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Clinicopathological features and prognostic validity of WHO grading classification of SI-NENs.

Clinicopathological features and prognostic validity of WHO grading classification of SI-NENs.
Author Information (click to view)

Chen L, Zhou L, Zhang M, Shang L, Zhang P, Wang W, Fang C, Li J, Xu T, Tan H, Zhang P, Qiu M, Yu X, Jin K, Chen Y, Chen H, Lin R, Zhang Q, Shen L, Chen M, Li J, Li L, Chen J,


Chen L, Zhou L, Zhang M, Shang L, Zhang P, Wang W, Fang C, Li J, Xu T, Tan H, Zhang P, Qiu M, Yu X, Jin K, Chen Y, Chen H, Lin R, Zhang Q, Shen L, Chen M, Li J, Li L, Chen J, (click to view)

Chen L, Zhou L, Zhang M, Shang L, Zhang P, Wang W, Fang C, Li J, Xu T, Tan H, Zhang P, Qiu M, Yu X, Jin K, Chen Y, Chen H, Lin R, Zhang Q, Shen L, Chen M, Li J, Li L, Chen J,

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BMC cancer 2017 08 0417(1) 521 doi 10.1186/s12885-017-3490-3
Abstract
BACKGROUND
The clinicopathological characteristics of small intestinal neuroendocrine neoplasms (SI-NENs) and the prognostic validity of WHO grading classification for SI-NENs are still unknown in Asian patients.

METHODS
277 patients and 8315 patients with SI-NENs were retrieved respectively from eleven Chinese hospitals and Surveillance, Epidemiology, and End Results (SEER) cancer registry. Overall survival was used as the major study outcome. Survival analysis using Kaplan-Meier analysis with log-rank test and cox regression analysis were applied.

RESULTS
Clinicopathological characteristics of SI-NENs were quite different among different races. Duodenum was the predominant tumor site in Chinese patients and Asian/Pacific Islander patients but not in white patients from SEER database. Patients with duodenal NENs tended to have more localized disease than patients with jejunal/ileal NENs which were confirmed by patients from SEER database. Grade 3 or poorly differentiated/undifferentiated tumor were more common and tumor size was significantly larger in ampullary NENs compared with that in non-ampullary duodenal NENs. As for the prognostic validity of WHO grading classification, survival between patients with grade 1 and grade 2 disease was not significantly different. Ki-67 index of 5% might be a better threshold between grade 1 and grade 2 than Ki-67 index of 2% in SI-NENs.

CONCLUSIONS
Our study revealed that the clinicopathological characteristics of SI-NENs among different races were quite different. This might because duodenal NENs was much more common in Chinese patients and Asian/Pacific Islander patients. Duodenal NENs and jejunal/ileal NENs, ampullary and non-ampullary duodenal NENs shared different characteristics. Ki-67 index of 5% might be a better threshold between grade 1 and grade 2 in SI-NENs.

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