Document Detail

Ki-67 grading of nonfunctioning pancreatic neuroendocrine tumors on histologic samples obtained by EUS-guided fine-needle tissue acquisition: a prospective study.
MedLine Citation:
PMID:  22898415     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Preoperative determination of Ki-67 expression, an important prognostic factor for grading nonfunctioning pancreatic endocrine tumors (NF-PETs), remains an important clinical challenge.
OBJECTIVE: To prospectively evaluate the feasibility, yield, and clinical impact of EUS-guided fine-needle tissue acquisition (EUS-FNTA) with a large-gauge needle to obtain tissue samples for histologic diagnosis and Ki-67 analysis in patients with suspected NF-PETs.
DESIGN: Prospective cohort study.
SETTING: Tertiary-care academic medical center.
PATIENTS: Consecutive patients with a single pancreatic lesion suspicious for NF-PET on imaging.
INTERVENTION: EUS-FNTA with a 19-gauge needle.
MAIN OUTCOME MEASUREMENTS: Feasibility and yield of EUS-FNTA for diagnosis and Ki-67 expression determination.
RESULTS: Thirty patients (mean [± SD] age 55.7 ± 14.9 years), with a mean (± SD) lesion size of 16.9 ± 6.1 mm were enrolled. EUS-FNTA was successfully performed without complications in all patients, with a mean (± SD) of 2.7 ± 0.5 passes per patient. Adequate samples for histologic examination were obtained in 28 of the 30 patients (93.3%). Ki-67 determination could be performed in 26 of these 28 patients (92.9%, 86.6% overall), 12 of whom underwent surgical resection. Preoperative and postoperative Ki-67 proliferation indexes were concordant in 10 patients (83.3%), whereas 2 patients were upstaged from G1 to G2 or downstaged from G2 to G1, respectively.
LIMITATIONS: Single center study with a single operator.
CONCLUSION: In patients with suspected nonfunctioning low-grade to intermediate-grade pancreatic neuroendocrine tumors (p-NETs), retrieval of tissue specimens with EUS-FNTA by using a 19-gauge needle is safe, feasible, and highly accurate for both diagnosis and Ki-67 determination. A Ki-67 proliferative index acquired through this technique might be of great help for further therapeutic decisions.
Alberto Larghi; Gabriele Capurso; Antonella Carnuccio; Riccardo Ricci; Sergio Alfieri; Domenico Galasso; Francesca Lugli; Antonio Bianchi; Francesco Panzuto; Laura De Marinis; Massimo Falconi; Gianfranco Delle Fave; Giovanni Battista Doglietto; Guido Costamagna; Guido Rindi
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  76     ISSN:  1097-6779     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-17     Completed Date:  2013-01-23     Revised Date:  2013-02-01    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  570-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2012. Published by Mosby, Inc.
Digestive Endoscopy Unit, Divisionof Digestive and Liver Disease, Catholic University, Rome, Italy.
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MeSH Terms
Aged, 80 and over
Carcinoma, Neuroendocrine / metabolism,  pathology,  surgery
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Ki-67 Antigen / metabolism*
Middle Aged
Neoplasm Grading
Neuroendocrine Tumors / metabolism*,  pathology*,  surgery
Pancreatic Neoplasms / metabolism*,  pathology*,  surgery
Postoperative Period
Preoperative Period
Prospective Studies
Reg. No./Substance:
0/Ki-67 Antigen
Erratum In:
Gastrointest Endosc. 2012 Nov;76(5):1085

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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