The role of endoscopic ultrasound in diagnosing pancreatic neuroendocrine tumours

Oncoreview ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. 19-23
Author(s):  
Przemysław Dyrla ◽  
Magdalena Chmielewska ◽  
Marta Mazur ◽  
Przemysław Witek
Keyword(s):  
Endoscopic Ultrasound ◽  
Neuroendocrine Tumours ◽  
Pancreatic Neuroendocrine Tumours

Pancreatic Neuroendocrine Tumours: The Role of Endoscopic Ultrasound Biopsy in Diagnosis and Grading Based on the WHO 2017 Classification

2019 ◽  
Vol 37 (4) ◽  
pp. 325-333 ◽  
Author(s):  
Milena Di Leo ◽  
Laura Poliani ◽  
Daoud Rahal ◽  
Francesco Auriemma ◽  
Andrea Anderloni ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Neuroendocrine Tumours ◽  
Histological Grade ◽  
Accurate Method ◽  
Biopsy Material ◽  
Ki 67 ◽  
Surgical Specimen ◽  
Study Population ◽  
Pancreatic Neuroendocrine Tumours

Background: One of the controversial issues in the diagnosis of pancreatic neuroendocrine tumours (pNETs) is the accurate prediction of their clinical behaviour. Objectives: The aim of the study was to evaluate the role of endoscopic ultrasound (EUS) biopsy in the diagnosis and grading of pNETs in a certified ENETS Center. Methods: A prospectively maintained database of EUS biopsy procedures was retrospectively reviewed to identify all consecutive patients referred to a certified ENETS Center with a suspicion of pNET between June 2014 and April 2017. The cytological and/or histological specimens were stained and the Ki-67 labeling index was evaluated. In patients undergoing surgery, the grade obtained with EUS-guided biopsy was compared with the final histological grade. The grade was evaluated according to the 2017 WHO classifications and grading. Results: The study population included 59 patients. EUS biopsy material reached an adequacy of 98.3% and was adequate for Ki-67 evaluation in 84.7% of cases. Twenty-nine patients (49.2%) underwent surgery. Of these, 25 patients had Ki-67 evaluated on EUS biopsy: the agreement between EUS biopsy grading and surgical specimen grading was 84%. Conclusion: EUS biopsy is an accurate method for the diagnosis and grading of pNETs based on the WHO 2017 Ki-67 labelling scheme.

Imaging of Pancreatic-Neuroendocrine Tumours: An Outline of Conventional Radiological Techniques

2019 ◽  
Vol 12 (2) ◽  
pp. 135-155 ◽  
Author(s):  
Muhammad Affan Zamir ◽  
Wasim Hakim ◽  
Siraj Yusuf ◽  
Robert Thomas
Keyword(s):  
Neuroendocrine Tumours ◽  
Treatment Options ◽  
Advantages And Disadvantages ◽  
Imaging Characteristics ◽  
Fundamental Understanding ◽  
Pancreatic Neuroendocrine Tumours ◽  
Direct Management ◽  
Important Disease ◽  
Similar Imaging

IIntroduction: Pancreatic Neuroendocrine Tumours (p-NETs) are an important disease entity and comprise of peptide-secreting tumours often with a functional syndrome. : Accounting for a small percentage of all pancreatic tumours, they have a good overall survival rate when diagnosed early, with surgery being curative. The role of nuclear medicine in the diagnosis and treatment of these tumours is evident. However, the vast majority of patients will require extensive imaging in the form of conventional radiological techniques. It is important for clinicians to have a fundamental understanding of the p-NET appearances to aid prompt identification and to help direct management through neoplastic staging. Methods: This article will review the advantages and disadvantages of conventional radiological techniques in the context of p-NETs and highlight features that these tumours exhibit. Conclusion: Pancreatic neuroendocrine tumours are a unique collection of neoplasms that have markedly disparate clinical features but similar imaging characteristics. Most p-NETs are small and welldefined with homogenous enhancement following contrast administration, although larger and less welldifferentiated tumours can demonstrate areas of necrosis and cystic architecture with heterogeneous enhancement characteristics. : Prognosis is generally favourable for these tumours with various treatment options available. However, conventional radiological techniques will remain the foundation for the initial diagnosis and staging of these tumours, and a grasp of these modalities is extremely important for physicians.

Role of 68Ga-DOTATOC PET-CT in the diagnosis and staging of pancreatic neuroendocrine tumours

2011 ◽  
Vol 21 (11) ◽  
pp. 2408-2416 ◽  
Author(s):  
Rakesh Kumar ◽  
Punit Sharma ◽  
Pramod Garg ◽  
Sellam Karunanithi ◽  
Niraj Naswa ◽  
...  
Keyword(s):  
Neuroendocrine Tumours ◽  
Pet Ct ◽  
Pancreatic Neuroendocrine Tumours

scholarly journals The Impact of Preoperative Endoscopic Ultrasound on the Surgical Management of Pancreatic Neuroendocrine Tumours

2008 ◽  
Vol 22 (10) ◽  
pp. 817-820 ◽  
Author(s):  
Fahad Alsohaibani ◽  
David Bigam ◽  
Norman Kneteman ◽  
AM James Shapiro ◽  
Gurpal Singh Sandha
Keyword(s):  
Surgical Management ◽  
Endoscopic Ultrasound ◽  
Neuroendocrine Tumours ◽  
Preoperative Assessment ◽  
Needle Aspiration ◽  
Ct Scanner ◽  
Extent Of Surgery ◽  
Pancreatic Neuroendocrine Tumours ◽  
Needle Aspiration Cytology ◽  
The Impact

BACKGROUND: Endoscopic ultrasound (EUS) is accurate in diagnosing pancreatic neuroendocrine tumours (PNETs), but its impact on surgical management is unclear.OBJECTIVE: To determine whether preoperative EUS findings altered the decision for, and extent of, surgery in patients with PNETs.METHODS: A retrospective review of patients referred for EUS because of suspected PNETs was conducted. The diagnosis of PNETs was confirmed by EUS-guided fine needle aspiration cytology, where indicated, or by surgical histology. EUS findings were compared with computed tomography (CT) findings to determine whether there was an impact on the decision for surgical management.RESULTS: Fourteen patients (10 women), with a mean age of 44 years, underwent EUS for suspected PNETs. PNETs were seen with CT in 10 of 13 patients (77%) and with EUS in 14 of 14 patients (100%). One obese patient could not fit into the CT scanner. This patient had five PNETs on EUS. Three patients with a normal CT scan were determined to have one or two PNETs on EUS. Three patients with one or two PNETs on CT were found to have five to eight PNETs on EUS. EUS altered the decision for possible surgical management in five of 14 patients (36%), either by identifying a PNET or by finding multiple and multifocal PNETs that were not visualized on CT scans.CONCLUSION: EUS is useful in the preoperative assessment of PNETs by providing information that significantly influences the decision for surgical intervention or changes the extent of the planned surgery.

The Role of Laparoscopic Surgery in Localized Pancreatic Neuroendocrine Tumours

2021 ◽  
Vol 22 (4) ◽  
Author(s):  
Valentina Ferraro ◽  
Michele Tedeschi ◽  
Letizia Laera ◽  
Michele Ammendola ◽  
Umberto Riccelli ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Neuroendocrine Tumours ◽  
Pancreatic Neuroendocrine Tumours

scholarly journals Filamin-A is required to mediate SST2 effects in pancreatic neuroendocrine tumours

2016 ◽  
Vol 23 (3) ◽  
pp. 181-190 ◽  
Author(s):  
Eleonora Vitali ◽  
Valeria Cambiaghi ◽  
Alessandro Zerbi ◽  
Carlo Carnaghi ◽  
Piergiuseppe Colombo ◽  
...  
Keyword(s):  
Cell Migration ◽  
Cell Adhesion ◽  
Cell Line ◽  
Neuroendocrine Tumours ◽  
Somatostatin Receptor ◽  
Inhibitory Effect ◽  
Filamin A ◽  
Pancreatic Neuroendocrine Tumours

Somatostatin receptor type 2 (SST2) is the main pharmacological target of somatostatin (SS) analogues widely used in patients with pancreatic neuroendocrine tumours (P-NETs), this treatment being ineffective in a subset of patients. Since it has been demonstrated that Filamin A (FLNA) is involved in mediating GPCR expression, membrane anchoring and signalling, we investigated the role of this cytoskeleton protein in SST2 expression and signalling, angiogenesis, cell adhesion and cell migration in human P-NETs and in QGP1 cell line. We demonstrated that FLNA silencing was not able to affect SST2 expression in P-NET cells in basal conditions. Conversely, a significant reduction in SST2 expression (−43±21%, P<0.05 vs untreated cells) was observed in FLNA silenced QGP1 cells after long term SST2 activation with BIM23120. Moreover, the inhibitory effect of BIM23120 on cyclin D1 expression (−46±18%, P<0.05 vs untreated cells), P-ERK1/2 levels (−42±14%; P<0.05 vs untreated cells), cAMP accumulation (−24±3%, P<0.05 vs untreated cells), VEGF expression (−31±5%, P<0.01 vs untreated cells) and in vitro release (−40±24%, P<0.05 vs untreated cells) was completely lost after FLNA silencing. Interestingly, BIM23120 promoted cell adhesion (+86±45%, P<0.05 vs untreated cells) and inhibited cell migration (−24±2%, P<0.00001 vs untreated cells) in P-NETs cells and these effects were abolished in FLNA silenced cells. In conclusion, we demonstrated that FLNA plays a crucial role in SST2 expression and signalling, angiogenesis, cell adhesion and cell migration in P-NETs and in QGP1 cell line, suggesting a possible role of FLNA in determining the different responsiveness to SS analogues observed in P-NET patients.

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