Pancreatic Neuroendocrine Tumours: The Role of Endoscopic Ultrasound Biopsy in Diagnosis and Grading Based on the WHO 2017 Classification

Dig Dis. 2019;37(4):325-333. doi: 10.1159/000499172. Epub 2019 Mar 21.

Abstract

Background: One of the controversial issues in the diagnosis of pancreatic neuroendocrine tumours (pNETs) is the accurate prediction of their clinical behaviour.

Objectives: The aim of the study was to evaluate the role of endoscopic ultrasound (EUS) biopsy in the diagnosis and grading of pNETs in a certified ENETS Center.

Methods: A prospectively maintained database of EUS biopsy procedures was retrospectively reviewed to identify all consecutive patients referred to a certified ENETS Center with a suspicion of pNET between June 2014 and April 2017. The cytological and/or histological specimens were stained and the Ki-67 labeling index was evaluated. In patients undergoing surgery, the grade obtained with EUS-guided biopsy was compared with the final histological grade. The grade was evaluated according to the 2017 WHO classifications and grading.

Results: The study population included 59 patients. EUS biopsy material reached an adequacy of 98.3% and was adequate for Ki-67 evaluation in 84.7% of cases. Twenty-nine patients (49.2%) underwent surgery. Of these, 25 patients had Ki-67 evaluated on EUS biopsy: the agreement between EUS biopsy grading and surgical specimen grading was 84%.

Conclusion: EUS biopsy is an accurate method for the diagnosis and grading of pNETs based on the WHO 2017 Ki-67 labelling scheme.

Keywords: Biopsy; Endoscopic ultrasound; Grading; Neuroendocrine tumour; Pancreatic neuroendocrine tumor.

MeSH terms

  • Endoscopic Ultrasound-Guided Fine Needle Aspiration*
  • Female
  • Humans
  • Ki-67 Antigen / metabolism
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neuroendocrine Tumors / classification
  • Neuroendocrine Tumors / diagnosis
  • Neuroendocrine Tumors / diagnostic imaging*
  • Neuroendocrine Tumors / pathology*
  • Pancreatic Neoplasms / classification
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / diagnostic imaging*
  • Pancreatic Neoplasms / pathology*
  • Retrospective Studies
  • World Health Organization*

Substances

  • Ki-67 Antigen