BACKGROUND AND AIM: Pancreatic neuroendocrine tumors (pNETs) are histologically categorized according to the WHO 2010 classification by their mitotic index or Ki-67 index as G1, G2, or G3. The present study examined the efficacy of endoscopic ultrasonography (EUS) and EUS-guided fine-needle aspiration (EUS-FNA) in the diagnosis and grading of pNET. METHODS: We retrospectively reviewed 61 pNETs in 51 patients who underwent EUS between January 2007 and June 2014. All lesions were pathologically diagnosed by surgical resection or EUS-FNA. We evaluated the detection rates of EUS for pNET and sensitivity of EUS-FNA, and compared the Ki-67 index between EUS-FNA samples and surgical specimens. EUS findings were compared between G1 and G2/G3 tumors. RESULTS: EUS showed significantly higher sensitivity (96.7%) for identifying pNET than CT (85.2%), MRI (70.2%), and ultrasonography (75.5%). The sensitivity of EUS-FNA for the diagnosis of pNET was 89.2%. The concordance rate of WHO classification between EUS-FNA and surgical specimens was 69.2% (9/13). The concordance rate was relatively high (87.5%, 5/6) in tumors <20 mm but lower (57.1%; 4/7) in tumors ≥20 mm. Regarding EUS findings, G2/G3 tumors were more likely to be large (>20 mm), heterogeneous, and have main pancreatic duct (MPD) obstruction than G1 tumors. Multivariate analysis showed large diameter and MPD obstruction were significantly associated with G2/G3 tumors. CONCLUSIONS: EUS and EUS-FNA are highly sensitive and accurate diagnostic methods for pNET. Characteristic EUS findings such as large tumor size and MPD obstruction are suggestive of G2/G3 tumors and would be helpful for grading pNETs.
BACKGROUND AND AIM: Pancreatic neuroendocrine tumors (pNETs) are histologically categorized according to the WHO 2010 classification by their mitotic index or Ki-67 index as G1, G2, or G3. The present study examined the efficacy of endoscopic ultrasonography (EUS) and EUS-guided fine-needle aspiration (EUS-FNA) in the diagnosis and grading of pNET. METHODS: We retrospectively reviewed 61 pNETs in 51 patients who underwent EUS between January 2007 and June 2014. All lesions were pathologically diagnosed by surgical resection or EUS-FNA. We evaluated the detection rates of EUS for pNET and sensitivity of EUS-FNA, and compared the Ki-67 index between EUS-FNA samples and surgical specimens. EUS findings were compared between G1 and G2/G3 tumors. RESULTS: EUS showed significantly higher sensitivity (96.7%) for identifying pNET than CT (85.2%), MRI (70.2%), and ultrasonography (75.5%). The sensitivity of EUS-FNA for the diagnosis of pNET was 89.2%. The concordance rate of WHO classification between EUS-FNA and surgical specimens was 69.2% (9/13). The concordance rate was relatively high (87.5%, 5/6) in tumors <20 mm but lower (57.1%; 4/7) in tumors ≥20 mm. Regarding EUS findings, G2/G3 tumors were more likely to be large (>20 mm), heterogeneous, and have main pancreatic duct (MPD) obstruction than G1 tumors. Multivariate analysis showed large diameter and MPD obstruction were significantly associated with G2/G3 tumors. CONCLUSIONS: EUS and EUS-FNA are highly sensitive and accurate diagnostic methods for pNET. Characteristic EUS findings such as large tumor size and MPD obstruction are suggestive of G2/G3 tumors and would be helpful for grading pNETs.
Authors: Ammar A Javed; Alessandra Pulvirenti; Samrah Razi; Jian Zheng; Theodoros Michelakos; Yurie Sekigami; Elizabeth Thompson; David S Klimstra; Vikram Deshpande; Aatur D Singhi; Matthew J Weiss; Christopher L Wolfgang; John L Cameron; Alice C Wei; Amer H Zureikat; Cristina R Ferrone; Jin He Journal: Ann Surg Date: 2022-01-25 Impact factor: 13.787
Authors: Barbara Braden; Christian Jenssen; Mirko D'Onofrio; Michael Hocke; Uwe Will; Kathleen Möller; Andre Ignee; Yi Dong; Xin-Wu Cui; Adrian Sãftoiu; Christoph F Dietrich Journal: Endosc Ultrasound Date: 2017 Jan-Feb Impact factor: 5.628
Authors: Florian Primavesi; Valentina Andreasi; Frederik J H Hoogwater; Stefano Partelli; Dominik Wiese; Charlotte Heidsma; Benno Cardini; Eckhard Klieser; Katharina Marsoner; Uwe Fröschl; Sabine Thalhammer; Ines Fischer; Georg Göbel; Andreas Hauer; Tobias Kiesslich; Philipp Ellmerer; Reinhold Klug; Daniel Neureiter; Helwig Wundsam; Franz Sellner; Peter Kornprat; Reinhold Függer; Dietmar Öfner; Elisabeth J M Nieveen van Dijkum; Detlef K Bartsch; Ruben H J de Kleine; Massimo Falconi; Stefan Stättner Journal: Cancers (Basel) Date: 2020-05-14 Impact factor: 6.639