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The new WHO classification of gastrointestinal neuroendocrine tumors and immunohistochemical expression of somatostatin receptor 2 and 5

Authors
  • Popa, Oana1, 2
  • Taban, Sorina Maria1
  • Pantea, Stelian3
  • Plopeanu, Andrei Dorel1, 4
  • Barna, Robert Alexandru1, 5
  • Cornianu, Marioara1
  • Pascu, Anca-Ariana5
  • Dema, Alis Liliana Carmen1
  • 1 Department of Microscopic Morphology-Pathology, ANAPATMOL Research Center, ‘Victor Babeș’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
  • 2 Endocrinology Clinic, ‘Pius Brînzeu’ County Emergency Clinical Hospital, 300723 Timisoara, Romania
  • 3 Surgical Emergency Clinic, ‘Victor Babeș’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
  • 4 Anatomic Pathology Service, ‘Pius Brînzeu’ County Emergency Clinical Hospital, 300723 Timisoara, Romania
  • 5 Department of Internal Medicine II-Discipline of Gastroenterology and Hepatology, ‘Victor Babeș’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
Type
Published Article
Journal
Experimental and Therapeutic Medicine
Publisher
Spandidos Publications
Publication Date
Aug 13, 2021
Volume
22
Issue
4
Identifiers
DOI: 10.3892/etm.2021.10613
PMID: 34475969
PMCID: PMC8406677
Source
PubMed Central
Keywords
Disciplines
  • Articles
License
Unknown

Abstract

The 2019 World Health Organization (WHO) classification of gastrointestinal tumors defines well-differentiated grade 3 neuroendocrine tumors, the mixed neuroendocrine-non-neuroendocrine tumors (MiNENs) and classifies goblet cell carcinoid as goblet cell adenocarcinoma. The expression of somatostatin receptors (SSTRs) is the foundation for somatostatin analogue therapy. At present, there are only a few studies that have analyzed the immunohistochemical reactivity of SSTRs in gastrointestinal neuroendocrine neoplasms (NENs). The aim of the present study was to evaluate the immunohistochemical expression of SSTR2 and SSTR5 in gastrointestinal NENs and goblet cell adenocarcinomas and the correlation of these markers with clinical and morphological factors. The study included 67 patients with NENs and 4 patients with adenocarcinoma ex-goblet cell carcinoid diagnosed between January 2008 and December 2018. Tumors were reclassified according to the 2019 WHO classification. Immunohistochemical staining for chromogranin A, synaptophysin, Ki-67, p53, SSTR2, and SSTR5 were performed in all the cases. The results showed that, G1 and G2 neuroendocrine tumors were more common SSTR2-positive in comparison with G3 carcinomas (P<0.0001). In addition, 33.3% of neuroendocrine carcinomas and 2 cases of low-grade adenocarcinoma ex-goblet cell carcinoid were SSTR2-positive. Neuroendocrine carcinomas had significantly lower SSTR2 and SSTR5 expression compared with well-differentiated neuroendocrine tumors (P=0.0130; P=0.0437, respectively). The SSTR2 expression in the early tumor stages was 100%, more often than in advanced stages (55.6%; P=0.0011). The results demonstrated the decrease in SSTR2 expression with increasing malignancy and tumor stage. The SSTR2-positive expression in neuroendocrine carcinomas and adenocarcinoma ex-goblet cell carcinoid provides evidence for the benefits of somatostatin analog treatment associated with surgery and chemotherapy.

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