Evaluation of Gastroenteropancreatic Neuroendocrine Tumors

Background

The incidence of Gastroenteropancreatic Neuroendocrine Tumors (GEP-NETs) was shown to be steadily increasing (~4-5% per year), especially in the older population, by a recent publication by Lee et al.¹ As the patients’ survival is directly related to their management, the treating oncologist is heavily dependent on the correct grading/staging by the pathologist. Currently there is a lack of clarity with the scoring of Ki67 staining and the best specimens to test.

Scope

The primary goal of this guideline is to provide evidence-based recommendations on the evaluation of GEP-NETs. The guideline scope begins with specimens submitted to the laboratory with confirmed diagnosis of GEP-NET. Specimens under review will include fine needle aspirations, biopsies, surgical resections of both primary tumors, and metastases.

Key Questions

The draft overarching questions include:

• What is the best Ki67 scoring method of assigning grades in GEP-NETs?
• What are the best specimens to grade in GEP-NETs?

Key questions would be developed around the pre-analytic factors of specimen adequacy and the analytic factors of testing, counting, and interpretation.

Guideline Information

• Guideline Status: Complete Recommendations and Draft Manuscript
• Collaborators: The North American Neuroendocrine Tumor Society (NANETS) and the European Neuroendocrine Tumor Society (ENETS)

Expert Panel Members

Rahul M. Jawale, MD, FCAP, Co-Chair Chanjuan Shi, MD, PhD, FCAP, Co-Chair Dana L. Altenburger, MD, FCAP Adam L. Booth, MD, FCAP Chandrikha Chandrasekharan, MBBS Deyali Chatterjee, MD, FCAP

Robert M. Najarian, MD, FCAP Guido Rindi, MD, PhD Lesley Souter, PhD Zhaohai Yang, MD, PhD, FCAP Marisol Hernandez, MA, MLS, Staff Christina B. Ventura, MPH, MLS(ASCP), Staff

Additional Information

PROSPERO Listing

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1. Lee MR, Harris C, Baeg KJ, et al. Incidence trends of gastroenteropancreatic neuroendocrine tumors in the United States [published online December 20, 2018]. Clin Gastroenterol Hepatol. 2018. doi: 10.1016/j.cgh.2018.12.017

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