Prognostic significance of defining L-cell type on the biologic behavior of rectal neuroendocrine tumors in relation with pathological parameters

Jin Hee Sohn, Mee Yon Cho, Yangsoon Park, Hyunki Kim, Woo Ho Kim, Joon Mee Kim, Eun Sun Jung, Kyoung Mee Kim, Jae Hyuk Lee, Hee Kyung Chang, Do Youn Park, Mee Joo, Sujin Kim, Woo Sung Moon, Mi Seon Kang, So Young Jin, Yun Kyung Kang, Sun Och Yoon, Hye Seung Han, Eun Hee Choi

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Abstract

Purpose In 2010, the World Health Organization categorized L-cell type neuroendocrine tumors (NETs) as tumors of uncertain malignancy, while all others were classified as malignant. However, the diagnostic necessity of L-cell immunophenotyping is unclear, as are tumor stage and grade that may guide diagnosis and management. To clarify the predictive markers of rectal neuroendocrine neoplasms (NENs), 5- and 10-year overall survival (OS) was analyzed by pathological parameters including L-cell phenotype. Materials and Methods A total of 2,385 rectal NENs were analyzed from our previous multicenter study and a subset of 170 rectal NENs was immunophenotyped. Results In univariate survival analysis, tumor grade (p < 0.0001), extent (p < 0.0001), size (p < 0.0001), lymph node metastasis (p = 0.0063), and L-cell phenotype (p < 0.0001) showed significant correlation with the prognosis of rectal NENs; however, none of these markers achieved independent significance in multivariate analysis. The 10-year OS of tumors of NET grade 1, < 10 mm, the mucosa/submucosa was 97.58%, 99.47%, and 99.03%, respectively. L-Cell marker, glucagon II (GLP-1 & 2), with a cut off score of > 10, is useful in defining L-Cell type. In this study, an L-cell immunophenotype was found in 83.5% of all rectal NENs and most, but not all L-cell type tumors were NET G1, small (< 10 mm) and confined to the mucosa/submucosa. Conclusion From these results, the biological behavior of rectal NENs does not appear to be determined by L-cell type alone but instead by a combination of pathological parameters.

Original languageEnglish
Pages (from-to)813-822
Number of pages10
JournalCancer Research and Treatment
Volume47
Issue number4
DOIs
Publication statusPublished - 2015

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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    Sohn, J. H., Cho, M. Y., Park, Y., Kim, H., Kim, W. H., Kim, J. M., Jung, E. S., Kim, K. M., Lee, J. H., Chang, H. K., Park, D. Y., Joo, M., Kim, S., Moon, W. S., Kang, M. S., Jin, S. Y., Kang, Y. K., Yoon, S. O., Han, H. S., & Choi, E. H. (2015). Prognostic significance of defining L-cell type on the biologic behavior of rectal neuroendocrine tumors in relation with pathological parameters. Cancer Research and Treatment, 47(4), 813-822. https://doi.org/10.4143/crt.2014.238