Predicting the behavior of pancreatic endocrine tumors is a difficult.
In this study, doctors evaluated the prognostic value of both traditional parameters and cytokeratin 19 (CK19).
The team assessed the clinicopathologic features of 101 curatively resected pancreatic endocrine tumors.
They performed the immunohistochemistry for Ki-67 in 45 cases and CK19 in 54 cases.
| None of the CK19-negative cases died of disease.|
|American Journal of Surgical Pathology|
The cases also were categorized using the Capella classification as benign, borderline, low-grade, and high-grade malignant.
The team determined, using univariate analyses, that mitoses, solid pattern, necrosis, vascular invasion, perineural invasion, CK19 staining, and Ki-67 were significant prognostic indicators. The Capella classification was not significant.
On multivariate analysis, only CK19 remained significant.
The team found that none of the CK19-negative cases died of disease, while 10 of 28 CK19-positive cases died.
Dr Vikram Deshpande's team concluded, "CK19 is a powerful predictor of survival and can potentially segregate benign and malignant pancreatic endocrine tumors".
"We suggest that all pancreatic endocrine tumors with any one of the following features be diagnosed as malignant: presence of necrosis, vascular invasion, perineural invasion, or CK19 positivity".
"We hypothesize that a subgroup of pancreatic endocrine tumors may share a common histogenesis with pancreatic adenocarcinomas".