The 2019 WHO classification of tumors of the digestive tract further delineated neuroendocrine tumors of the gastrointestinal tract and hepatobiliary organs.
Categories:
(1) NET (neuroendocrine tumors)
(2) NEC (neuroendocrine carcinomas)
(3) MiNEN (mixed adenoneuroendocrine neoplasms)
Parameters:
(1) differentiation
(2) mitotic rate (mitoses in 2 square mm)
(3) Ki-67 index in percent
Features of NET
Differentiation
Mitotic Rate
Ki-67 Index
Grade
well
< 2
< 3%
low (G1)
well
2 to 20
3 to 20%
intermediate (G2)
well
> 20
> 20%
high (G3)
Features of NEC:
(1) poorly differentiated
(2) mitotic rate > 20 per 2 square mm
(3) Ki-67 index > 20%
(4) subclassified as small cell (SCNEC) or large cell (LCNEC)
Features of MiNEN:
(1) may be well to poorly differentiated
(2) show both adenocarcinoma and neuroendocrine tumors
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