Clinical Endoscopy

Original Articles

The Role of Endoscopic Ultrasound-Guided Ki67 in the Management of Non-Functioning Pancreatic Neuroendocrine Tumors: YongYan Cui, Lauren G. Khanna, Anjali Saqi, John P. Crapanzano, James M. Mitchell, Amrita Sethi, Tamas A. Gonda, Michael D. Kluger, Beth A. Schrope, John Allendorf, John A. Chabot, John M. Poneros; Clin Endosc 2020;53(2):213-220. Published online July 15, 2019; DOI: https://doi.org/10.5946/ce.2019.068

Background
/Aims: The management of small, incidentally discovered nonfunctioning pancreatic neuroendocrine tumors (NF-PNETs) has been a matter of debate. Endoscopic ultrasound with fine-needle aspiration (EUS-FNA) is a tool used to identify and risk-stratify PNETs. This study investigates the concordance rate of Ki67 grading between EUS-FNA and surgical pathology specimens in NFPNETs and whether certain NF-PNET characteristics are associated with disease recurrence and disease-related death.
Methods
We retrospectively reviewed the clinical history, imaging, endoscopic findings, and pathology records of 37 cases of NFPNETs that underwent pre-operative EUS-FNA and surgical resection at a single academic medical center.
Results
There was 73% concordance between Ki67 obtained from EUS-FNA cytology and surgical pathology specimens; concordance was the highest for low- and high-grade NF-PNETs. High-grade Ki67 NF-PNETs based on cytology (p=0.028) and histology (p=0.028) were associated with disease recurrence and disease-related death. Additionally, tumors with high-grade mitotic rate (p=0.005), tumor size >22.5 mm (p=0.104), and lymphovascular invasion (p=0.103) were more likely to have poor prognosis.
Conclusions
NF-PNETs with high-grade Ki67 on EUS-FNA have poor prognosis despite surgical resection. NF-PNETs with intermediate-grade Ki67 on EUS-FNA should be strongly considered for surgical resection. NF-PNETs with low-grade Ki67 on EUSFNA can be monitored without surgical intervention, up to tumor size 20 mm.

Citations

Citations to this article as recorded by

Endoscopic Ultrasound-Guided Fine Needle Acquisition for Evaluation of Pancreatic Neuroendocrine Tumors
Xiaohua Ye, Hongjun Hua, Chunxiao Hu, Jianying Dai, Chenjiao Wu, Jiaping Huai, Zhe Shen
Journal of Clinical Gastroenterology.2025; 59(4): 310. CrossRef
Alternative lengthening of telomeres and Ki‐67 proliferation index provide complementary information on recurrence risk after resection of pancreatic neuroendocrine tumors
Hallbera Gudmundsdottir, Rondell P. Graham, Patricia T. Greipp, Elizabeth B. Habermann, Ryan A. Knudson, Carrie A. Brandt, Patrick Starlinger, Cornelius A. Thiels, Susanne G. Warner, Rory L. Smoot, Mark J. Truty, Michael L. Kendrick, David M. Nagorney, Se
Journal of Neuroendocrinology.2025;[Epub] CrossRef
Accurate non-invasive grading of nonfunctional pancreatic neuroendocrine tumors with a CT derived radiomics signature
Ammar A. Javed, Zhuotun Zhu, Benedict Kinny-Köster, Joseph R. Habib, Satomi Kawamoto, Ralph H. Hruban, Elliot K. Fishman, Christopher L. Wolfgang, Jin He, Linda C. Chu
Diagnostic and Interventional Imaging.2024; 105(1): 33. CrossRef
Preoperative Prediction of Lymph Node Metastases in Nonfunctional Pancreatic Neuroendocrine Tumors Using a Combined CT Radiomics–Clinical Model
Taha M. Ahmed, Zhuotun Zhu, Mohammad Yasrab, Alejandra Blanco, Satomi Kawamoto, Jin He, Elliot K. Fishman, Linda Chu, Ammar A. Javed
Annals of Surgical Oncology.2024; 31(12): 8136. CrossRef
Improving fine needle aspiration to predict the tumor biological aggressiveness in pancreatic neuroendocrine tumors using Ki-67 proliferation index, phosphorylated histone H3 (PHH3), and BCL-2
Chaohui Lisa Zhao, Bahram Dabiri, Iman Hanna, Lili Lee, Zhang Xiaofei, Zarrin Hossein-Zadeh, Wenqing Cao, John Allendorf, Alex Pipas Rodriguez, Katherine Weng, Solomon Turunbedu, Adrienne Boyd, Mala Gupta
Annals of Diagnostic Pathology.2023; 65: 152149. CrossRef
Grading Pancreatic Neuroendocrine Tumors Via Endoscopic Ultrasound-guided Fine Needle Aspiration
Ammar A. Javed, Alessandra Pulvirenti, Samrah Razi, Jian Zheng, Theodoros Michelakos, Yurie Sekigami, Elizabeth Thompson, David S. Klimstra, Vikram Deshpande, Aatur D. Singhi, Matthew J. Weiss, Christopher L. Wolfgang, John L. Cameron, Alice C. Wei, Amer
Annals of Surgery.2023; 277(6): e1284. CrossRef
What Is the Role of Lymph Node Resections in Small Islet Tumors?
Alexandra Gangi, Cristina R. Ferrone
Advances in Surgery.2023; 57(1): 47. CrossRef
Diagnostic Accuracy of ki-67 Labeling Index in Endoscopic Ultrasonography-Fine-Needle Aspiration Cytology and Biopsy of Pancreatic Neuroendocrine Neoplasms
Jung-Soo Pyo, Nae Yu Kim, Kyueng-Whan Min, Il Hwan Oh, Dae Hyun Lim, Byoung Kwan Son
Diagnostics.2023; 13(17): 2756. CrossRef
A New Preoperative Scoring System for Predicting Aggressiveness of Non-Functioning Pancreatic Neuroendocrine Neoplasms
Tetsuya Takikawa, Kazuhiro Kikuta, Shin Hamada, Kiyoshi Kume, Shin Miura, Naoki Yoshida, Yu Tanaka, Ryotaro Matsumoto, Mio Ikeda, Fumiya Kataoka, Akira Sasaki, Hidehiro Hayashi, Waku Hatta, Yohei Ogata, Kei Nakagawa, Michiaki Unno, Atsushi Masamune
Diagnostics.2022; 12(2): 397. CrossRef
The Utility of Endoscopic-Ultrasonography-Guided Tissue Acquisition for Solid Pancreatic Lesions
Hiroki Tanaka, Shimpei Matsusaki
Diagnostics.2022; 12(3): 753. CrossRef
A novel tool to predict nodal metastasis in small pancreatic neuroendocrine tumors: A multicenter study
Ammar A. Javed, Alessandra Pulvirenti, Jian Zheng, Theodoros Michelakos, Yurie Sekigami, Samrah Razi, Caitlin A. McIntyre, Elizabeth Thompson, David S. Klimstra, Vikram Deshpande, Aatur D. Singhi, Matthew J. Weiss, Christopher L. Wolfgang, John L. Cameron
Surgery.2022; 172(6): 1800. CrossRef
Reliability of grading preoperative pancreatic neuroendocrine tumors on EUS specimens: a systematic review with meta-analysis of aggregate and individual data
Matteo Tacelli, Niccolò Bina, Stefano Francesco Crinò, Antonio Facciorusso, Ciro Celsa, Andrea Sbrozzi Vanni, Alberto Fantin, Filippo Antonini, Massimo Falconi, Fabio Monica, Gabriele Capurso, Paolo Giorgio Arcidiacono, Luca Barresi
Gastrointestinal Endoscopy.2022; 96(6): 898. CrossRef
Ki-67 Proliferation Index in Fine Needle Aspiration to Predict the Tumor Biological Aggressiveness in Pancreatic Neuroendocrine Tumors
Chaohui Lisa Zhao, Bahram Dabiri, Iman Hanna, Zarrin Hossein-Zadeh, Wenqing Cao, Bebu Ram, John Allendorf, Alex Pipas Rodriguez, Adrienne Boyd, Mala Gupta
SSRN Electronic Journal.2022;[Epub] CrossRef
Role of Endoscopic Ultrasound in the Diagnosis of Pancreatic Neuroendocrine Neoplasms
Tatsuya Ishii, Akio Katanuma, Haruka Toyonaga, Koki Chikugo, Hiroshi Nasuno, Toshifumi Kin, Tsuyoshi Hayashi, Kuniyuki Takahashi
Diagnostics.2021; 11(2): 316. CrossRef
Editors' Choice of Noteworthy Clinical Endoscopy Publications in the First Decade
Gwang Ha Kim, Kwang An Kwon, Do Hyun Park, Jimin Han
Clinical Endoscopy.2021; 54(5): 633. CrossRef
Current update on imaging for pancreatic neuroendocrine neoplasms
Nicole Segaran, Catherine Devine, Mindy Wang, Dhakshinamoorthy Ganeshan
World Journal of Clinical Oncology.2021; 12(10): 897. CrossRef
Assessment of ARX expression, a novel biomarker for metastatic risk in pancreatic neuroendocrine tumors, in endoscopic ultrasound fine‐needle aspiration
Wenzel M. Hackeng, Folkert H. M. Morsink, Leon M. G. Moons, Christopher M. Heaphy, G. Johan A. Offerhaus, Koen M. A. Dreijerink, Lodewijk A. A. Brosens
Diagnostic Cytopathology.2020; 48(4): 308. CrossRef
Experience and future perspectives on the use of the Papanicolaou Society of Cytopathology Terminology System for reporting pancreaticobiliary cytology
Mauro Saieg, Martha B. Pitman
Diagnostic Cytopathology.2020; 48(5): 494. CrossRef
Is Endoscopic Ultrasound-Fine Needle Aspiration for Ki67 Aspirational Enough?
Yakira David, Michelle Kang Kim
Clinical Endoscopy.2020; 53(2): 111. CrossRef
Clinical relevance of performing endoscopic ultrasound‐guided fine‐needle biopsy for pancreatic neuroendocrine tumors less than 2 cm
Charlotte M. Heidsma, Diamantis I. Tsilimigras, Flavio Rocha, Daniel E. Abbott, Ryan Fields, Paula M. Smith, George A. Poultsides, Cliff Cho, Casper van Eijck, Elisabeth Nieveen van Dijkum, Shishir K. Maithel, Timothy M. Pawlik
Journal of Surgical Oncology.2020; 122(7): 1393. CrossRef
Endoscopic ultrasound-guided fine-needle aspiration for the diagnosis and grading of pancreatic neuroendocrine tumors: a retrospective analysis of 110 cases
Salvatore Paiella, Luca Landoni, Roberta Rota, Matteo Valenti, Giovanni Elio, Stefano Francesco Crinò, Erminia Manfrin, Alice Parisi, Sara Cingarlini, Mirko D’Onofrio, Aldo Scarpa, Rita Teresa Lawlor, Laura Bernardoni, Paola Capelli, Chiara Nessi, Marco M
Endoscopy.2020; 52(11): 988. CrossRef

6,079 View
184 Download
18 Web of Science
21 Crossref

The Utility of Endoscopic Ultrasound in Patients with Isolated Elevations in Serum Amylase and/or Lipase: Lalitha M. Sitaraman, Amit H. Sachdev, Tamas A. Gonda, Amrita Sethi, John M. Poneros, Frank G. Gress; Clin Endosc 2019;52(2):175-181. Published online January 16, 2019; DOI: https://doi.org/10.5946/ce.2018.110

Abstract PDF PubReader ePub

Background
/Aims: The aim of this study was to describe the diagnostic yield of endoscopic ultrasound (EUS) in patients with isolated elevated levels of amylase and/or lipase.
Methods
A retrospective chart review was conducted at a large academic medical center from 2000 to 2016. Patients were selected based on having elevated amylase, lipase, or both, but without a diagnosis of pancreatitis or known pancreatobiliary disease. Patients were excluded if they had abnormal liver function tests or abnormal imaging of the pancreas.
Results
Of 299 EUS procedures performed, 38 met inclusion criteria. Symptoms were present in 31 patients, most frequently abdominal pain (87%). In 20 patients (53%), initial EUS most commonly found chronic pancreatitis (n=7; 18%), sludge (5; 13%), or new diagnosis of pancreas divisum (3; 8%). In the asymptomatic patients (7), 3 had a finding on EUS, most importantly sludge (2), stone (1), and pancreas divisum (1). No patients were diagnosed with a mass or pancreatic cyst. During the follow up period, 6 patients (22%) had cholecystectomy.
Conclusions
In our study of patients with isolated elevations in amylase and/or lipase without acute pancreatitis who underwent EUS, approximately 50% had a pancreatobiliary finding, most commonly chronic pancreatitis or biliary sludge.

Citations

Citations to this article as recorded by

Endosonographic features in patients with non-alcoholic early chronic pancreatitis improved with treatment at one year follow up
Kazutoshi Higuchi, Seiji Futagami, Hiroshi Yamawaki, Makoto Murakami, Kumiko Kirita, Shuhei Agawa, Go Ikeda, Hiroto Noda, Yasuhiro Kodaka, Nobue Ueki, Keiko Kaneko, Katya Gudis, Ryuji Ohashi, Katsuhiko Iwakiri
Journal of Clinical Biochemistry and Nutrition.2021; 68(1): 86. CrossRef
Do Patients with Pancreatic Hyperenzymemia without Abnormal Imaging Need Additional Endoscopic Ultrasound?
Jung Wan Choe, Jong Jin Hyun
Clinical Endoscopy.2019; 52(2): 97. CrossRef

10,533 View
164 Download
3 Web of Science
2 Crossref

First
Prev
Page of 1
Next
Last

Search