Pancreatic neuroendocrine tumors in MEN1 disease: a mono-centric longitudinal and prognostic study

Endocrine. 2018 May;60(2):362-367. doi: 10.1007/s12020-017-1327-0. Epub 2017 May 31.

Abstract

Purpose: Multiple endocrine neoplasia type 1 (MEN1) is an inherited endocrine neoplastic syndrome associated with a greater risk of endocrine tumor development like pancreatic neuroendocrine tumors (p-NET), with different clinical characteristics from sporadic ones. This paper aims to compare clinical, hystological and morphological aspects of p-NET in patients affected from MEN1 (MEN1+) and not-affected ones (MEN1-).

Methods: We performed a retrospective observational study. Data was collected between December 2010 and December 2015, including patients with a histological diagnosis of p-NET and radiological imaging. We compared clinical, histological, radiological, and prognostic aspects of MEN+ p-NET with MEN-1 p-NET.

Results: Of the 45 patients enrolled, 13 MEN1+ and 21 MEN1- cases were analyzed. Frequency of not secreting p-NETs and insulin secreting p-NETs, histopathological grades and Ki67 expression were superimposable between MEN1+ and MEN1- patients. MEN1+ pNETs are more often multicentric compared to MEN1- pNETs. Frequency of liver and nodes metastatic spread was higher in MEN1- p-NET compared to MEN1+ p-NET. Analyzing p-NET according to the disease outcome, we found that recovered and stable p-NETs in MEN1+ patients, compared to MEN1- cases, are diagnosed at lower age (p = 0.04/p = 0.002) and that are more frequently multifocal lesions (p = 0.009/p = 0.002).

Conclusions: In our study pNETs in MEN1+ and pNETs in MEN1- don't significantly differ for prognosis but only for clinical features. p-NET stage disease and prognosis can be positively influenced by early diagnosis and screening in index patients' first-degree relatives.

Keywords: MEN1; Neuroendocrine tumor; Pancreas; pNET.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Multiple Endocrine Neoplasia Type 1 / pathology*
  • Neuroendocrine Tumors / etiology
  • Neuroendocrine Tumors / pathology*
  • Pancreas / pathology*
  • Pancreatic Neoplasms / etiology
  • Pancreatic Neoplasms / pathology*
  • Retrospective Studies