The grey zone between pure (neuro)endocrine and non-(neuro)endocrine tumours: a comment on concepts and classification of mixed exocrine–endocrine neoplasms
- 11 October 2006
- journal article
- review article
- Published by Springer Science and Business Media LLC in Virchows Archiv
- Vol. 449 (5), 499-506
- https://doi.org/10.1007/s00428-006-0306-2
Abstract
Terms such as “mixed endocrine–exocrine carcinoma” (MEEC) and “adenocarcinoma with neuroendocrine (NE) differentiation” (ADC-NE) identify tumours belonging to the spectrum of neoplasms with divergent exocrine and (neuro)endocrine differentiation. These tumours display variable quantitative extent of the two components, potentially ranging from 1 to 99%, and variable structural patterns, ranging from single scattered NE cells to a well-defined NE tumour cell population organized in organoid, trabecular or solid growth patterns. In the present report, the grey zone of tumours/carcinomas with mixed NE and non-NE features is explored for various organs. From a practical point of view, MEECs differ from carcinomas with focal NE differentiation by (1) the extension of each component (more than 30%) and (2) the structural pattern of the NE component, either organoid for well-differentiated or solid/diffuse for poorly differentiated cases. In MEECs, the most aggressive cell population drives the clinical behaviour. Conversely, ADC-NE generally do not show a different clinical outcome, compared to the corresponding conventional forms, except for prostatic adenocarcinoma, in which NE cells are a negative prognostic factor. The recognition of MEECs may be of relevance for a targeted therapeutic strategy, foreseeing the use of biotherapies similar to those proposed for pure NE tumours.This publication has 56 references indexed in Scilit:
- Neuroendocrine differentiation in prostate cancer: a sheep in wolf's clothing?Nature Reviews Endocrinology, 2006
- Independent prognostic role of circulating chromogranin A in prostate cancer patients with hormone-refractory diseaseEndocrine-Related Cancer, 2005
- Neuroendocrine differentiation in non‐small cell lung cancer and its relation to prognosis and therapyHistopathology, 2005
- Prognostic implications of neuroendocrine differentiation and hormone production in patients with Stage I nonsmall cell lung carcinomaCancer, 2003
- Ductulo-insular Pancreatic Endocrine NeoplasmsThe American Journal of Surgical Pathology, 2003
- Increased Endocrine Cells in Treated Rectal AdenocarcinomasThe American Journal of Surgical Pathology, 2002
- Expression of Apocrine Differentiation Markers in Neuroendocrine Breast Carcinomas of Aged WomenLaboratory Investigation, 2001
- Primary Large-Cell Neuroendocrine Carcinoma of the Parotid Gland: Immunohistochemical and Molecular Analysis of Two CasesLaboratory Investigation, 2000
- Prevalence and Prognostic Significance of Neuroendocrine Cells in Esophageal AdenocarcinomaLaboratory Investigation, 2000
- Neuroendocrine Tumors of the Lung With Proposed Criteria for Large-Cell Neuroendocrine CarcinomaThe American Journal of Surgical Pathology, 1991