ArticleEndocrine2021
Distinctive features of pancreatic neuroendocrine neoplasms exhibiting an increment in proliferative activity during the course of the disease.
Article in Endocrine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Immunotherapeutics at the spearhead: current status in targeting neuroendocrine neoplasms.Endocrine · 2021Pooled it
- Shift in secretory profile of a pNET: from indolent glucagonoma to aggressive insulinoma - a case report.Frontiers in endocrinology · 2025Article
- Pancreatic neuroendocrine tumors andTherapeutic advances in medical oncology · 2025Article
- Article
- Review
- "The past is a different country, they do things differently there": using the SEER data-base to assess prognosis in neuroendocrine tumours.Endocrine · 2022Article
- A real-life treatment cohort of pancreatic neuroendocrine tumors: High-grade increase in metastases confers poor survival.Frontiers in endocrinology · 2022Article
- Gene Expression Profiling of Pancreas Neuroendocrine Tumors with Different Ki67-Based Grades.Cancers · 2021Article
- Molecular Pathology of Well-Differentiated Gastro-entero-pancreatic Neuroendocrine Tumors.Endocrine pathology · 2021Review
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeNeuroendocrine neoplasms (NENs) differ in their biological behavior and growth potential in a way that can be predicted using histological classification and grading systems. A subset of pancreatic NENs (pNENs) may develop a more aggressive phenotype during the course of the disease, associated with an increase in the Ki-67 proliferation index (PI). The purpose of the study was to present the clinical characteristics of these patients.
methodsUsing re-biopsy of growing lesions, we investigated the increase in Ki-67 PI sufficient to change initial grading (G).
resultsOf 264 patients with well differentiated (WD) pNENs who showed progressive disease during follow-up, 15 (6%) exhibited an increase in Ki-67 PI at a median time 36.8 (9.3-255.8) months. All neoplasms had WD-morphology: five had G1 (Ki-67 median value 1%), nine G2 (median value 5%), one G3 (25%) grades. Upon change of Ki-67 PI, 3 patients had G2 (8%) and 12 G3 (57.5%) NENs, while all retained their WD-morphology. At last follow-up, eight patients were alive with a median overall survival (OS) of 52.5 (9.5-264.3) months. Μedian OS was shorter in patients who had a change in Ki-67 PI before 36 months compared to those who had a change of Ki-67 PI at a later stage (27.5 95%CI: 11.88-43.06 vs. 120.87 95%CI: 96.05-145.69; log-rank p = 0.018).
conclusionsDuring the course of their disease, 6% patients with progressive pNENs develop an increase in Ki-67 PI resulting in an increase in grading status while maintaining their morphology. This process is associated with worse OS when it occurs at an early stage.
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