CLINICOPATHOLOGICAL SPECTRUM OF GASTROENTEROPANCREATIC NEUROENDOCRINE NEOPLASMS: A RETROSPECTIVE STUDY AT TERTIARY CARE HOSPITAL, KARACHI, PAKISTAN daniyal_zahoor2009@live.com

 

CLINICOPATHOLOGICAL SPECTRUM OF GASTROENTEROPANCREATIC NEUROENDOCRINE NEOPLASMS: A RETROSPECTIVE STUDY AT TERTIARY CARE HOSPITAL, KARACHI, PAKISTAN

1

 

 

 

 

Pakistan

Oral only

To evaluate the clinicopathological features of gastroenteropancreatic neuroendocrine tumours (GEP-NETs) using the updated WHO 2010 classification and highlight their distribution, grade, and immunohistochemical profile in a tertiary care setting.

This retrospective study included histologically confirmed cases of GEP-NETs diagnosed at the Department of Pathology, Jinnah Postgraduate Medical Centre, between January 2020 and March 2025. Tumours were graded according to WHO 2010 criteria based on mitotic activity and Ki-67 index. Immunohistochemistry for synaptophysin and chromogranin was performed to confirm neuroendocrine differentiation.

A total of 125 cases were analyzed (mean age: 51.6 ± 15.8 years; 57% males). The majority of patients (87%) were symptomatic at presentation, while 13% were incidentally diagnosed. The pancreas (31%) was the most common primary site, followed by the stomach (15%) and duodenum (12%). The predominant histological subtype was well-differentiated neuroendocrine tumour (WDNET) in 102 (81.6%) cases, of which 50% were Grade 1, 30% Grade 2, and 10% Grade 3. Neuroendocrine carcinoma (NEC) accounted for 18 (14.4%) cases, with small cell carcinoma most frequently seen in the oesophagus. Liver was the most common metastatic site (18% of metastatic cases). Synaptophysin was positive in 95% of tumours; chromogranin was positive in 85%, particularly in low-grade tumours.

GEP-NETs demonstrate diverse clinical and histopathological patterns. The pancreas remains the most common primary site, while grade 3 WDNETs show a predilection for colonic origin. Accurate grading and site-based distribution are essential for prognosis and therapeutic strategies. Continued surveillance and application of WHO criteria can significantly aid in effective classification and management.