Medical College of Wisconsin
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Liver metastases of small intestine neuroendocrine tumors: Ki-67 heterogeneity and World Health Organization grade discordance with primary tumors. Am J Clin Pathol 2015 Mar;143(3):398-404

Date

02/20/2015

Pubmed ID

25696798

Pubmed Central ID

PMC4354931

DOI

10.1309/AJCPQ55SKOCYFZHN

Scopus ID

2-s2.0-84947751642 (requires institutional sign-in at Scopus site)   80 Citations

Abstract

OBJECTIVES: We examined Ki-67 heterogeneity within single and between synchronous liver metastases of small intestine neuroendocrine tumors.

METHODS: There were 27 patients (10 men and 17 women) with two or more liver metastases. The Ki-67 index was used to classify the tumors into World Health Organization grade 1, 2, or 3. The association between Ki-67 heterogeneity and tumor size of liver metastases was analyzed. Correlation of tumor grade with patient survival was also evaluated.

RESULTS: Primary tumors from 20 patients were graded, including 17 grade 1 and three grade 2. A total of 188 liver metastases were resected, including 122 (65%) grade 1, 47 (25%) grade 2, and 19 (10%) grade 3. The highest tumor grade was grade 1 in 10 (37%), grade 2 in nine (33%), and grade 3 in eight (30%) patients. Patients with one or more grade 3 liver lesions had a shorter progression-free survival compared with those with grade 1/2 tumors (P < .001). A positive association was found between tumor size and Ki-67 index (P = .04), as well as between tumor size and intratumoral Ki-67 heterogeneity (P < .001).

CONCLUSIONS: Intratumoral and intertumoral Ki-67 heterogeneity is common and positively correlated with tumor size. The presence of one or more grade 3 liver lesions predicts a worse prognosis.

Author List

Shi C, Gonzalez RS, Zhao Z, Koyama T, Cornish TC, Hande KR, Walker R, Sandler M, Berlin J, Liu EH

Author

Toby Charles Cornish MD, PhD Professor in the Pathology and Laboratory Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Aged
Biomarkers, Tumor
Demography
Disease Progression
Disease-Free Survival
Education, Medical, Continuing
Female
Humans
Intestinal Neoplasms
Intestine, Small
Ki-67 Antigen
Liver
Liver Neoplasms
Male
Middle Aged
Neoplasm Grading
Neuroendocrine Tumors
Prognosis
World Health Organization
Young Adult