Abstract
BACKGROUND:
The objectives of this study were to evaluate the role of endoscopic ultrasonography (EUS)โguided fineโneedle aspiration (FNA) in the preoperative diagnosis of pancreatic endocrine tumors (PETs) and to investigate whether the Kiโ67 index determined on cytologic material could help predict their behavior.
METHODS:
The study included 10 men and 5 women (ratio of men to women, 2:1) with a mean age of 62.4 years (range, 40โ79 years). DiffโQuikโ and Papanicolaouโstained FNA samples were analyzed retrospectively, and immunocytochemical stains were performed for chromogranin A, synaptophysin, vimentin, ฮฑโ1โantitrypsin, and Kiโ67 on cell block sections. The Kiโ67 index was evaluated by using digital imageโanalysis software and was correlated with followโup (mean, 21.5 months; range, 2โ43 months).
RESULTS:
The overall survival was rate 86.7% (13 of 15 patients). Seven of 15 patients (46.7%) patients developed lymph node and/or hematogenous metastases. The Kiโ67 index in PETs with no metastases was lower (mean, 6.3%; range, 2%โ13%) than in clinically aggressive (metastatic) tumors (mean, 7.7%; range, 3%โ27%; P = .03). None of the tumors that had a Kiโ67 index โค2% were metastatic. Both patients who died of disease had a Kiโ67 index of 4%.
CONCLUSIONS:
Although tumors with metastatic potential tended to exhibit a slightly higher Kiโ67 index, there was a significant overlap with nonmetastatic tumors, and PETs that had a very low proliferative rate still could behave aggressively; therefore, the authors concluded that the Kiโ67 index does not predict the risk of disease progression in patients with PETs. Cancer (Cancer Cytopathol) 2009. ยฉ 2009 American Cancer Society.