scholarly journals Modern view on the classification of neuroendocrine neoplasms of stomach

2021 ◽  
Vol 67 (5) ◽  
pp. 600-605
Author(s):  
Ivan Peregorodiev ◽  
Vagan Bokhian ◽  
Vera Delektorskaya ◽  
Anna Safonova
Keyword(s):  
Proton Pump ◽  
Who Classification ◽  
Tnm Classification ◽  
Term Therapy ◽  
Favourable Result ◽  
Neuroendocrine Neoplasms ◽  
Adequate Treatment ◽  
The Past ◽  
Well Differentiated

Neuroendocrine neoplasms (NEN) of the stomach include a heterogeneous group of neoplasms characterized by different pathogenetic mechanisms, metastatic potential, and prognosis. The incidence of gastric NAN has increased 15-fold over the past few decades. It is necessary to clearly distinguish between well-differentiated neuroendocrine neoplasms (NETs) of the stomach and neuroendocrine cancer (NECs) of the stomach, as well as mixed neuroendocrine-non-neuroendocrine neoplasms. To date, there are three classifications that are used in clinical practice: clinicopathological classification, WHO classification, and UICC TNM classification. It should be noted that over the past five years, these classifications have undergone important changes. In the clinicopathological classification, in addition to the existing three types, a number of authors proposed to add the 4th type (developing as a result of inadequate functioning of the proton pump) and the 5th type (developing in patients who receive long-term therapy with proton pump inhibitors). In the 2019 WHO classification, an important change is the acceptance that well-differentiated NETs can have a high degree of malignancy – Grade III. The main changes in the 8th edition of the TNM classification concerned the differentiation of the M symbol. Thus, to date, the classification of gastric NENs allows us to accurately characterize tumor staging, the pathogenesis underlying their development, and prognosis. They form the basis for choosing an adequate treatment strategy that makes possible to achieve the most favourable result.

scholarly journals Co-existence of gastric adenocarcinoma and neuroendocrine carcinoma: a rare entity

2017 ◽  
Vol 7 (2) ◽  
pp. 1221-1223 ◽  
Author(s):  
Nirajan Mainali ◽  
Niraj Nepal ◽  
Prabesh Kumar Choudhary ◽  
Amrita Sinha ◽  
Saroj Rajbanshi ◽  
...  
Keyword(s):  
Neuroendocrine Carcinoma ◽  
Partial Gastrectomy ◽  
Endoscopic Biopsy ◽  
World Health ◽  
Neuroendocrine Neoplasms ◽  
World Health Organization Classification ◽  
Well Differentiated ◽  
Health Organization ◽  
Histopathology Examination

A mixed adenoneuroendocrine carcinoma is a tumor composed of both adenocarcinoma and neuroendocrine carcinoma components, with each comprising  at least one-third of the lesion, as defined by the World Health Organization classification of neuroendocrine neoplasms in 2010.. A 67-years-old male was admitted to the hospital with symptoms suggesting gastric cancer. Histopathology examination from endoscopic biopsy revealed adenocarcinoma. Later partial gastrectomy specimen examination the lesion show presence of well differentiated adenocarcinoma along with neuro endocrine carcinoma.

Well-differentiated grade 3 digestive neuroendocrine tumors: Myth or reality? The PRONET study group.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 4129-4129 ◽  
Author(s):  
Jean-Yves Scoazec ◽  
Anne Couvelard ◽  
Genevieve Monges ◽  
Emmanuelle Leteurtre ◽  
Genevieve Belleannee ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Who Classification ◽  
Epidemiologic Study ◽  
Histologic Grade ◽  
World Health ◽  
Ki67 Index ◽  
Poorly Differentiated ◽  
Well Differentiated ◽  
Incident Cases

4129 Background: In contrast to the 2000 World Health Organization (WHO) classification of digestive neuroendocrine tumors (NET) in which morphologic differentiation was the first criterion, the 2010 WHO classification of NET is based mostly on histologic grade. NET are now classified into three main categories: NET G1 (mitotic count <2/10 HPF and/or ≤2% Ki67 index), NET G2 (2-20/10 HPF and/or 3-20%), and neuroendocrine carcinoma (NEC) of small or large cell type. While NET G1 and G2 are well-differentiated tumors, NEC are considered poorly differentiated G3 tumors. We looked at the agreement between grade and differentiation to determine whether all NET can be readily classified according to the 2010 WHO classification. Methods: We designed a 1-year prospective, epidemiologic study to assess the characteristics of newly diagnosed NET, including diagnostic pathology. From August 2010 to July 2011, all pathology laboratories in France were invited to register all incident cases of gastroenteropancreatic (GEP) and thoracic NET, excluding small cell carcinoma. For GEP-NET, investigators were asked to indicate morphologic differentiation (according to WHO 2000) and elements of histologic grade (mitotic index, Ki67 index), according to ENETS. Results: Of 500 invited centers, 80 participated; 1417 incidental cases were included and 77 excluded (duplicates or exclusion criteria), totaling 1340 cases; 778 (58.1%) were GEP-NET; 660/778 (85%) were well differentiated, 72 (9%) poorly differentiated, and 46 (6%) adenocarcinoid, nonclassified, or not evaluable; 422 (54.2%) were G1, 220 (28%) G2, 104 (13.5%) G3, and 32 (4.1%) had missing grades. Of those deemed G3, 72 (69%) were described as poorly differentiated, 21 (20%) as well differentiated (mean Ki67 index 35%, range 25%-60%), and 11 (10.5%) as adenocarcinoid. Conclusions: In this prospective, epidemiologic study, overall agreement between grade and differentiation was good. However, a significant proportion of G3 NET were classified as well differentiated and thus unclassifiable by 2010 WHO classification. This group of tumor deserves to be included in future classifications to help the clinician decide whether they should be treated as NET G1/G2 or NEC G3.

scholarly journals The cIMPACT-NOW updates and their significance to current neuro-oncology practice

2020 ◽  
Author(s):  
L Nicolas Gonzalez Castro ◽  
Pieter Wesseling
Keyword(s):  
Molecular Pathology ◽  
Who Classification ◽  
Cns Tumors ◽  
World Health ◽  
The Past ◽  
Diagnosis And Classification ◽  
Health Organization ◽  
Oncology Practice ◽  
Practical Recommendations

Abstract Over the past 4 years, advances in molecular pathology have enhanced our understanding of CNS tumors, providing new elements to refine their classification and improve the 2016 World Health Organization (WHO) Classification of CNS tumors. The Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy—Not Official WHO (cIMPACT-NOW) was formed in late 2016 by a group of neuropathology and neuro-oncology experts to provide practical recommendations (published as cIMPACT-NOW updates) to improve the diagnosis and classification of CNS tumors, in advance of the publication of a new WHO Classification of CNS tumors. Here we review the content of all the available cIMPACT-NOW updates and discuss the implications of each update for the diagnosis and management of patients with CNS tumors.

scholarly journals INSM1 Expression in Breast Neoplasms with Neuroedocrine Features

2021 ◽  
Author(s):  
Jasna Metovic ◽  
Isabella Castellano ◽  
Eleonora Marinelli ◽  
Simona Osella-Abate ◽  
Anna Sapino ◽  
...  
Keyword(s):  
Chromogranin A ◽  
Mixed Type ◽  
Breast Tumors ◽  
Negative Control ◽  
Neuroendocrine Neoplasms ◽  
Breast Cancers ◽  
Pathological Characteristics ◽  
Poorly Differentiated ◽  
Well Differentiated

AbstractAccording to the 2019 WHO classification of breast tumors, neuroendocrine neoplasms (NENs) are classified into well-differentiated NE tumors (NET) and poorly differentiated NE carcinomas (NEC), while other breast cancers (BCs) of special and no special type with neuroendocrine (NE) features are not incorporated in this scheme anymore. We aimed to assess whether INSM1, a novel NE marker, could have a role in breast NEN subtyping. We selected 63 BCs operated from 2003 to 2018, classified as BCs with NE features, with available clinico-pathological data. Following 2019 WHO criteria, this cohort was reclassified into 37 NETs/NECs, the remaining 26 tumors representing solid-papillary (7), mucinous (7), and mixed type (12) carcinomas with NE differentiation. Chromogranin A (CGA) and synaptophysin (SYN) immunostains were reviewed, and INSM1 was tested by immunohistochemistry. Thirty CGA- and SYN-negative no special type BCs served as negative control. INSM1 was expressed in 52/63 cases of the whole cohort (82.54%). INSM1 positive and negative cases had no significantly different clinico-pathological characteristics. INSM1 expression was not significantly different between the newly reclassified NET/NEC group and other BCs with NE features. No immunoexpression was observed in control BCs. The sensitivity and specificity of INSM1 for the NE phenotype was 82.5% and 100%, respectively, compared to 61.9% and 100% for CGA, and 95.2 and 100% for SYN. In conclusion, INSM1 is as accurate as traditional NE biomarkers to identify NE differentiation in BC. In analogy to standard NE markers, INSM1 could not distinguish NET and NEC from the other BC histotypes with NE differentiation.

scholarly journals Advances in the Diagnosis and Management of Well-Differentiated Neuroendocrine Neoplasms

2020 ◽  
Vol 41 (2) ◽  
pp. 371-403 ◽  
Author(s):  
Johannes Hofland ◽  
Gregory Kaltsas ◽  
Wouter W de Herder
Keyword(s):  
Neuroendocrine Cells ◽  
Neuroendocrine Neoplasms ◽  
Tumor Grading ◽  
Diagnostic Biomarkers ◽  
Randomized Controlled ◽  
The Past ◽  
Well Differentiated ◽  
Excessive Secretion ◽  
Evidence Based Guidelines

Abstract Neuroendocrine neoplasms constitute a diverse group of tumors that derive from the sensory and secretory neuroendocrine cells and predominantly arise within the pulmonary and gastrointestinal tracts. The majority of these neoplasms have a well-differentiated grade and are termed neuroendocrine tumors (NETs). This subgroup is characterized by limited proliferation and patients affected by these tumors carry a good to moderate prognosis. A substantial subset of patients presenting with a NET suffer from the consequences of endocrine syndromes as a result of the excessive secretion of amines or peptide hormones, which can impair their quality of life and prognosis. Over the past 15 years, critical developments in tumor grading, diagnostic biomarkers, radionuclide imaging, randomized controlled drug trials, evidence-based guidelines, and superior prognostic outcomes have substantially altered the field of NET care. Here, we review the relevant advances to clinical practice that have significantly upgraded our approach to NET patients, both in diagnostic and in therapeutic options.

scholarly journals Principles of medullary thyroid cancer staging according to AJCC TNM 8th edition

2021 ◽  
Vol 27 (1-2) ◽  
pp. 101-116
Author(s):  
O.R. Duda ◽  
◽  
R.R. Slipetsky ◽  
N.I. Bojko ◽  
◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Medullary Thyroid Cancer ◽  
Tnm Classification ◽  
Medical Documentation ◽  
Basic Principles ◽  
Adequate Treatment ◽  
Medullary Thyroid ◽  
7Th Edition ◽  
8Th Edition

Aim. The research aims at analyzing the main changes in classification of medullary thyroid cancer and outlining the principles of staging according to modern studies. Material and Methods. Specific scientific articles for the period of 2009-2019 referring to the principles and rules of the TNM classification process, as well as recommendations of the TNM committees of the American Joint Committee on Cancer (AJCC) and the International Union Against Cancer (IUAC) were selected for the analysis. The basic principles of classification and staging for 8th edition of TNM, as well as changes that have taken place in comparison with 7th edition of TNM It were defined. Results and Discussion. Medullary thyroid cancer accounts for 1-2 percent in the structure of cancers of the thyroid gland, however it is associated with a high mortality rate compared to highly differentiated forms of thyroid cancer. The main radical method of treatment is an adequate volume of surgical intervention, which is determined on the basis of proper staging, the use of visualization methods and the practical experience of doctors. The 7th edition of the TNM was introduced to the scientific society in 2009. It has been 10 years since a new version of the 8th edition based on the new data in evidence-based medicine appeared. It included numerous changes and additions, namely for medullary thyroid cancer. The following research suggests a detailed review and analysis of the basic principles of the staging and classification of medullary thyroid cancer for AJCC TNM-8 in order to improve the diagnosis and treatment of patients with the mentioned above disease. Conclusions. The use of modern principles of classification and staging of medullary thyroid cancer in clinical practice promotes choosing the adequate treatment method and estimating the patient's prognosis. In addition, further improvement of the staging system by TNM-committee and cancer registers depends on the presence of detailed information on additional "parameters for collection and further evaluation" in medical documentation.

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