ArticleModern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc2022
Infiltration pattern predicts metastasis and progression better than the T-stage and grade in pancreatic neuroendocrine tumors: a proposal for a novel infiltration-based morphologic grading.
Article in Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Neuroendocrine Tumors of the Gallbladder: A Multicenter Case Series and Systematic Literature Review Indicating Predominantly Non-Aggressive Tumor Behavior and a Common Association with Cholesterol Polyps and Cholesterolosis.Endocrine pathology · 2026Pooled it
- Low Expression of Cell Adhesion Molecule 1 in Resected Gastroenteropancreatic Neuroendocrine Tumors: Relationship With Lymph Node and Distant Metastasis.Pathology international · 2026Article
- Multi-omic profiles of neuroendocrine neoplasms of the pancreas: an integrated landscape.Molecular cancer · 2026Review
- Differentiating well-differentiated neuroendocrine tumors grade 3 from poorly differentiated neuroendocrine carcinomas and adenocarcinoma with neuroendocrine differentiation: a comprehensive review.Virchows Archiv : an international journal of pathology · 2026Review
- Contrast-enhanced ultrasound as a non-invasive diagnostic modality for pancreatic ductal adenocarcinoma: The question of Ki67 for study validation.World journal of gastrointestinal oncology · 2025Article
- Intratumoral Heterogeneity of Ki67 Index and Its Impact on the Diagnosis and Prognostication of Pancreatic Neuroendocrine Tumors: Hot-Spot Count Differs Significantly from Random-Area Count.Endocrine pathology · 2025Article
- Prognostic Features in Surgically Resected Well-Differentiated Pancreatic Neuroendocrine Tumors: an Analysis of 904 Patients with 7882 Person-Years of Follow-Up.Endocrine pathology · 2025Article
- Article
- Investigation of three alternative histopathological scoring methods at the invasive tumour front in colorectal cancer.The journal of pathology. Clinical research · 2025Article
- Article
- [Neuroendocrine tumors].Pathologie (Heidelberg, Germany) · 2025Review
- SEMA7A-mediated juxtacrine stimulation of IGFBP-3 upregulates IL-17RB at pancreatic cancer invasive front.Cancer gene therapy · 2024Article
- Practical hints for the diagnosis of mixed neuroendocrine-non-neuroendocrine neoplasms of the digestive system.World journal of gastrointestinal oncology · 2024Article
- Subgrading of G2 Pancreatic Neuroendocrine Tumors as 2A (Ki67 3% to < 10%) Versus 2B (10% to ≤ 20%) Identifies Behaviorally Distinct Subsets in Keeping with the Evolving Management Protocols.Annals of surgical oncology · 2024Article
- Pancreatic Neuroendocrine Microtumors (WHO 2022) Are Not Always Low-Grade Neoplasms: A Case with a Highly Increased Proliferation Rate.Endocrine pathology · 2024Article
- Infiltrative Growth Predicts the Risk of Recurrence After Surgery in Well-Differentiated Non-Functioning Pancreatic Neuroendocrine Tumors.Endocrine pathology · 2023Article
- Silva cumulative score and its relationship with prognosis in Endocervical adenocarcinoma.BMC cancer · 2022Article
- "Pure" hepatoid tumors of the pancreas harboring CTNNB1 somatic mutations: a new entity among solid pseudopapillary neoplasms.Virchows Archiv : an international journal of pathology · 2022Article
- A Nomogram to Accurately Identify Pancreatic Neuroendocrine Tumors Metastasizing to Distant Organs: A Study Based on Two National Population-Based Cohorts From the United States and China.Clinical Medicine Insights. Oncology · 2022Article
Corrections and comments
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Authors and funding
21 authors at 8 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The advancing edge profile is a powerful determinant of tumor behavior in many organs. In this study, a grading system assessing the tumor-host interface was developed and tested in 181 pancreatic neuroendocrine tumors (PanNETs), 63 of which were <=2 cm. Three tumor slides representative of the spectrum (least, medium, and most) of invasiveness at the advancing edge of the tumor were selected, and then each slide was scored as follows. Well-demarcated/encapsulated, 1 point; Mildly irregular borders and/or minimal infiltration into adjacent tissue, 2 points; Infiltrative edges with several clusters beyond the main tumor but still relatively close, and/or satellite demarcated nodules, 3 points; No demarcation, several cellular clusters away from the tumor, 4 points; Exuberantly infiltrative pattern, scirrhous growth, dissecting the normal parenchymal elements, 5 points. The sum of the rankings on the three slides was obtained. Cases with scores of 3-6 were defined as "non/minimally infiltrative" (NI; n = 77), 7-9 as "moderately infiltrative" (MI; n = 68), and 10-15 as "highly infiltrative" (HI; n = 36). In addition to showing a statistically significant correlation with all the established signs of aggressiveness (grade, size, T-stage), this grading system was found to be the most significant predictor of adverse outcomes (metastasis, progression, and death) on multivariate analysis, more strongly than T-stage, while Ki-67 index did not stand the multivariate test. As importantly, cases <=2 cm were also stratified by this grading system rendering it applicable also to this group that is currently placed in "watchful waiting" protocols. In conclusion, the proposed grading system has a strong, independent prognostic value and therefore should be considered for integration into routine pathology practice after being evaluated in validation studies with larger series.
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