Alternative lengthening of telomeres and Ki-67 proliferation index provide complementary information on recurrence risk after resection of pancreatic neuroendocrine tumors

被引：0

作者：

Gudmundsdottir, Hallbera ^{[1
,2
]}

Graham, Rondell P. ^{[3
]}

Greipp, Patricia T. ^{[4
]}

Habermann, Elizabeth B. ^{[2
]}

Knudson, Ryan A. ^{[4
]}

Brandt, Carrie A. ^{[4
]}

Starlinger, Patrick ^{[1
]}

Thiels, Cornelius A. ^{[1
]}

Warner, Susanne G. ^{[1
]}

Smoot, Rory L. ^{[1
]}

Truty, Mark J. ^{[1
]}

Kendrick, Michael L. ^{[1
]}

Nagorney, David M. ^{[1
]}

Cleary, Sean P. ^{[1
]}

Halfdanarson, Thorvardur R. ^{[5
]}

机构：

[1] Mayo Clin, Dept Surg, Div Hepatobiliary & Pancreas Surg, Rochester, MN USA

[2] Mayo Clin, Robert D & Patricia E Kern Ctr Sci Hlth Care Deliv, Rochester, MN USA

[3] Mayo Clin, Dept Lab Med & Pathol, Div Anat Pathol, Rochester, MN USA

[4] Mayo Clin, Cytogenet Core Lab, Med Genome Facil, Rochester, MN USA

[5] Mayo Clin, Dept Oncol, Div Med Oncol, 200 1st St SW, Rochester, MN 55905 USA

来源：

JOURNAL OF NEUROENDOCRINOLOGY | 2025年

关键词：

alternative lengthening of telomeres; Ki-67; pancreatic neuroendocrine tumors; recurrence risk; MANAGEMENT; ATRX; DAXX; BEHAVIOR;

D O I：

10.1111/jne.70003

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Given the heterogeneous clinical behavior of pancreatic neuroendocrine tumors (pNETs), improved prognostic markers are needed to guide management and post-resection surveillance. Patients who underwent resection of large (>= 3 cm) sporadic well-differentiated pNETs from 2000 to 2019 were identified. The Ki-67 proliferation index was determined using immunohistochemistry, and alternative lengthening of telomeres (ALT) status was assessed using fluorescence in situ hybridization. Recurrence-free and overall survival were estimated using Kaplan-Meier analysis. Multivariable Cox regression analysis evaluated factors associated with recurrence-free survival. A total of 106 patients were identified. ALT was positive in 57 (54%) and negative in 49 (46%). Ki-67 was >= 3% in 74 (70%) and <3% in 32 (30%). Tumors with Ki-67 >= 3% were more likely to be ALT positive (61% vs. 38%, p = .046). Stratifying by ALT status and Ki-67 proliferation index, median recurrence-free survival was 4.6 years for patients with ALT-positive/Ki-67 >= 3% tumors, 3.1 years for patients with ALT-positive/Ki-67 <3% tumors, 12.4 years for patients with ALT-negative/Ki-67 >= 3% tumors, and 20.2 years for patients with ALT-negative/Ki-67 <3% tumors (p < .001). Initial recurrence was distant in 82% and locoregional in 18%. Across all groups, overall survival was similar (p = .19). In multivariable analysis, advanced age, ALT positivity, perineural invasion, and lymph node metastases were associated with increased recurrence risk (all p < .05). ALT and Ki-67 provide complementary information on post-resection recurrence risk, which can guide subsequent surveillance and management strategies. These data support the incorporation of ALT testing into routine clinical practice.

引用

页数：8

共 32 条

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