Classification and Prognostic Stratification of Bronchopulmonary Neuroendocrine Neoplasms.

Oka, Naomi; Kasajima, Atsuko; Konukiewitz, Björn; Sakurada, Akira; Okada, Yoshinori; Kameya, Toru; Weichert, Wilko; Ishikawa, Yuichi; Suzuki, Hiroyoshi; Sasano, Hironobu; Klöppel, Günter

doi:10.1159/000502776

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journal article

Document type:: Journal Article
Author(s):: Oka, Naomi; Kasajima, Atsuko; Konukiewitz, Björn; Sakurada, Akira; Okada, Yoshinori; Kameya, Toru; Weichert, Wilko; Ishikawa, Yuichi; Suzuki, Hiroyoshi; Sasano, Hironobu; Klöppel, Günter
Title:: Classification and Prognostic Stratification of Bronchopulmonary Neuroendocrine Neoplasms.
Abstract:: The accuracy and reproducibility of the World Health Organization (WHO) 2015 classification of bronchopulmonary neuroendocrine neoplasms (BP-NENs) is disputed. The aim of this study is to classify and grade BP-NENs using the WHO 2019 classification of digestive system NENs (DiS-NEN-WHO 2019), and to analyze its accuracy and prognostic impact. Two BP-NEN cohorts from Japan and Germany, 393 tumors (88% surgically resected), were reviewed and the clinicopathological data of the resected tumors (n = 301) correlated to patients' disease-free survival (DFS). The DiS-NEN-WHO 2019 stratified the 350 tumors into 91 (26%) neuroendocrine tumors (NET) G1, 52 (15%) NET G2, 15 (4%) NET G3, and 192 (55%) neuroendocrine carcinomas (NEC). NECs, but not NETs, were immunohistochemically characterized by abnormal p53 (100%) and retinoblastoma 1 (83%) expression. The Ki67 index, which was on average 4 times higher than mitotic count (p < 0.0001), was prognostically more accurate than the mitotic count. NET G3 patients had a worse outcome than NET G1 (p < 0.01) and NET G2 patients (p = 0.02), respectively. No prognostic difference was detected between NET G3 and NEC patients after 5 year DFS. It is concluded that stratifying BP-NEN patients according to the DiS-NEN-WHO 2019 classification results in 3 prognostically well-defined NET groups, if grading is solely based on Ki67 index. Mitotic count alone may underestimate malignant potential of NETs.
Journal title abbreviation:: Neuroendocrinology
Year:: 2020
Journal volume:: 110
Journal issue:: 5
Pages contribution:: 393-403
Fulltext / DOI:: doi:10.1159/000502776
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/31422400
Print-ISSN:: 0028-3835
TUM Institution:: Institut für Allgemeine Pathologie und Pathologische Anatomie
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