Gülzade ÖZYALVAÇLI, Esra PAŞAOĞLU, Erol Rüştü BOZKURT

Gastrointestinal ve Pankreatik Nöroendokrin Tümörlerde Prognostik Parametreler

AMAÇ: Bu çalışmada, WHO’ya göre klasifiye edilen Gastroenteropankreatik nöroendokrin tümörler GEPNET olgularında; çap, mitoz, nekroz, anjiyolenfatik invazyon, perinöral invazyon ve lenf nodu metastazı gibi prognostik parametreler açısından tümör grupları arasındaki farklılıkların ortaya konulması amaçlanmıştır.YÖNTEMLER: 2001-2009 yılları arasında İstanbul Eğitim ve Araştırma Hastanesi Patoloji Bölümünde tanı alan 41 adet gastroenteropankreatik nöroendokrin tümör olgusu yaş, cinsiyet, lokalizasyon, çap, mitoz, nekroz, anjiyolenfatik invazyon, perinöral invazyon ve lenf nodu metastazı durumu açısından incelendi.BULGULAR: Tümör çapı benign grupta 0,76±0,78 cm olup malign grupta 2,82±2,86 cm olarak saptandı p=0.006 . İyi diferansiye tümör grubu ile iyi diferansiye karsinom grubu arasında mitoz sayısı açısından istatistiksel olarak anlamlı bir farklılık bulunmazken p>0,05 , az diferansiye karsinom grubunda bu parametre diğer gruplardan anlamlı olarak yüksek bulunmuştur p

Anahtar Kelimeler:

gastroenteropankreatik, nöroendokrin, tümör

The Prognostic Parameters in Gastrointestinal and Pancreatic Neuroendocrine Tumors

OBJECTIVE: In this study, we aimed that to find the differences in prognostic parameters as diameter, mitosis, necrosis, angiolymphatic invasion, perinoral invasion and lymph node metastasis of gastroenteropancreatic neuroendocrine tumor GEPNET cases which were classified by WHO.METHODS: Between 2001-2009 in Istanbul Educational And Research Hospital Hospital Pathology Department 41 GEPNET cases were searched according to age, gender, localization, diameter, mitosis, necrosis, angiolymphatic invasion, perinoral invasion and lymph node metastasis.RESULTS: Tumor diameter was 0,76±0,78 cm in benign group and 2,82±2,86 cm in malign group p=0.006 . There was not significant differences between well differentiated neuroendocrine tumor and well differentiated neuroendocrine carcinomas for number of mitosis p>0,05 , but poorly differantiated neuroendocrine carcinomas was significantly higher number of mitosis than the others p

Keywords:

gastroenteropancreatic, neuroendocrine, tumor,

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Alexiev BA, Drachenberg CB, Papadimitriou JC. Endocrine tumors of the gastrointestinal tract and pancreas: Grading, tumor size and proliferation index do not predict malignant behavior. Diagn Pathol 2007, 2:28.
Modlin IM, Shapiro MD, Kidd M. Siegfried Obendorfer: origins and perspective of carcinoid tumors. Hum Pathol 2004: 35:1440- 51
Grame-Cook F, Neuroendocrine tumors of the gastrointestinal tract and appendix. In: Odse RD, Goldblum JR. Surgical Pathology of the GI Tract, Liver, Biliary Tract and Pancreas. 2nd reved. Philadelphia, 2009: 653-693
Klöppel G, Rindi G, Anlauf M, Perren A, Komminoth P. Site- specific biology and pathology of gastroenteropancreatic neuro- endocrine tumors. Virchows Arch. 2007;451 Suppl 1:S9-27.
Van Gompel JJ, Sippel RS, Warner TF, Chen H. Gastrointestinal carcinoid tumors: factors that predict outcome. World J Surg. 2004;28:387-92.
Rorstad O. prognostic indicators for cardinoid neuroendocrine tumors of the gastrointestinal tract. J. Surg. Oncol 2005;89:151- 160
Oberg K, Akerström G, Rindi G, Jelic S; ESMO Guidelines Wor- king Group. Neuroendocrine gastroenteropancreatic tumours: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2010;21 Suppl 5:v223-7.
Estrozi B, Bacchi CE. Neuroendocrine tumors involving the gastroenteropancreatic tract: a clinicopathological evaluation of 773 cases. Clinics(Sau Paulo),2011;66:1671-5
Rindi G. The ENETS guidelines: The new TNM classification system. Tumori 2010;96:806-809
Soga J: Early-stage carcinoids of the gastrointestinal tract: An analysis of 1914 reported cases. Cancer 2005; 103:1587-1595.
Xie SD, Vang LB, Song XY, Pan T. Minute gastric carcinoid tumour with regional lymph node metastasis: a case report and review of literature. World J Gastroenterol 2004;10:2461-3
Kumashiro R, Naitoh H, Teshima K et al. Minute gastric carci- noid tumor with regional lymph node metastasis. Int Surg 1989;74:198-200
Hochwald SN, Zee S, Conlon KC, Colleoni R, Louie O, Brennan MF, Klimstra DS: Prognostic factors in pancreatic endocrine neoplasms: An analysis of 136 cases with a proposal for lowgrade and intermediate-grade groups. J Clin Oncol 2002, 20:2633-2642.
Strosberg J, Nasir A, Coppola D, Wick M, Kvols L. Correlation between grade and prognosis in metastatic gastroenteropancre- atic neuroendocrine tumors. Hum Pathol. 2009;40:1262-8.
Rindi G, Kloppel G. Endocrine tumors of the gut and pancreas tumor biology and classification. Neuroendocrinology 2004;1:12- 15
Solcia E, Rindi G, Paolotti D, La Rosa S, Capella C, Fiocca R. Clinicopathological profile as a basis for classification of the endocrine tumours of the gastroenteropancreatic tract. Ann Oncol. 1999;10 Suppl 2:S9-15.
Panzuto F, Nasoni S, Falconi M, Corleto VD, Capurso G, Cassetta S, Di Fonzo M, Tornatore V, Milione M, Angeletti S, Cattaruzza MS, Ziparo V, Bordi C, Pederzoli P, Delle Fave G. Prognostic factors and survival in endocrine tumor patients: comparison between gastrointestinal and pancreatic localization. Endocr Relat Cancer. 2005;12:1083-92.
Solcia E, Kloppel G, Sobin LH (in collaboration with 9 patholo- gists from 4 countries). Histological Typing of Endocrine Tumo- urs. WHO International Histological Classification of Tumours, 2nd ed. Berlin, Germany: Springer;2000
Rossi G, Valli R, Bertolini F, Sighinolfi P, Losi L, Cavazza A, Rivasi F, Luppi G. Does mesoappendix infiltration predict a worse prognosis in incidental neuroendocrine tumors of the appendix? A clinicopathologic and immunohistochemical study of 15 cases. Am J Clin Pathol. 2003;120:706-11.
Moertel CG, Dockerty MB, Judd ES. Carcinoid tumurs of the vermiform appendix. Carcer 1968;21:270-278