Pancreatic neuroendocrine tumors: Accurate grading with Ki‐67 index on fine‐needle aspiration specimens using the WHO 2010/ENETS criteria

The natural history of pancreatic neuroendocrine tumors (panNETs) is extremely variable. One of the most controversial problems in diagnosis is the accurate prediction of the clinical behavior of these tumors. PanNETs that behave aggressively with a malignant course may have bland cytologic features, while some tumors with previously described “malignant” features may behave in a benign or indolent fashion. Various classification schemes have been proposed for grading panNETs. The European Neuroendocrine Tumor Society (ENETS) and 2010 World Health Organization (WHO) classification schemes include counting the mitotic index and/or the Ki‐67 proliferation index for grading. The current study was undertaken to determine whether tumors sampled by endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA) can be accurately graded based on the Ki‐67 index when compared to surgical samples.

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