DOI QR코드

DOI QR Code

Digestive Neuroendocrine Tumor Distribution and Characteristics According to the 2010 WHO Classification: a Single Institution Experience in Lebanon

  • Kourie, Hampig Raphael (Hematology-Oncology Department, Faculty of medicine, Saint Joseph University) ;
  • Ghorra, Claude (Pathology Department, Faculty of medicine, Saint Joseph University) ;
  • Rassy, Marc (Pathology Department, Faculty of medicine, Saint Joseph University) ;
  • Kesserouani, Carole (Pathology Department, Faculty of medicine, Saint Joseph University) ;
  • Kattan, Joseph (Hematology-Oncology Department, Faculty of medicine, Saint Joseph University)
  • Published : 2016.05.01

Abstract

Background: Gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NEN) are relatively rare tumors, not equally distributed in gastro-intestinal system. In 2010, a revised version of the WHO classification of GEP-NENs was published. This study reports for the first time the distribution and characteristics of GEP-NEN in a Lebanese population. Materials and Methods: This descriptive retrospective study concerns all the digestive neuroendocrine tumors with their characteristics diagnosed in $H\hat{o}tel$ Dieu de France in Beirut, Lebanon from 2001 to 2012, all the pathology reports being reanalyzed according to the latest WHO 2010 classification. The characteristics and features of GEP-NEN analyzed in this study were age, gender, grade and site. Results: A total of 89 GEP-NENs were diagnosed, representing 28.2% of all neuroendocrine tumors. The mean age of GEP-NEN patients was 58.7 years and the M/F sex ratio was 1.2. The primary localization was as follows: 21.3%(19) pancreatic, 18% (16) gastric, 15.7% (14) duodenal, 11.2% (10) appendix, 10.1% (9) intestinal, 10.1% (9) colorectal (7.9% colonic and 2.2% rectal), 5.6% (4) hepatic, 2.2% (2) ampulla, 1.1% (1) esophageal and 7.9%(5) NOS digestive (metastatic with unknown primary). Of the 89 patients with GEP-NEN, 56.2% (50) were diagnosed as grade I, 11.2% (10) as grade II, 20.2% (18) as grade III and 12.4% (11) were considered as mixed adeno-neuroendocrine carcinomas (MANEC). Conclusions: This study, one of the rare examples based on the 2010 WHO classification of neuroendocrine tumors in the literature, indicates that in the Lebanese population, all duodenal and appendicular tumors are G1 and the majority of MANEC tumors are gastric and pancreatic tumors. Moreover, more duodenal tumors and fewer rectal tumors were encountered in our study compared to European reports.

Keywords

References

  1. Begum N, Maasberg S, Plockinger U, et al (2014). Neuroendocrine tumours of the GI tract--data from the German NET Registry. Zentralbl Chir, 139, 276-83.
  2. Galvan JA, Astudillo A, Vallina A, et al (2013). Epithelial-mesenchymal transition markers in the differential diagnosis of gastroenteropancreatic neuroendocrine tumors. Am J Clin Pathol, 140, 61-72. https://doi.org/10.1309/AJCPIV40ISTBXRAX
  3. Helland SK, Prosch AM, Viste A (2006). Carcinoid tumours in the gastrointestinal tract--a population-based study from Western Norway. Scand J Surg, 95, 158-61. https://doi.org/10.1177/145749690609500305
  4. Jiao X, Li Y, Wang H, et al (2015). Clinicopathological features and survival analysis of gastroenteropancreatic neuroendocrine neoplasms: a retrospective study in a single center of China. Chin J Cancer Res, 27, 258-66.
  5. Kloppel G, Rindi G, Anlauf M et al (2007). Site-specific biology and pathology of gastroenteropancreatic neuroendocrine tumors. Virchows Arch Aug, 451, 9-27. https://doi.org/10.1007/s00428-007-0461-0
  6. Kloppel G (2011). Classification and pathology of gastroenteropancreatic neuroendocrine neoplasms. Endocr Relat Cancer, 18, 1-16.
  7. Lombard-Bohas C, Mitry E, O'Toole D, et al (2009). Thirteen-month registration of patients with gastroenteropancreatic endocrine tumours in France. Neuroendocrinol, 89, 217-22. https://doi.org/10.1159/000151562
  8. Lewkowicz E, Trofimiuk-Muldner M, Wysocka K et al (2015). Gastroenteropancreatic neuroendocrine neoplasms: a 10-year experience of a single center. Pol Arch Med Wewn, 125, 337-46.
  9. Maggard MA, O'Connell JB, Ko CY (2004). Updated population-based review of carcinoid tumors. Ann Surg, 240, 117-22. https://doi.org/10.1097/01.sla.0000129342.67174.67
  10. Niederle MB, Niederle B (2011). Diagnosis and treatment of gastroenteropancreatic neuroendocrine tumors: current data on a prospectively collected, retrospectively analyzed clinical multicenter investigation. Oncologist, 16, 602-13. https://doi.org/10.1634/theoncologist.2011-0002
  11. Rindi G (2010). The ENETS guidelines: the new TNM classification system. Tumori, 96, 806-9. https://doi.org/10.1177/030089161009600532
  12. Scoazec JY, Couvelard A (2011). The new WHO classification if digestive neuroendocrine tumors. Ann Pathol, 31, 88-92. https://doi.org/10.1016/j.annpat.2011.01.001