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Proliferative rate in endoscopic ultrasound fine‐needle aspiration of pancreatic endocrine tumors
Author(s) -
Alexiev Borislav A.,
Darwin Peter E.,
Goloubeva Olga,
Ioffe Olga B.
Publication year - 2009
Publication title -
cancer cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.29
H-Index - 57
eISSN - 1934-6638
pISSN - 1934-662X
DOI - 10.1002/cncy.20014
Subject(s) - medicine , fine needle aspiration , endoscopic ultrasound , neuroendocrine tumors , radiology , proliferation index , ki 67 , pathology , biopsy , gastroenterology , immunohistochemistry
BACKGROUND: The objectives of this study were to evaluate the role of endoscopic ultrasonography (EUS)‐guided fine‐needle aspiration (FNA) in the preoperative diagnosis of pancreatic endocrine tumors (PETs) and to investigate whether the Ki‐67 index determined on cytologic material could help predict their behavior. METHODS: The study included 10 men and 5 women (ratio of men to women, 2:1) with a mean age of 62.4 years (range, 40‐79 years). Diff‐Quik‐ and Papanicolaou‐stained FNA samples were analyzed retrospectively, and immunocytochemical stains were performed for chromogranin A, synaptophysin, vimentin, α‐1‐antitrypsin, and Ki‐67 on cell block sections. The Ki‐67 index was evaluated by using digital image‐analysis software and was correlated with follow‐up (mean, 21.5 months; range, 2‐43 months). RESULTS: The overall survival was rate 86.7% (13 of 15 patients). Seven of 15 patients (46.7%) patients developed lymph node and/or hematogenous metastases. The Ki‐67 index in PETs with no metastases was lower (mean, 6.3%; range, 2%‐13%) than in clinically aggressive (metastatic) tumors (mean, 7.7%; range, 3%‐27%; P = .03). None of the tumors that had a Ki‐67 index ≤2% were metastatic. Both patients who died of disease had a Ki‐67 index of 4%. CONCLUSIONS: Although tumors with metastatic potential tended to exhibit a slightly higher Ki‐67 index, there was a significant overlap with nonmetastatic tumors, and PETs that had a very low proliferative rate still could behave aggressively; therefore, the authors concluded that the Ki‐67 index does not predict the risk of disease progression in patients with PETs. Cancer (Cancer Cytopathol) 2009. © 2009 American Cancer Society.