Sabato 27 ottobre 2012 - Pacini Editore

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Fig. 2. Histological sample: EE 5X (a), HBmE-1 5X (b) and tROp-2 5X (c).
In 134 cytological specimens tested, HBME-1 showed a sensitivity
of 100% but a specificity of 76.1% whereas, in 61 evaluable
samples TROP-2 evidenced a Sensitivity of 100% and a specificity
of 82%. On histological specimens, 82.7% overall agreement
(p = 0.000, by χ2 test) between the two markers was achieved,
with a sensitivity of 79% and a specificity of 87 % for HBME-1,
whereas TROP-2 evidenced a Sensitivity of 67% and a Specificity
of 94.6%.
Conclusion. TROP-2 is an available diagnostic tool in thyroid
cytology such us HBME-1, but our data also evidenced less sensitivity
in histological samples even if more specificity, probably
due to technical reasons those request more standardization of
the method.
A
B
C
CONGRESSO aNNualE di aNatOmia patOlOGiCa SiapEC – iap • fiRENzE, 25-27 OttOBRE 2012
references
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2 Cochand-Priollet B, Dahan H, Laloi-Michelin M, et al. Immunocytochemistry
with cytokeratin 19 and anti-human mesothelial cell
antibody (HBME1) increases the diagnostic accuracy of thyroid fineneedle
aspirations: preliminary report of 150 liquid-based fine-needle
aspirations with histological control. Thyroid 2011;21:1067-73.
3 Alberti S, Miotti S, Stella M, et al. Biochemical characterization of
Trop-2, a cell surface molecule expressed by human carcinomas: formal
proof that the monoclonal antibodies T16 and MOv-16 recognize
Trop-2. Hybridoma 1992;11:539-45.
Ten years of gastroenteropancreatic
neuroendocrine tumors: is reclassification
worth while?
F. Grillo1 , M. Albertelli2 , L. Mastracci1 , M.P. Brisigotti1 , F. Annunziata2
, M. Arvigo2 , F. Minuto2 , R. Fiocca1 , D. Ferone2 1 2 Histopathology, DISC, Endocrinology, DiMI and Centre of Excellence
for Biomedical Research. University of Genova, IRCCS Azienda Ospedaliera
Universitaria San Martino, IST, Istituto Nazionale per la Ricerca
sul Cancro
Introduction. Gastro-entero-pancreatic (GEP) neuroendocrine
tumors (NETs) are rare neoplasms with heterogeneous clinical
behavior and potential long-term survival 1 2 . In the last decade
GEP-NET nomenclature and classification have been twice
reviewed. The 2000 WHO classification 3 had poor prognostic
power in well differentiated (WD) neoplasms which led to the
introduction of two new important parameters: grade and stage,
by ENETS 4 5 ; the former became part of the new 2010 WHO
classification 6 . Considering the recent introduction of grade and
stage, their external validation on diverse case series from different
populations has been called for in the Literature 7 . Retrospective
reclassification of all cases has not yet been advocated. However
in view of new targeted therapies, which may be licensed
for specific grade NETs (eg. Everolimus in G1-G2 pancreatic
NETs) 8 , this may become important in the future. Our aim was
to therefore to reclassify retrospectively with grade and stage our
series, correlate with follow up and identify whether retrospective
reclassification is feasible.
Tab. I. distribution of cases according to differentiation, grade and
stage.
Differentiation
(WHO 2000)
grade
(ENEtS/WHO 2010)
Stage
(Uicc 2009)
Well
Differentiated
Poorly
Differentiated
45(90%)
5(10%)
g1 31(62%)
g2 13(26%)
g3 6(12%)
i 12 (24%)
ii 4(9%)
iii 12%23%)
iV 22(44%)
Well
differentiated
tumour
Well
differentiated
carcinoma
14(28%)
31(62%)
Materials and methods. From the Histopathology archive at our
centre, 170 GEP-NETs (1993-2011) were identified. Until now
50 patients have been reclassified. Mean age at diagnosis was 56
years, F:M ratio was 1:1.2 and mean follow up was 56 months
(2-196). The primary sites were; stomach 5; duodenum 3; ileum
15; appendix 5; colon 6; pancreas 12; liver metastases from unknown
primary 5. For all cases, slides were reviewed and differentiation,
grade (as suggested by ENETs – mitotic count/10HPF
and percentage of Ki67 positive cells counting 2000 neoplastic