%0 Journal Article
%T Neuroendocrine Neoplasms of the Pancreas: The Pathological
Viewpoint | Insight Medical Publishing
%A Noriyoshi Fukushima
%J January 2019
%D 2018
%X Neuroendocrine neoplasms of the pancreas are relatively rare, accounting for approximately 1¨C2% of all pancreatic neoplasms, and are composed of epithelial neoplastic cells with neuroendocrine differentiation. Neuroendocrine neoplasms are potentially malignant neoplasms including well-differentiated types (neuroendocrine tumors, neuroendocrine tumors) and poorly differentiated types (neuroendocrine carcinomas). The WHO classification released in 2010 led to a significant change in the grading system of neuroendocrine neoplasms of the digestive system. ¡°Endocrine neoplasm¡± was changed to ¡°neuroendocrine neoplasm¡±. Neuroendocrine neoplasms are graded according to the number of mitoses and/or Ki-67 index. These changes simplified the classification scheme. However, there are a number of remaining issues. Neuroendocrine tumors meeting the WHO criteria for neuroendocrine carcinoma (>20 mitoses/10 high power fields and/or Ki67 index > 20%) with a well-differentiated morphology, known as an ¡°organoid pattern¡± have been identified. In the revised version of the ¡°WHO Classification of Tumours of Endocrine Organs¡± published in 2017, to solve the problems of high-grade (grade 3) neuroendocrine neoplasms, they are divided into pancreatic neuroendocrine tumors, grade 3 (PanNET G3) and neuroendocrine carcinomas, grade 3 (PanNEC G3) depending on their histo-morphologic characteristics. The neuroendocrine tumor G3 category is associated with a better prognosis and does not significantly responds to cisplatin-based chemotherapy. Defining that subgroup of patients using a combination of tumor morphology and cell proliferation is important. Better strategies to treat and improve the outcomes of patients with pancreatic neuroendocrine neoplasms are required.
%U http://pancreas.imedpub.com/neuroendocrine-neoplasms-of-the-pancreas-the-pathologicalviewpoint.php?aid=21172