BACKGROUND AND OBJECTIVES: The Ki-67 index has been incorporated into The World Health Organization's classification system of pancreatic neuroendocrine tumors. However, pathologists continue to question the utility of Ki-67 index over that of mitotic count as an indicator of proliferative activity. The intent of the current study is to compare K-i67 index with tumor size and mitotic rate for the association of each with lymph node metastasis and survival. METHODS: The current study is a review of 24 patients with pancreatic neuroendocrine tumors. RESULTS: Regional LNM were present in 100% of tumors with Ki-67 index >10%, while only 25% of tumors with <10% Ki-67 had LNM (P = 0.003). No tumors <2 cm had >10% Ki-67 labeling. Of patients with tumors showing ≥ 10% Ki-67 labeling, 80% died during the observation period of this study, while during the same time period, no patients with <10% Ki-67 labeling died. CONCLUSION: Ki-67 index of >10% is a sensitive indicator of malignant behavior and mortality. Future advances in management of pNETs will require development of staging guidelines with higher predictive value. Inclusion of Ki-67 labeling >10% as an indicator of aggressive disease may contribute to such improvements.
BACKGROUND AND OBJECTIVES: The Ki-67 index has been incorporated into The World Health Organization's classification system of pancreatic neuroendocrine tumors. However, pathologists continue to question the utility of Ki-67 index over that of mitotic count as an indicator of proliferative activity. The intent of the current study is to compare K-i67 index with tumor size and mitotic rate for the association of each with lymph node metastasis and survival. METHODS: The current study is a review of 24 patients with pancreatic neuroendocrine tumors. RESULTS: Regional LNM were present in 100% of tumors with Ki-67 index >10%, while only 25% of tumors with <10% Ki-67 had LNM (P = 0.003). No tumors <2 cm had >10% Ki-67 labeling. Of patients with tumors showing ≥ 10% Ki-67 labeling, 80% died during the observation period of this study, while during the same time period, no patients with <10% Ki-67 labeling died. CONCLUSION:Ki-67 index of >10% is a sensitive indicator of malignant behavior and mortality. Future advances in management of pNETs will require development of staging guidelines with higher predictive value. Inclusion of Ki-67 labeling >10% as an indicator of aggressive disease may contribute to such improvements.
Authors: Olca Basturk; Zhaohai Yang; Laura H Tang; Ralph H Hruban; Volkan Adsay; Chad M McCall; Alyssa M Krasinskas; Kee-Taek Jang; Wendy L Frankel; Serdar Balci; Carlie Sigel; David S Klimstra Journal: Am J Surg Pathol Date: 2015-05 Impact factor: 6.394
Authors: Chad M McCall; Chanjuan Shi; Toby C Cornish; David S Klimstra; Laura H Tang; Olca Basturk; Liew Jun Mun; Trevor A Ellison; Christopher L Wolfgang; Michael A Choti; Richard D Schulick; Barish H Edil; Ralph H Hruban Journal: Am J Surg Pathol Date: 2013-11 Impact factor: 6.394
Authors: Shayna Brathwaite; Jonathan Rock; Martha M Yearsley; Tanios Bekaii-Saab; Lai Wei; Wendy L Frankel; John Hays; Christina Wu; Sherif Abdel-Misih Journal: Ann Surg Oncol Date: 2016-03-10 Impact factor: 5.344
Authors: Mohammad Y Zaidi; Alexandra G Lopez-Aguiar; Jeffrey M Switchenko; Joseph Lipscomb; Valentina Andreasi; Stefano Partelli; Adriana C Gamboa; Rachel M Lee; George A Poultsides; Mary Dillhoff; Flavio G Rocha; Kamran Idrees; Clifford S Cho; Sharon M Weber; Ryan C Fields; Charles A Staley; Massimo Falconi; Shishir K Maithel Journal: Ann Surg Date: 2019-09 Impact factor: 12.969