Preoperative determination of Ki-67 expression, an important prognostic factor for grading nonfunctioning pancreatic endocrine tumors (NF-PETs), remains an important clinical challenge. To prospectively evaluate the feasibility, yield, and clinical impact of EUS-guided fine-needle tissue acquisition (EUS-FNTA) with a large-gauge needle to obtain tissue samples for histologic diagnosis and Ki-67 analysis in patients with suspected NF-PETs. Prospective cohort study. Tertiary-care academic medical center. Consecutive patients with a single pancreatic lesion suspicious for NF-PET on imaging. EUS-FNTA with a 19-gauge needle. Feasibility and yield of EUS-FNTA for diagnosis and Ki-67 expression determination. Thirty patients (mean [± SD] age 55.7 ± 14.9 years), with a mean (± SD) lesion size of 16.9 ± 6.1 mm were enrolled. EUS-FNTA was successfully performed without complications in all patients, with a mean (± SD) of 2.7 ± 0.5 passes per patient. Adequate samples for histologic examination were obtained in 28 of the 30 patients (93.3%). Ki-67 determination could be performed in 26 of these 28 patients (92.9%, 86.6% overall), 12 of whom underwent surgical resection. Preoperative and postoperative Ki-67 proliferation indexes were concordant in 10 patients (83.3%), whereas 2 patients were upstaged from G1 to G2 or downstaged from G2 to G1, respectively. Single center study with a single operator. In patients with suspected nonfunctioning low-grade to intermediate-grade pancreatic neuroendocrine tumors (p-NETs), retrieval of tissue specimens with EUS-FNTA by using a 19-gauge needle is safe, feasible, and highly accurate for both diagnosis and Ki-67 determination. A Ki-67 proliferative index acquired through this technique might be of great help for further therapeutic decisions. © 2012 American Society for Gastrointestinal Endoscopy.

Ki-67 grading of nonfunctioning pancreatic neuroendocrine tumors on histologic samples obtained by EUS-guided fine-needle tissue acquisition. A prospective study / Alberto, Larghi; Gabriele, Capurso; Antonella, Carnuccio; Riccardo, Ricci; Sergio, Alfieri; Domenico, Galasso; Lugli, Francesca; Antonio, Bianchi; Panzuto, Francesco; Laura De, Marinis; Massimo, Falconi; DELLE FAVE, Gianfranco; Giovanni Battista, Doglietto; Guido, Costamagna; Guido, Rindi. - In: GASTROINTESTINAL ENDOSCOPY. - ISSN 0016-5107. - ELETTRONICO. - 76:3(2012), pp. 570-577. [10.1016/j.gie.2012.04.477]

Ki-67 grading of nonfunctioning pancreatic neuroendocrine tumors on histologic samples obtained by EUS-guided fine-needle tissue acquisition. A prospective study

LUGLI, FRANCESCA;PANZUTO, Francesco;DELLE FAVE, Gianfranco;
2012

Abstract

Preoperative determination of Ki-67 expression, an important prognostic factor for grading nonfunctioning pancreatic endocrine tumors (NF-PETs), remains an important clinical challenge. To prospectively evaluate the feasibility, yield, and clinical impact of EUS-guided fine-needle tissue acquisition (EUS-FNTA) with a large-gauge needle to obtain tissue samples for histologic diagnosis and Ki-67 analysis in patients with suspected NF-PETs. Prospective cohort study. Tertiary-care academic medical center. Consecutive patients with a single pancreatic lesion suspicious for NF-PET on imaging. EUS-FNTA with a 19-gauge needle. Feasibility and yield of EUS-FNTA for diagnosis and Ki-67 expression determination. Thirty patients (mean [± SD] age 55.7 ± 14.9 years), with a mean (± SD) lesion size of 16.9 ± 6.1 mm were enrolled. EUS-FNTA was successfully performed without complications in all patients, with a mean (± SD) of 2.7 ± 0.5 passes per patient. Adequate samples for histologic examination were obtained in 28 of the 30 patients (93.3%). Ki-67 determination could be performed in 26 of these 28 patients (92.9%, 86.6% overall), 12 of whom underwent surgical resection. Preoperative and postoperative Ki-67 proliferation indexes were concordant in 10 patients (83.3%), whereas 2 patients were upstaged from G1 to G2 or downstaged from G2 to G1, respectively. Single center study with a single operator. In patients with suspected nonfunctioning low-grade to intermediate-grade pancreatic neuroendocrine tumors (p-NETs), retrieval of tissue specimens with EUS-FNTA by using a 19-gauge needle is safe, feasible, and highly accurate for both diagnosis and Ki-67 determination. A Ki-67 proliferative index acquired through this technique might be of great help for further therapeutic decisions. © 2012 American Society for Gastrointestinal Endoscopy.
2012
pancreatic endocrne tumors
01 Pubblicazione su rivista::01a Articolo in rivista
Ki-67 grading of nonfunctioning pancreatic neuroendocrine tumors on histologic samples obtained by EUS-guided fine-needle tissue acquisition. A prospective study / Alberto, Larghi; Gabriele, Capurso; Antonella, Carnuccio; Riccardo, Ricci; Sergio, Alfieri; Domenico, Galasso; Lugli, Francesca; Antonio, Bianchi; Panzuto, Francesco; Laura De, Marinis; Massimo, Falconi; DELLE FAVE, Gianfranco; Giovanni Battista, Doglietto; Guido, Costamagna; Guido, Rindi. - In: GASTROINTESTINAL ENDOSCOPY. - ISSN 0016-5107. - ELETTRONICO. - 76:3(2012), pp. 570-577. [10.1016/j.gie.2012.04.477]
File allegati a questo prodotto
File Dimensione Formato  
Larghi_Ki-67grating-ofnonfunctioning-pancreatic_2012.pdf

solo gestori archivio

Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 3.34 MB
Formato Adobe PDF
3.34 MB Adobe PDF   Contatta l'autore

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/511709
Citazioni
  • ???jsp.display-item.citation.pmc??? 40
  • Scopus 145
  • ???jsp.display-item.citation.isi??? 135
social impact