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Elevated K i‐67 labeling index in ‘synchronous liver metastases’ of well differentiated enteropancreatic neuroendocrine tumor
Author(s) -
Zen Yoh,
Heaton Nigel
Publication year - 2013
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/pin.12108
Subject(s) - medicine , metastasis , neuroendocrine tumors , grading (engineering) , ki 67 , pathology , primary tumor , pancreas , liver tumor , gastroenterology , immunohistochemistry , cancer , hepatocellular carcinoma , biology , ecology
There is no consensus as to whether or not metastatic nodules in the liver should be biopsied for tumor grading in cases of neuroendocrine tumors with ‘synchronous liver metastasis’. In this study, we compared the K i‐67 labeling index between the primary tumor and synchronous liver metastasis in 30 patients, who had received simultaneous resections. Examined tumors were of the small bowel (n = 18) or pancreas (n = 12), and G 1 or G 2 in primary histologic grade. In 20 patients (67%), the K i‐67 index was similar between the primary tumor and liver metastasis, but 10 (33%) showed an elevation of 3.4–14.4% in the liver, which increased the tumor grade in 4 cases. The K i‐67 elevation in the liver was more common in G 2 than G 1 neoplasms ( P = 0.002). The size, but not number, of liver metastases was significantly larger in patients with an elevated K i‐67 index ( P = 0.006). Using 40 mm as a provisional cutoff for the greatest diameter of liver metastases, the positive predictive value of this discriminator for elevated K i‐67 was 56%, and the negative predictive value was 93%. In conclusion, synchronous liver metastases can yield a higher K i‐67 labeling index than primary neuroendocrine tumours, particularly when the secondary is greater than 40 mm.