Prognostic value of immunohistochemistry in gastric neuroendocrine (carcinoid) tumors

Safatle‐Ribeiro, Adriana Vaz; Ribeiro, Ulysses; Corbett, Carlos Eduardo Pereira; Iriya, Kiyoshi; Kobata, Cristina H. P.; Sakai, Paulo; Yagi, Osmar Kenji; Pinto, Paulo Engler; Zilberstein, Bruno; Gama-Rodrigues, Joaquim

doi:10.1097/01.meg.0000250582.30737.bd

Cited by 20 publications

(18 citation statements)

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“…Nishikura et al [4] showed that p53 overexpression was observed in 58.8% of gastric ECs, but not in gastric carcinoid tumors. Expression of p53 was associated with a high degree of cell proliferation (Ki-67-positive nuclear cells) and this marker also was able to predict a shorter survival time [5]. Thus, tumor progression is likely to accelerate cell proliferation, as reflected by the Ki-67 labeling index.…”

Section: Discussionmentioning

confidence: 95%

“…This hypothesis was supported by correlations between the pattern of p53 protein overexpression and the concordance of common p53 mutational patterns between the gastric EC and adenocarcinoma components. Expression of p53 was associated with a high degree of cell proliferation (Ki-67-positive nuclear cells) and this marker was able to predict a shorter survival time [5].…”

Section: Introductionmentioning

confidence: 96%

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Endocrine carcinoma of the stomach: clinicopathological analysis of 27 surgically treated cases in a single institute

et al. 2012

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Background Gastric endocrine carcinoma (EC) is an uncommon tumor of the stomach and the clinical features are not well known. Additionally, the classification and staging systems of this tumor are not yet unified worldwide. In this study, we reviewed 27 patients with gastric EC to evaluate the clinicopathological characteristics of this tumor. Methods We retrospectively reviewed 27 patients with gastric EC among 6466 patients who had undergone gastrectomy between 1986 and 2008 at our institute. Clinicopathological features including immunohistochemistry of Ki-67 were investigated to evaluate the malignant potential of the tumor. Furthermore, survivals were compared between the 7th edition of the International Union Against Cancer (UICC)-TNM (7th TNM) classification for gastric cancer (GC) and the new TNM classification for foregut neuroendocrine tumors (NET). Results The median survival of the patients was 19.0 months. The 5-year survival rate was 100% in pathological stage (pStage) I, 40% in pStage II, 38% in pStage III, and 11% in pStage IV according to the 7th TNM classification for GC. Survivals by stage showed great difference between the 7th TNM classification for GC and the new TNM classification for foregut NET, but each system correlated with survival. The Ki-67 labeling index was more than 20% in most of the patients. Univariate analysis revealed that maximum tumor diameter, tumor depth, lymph node metastasis, lymphatic invasion, pStage, and curability had significant correlations with survival. Conclusion Early detection and curative operations are essential for improving the prognosis of gastric EC. However, some adjuvant chemotherapies are required for advanced-stage tumors. Classification and staging systems may need to be unified worldwide for further analysis.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 96%

Endocrine carcinoma of the stomach: clinicopathological analysis of 27 surgically treated cases in a single institute

et al. 2012

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“…This highlights the need to better understand the behavior of GCs and to precisely classify them. 22 After all, how do we identify those patients with small type I GCs that have bad prognosis and should undergo surgical management? Should we base our decision on the grade provided by the 2010 WHO classification alone?…”

Section: Discussionmentioning

confidence: 99%

Minute Type I Gastric Carcinoid With Regional Lymph Node Metastasis

et al. 2012

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Type I gastric carcinoids are indolent lesions that only rarely metastasize. Until now, lymph node metastasis had only being observed in large (≥10 mm) and usually invasive lesions (deep submucosa or beyond). This study reports a diminutive (8 mm) gastric carcinoid, limited to the superficial layer of the submucosa (sm1), with no angiovascular invasion, but with a high Ki-67 index (7%) and an involved perigastric lymph node. The aggressive behavior of this lesion ends the previous believe that small and superficial type I gastric carcinoids do not metastasize. This case also indicates that better parameters are necessary to evaluate the malignant potential of these lesions and presents a further support to the value of 2010 World Health Organization classification of gastrointestinal neuroendocrine tumors.

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“…Of 270 genes differentially altered, CgA [30], MAGE-D2 (adhesin), MTA1 (histone deacetlyase regulator) [31] and CCN2 (growth factor) [20] can differentiate between type III and I tumours. Mutation of the tumour suppressor gene p53 has been reported to be strongly correlated with type III tumours and functionally may play a role in stimulating proliferation [32].…”

Section: Type III Gastric Netsmentioning

confidence: 99%

Gastric NeuroendocrineTumours

et al. 2012

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Background: Gastric neuroendocrine tumours (NETs) are increasingly recognised, and management decisions may be difficult due to an incomplete understanding of aetiology, natural history and optimum therapy. This article presents a current understanding based on recent advances in epidemiology, classification, molecular profiling, and treatment. Methods: Relevant medical literature was identified from searches of PubMed and references cited in appropriate articles identified. Selection of articles was based on peer review, journal and relevance. Results: Gastric NETs may be divided into three clinical prognostic groups: type I is associated with autoimmune atrophic gastritis and hypergastrinaemia, type II is associated with Zollinger-Ellison syndrome, and type III lesions are gastrin-independent, have the greatest metastatic potential and poorest prognosis. There has been an increased frequency of gastric NETs reported. Management approaches have evolved in parallel with advances in endoscopic staging and surgery, as well as improved understanding of the biology and natural history of NETs. Conclusions: Gastric NETs present a spectrum of activity from indolent tumours to metastatic malignancy. Treatment decisions for patients must be individualised and are best managed by a multidisciplinary team approach. The current evidence base is limited to small series and efforts to treat patients within clinical networks of expertise are warranted.

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Prognostic value of immunohistochemistry in gastric neuroendocrine (carcinoid) tumors

Abstract: (i) p53 immunoexpression associated with high proliferative rate was useful to distinguish between type I and type III gastric carcinoid tumors and (ii) these markers were able to predict a shorter survival.

Cited by 20 publications

References 20 publications

Endocrine carcinoma of the stomach: clinicopathological analysis of 27 surgically treated cases in a single institute

Endocrine carcinoma of the stomach: clinicopathological analysis of 27 surgically treated cases in a single institute

Minute Type I Gastric Carcinoid With Regional Lymph Node Metastasis

Gastric NeuroendocrineTumours

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