Can Lymph Node Metastasis be Predicted in Gastroenteropancreatic Neuroendocrine Neoplasias?


Ocakli S., CEYLAN c., Canlikarakaya F., Goktas A., Kankoc R., Terzioglu S. G.

Journal of the College of Physicians and Surgeons Pakistan, cilt.35, sa.5, ss.601-605, 2025 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 35 Sayı: 5
  • Basım Tarihi: 2025
  • Doi Numarası: 10.29271/jcpsp.2025.05.601
  • Dergi Adı: Journal of the College of Physicians and Surgeons Pakistan
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, MEDLINE, Veterinary Science Database
  • Sayfa Sayıları: ss.601-605
  • Anahtar Kelimeler: Gastrointestinal system, Lymph node metastasis, Neuroendocrine neoplasm
  • İnönü Üniversitesi Adresli: Evet

Özet

Objective: To investigate the predictive factors influencing lymphatic metastasis in gastroenteropancreatic neuroendocrine neoplasm (GEP-NENs). Study Design: Observational study. Place and Duration of the Study: Department of General Surgery, Ankara City Hospital, Ankara, Turkiye, between the years 2019 and 2022. Methodology: Patients who underwent surgery and were diagnosed with GEP-NEN based on final pathology between the study years were enrolled. Demographic information of the patients including age, gender, tumour location, and pathological characteristics (tumour size, grade, Ki-67 index, mitotic rate, total number of lymph nodes examined, pathological lymph nodes), inflammatory markers (White blood cell, lymphocyte, neutrophil, and monocyte counts, albumin levels, modified systemic inflammation score [mSIS], delta neutrophil index [DNI], neutrophil-lymphocyte ratio [NLR], and lymphocyte-monocyte ratio [LMR]) were retrieved from the patient database. Results: One hundred and thirty-two patients were included. The median age was 51 (34-64) years, with 56.8% being male. GEP-NENs were most commonly found in the pancreas (43.2%) and appendix (22.7%). The median tumour size was 1.7 cm (0.7-3.5 cm), the mitotic rate was 1(1-2), and the Ki-67 Index was 2 (1-5). Grade I and II accounted for 91.6 % of cases. In multivariate analysis, independent predictive factors for pathological lymph node involvement were identified as small bowel tumour location (p = 0.002), tumour Grade III (p = 0.008), and tumour size ≥2 cm (p = 0.017). Conclusion: This study identified tumour size, grade, and site of origin as independent risk factors for LN metastasis.