ArticleCancer research and treatment2020
Pancreatic High-Grade Neuroendocrine Neoplasms in the Korean Population: A Multicenter Study.
Article in Cancer research and treatment, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 25 citations in OpenAlex.
- Prognostic and Predictive Significance of Selected Gene Mutations in Pancreatic and Intestinal Neuroendocrine Tumors.International journal of molecular sciences · 2026Review
- Differentiation between G3 pancreatic neuroendocrine tumor and pancreatic neuroendocrine carcinoma based on intratumor and peritumor CT value ratio and abnormal vascular network.Frontiers in oncology · 2025Article
- Treatment status, survival and gene expression analysis of large-cell neuroendocrine lung carcinoma: a real-world study in China.Therapeutic advances in medical oncology · 2025Article
- Rapid Evolution of Metastases in Patients with Treated G3 Neuroendocrine Tumors Associated with NEC-Like Transformation and TP53 Mutation.Endocrine pathology · 2024Article
- Malignant potential of neuroendocrine microtumor of the pancreas harboring high-grade transformation: lesson learned from a patient with von Hippel-Lindau syndrome.Journal of pathology and translational medicine · 2024Article
- The association between jaundice and poorly differentiated pancreatic neuroendocrine neoplasms (Ki67 index > 55.0%).BMC gastroenterology · 2023Article
- MicroRNAs associated with postoperative outcomes in patients with limited stage neuroendocrine carcinoma of the esophagus.Oncology letters · 2023Article
- The Complex Histopathological and Immunohistochemical Spectrum of Neuroendocrine Tumors-An Overview of the Latest Classifications.International journal of molecular sciences · 2023Review
- A systematic review of therapeutic strategies in gastroenteropancreatic grade 3 neuroendocrine tumors.Therapeutic advances in medical oncology · 2023Review
- An analysis of 130 neuroendocrine tumors G3 regarding prevalence, origin, metastasis, and diagnostic features.Virchows Archiv : an international journal of pathology · 2022Article
- Solid pancreatic masses in children: A review of current evidence and clinical challenges.Frontiers in pediatrics · 2022Review
- Review
- Digestive Well-Differentiated Grade 3 Neuroendocrine Tumors: Current Management and Future Directions.Cancers · 2021Review
- Neuroendocrine Carcinomas with Atypical Proliferation Index and Clinical Behavior: A Systematic Review.Cancers · 2021Review
- CD56 Expression Is Associated with Biological Behavior of Pancreatic Neuroendocrine Neoplasms.Cancer management and research · 2020Article
- Prognostic and predictive factors on overall survival and surgical outcomes in pancreatic neuroendocrine tumors: recent advances and controversies.Expert review of anticancer therapy · 2019Review
Corrections and comments
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Authors and funding
21 authors at 15 institutions in 1 country.
Funding
Abstract
purposeThe most recent 2017 World Health Organization (WHO) classification of pancreatic neuroendocrine neoplasms (PanNENs) has refined the three-tiered 2010 scheme by separating grade 3 pancreatic neuroendocrine tumors (G3 PanNETs) from poorly differentiated pancreatic neuroendocrine carcinomas (PanNECs). However, differentiating between G3 Pan- NETs and PanNECs is difficult in clinical practice. MATERIALS AND
methodsEighty-two surgically resected PanNENs were collected from 16 institutions and reclassified according to the 2017 WHO classification based on the histological features and proliferation index (mitosis and Ki-67). Immunohistochemical stains for ATRX, DAXX, retinoblastoma, p53, Smad4, p16, and MUC1 were performed for 15 high-grade PanNENs.
resultsRe-classification resulted in 20 G1 PanNETs (24%), 47 G2 PanNETs (57%), eight G3 well-differentiated PanNETs (10%), and seven poorly differentiated PanNECs (9%). PanNECs showed more frequent diffuse nuclear atypia, solid growth patterns and apoptosis, less frequent organoid growth and regular vascular patterns, and absence of low-grade PanNET components than PanNETs. The Ki-67 index was significantly higher in PanNEC (58.2%± 15.1%) compared to G3 PanNET (22.6%±6.1%, p < 0.001). Abnormal expression of any two of p53, p16, MUC1, and Smad4 could discriminate PanNECs from G3 PanNETs with 100% specificity and 87.5% sensitivity.
conclusionHistological features supporting the diagnosis of PanNECs over G3 PanNETs were the absence of a low-grade PanNET component in the tumor, the presence of diffuse marked nuclear atypia, solid growth pattern, frequent apoptosis and markedly increased proliferative activity with homogeneous Ki-67 labeling. Immunohistochemical stains for p53, p16, MUC1, and Smad4 may be helpful in distinguishing PanNECs from G3 PanNETs in histologically ambiguous cases, especially in diagnostic practice when only small biopsied tissues are available.
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