Milena Di Leo1,2, Laura Poliani3, Daoud Rahal4, Francesco Auriemma3, Andrea Anderloni3, Cristina Ridolfi5, Paola Spaggiari4, Giovanni Capretti5, Luca Di Tommaso6,4, Paoletta Preatoni7, Alessandro Zerbi6,5, Carlo Carnaghi8, Andrea Lania6,9, Alberto Malesci6,7, Alessandro Repici3,6, Silvia Carrara3. 1. Humanitas Clinical and Research Center, IRCCS, Digestive Endoscopy Unit, Division of Gastroenterology, Milan, Italy, milena.di_leo@hunimed.eu. 2. Humanitas University, Department of Biomedical Sciences, Milan, Italy, milena.di_leo@hunimed.eu. 3. Humanitas Clinical and Research Center, IRCCS, Digestive Endoscopy Unit, Division of Gastroenterology, Milan, Italy. 4. Department of Pathology, Humanitas Clinical and Research Center, IRCCS, Milan, Italy. 5. Humanitas Clinical and Research Center, IRCCS, Pancreatic Surgery Unit, Milan, Italy. 6. Humanitas University, Department of Biomedical Sciences, Milan, Italy. 7. Humanitas Clinical and Research Center, IRCCS, Division of Gastroenterology, Milan, Italy. 8. Humanitas Clinical and Research Center, IRCCS, Division of Oncology, Milan, Italy. 9. Humanitas Clinical and Research Center, IRCCS, Division of Endocrinology, Milan, Italy.
Abstract
BACKGROUND: One of the controversial issues in the diagnosis of pancreatic neuroendocrine tumours (pNETs) is the accurate prediction of their clinical behaviour. OBJECTIVES: The aim of the study was to evaluate the role of endoscopic ultrasound (EUS) biopsy in the diagnosis and grading of pNETs in a certified ENETS Center. METHODS: A prospectively maintained database of EUS biopsy procedures was retrospectively reviewed to identify all consecutive patients referred to a certified ENETS Center with a suspicion of pNET between June 2014 and April 2017. The cytological and/or histological specimens were stained and the Ki-67 labeling index was evaluated. In patients undergoing surgery, the grade obtained with EUS-guided biopsy was compared with the final histological grade. The grade was evaluated according to the 2017 WHO classifications and grading. RESULTS: The study population included 59 patients. EUS biopsy material reached an adequacy of 98.3% and was adequate for Ki-67 evaluation in 84.7% of cases. Twenty-nine patients (49.2%) underwent surgery. Of these, 25 patients had Ki-67 evaluated on EUS biopsy: the agreement between EUS biopsy grading and surgical specimen grading was 84%. CONCLUSION: EUS biopsy is an accurate method for the diagnosis and grading of pNETs based on the WHO 2017 Ki-67 labelling scheme.
BACKGROUND: One of the controversial issues in the diagnosis of pancreatic neuroendocrine tumours (pNETs) is the accurate prediction of their clinical behaviour. OBJECTIVES: The aim of the study was to evaluate the role of endoscopic ultrasound (EUS) biopsy in the diagnosis and grading of pNETs in a certified ENETS Center. METHODS: A prospectively maintained database of EUS biopsy procedures was retrospectively reviewed to identify all consecutive patients referred to a certified ENETS Center with a suspicion of pNET between June 2014 and April 2017. The cytological and/or histological specimens were stained and the Ki-67 labeling index was evaluated. In patients undergoing surgery, the grade obtained with EUS-guided biopsy was compared with the final histological grade. The grade was evaluated according to the 2017 WHO classifications and grading. RESULTS: The study population included 59 patients. EUS biopsy material reached an adequacy of 98.3% and was adequate for Ki-67 evaluation in 84.7% of cases. Twenty-nine patients (49.2%) underwent surgery. Of these, 25 patients had Ki-67 evaluated on EUS biopsy: the agreement between EUS biopsy grading and surgical specimen grading was 84%. CONCLUSION: EUS biopsy is an accurate method for the diagnosis and grading of pNETs based on the WHO 2017 Ki-67 labelling scheme.
Authors: Alexander Appelstrand; Fredrik Bergstedt; Anna-Karin Elf; Henrik Fagman; Per Hedenström Journal: Sci Rep Date: 2022-04-08 Impact factor: 4.379