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KMID : 0939920150470040813
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대한암학회지
2015 Volume.47 No. 4 p.813 ~ p.822
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Prognostic Significance of Defining L-Cell Type on the Biologic Behavior of Rectal Neuroendocrine Tumors in Relation with Pathological Parameters
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Sohn Jin-Hee
Cho Mee-Yon
Park Yang-Soon
Kim Hyun-Ki
Kim Woo-Ho
Kim Joon-Mee
Jung Eun-Sun
Kim Kyoung-Mee
Lee Jae-Hyuk
Chan Hee-Kyung
Park Do-Youn
Joo Mee
Kim Su-Jin
Moon Woo-Sung
Kang Dong-Woo
Jin So-Young
Kang Yun-Kyung
Yoon Sun-Och
Han Hye-Seung
Choi Eun-Hee
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Abstract
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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.
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KEYWORD
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Rectal neoplasms, Neuroendocrine tumors, L cells, Immunohistochemistry, Survival, International Classification of Diseases
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