Морфологическая классификация нэйроэндокринных новообразований пищеварительной системы: современное состояние проблемы и нерешенные вопросы
https://doi.org/10.17650/2313-805X-2016-3-3-56-66
Аннотация
Нейроэндокринные опухоли образуют разнородную группу злокачественных эпителиальных новообразований, диагностика которых основывается на особенностях гистологической структуры и иммуногистохимического профиля. В классификации Всемирной организации здравоохранения (2010) для нейроэндокринных новообразований пищеварительной системы были определены основные категории, номенклатура, критерии градации и стадирования. При этом накопленные данные демонстрируют ряд важных патоморфологических противоречий в подходе к классификации. В данном обзоре мы остановимся на некоторых общих особенностях нейроэндокринных новообразований, их классификации, морфологических и биологических различиях основных категорий, наиболее важных иммуногистохимических маркерах.
Об авторе
В. В. Делекторская
ФГБУ «Российский онкологический научный центр им. Н. Н. Блохина» Минздрава России; Россия, 115478, Москва, Каширское шоссе, 24
Россия
Россия
Список литературы
1. Anlauf M. Neuroendocrine neoplasms of the gastroenteropancreatic system: pathology and classification. Horm Metab Res 2011;43(12):825–31. DOI: 10.1055/s-0031–1291307.
2. Yao J. C., Hassan M., Phan A. et al. One hundred years after “carcinoid”: epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol 2008;26(18):3063–72. DOI: 10.1200/JCO. 2007.15.4377.
3. Sandvik O. M., Søreide K., Gudlaugsson E. et al. Epidemiology and classification of gastroenteropancreatic neuroendocrine neoplasms using current coding criteria. Br J Surg 2016;103(3):226–32. DOI: 10.1002/bjs. 10034.
4. Fraenkel M., Kim M., Faggiano A. et al. Incidence of gastroenteropancreatic neuroendocrine tumours: a systematic review of the literature. Endocr Relat Cancer 2014; 21(3):153–63. DOI: 10.1530/ERC-13–0125.
5. Öberg K. Neuroendocrine gastro-enteropancreatic tumors – from eminence based to evidence-based medicine – A Scandinavian view. Scand J Gastroenterol 2015;50(6):727–39. DOI: 10.3109/00365521.2015.1033001.
6. Verbeek W. H., Korse C. M., Tesselaar M. E. GEP-NETs update: Secreting gastro- enteropancreatic neuroendocrine tumours and biomarkers. Eur J Endocrinol 2016;174(1):1– 7. DOI: 10.1530/EJE-14–0971.
7. Walenkamp A., Crespo G., Fierro Maya F. et al. Hallmarks of gastrointestinal neuroendocrine tumours: implications for treatment. Endocr Relat Cancer 2014;21(6): 445– 60. DOI: 10.1530/ERC-14–0106.
8. Meeker A., Heaphy C. Gastroenteropancre atic endocrine tumors. Mol Cell Endocrinol 2014;386(1–2):101–20. DOI: 10.1016/j. mce.2013.07.015.
9. Solcia E., Klöppel G., Sobin L. et al. Histological typing of endocrine tumours. 2nd edn. World Health Organization. Berlin: Springer, 2000.
10. Klöppel G., Perren A., Heitz P. U. The gas troenteropancreatic neuroendocrine cell system and its tumors: the WHO classification. Ann NY Acad Sci 2004;1014:13–27. DOI: 10.1196/annals. 1294.002.
11. Klöppel G. Classification and pathology of gastroenteropancreatic neuroendocrine neoplasms. Endocr Relat Cancer 2011;18(Suppl 1):S1–16. DOI: 10.1530/ERC-11–0013.
12. Klöppel G. Tumour biology and histopathology of neuroendocrine tumours. Best Pract Res Clin Endocrinol Metab 2007;21(1): 15–31. DOI: 10.1016/j.beem.2007.01.004.
13. Bosman F. T., Carneiro F., Hruban R. H., Theise N. D. WHO classification of tumours of the digestive system. 4th edn. Lyon, France: IARC Press, 2010.
14. Schmitt A. M., Blank A., Marinoni I. et al. Histopathology of NET: Current concepts and new developments. Best Pract Res Clin Endocrinol Metab 2016;30(1):33–43. DOI: 10.1016/j. beem. 2016.02.002.
15. Strosberg J., Nasir A., Coppola D. et al. Correlation between grade and prognosis in metastatic gastroenteropancreatic neuroendocrine tumors. Hum Pathol 2009;40(9):1262–8. DOI: 10.1016/j. humpath. 2009.01.010.
16. Kidd M., Modlin I., Öberg K. Towards a new classification of gastroenteropancreatic neuroendocrine neoplasms. Nat Rev Clin Oncol 2016. DOI: 10.1038/nrclinonc. 2016.85.
17. Grillo F., Albertelli M., Annunziata F. et al. Twenty years of gastroenteropancreatic neuroendocrine tumors: is reclassification worthwhile and feasible? Endocrine 2016;53(1):58–62. DOI: 10.1007/s12020-015-0734-3.
18. Jiao Y., Shi C., Edil B. H. et al. DAXX/ATRX, MEN1, and mTOR pathway genes are frequently altered in pancreatic neuroendocrine tumors. Science 2011;331(6021):1199–203. DOI: 10.1126/science.120060.
19. Yachida S., Vakiani E., White C. M. et al. Small cell and large cell neuroendocrine carcinomas of the pancreas are genetically similar and distinct from well-differentiated pancreatic neuroendocrine tumors. Am J Surg Pathol 2012;36(2):173–84. DOI: 10.1097/PAS. 0b013e3182417d36.
20. Kim J. Y., Hong S. M. Recent Updates on neuroendocrine tumors from the gastrointestinal and pancreatobiliary tracts. Arch Pathol Lab Med 2016;140(5):437–48. DOI: 10.5858/arpa. 2015–0314-RA.
21. Gurevich L., Kazantseva I., Isakov V. A. et al. The analysis of immunophenotype of gastrin-producing tumors of the pancreas and gastrointestinal tract. Cancer 2003;98(9):1967–76. DOI: 10.1002/cncr. 11739.
22. Kim J. Y., Kim M. S., Kim K. S. et al. Clinicopathologic and prognostic significance of multiple hormone expression in pancreatic neuroendocrinetumors. Am J Surg Pathol 2015;39(5):592–601. DOI: 10.1097/PAS. 0000000000000383.
23. Minnetti M., Grossman A. Somatic and germline mutations in NETs: Implications for their diagnosis and management. Best Pract Res Clin Endocrinol Metab 2016;30(1):115–27. DOI: 10.1016/j. beem. 2015.09.007.
24. Uccella S., Sessa F., La Rosa S. Diagnostic approach to neuroendocrine neoplasms of the gastrointestinal tract and pancreas. Turk Patoloji Derg 2015;31(1)(Supp l):113–27. DOI: 10.5146/tjpath. 2015.01319.
25. Sorbye H., Strosberg J., Baudin E. et al. Gastroenteropancreatic high-grade neuroendocrine carcinoma. Cancer 2014;120(18):2814–23. DOI: 10.1002/cncr.28721.
26. Basturk O., Tang L., Hruban R. H. et al. Poorly differentiated neuroendocrine carcinomas of the pancreas: a clinicopathologic analysis of 44 cases. Am J Surg Pathol 2014;38(4):437– 47. DOI: 10.1097/PAS. 0000000000000169.
27. DeLellis R. A., Shin S. J., Treaba O. D. Immunohistology of endocrine tumors. Ed. by D. J. Dabbs. In book: Diagnostic immunohistochemistry: theranostic and genomic applications. 3rd edn. Elsevier Inc, 2010. Pp. 291–329.
28. Klimstra D. S., Modlin I. R., Adsay N. V. et al. Pathology reporting of neuroendocrine tumors: application of the Delphic consensus process to thedevelopment of a minimum pathology data set. Am J Surg Pathol 2010;34(3):300–13. DOI: 10.1097/PAS.0b013e3181ce1447.
29. Saqi A., Alexis D., Remotti F., Bhagat G. Usefulness of CDX-2 and TTF-1 in differentiating gastrointestinal from pulmonary carcinoids. Am J Clin Pathol 2005;123(3):394–404. DOI: 10.1309/ukn6-pvrk-xhg4-22da.
30. Schmitt A. M., Riniker F., Anlauf M. et al. Islet 1(Isl-1) expression is a reliable marker for pancreatic endocrine tumors and their metastases. Am J Surg Pathol 2008;32(3):420–5. DOI: 10.1097/PAS.0b013e318158a397.
31. Srivastava A., Hornick J. L. Immunohistoc hemical staining for CDX-2, PDX-1, NESP-55, and TTF-1 can help distinguish gastrointestinalcarcinoid tumors from pancreatic endocrine and pulmonary carcinoid tumors. Am J Surg Pathol 2009;33(4):626–32. DOI: 10.1097/PAS.0b013e31818d7d8b.
32. Chan E. S., Alexander J., Swanson P. E. et al. PDX-1, CDX-2, TTF-1, and CK7: a reliable immunohistochemical panel for pancreatic neuroendocrineneoplasms. Am J Surg Pathol 2012;36(5):737–43. DOI: 10.1097/PAS. 0b013e31824aba59.
33. Long K. B., Srivastava A., Hirsch M. S., Hornick J. L. PAX-8 Expression in welldifferentiated pancreatic endocrine tumors: correlation with clinicopathologicfeatures and comparison with gastrointestinal and pulmonary carcinoid tumors. Am J Surg Pathol 2010;34(5):723–9. DOI: 10.1097/PAS.0b013e3181da0a20.
34. Sangoi A. R., Ohgami R. S., Pai R. K. et al. PAX-8 expression reliably distinguishes pancreatic well-differentiated neuroendocrine tumors from ileal and pulmonary welldifferentiated neuroendocrine tumors and pancreatic acinar cell carcinoma. Mod Pathol 2011;24(3):412–24. DOI: 10.1038/modpathol. 2010.176.
35. Tseng I. C., Yeh M. M., Yang C. Y., Jeng Y. M. NKX6-1 is a novel immunohistochemical marker for pancreatic and duodenal neuroendocrine tumors. Am J Surg Pathol 2015;39(6):850–7. DOI: 10.1097/PAS.0000000000000435.
36. Salaria S., Means A., Revetta F. et al. Expression of CD24, a stem cell marker, in pancreatic and small intestinal neuroendocrine tumors. Am J Clin Pathol 2015;144(4): 642– 8. DOI: 10.1309/AJCPMZY5P9TWNJJV.
37. Jamali M., Chetty R. Predicting prognosis in gastroentero-pancreatic neuroendocrine tumors: an overview and the value of Ki-67 immunostaining. Endocr Pathol 2008;19(4):282– 8. DOI: 10.1007/s12022-008-9044-0.
38. Körner M., Waser B., Reubi J. C. Does somatostatin or gastric inhibitory peptide receptor expression correlate with tumor grade and stage in gut neuroendocrine tumors? Neuroendocrinology 2015;101(1):45–57. DOI: 10.1159/000371804.
39. Делекторская В. В. Нейроэндокринные опухоли пищеварительной системы: морфологические и молекулярные особенности. Успехи молекулярной онкологии 2015;2(1):52–60. [Delektorskaya V. V. Neuroendocrine tumors of the digestive system: pathologic and molecular characteristics. Uspekhi molekulyarnoy onkologii = Advances in Molecular Oncology 2015;2(1):52–60. (In Russ.)]. DOI: 10.17650/2313-805x. 2015.2.1.52–60.
40. Qian Z. R., Ter-Minassian M., Chan J. A. et al. Prognostic significance of MTOR pathway component expression in neuroendocrine tumors. J Clin Oncol 2013;31(27):3418–25. DOI: 10.1200/JCO.2012.46.6946.
41. Schmitt A. M., Pavel M., Rudolph T. et al. Prognostic and predictive roles of MGMT protein expression and promoter methylation in sporadic pancreatic neuroendocrine neoplasms. Neuroendocrinology 2014;100(1):35–44. DOI: 10.1159/000365514.
42. Marinoni I., Kurrer A. S., Vassella E. et al. Loss of DAXX and ATRX are associated with chromosome instability and reduced survival of patients with pancreatic neuroendocrine tumors. Gastroenterology 2014;146(2):453–60. DOI: 10.1053/j.gastro.2013.10.020.
43. Rindi G., Klöppel G., Alhman H. et al. TNM staging of foregut (neuro) endocrine tumors: a consensus proposal including a grading system. Virchows Arch 2006;449(4):395–401. DOI: 10.1007/s00428-006-0250-1.
44. Voss S. M., Riley M. P., Lokhandwala P. M. et al. Mitotic count by phosphohistone H3 immunohistochemical staining predicts survival and improvesinterobserver reproducibility in well-differentiated neuroendocrine tumors of the pancreas. Am J Surg Pathol 2015;39(1):13–24. DOI: 10.1097/PAS.0000000000000341.
45. Dhall D., Mertens R., Bresee C. et al. Ki-67 proliferative index predicts progressionfree survival of patients with well-differentiated ileal neuroendocrine tumors. Hum Pathol 2012;43(4):489–95. DOI: 10.1016/j.humpath. 2011.06.011.
46. Делекторская В. В., Козлов Н. А., Чемерис Г. Ю. Клинико-морфологический анализ новообразований гастроэнтеропанкреатической системы. Клиническая лабораторная диагностика 2013;(10):48–50; 10–3. [Delektorskaya V. V., Kozlov N. A., Chemeris G. Yu. Clinico-morphological analysis of the neuroendocrine neoplasms of the gastroenteropancreatic system. Klinicheskaya laboratornaya diagnostika = Clinical Laboratory Diagnostics 2013;(10):48–50, 10–3. (In Russ.)].
47. Делекторская В. В., Кушлинский Н. Е. Нейроэндокринные опухоли пищеварительной системы: морфологический спектр и клеточная пролиферация (индекс Ki-67). Вестник РАМН 2013;(5):28–37. [Delektorskaya V. V., Kushliskiy N. E. Neuroendocrine tumors of digestive system: morphologic spectrum and cell proliferation (Ki-67 index). Vestnik RAMN = RAMS Herald 2013;(5):28–37. (In Russ.)]. DOI: 10.15690/vramn.v68i5.660.
48. Grillo F., Albertelli M., Brisigotti M. P. et al. Grade increases in gastro-enteropancreatic neuroendocrine tumor metastases compared to the primary tumor. Neuroendocrinology 2015. http://dx.DOI: org/10.1159/000439434.
49. Kroneman T. N., Voss J. S., Lohse C. M. et al. Comparison of three Ki-67 index quantification methods and clinical significance in pancreatic neuroendocrine tumors. Endocr Pathol 2015;26(3):255–62. DOI: 10.1007/s12022-015-9379-2.
50. Blank A., Wehweck L., Marinoni I. et al. Interlaboratory variability of MIB-1 staining in well-differentiated pancreatic neuro endocrine tumors. Virchows Arch 2015;467(5):543–50. DOI: 10.1007/s00428-015-1843-3.
51. Klöppel G., Rindi G., Perren A. et al. The ENETS and ACC/UICC TNM classifications of the neuroendocrine tumors of the gastrointestinal tract and the pancreas: a statement. Virchows Arch 2010;456(6): 595–7. DOI: 10.1007/s00428-010-0924-6.
52. Edge S. B., Byrd D. R., Compton C. C. et al. AJCC cancer staging manual. 7th edn. American joint commision on cancer. New York: Springer, 2010.
53. Rindi G., Falconi M., Klersy C. et al. TNM staging of neoplasms of the endocrine pancreas: results from a large international cohort study. J Natl Cancer Inst 2012;104(10):764–77. DOI: 10.1093/jnci/djs208.
54. Qadan M., Ma Y., Visser B. C. et al. Reassessment of the current American Joint Committee on Cancer staging system for pancreatic neuroendocrine tumors. J Am Coll Surg. 2014;218(2):188–95. DOI: 10.1016/j.jamcollsurg.2013.11.001.
55. Delle Fave G., O’Toole D., Sundin A. et al. ENETS consensus guidelines update for gastroduodenal neuroendocrine neoplasms. Neuroendocrinology 2016;103(2): 119–24. DOI: 10.1159/000443168.
56. Tang L. H., Basturk O., Sue J. J., Klimstra D. S. A practical approach to the classification of HO Grade 3 (G3) well-differentiated neuroendocrine tumor (WD-NET) and poorly differentiated neuroendocrine carcinoma (PD-NEC) of the pancreas. Am J Surg Pathol 2016;40(9):1192–202. DOI: 10.1097/pas.0000000000000662.
57. Tang L. H., Untch B. R., Reidy D. L. et al. Well-differentiated neuroendocrine tumors with a morphologically apparent high-grade component: a pathway distinct from poorly differentiated neuroendocrine carcinomas. Clin Cancer Res 2016;22(4):1011–7. DOI: 10.1158/1078–0432. CCR-15–0548.
58. Milione M., Maisonneuve P., Spada F. et al. The clinicopathologic heterogeneity of Grade 3 gastroenteropancreatic neuroendocrine neoplasms: morphological differentiation and proliferation identify different prognostic categories. Neuroendocrinology 2016. DOI: 10.1159/000445165.
59. Garcia-Carbonero R., Sorbye H., Baudin E. et al. ENETS consensus guidelines for high- grade gastroenteropancreatic neuroendocrine tumors and neuroendocrine carcinomas. Neuroendocrinology. 2016;103(2):186–94. DOI: 10.1159/000443172.
60. La Rosa S., Sessa F., Uccella S. Mixed neuroendocrine-nonneuroendocrine neoplasms (MiNENs): unifying the concept of a heterogeneous group of neoplasms. Endocr Pathol 2016. DOI: 10.1007/s12022-016-9432-9.
Рецензия
Для цитирования:
Делекторская В.В. Морфологическая классификация нэйроэндокринных новообразований пищеварительной системы: современное состояние проблемы и нерешенные вопросы. Успехи молекулярной онкологии. 2016;3(3):56-66. https://doi.org/10.17650/2313-805X-2016-3-3-56-66
For citation:
Delektorskaya V.V. Morphological classification of digestive neuroendocrine neoplasms: the current concepts and controversies. Advances in Molecular Oncology. 2016;3(3):56-66. (In Russ.) https://doi.org/10.17650/2313-805X-2016-3-3-56-66
Просмотров:
719
Послать статью по эл. почте 