Comparison of morphological features in lymph node metastasis between pancreatic neuroendocrine neoplasms and pancreatic ductal adenocarcinomas |
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| Institution: | 1. Division of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital East, Kashiwa, Japan;2. Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Kashiwa, Japan;3. Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan;1. Department of Internal Medicine I, Martin Luther University, Halle, Germany;2. Klinik und Poliklinik für Innere Medizin II, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Germany;3. Department for Internal Medicine, Neurology and Dermatology, Division of Gastroenterology, University of Leipzig, Leipzig, Germany;4. Department of Visceral, Vascular and Endocrine Surgery, Martin Luther University Halle-Wittenberg, 06120, Halle (Saale), Germany;5. Leipzig University Medical Center, IFB Adiposity Diseases, University of Leipzig, Leipzig, Germany;6. Medical Department III – Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, 04103, Germany;7. Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service of Baden-Württemberg, Mannheim, Germany;1. Associate Professor of Gastroenterology, Department of Gastroenterology, Bahcelievler Memorial Hospital, Turkey;2. Tulane University, School of Medicine, Department of Medicine, Section of Gastroenterology and Hepatology, USA;3. Specialist of Gastroenterology and Internal Medicine, Department of Gastroenterology, Sisli Hamidiye Etfal Education and Research Hospital, Turkey;4. Specialist of Internal Medicine, Department of Internal Medicine, Sisli Hamidiye Etfal Education and Research Hospital, Turkey;5. Associate Professor of of Pathology, Department of Pathology, Sisli Hamidiye Etfal Education and Research Hospital, Turkey;6. Associate Professor of of Medical Biochemistry, Department of Biochemistry, Sisli Hamidiye Etfal Education and Research Hospital, Turkey;7. Professor of of Radiology, Department of Radiology, Sisli Hamidiye Etfal Education and Research Hospital, Turkey;8. Professor of Gastroenterology, Department of Gastroenterology, Sisli Hamidiye Etfal Education and Research Hospital, Turkey;1. Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea;2. Department of Medicine, Yonsei University Graduate School, Seoul, Republic of Korea;3. Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea;1. Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA;2. Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA;3. Cancer Center, Massachusetts General Hospital, Boston, MA, USA;4. Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA |
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| Abstract: | BackgroundVarious studies have reported inconsistent results regarding the use of lymph node size for the prediction of metastasis in pancreatic cancer. Further, there is even less information in pNENs. Thus, the clinical accuracy and utility of using lymph node size to predict lymph node metastasis in pNENs has not been fully elucidatedObjectivesThis study aimed to examine differences in lymph node morphology between pancreatic neuroendocrine neoplasms (pNENs) and pancreatic ductal adenocarcinomas (PDACs) to create more accurate diagnostic criteria for lymph node metastasis.MethodsWe assessed 2139 lymph nodes, 773 from pNEN specimens and 1366 from PDAC specimens, surgically resected at our institute between 1994 and 2016. We evaluated the number, shape, size, and presence of metastasis.ResultsSixty-eight lymph nodes from 16 pNEN patients and 109 lymph nodes from 33 PDAC patients were metastatic. There were more lymph nodes sampled per case in the PDAC group than in the pNEN group (31.8 vs. 18.0). Metastatic lymph nodes in pNEN patients were larger and rounder than those in PDAC patients (minor axis: 5.15 mm vs. 3.11 mm; minor axis/major axis ratio: 0.701 vs. 0.626). The correlation between lymph node size and metastasis was stronger in pNENs (r = 0.974) than in PDACs (r = 0.439).ConclusionsLymph node status and morphology are affected by differences in tumor histology. The lymph node minor axis is a reliable parameter for the prediction of lymph node metastasis and has more utility as a predictive marker in pNENs than in PDACs. |
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| Keywords: | Neuroendocrine neoplasms Pancreatic cancer Lymph node metastasis Imaging Diagnosis |
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