NENs.
- To outline a practical, eight-step pathological diagnostic process for NENs.
- To discuss and clarify four key areas of diagnostic inconsistency in NENs.
Main Methods:
- Literature review of NEN definitions, diagnostic terminology, and grading systems.
- Description of a structured, eight-step pathological diagnostic workflow.
- Analysis and discussion of four controversial topics in NEN diagnosis.
Main Results:
- The article provides a comprehensive overview of NEN classification and diagnostic criteria.
- An eight-step diagnostic protocol is presented to guide pathologists.
- Key diagnostic ambiguities concerning biomarkers, proliferation, differentiation, and molecular genetics are addressed.
Conclusions:
- A thorough understanding of NENs' definition, diagnostic history, and current challenges is vital.
- Standardized diagnostic approaches and clarification of inconsistencies will enhance NEN patient treatment.
- Precise pathological diagnosis underpins the success of targeted therapies for neuroendocrine neoplasms.
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