title: Can pancreatic neuroendocrine tumour biopsy accurately determine pathological characteristics?
abstract: BACKGROUND
  Assessment of the pathological characteristics of pancreatic neuroendocrine tumours is crucial for appropriate management. We compared preoperative pathological data with surgical specimens for accuracy.
  
  
  METHODS
  Surgical patients with pancreatic neuroendocrine tumours who underwent preoperative endoscopic ultrasound-guided fine needle aspiration of the primary tumour or biopsy of liver metastasis were retrospectively included. Tumour differentiation and the Ki67 proliferation index on biopsies were compared with pancreatic specimens.
  
  
  RESULTS
  Fifty-seven patients were included. A preoperative biopsy of the primary tumour or of a liver metastasis was obtained in 48 and 9 patients respectively. Tumour differentiation was high in 98%, and poor in 2% on biopsy and high in 100% of surgical specimens. Ki67 index values were 0 (0-19) and 2 (0-15) on biopsy and surgical specimens (p=0.01). Correlation between preoperative and surgical findings was stronger for liver (r=0.62, p=0.001) than for pancreas (r=0.23, p=0.11). Correlation for pancreas varied according to the tumour pattern: solid (r=0.24, p=0.16), mixed (r=0.91, p=0.0036) or cystic (r=0.04, p=0.89). Tumour grade was different between pancreatic biopsies and surgical specimens, for grade 1 (63% vs 37%) and grade 2 (28% vs 72%), p=0.0007.
  
  
  CONCLUSIONS
  Tumour grade assessment is accurate in biopsies of liver metastases of pancreatic neuroendocrine tumours, while pancreatic fine-needle aspiration biopsies are less accurate.
authors.affiliation: Pancreatology Department, Beaujon Hospital, AP-HP, Clichy, Paris-Diderot University, France; Inserm U773-CRB3, Paris-Diderot University, Paris, France. Electronic address: vinciane.rebours@bjn.aphp.fr.
authors.forename: Vinciane
authors.initials: V
authors.lastname: Rebours
authors.affiliation: Pancreatology Department, Beaujon Hospital, AP-HP, Clichy, Paris-Diderot University, France.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Cordova
authors.affiliation: Inserm U773-CRB3, Paris-Diderot University, Paris, France; Pathology Department, Bichat Hospital, AP-HP, Paris-Diderot University, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Couvelard
authors.affiliation: Pathology Department, Institut Gustave Roussy, Villejuif, France.
authors.forename: Monique
authors.initials: M
authors.lastname: Fabre
authors.affiliation: Endoscopy and Gastroenterology Department, Clinique du Trocadéro, Paris, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Palazzo
authors.affiliation: Radiology Department, Beaujon Hospital, AP-HP, Clichy, Paris-Diderot University, France.
authors.forename: Marie Pierre
authors.initials: MP
authors.lastname: Vullierme
authors.affiliation: Pancreatology Department, Beaujon Hospital, AP-HP, Clichy, Paris-Diderot University, France.
authors.forename: Olivia
authors.initials: O
authors.lastname: Hentic
authors.affiliation: Pancreatic Surgery Department, Beaujon Hospital, AP-HP, Clichy, Paris-Diderot University, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Sauvanet
authors.affiliation: Pancreatology Department, Beaujon Hospital, AP-HP, Clichy, Paris-Diderot University, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Aubert
authors.affiliation: Pathology Department, Beaujon Hospital, AP-HP, Clichy, Paris-Diderot University, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Bedossa
authors.affiliation: Pancreatology Department, Beaujon Hospital, AP-HP, Clichy, Paris-Diderot University, France; Inserm U773-CRB3, Paris-Diderot University, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Ruszniewski
mesh_terms: D000328:Adult; D000368:Aged; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D008113:Liver Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D018358:Neuroendocrine Tumors / Q000378:metabolism / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D010179:Pancreas / Q000473:pathology*; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D019394:Ki-67 Antigen
keywords: Ki67; Pancreatic neuroendocrine tumour; Preoperative biopsy accuracy