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The clinical significance of cell proliferation determination in primary and metastatic neuroendocrine tumors of the pancreas


V.V. Delektorskaya, N.A. Kozlov, G.Yu. Chemeris

A retrospective clinical and morphological analysis of 72 primary pancreatic neuroendocrine tumors and 32 synchronous and metachronous metastases of these tumors in the liver are presented. The aim of the study was to compare the values of the Ki67 proliferation index in primary and metastatic tumors to evaluate the clinical significance of immunohistochemical determination of the indicator in metastases in the liver. It is shown that the Ki67 index may change in the course of tumor progression, with the synchronous and/or metachronous metastases in the liver, having the typical well differentiated histological structure, do not always repeat the potential of malignancy of primary neoplasms. Increase in the level of the proliferative activity of cells in 2-4 times in comparison with the initial tumor observed in 9 (27.3%) metastases in the liver, with the significant growth of the Ki67 index in the cells of the secondary tumor foci in 6 patients in metastatic group led to an overestimation of the pancreatic neuroendocrine tumor grade (criterion G). Thus, the results of the study show that the increase in the level of Ki67 expression in metastases compared with the primary tumor should be considered as an adverse factor for the progression of the disease and taken into account in assessing the degree of malignancy of tumors and choose the option of further drug treatment of metastatic liver lesions.
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