Related Experiment Video
Updated: Jul 26, 2025
Author Spotlight: Genetically Engineered Mouse Models and Pathological Characterization of Neurofibromatosis Type 1 Associated Tumors
Published on: May 17, 2024
Prognostic differences in grading and metastatic lymph node pattern in patients with small bowel neuroendocrine
Lisa Reinhard1, Martina T Mogl2, Fabian Benz3
1Department of Surgery, Campus Charité Mitte | Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Prognostic factors in small intestine neuroendocrine tumors (si-NET) were investigated. Subdividing G2 tumors by Ki67 index and analyzing lymphatic spread patterns revealed significant differences in patient outcomes.
Area of Science:
- Oncology
- Pathology
Background:
- Small intestine neuroendocrine tumors (si-NET) are heterogeneous neoplasms.
- Tumor grading (G1, G2, G3) based on Ki67 index is standard, but its prognostic impact in si-NET requires further evaluation.
- si-NET exhibit diverse lymphatic spread patterns, influencing patient prognosis.
Purpose of the Study:
- To identify prognostic factors in small intestine neuroendocrine tumors (si-NET).
- To evaluate the impact of tumor grading and lymphatic spread patterns on patient outcomes.
- To investigate potential differences within the G2 tumor grade based on Ki67 index.
Main Methods:
- Retrospective analysis of demographic, pathological, and surgical data from 208 patients with si-NET treated between 2010 and 2020.
- Classification of tumors into G1, G2, and G3 based on Ki67 proliferation index.
- Subgroup analysis of G2 tumors (Ki67 3-20%) into G2 low (3-9%) and G2 high (10-20%).
Main Results:
- 113 tumors were G1 and 93 were G2.
- Significant differences in overall survival (OS) and progression-free survival (PFS) were observed between G2 low and G2 high subgroups (p=0.008 and p=0.004, respectively).
- Patients with higher Ki67 index (>10%) had lower remission rates post-surgery. Lymph node metastases were present in 83.6% of patients, with isolated locoregional disease correlating with better PFS and OS.
Conclusions:
- Lymphatic spread patterns significantly influence patient outcomes in si-NET.
- The G2 tumor grade is heterogeneous, with distinct prognostic implications for G2 low and G2 high subgroups.
- Stratifying G2 tumors may refine follow-up strategies, adjuvant treatment decisions, and surgical planning for si-NET patients.
