Related Experiment Video
Updated: Feb 14, 2026
Human Neuroendocrine Tumor Cell Lines as a Three-Dimensional Model for the Study of Human Neuroendocrine Tumor Therapy
Published on: August 14, 2012
Prognostic and recurrence implications of subdividing WHO grade 2 pancreatic neuroendocrine tumors at a 10% Ki-67
Go-Won Choi1, Inhyuck Lee1, Younsoo Seo1
1Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.
Background:
Although World Health Organization (WHO) grade 1 and 2 pancreatic neuroendocrine tumors (pNETs) are generally regarded as indolent, substantial biological heterogeneity exists, particularly within grade 2 (G2) tumors. This study evaluated whether subdividing G2 pNETs using new Ki-67 threshold improves postoperative risk stratification following curative resection.
Methods:
We retrospectively analyzed consecutive adults who underwent pancreatectomy for pNETs between 2010 and 2022. Tumors were classified as G1 (<3%), G2a (3-<10%), G2b (10-<20%), and G3 (≥20%). Outcomes were disease-free survival (DFS) and overall survival (OS) assessed through December 31, 2024. Multivariable Cox models identified independent predictors of DFS and OS.
Results:
Among 300 patients (mean tumor size 2.65 ± 1.90 cm), grade distribution was 65.3%, 26.3%, 6.0%, and 2.3% for G1, G2a, G2b, and G3, respectively. DFS declined stepwise across grades (p < 0.001), with 5-year DFS of 88.1%, 68.9%, 45.5%, and 21.4%, respectively. OS also differed by grade (p < 0.001). On multivariable analysis, T stage >2, lymph node positivity, mitotic count >2, and grade subtype were independently associated with worse DFS, while grade subtype remained the only independent predictor of OS.
Conclusion:
Subclassification of WHO G2 pNETs using a 10% Ki-67 threshold enhances postoperative risk stratification. When integrated with established pathological factors, this approach may better identify patients at increased risk of recurrence following curative resection.
Related Concept Videos
01:19Graded Potential
Graded potentials fall into two categories: depolarizing and hyperpolarizing. Depolarizing graded potentials typically occur when sodium (Na+) or...
01:15Types of Aggregate Grading
Well-graded aggregates include a complete range of necessary size fractions that fit together to create a dense matrix with minimal voids, represented by a smooth, continuous gradation curve. This type of grading ensures good...
01:19Sieve Analysis and Grading Curves
01:13meta-Directing Deactivators: –NO2, –CN, –CHO, –CO2R, –COR, –CO2H
01:26Pancreatic Juice and Secretion
When acidic chyme from the stomach enters the duodenum, it triggers the release of secretin, a hormone that prompts pancreatic juice secretion. After a fatty meal, cholecystokinin, another hormone, stimulates gallbladder contraction and enhances enzyme-rich...
01:27Acute Pancreatitis I: Introduction
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include: