The diagnostic value of FNA biopsy in grading pancreatic neuroendocrine tumors

Abstract

The current results exhibit good correlation between FNA grade and final grade on surgical resection specimens using Ki-67 index, even in samples with less than the recommended total cell count. Therefore, grading of PNETs on FNA with the Ki-67 proliferation index should be assessed and is a practical parameter to report to clinicians. Cancer Cytopathol 2018;126:170-8. © 2017 American Cancer Society.

Pancreatic Neuroendocrine Tumours: The Role of Endoscopic Ultrasound Biopsy in Diagnosis and Grading Based on the WHO 2017 Classification

“…Moreover, when they excluded EUS-FNA samples with less than 2,000 tumour cells (26% of EUS-FNA), concordance rose to 90%. On the contrary, Laskiewicz et al [22] obtained 84.6% concordance in the evaluation of grading between FNA and tumour resection specimens, including 26.9% of FNA samples with less than 1,000 cells.…”

Reply to FNA biopsy in grading pancreatic neuroendocrine tumors: Methodological issues regarding diagnostic value

“…We thank Sabour et al for their knowledgeable comments on our study . Immunohistochemical study for the Ki‐67 proliferation index and using the Ki‐67 proliferation index to grade gastrointestinal and pancreatobiliary neuroendocrine tumors have been well‐established practices in pathology for many years.…”

“…As indicated in our article, the main issue we addressed was the accuracy of grading on FNA specimens and its correlation with grading on the final surgical resection specimens. We used the sensitivity, specificity, and positive predictive value to analyze the data.…”

“…Sabour et al have suggested using the receiver operating characteristic curve to assess the data from our study . The receiver operating characteristic curve is defined as a graphical plot of test sensitivity as the y coordinate versus its 1‐specificity or false‐positive rate as the x coordinate.…”

FNA biopsy in grading pancreatic neuroendocrine tumors: Methodological issues regarding diagnostic value

“…We were interested to read the article by Laskiewicz et al that was recently published in Cancer Cytopathology . Due to the controversy regarding the accuracy of grading pancreatic neuroendocrine tumors (PNETs) on fine‐needle aspiration (FNA) biopsy, the authors' objective was to evaluate whether grading according to the percentage of Ki‐67‐positive tumor cells (the Ki‐67 proliferation index) on material from endoscopic ultrasound‐guided FNA biopsies correlated with grading on surgical resection specimens.…”