title: Clinicopathologic and prognostic significance of multiple hormone expression in pancreatic neuroendocrine tumors.
abstract: Pancreatic neuroendocrine tumors (PanNETs) produce variable peptide hormones. The expression status of some hormones has been linked to the biological and clinical behaviors of PanNETs. A total of 226 surgically resected PanNETs were selected. Immunolabeling for peptide hormones was compared with various clinicopathologic factors, including patient survival. Expression of insulin, glucagon-like peptide 1, glucagon, gastrin, somatostatin, and serotonin were observed in 56 (24.8%), 41 (18.1%), 25 (11.1%), 5 (2.2%), 5 (2.2%), and 4 (1.8%) cases, respectively. Expression of 1, 2, and 3 hormones was noted in 70 (31.0%), 28 (12.4%), and 3 (1.3%) cases, respectively; 125 cases (55.3%) were negative for all hormones. PanNETs with insulin and glucagon-like peptide 1 expression were associated with a lower grade, smaller size, lower pT and pN classifications, absence of lymphovascular invasion, and lymph node metastasis and had better survival by univariate analysis, whereas PanNETs with gastrin expression were associated with a higher grade, larger size, higher pT and pN classifications, presence of lymphovascular invasion, and lymph node metastasis and had worse survival. Gastrin expression, increased age, and tumor grade were negative prognostic factors in multivariate analysis. As the number of hormones expressed increased, the survival rate of PanNET patients increased. In summary, PanNET patients showing insulin or glucagon-like peptide 1 expression and increased numbers of expressed hormones had a better survival outcome by univariate analysis, whereas gastrin expression was a negative prognostic indicator in surgically resected PanNET patients.
authors.affiliation: Departments of *Pathology **Radiology Divisions of ∥Hepatobiliary and Pancreas Surgery ¶Endocrinology and Metabolism #Oncology, Asan Medical Center, University of Ulsan College of Medicine ‡Asan Institute for Life Science, Asan Medical Center †Department of Pathology, Korea University Anam Hospital, Korea University College of Medicine §Department of Biochemistry, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors.forename: Joo Young
authors.initials: JY
authors.lastname: Kim
authors.forename: Min-Sun
authors.initials: MS
authors.lastname: Kim
authors.forename: Ki-Suk
authors.initials: KS
authors.lastname: Kim
authors.forename: Ki-Byung
authors.initials: KB
authors.lastname: Song
authors.forename: Seung Hun
authors.initials: SH
authors.lastname: Lee
authors.forename: Dae Wook
authors.initials: DW
authors.lastname: Hwang
authors.forename: Kyu-Pyo
authors.initials: KP
authors.lastname: Kim
authors.forename: Hyoung Jung
authors.initials: HJ
authors.lastname: Kim
authors.forename: Eunsil
authors.initials: E
authors.lastname: Yu
authors.forename: Song Cheol
authors.initials: SC
authors.lastname: Kim
authors.forename: Hyeung-Jin
authors.initials: HJ
authors.lastname: Jang
authors.forename: Seung-Mo
authors.initials: SM
authors.lastname: Hong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D036361:Peptide Hormones / Q000032:analysis / Q000096:biosynthesis*; D016016:Proportional Hazards Models; D046888:Tissue Array Analysis; D055815:Young Adult
chemical_list: D036361:Peptide Hormones