Onkológia 5/2017

Pathologic classification of gastroenteropancreatic neuroendocrine neoplasias

The presented paper represents a review on pathologic classification and grading of gastroenteropancreatic neuroendocrine neoplasias using verification a) of their morphologic and functional differentiation and b) tumor´s proliferation fraction by determination of the mitotic activity and Ki-67 proliferative indexes. This approach allows to distinguish two categories of well differentiated neuroendocrine tumors (NET) G1 a G2 and one category of poorly differentiated either small-cell or large-cell neuroendocrine carcinoma (NEC) G3. The authors further briefly summarize the recent criteria of the WHO 2017 clasification which accepts for the pancreatic neuroendocrine neoplasias 3rd category of NET G3 and critically discusse also the weak moments of this definition including problems of the determination of proliferative fractions of the neuroendocrine neoplasias. Finally, the authors comment on recent advances of molecular pathology and oncogenesis of neuroendocrine neoplasias, what opens new possibilities of the detection of today´s prognostic and pro futuro also predictive factors of the biopsy diagnosis of these neoplams.

Keywords: neuroendocrine tumor, neuroendocrine neoplasm, neuroendocrine carcinoma, grading of NEN