Grading of well-differentiated pancreatic Neuroendocrine tumors is improved by the inclusion of both ki67 Proliferative index and mitotic rate

Chad M. McCall, Chanjuan Shi, Toby C. Cornish, David S. Klimstra, Laura H. Tang, Olca Basturk, Liew Jun Mun, Trevor A. Ellison, Christopher Wolfgang, Michael A. Choti, Richard D. Schulick, Barish H. Edil, Ralph H Hruban

Research output: Contribution to journalArticle

Abstract

The grading system for pancreatic neuroendocrine tumors (PanNETs) adopted in 2010 by the World Health Organization (WHO) mandates the use of both mitotic rate and Ki67/MIB-1 index in defining the proliferative rate and assigning the grade. In cases when these measures are not concordant for grade, it is recommended to assign the higher grade, but specific data justifying this approach do not exist. Thus, we counted mitotic figures and immunolabeled, using the Ki67 antibody, 297 WHO mitotic grade 1 and 2 PanNETs surgically resected at a single institution. We quantified the Ki67 proliferative index by marking at least 500 cells in "hot spots" and by using digital image analysis software to count each marked positive/negative cell and then compared the results with histologic features and overall survival. Of 264 WHO mitotic grade 1 PanNETs, 33% were WHO grade 2 by Ki67 proliferative index. Compared with concordant grade 1 tumors, grade-discordant tumors were more likely to have metastases to lymph node (56% vs. 34%) (P

Original languageEnglish (US)
Pages (from-to)1671-1677
Number of pages7
JournalAmerican Journal of Surgical Pathology
Volume37
Issue number11
DOIs
StatePublished - Nov 2013

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Mitotic Index
Neuroendocrine Tumors
Neoplasms
Software
Lymph Nodes
Neoplasm Metastasis
Antibodies

Keywords

  • endocrine neoplasm
  • gastroenteropancreatic neuroendocrine tumor
  • Ki67
  • neuroendocrine tumor
  • pancreas
  • pancreatic cancer
  • pancreatic endocrine neoplasm islet cell tumor
  • pancreatic neuroendocrine tumor

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine
  • Surgery

Cite this

Grading of well-differentiated pancreatic Neuroendocrine tumors is improved by the inclusion of both ki67 Proliferative index and mitotic rate. / McCall, Chad M.; Shi, Chanjuan; Cornish, Toby C.; Klimstra, David S.; Tang, Laura H.; Basturk, Olca; Mun, Liew Jun; Ellison, Trevor A.; Wolfgang, Christopher; Choti, Michael A.; Schulick, Richard D.; Edil, Barish H.; Hruban, Ralph H.

In: American Journal of Surgical Pathology, Vol. 37, No. 11, 11.2013, p. 1671-1677.

Research output: Contribution to journalArticle

McCall, CM, Shi, C, Cornish, TC, Klimstra, DS, Tang, LH, Basturk, O, Mun, LJ, Ellison, TA, Wolfgang, C, Choti, MA, Schulick, RD, Edil, BH & Hruban, RH 2013, 'Grading of well-differentiated pancreatic Neuroendocrine tumors is improved by the inclusion of both ki67 Proliferative index and mitotic rate', American Journal of Surgical Pathology, vol. 37, no. 11, pp. 1671-1677. https://doi.org/10.1097/PAS.0000000000000089
McCall, Chad M. ; Shi, Chanjuan ; Cornish, Toby C. ; Klimstra, David S. ; Tang, Laura H. ; Basturk, Olca ; Mun, Liew Jun ; Ellison, Trevor A. ; Wolfgang, Christopher ; Choti, Michael A. ; Schulick, Richard D. ; Edil, Barish H. ; Hruban, Ralph H. / Grading of well-differentiated pancreatic Neuroendocrine tumors is improved by the inclusion of both ki67 Proliferative index and mitotic rate. In: American Journal of Surgical Pathology. 2013 ; Vol. 37, No. 11. pp. 1671-1677.
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