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, Francesca Lugli, Antonio Bianchi, Francesco Panzuto, Laura De Marinis, Massimo Falconi, Gianfranco Delle Fave, Giovanni Battista Doglietto, Guido Costamagna, Guido Rindi

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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.

Original languageEnglish
Pages (from-to)570-577
Number of pages8
JournalGastrointestinal Endoscopy
Volume76
Issue number3
DOIs
Publication statusPublished - Sep 2012

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ASJC Scopus subject areas

  • Gastroenterology
  • Radiology Nuclear Medicine and imaging

Cite this

Larghi, A., Capurso, G., Carnuccio, A., Ricci, R., Alfieri, S., Galasso, D., Lugli, F., Bianchi, A., Panzuto, F., De Marinis, L., Falconi, M., Delle Fave, G., Doglietto, G. B., Costamagna, G., & Rindi, G. (2012). Ki-67 grading of nonfunctioning pancreatic neuroendocrine tumors on histologic samples obtained by EUS-guided fine-needle tissue acquisition: A prospective study. Gastrointestinal Endoscopy, 76(3), 570-577. https://doi.org/10.1016/j.gie.2012.04.477