Reliability of Ki-67 Determination in FNA Samples for Grading Pancreatic Neuroendocrine Tumors

Neuroendocrine pancreatic tumors (PanNETs) are graded on the basis of their proliferative activity. Cytological samples are commonly the only samples available, but the determination of Ki-67 in cytology and its reliability as a measure of tumor mitotic activity is not well settled. We have retrospe...

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Bibliographic Details
Published in:Endocrine pathology 2016-12, Vol.27 (4), p.276-283
Main Authors: Díaz del Arco, Cristina, Díaz Pérez, J. Ángel, Ortega Medina, Luis, Sastre Valera, Javier, Fernández Aceñero, M. Jesús
Format: Article
Language:English
Subjects:
Adult
Aged
Cytodiagnosis - methods
Endocrinology
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Female
Humans
Immunohistochemistry
Ki-67 Antigen - analysis
Male
Medicine
Medicine & Public Health
Middle Aged
Mitotic Index
Neoplasm Grading - methods
Neuroendocrine Tumors - pathology
Oncology
Pancreatic Neoplasms - pathology
Pathology
Reproducibility of Results
Retrospective Studies
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Summary:Neuroendocrine pancreatic tumors (PanNETs) are graded on the basis of their proliferative activity. Cytological samples are commonly the only samples available, but the determination of Ki-67 in cytology and its reliability as a measure of tumor mitotic activity is not well settled. We have retrospectively reviewed all the cases of FNA under EUS control of PanNETs in a 10-year period (2006–2016) in the Hospital Clínico San Carlos (Madrid). We identified 10 PanNET cases with histological correlation. Median age was 49.4 years and the patients were mainly women. PanNETs were located more frequently in the tail of the pancreas, with a median size of 33.8 mm. None of our cases was a grade 3 tumor. The seven grade 1 tumors confirmed in histology had consistent Ki-67 in cytology. In three cases (30 %), there were discrepancies between the Ki-67 index measured in cytology and histology, and the differences ranged from 2 to 15 %; all these cases were grade 2 tumors in histology and were graded as grade 1 tumors in FNA material. Our results are consistent with previous studies which showed understaging when tumor grade was assessed in cytological samples, mainly in G2 tumors. Previous literature has shown that Ki-67 assessment in EUS-FNA samples is a useful tool to rule out G3 tumors, but can be problematic for distinguishing G1 and G2 tumors.
ISSN:1046-3976
1559-0097
DOI:10.1007/s12022-016-9455-2