The New Classification of NET Review article
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Abstract
There are three imporant directions in the field of GEP NET. The first one is the NET Registry which collects the data from different clinical centers, that can be compared, providing the konwledge of these tumors. The second one is the diagnosis assessment where the patomorphological report is based on generally accepted nomenclatures and classifications. The quality of the report is fundamental for the therapeutic decision.The third problem is the prognostic and predictive markers for stratification of patients for therapy: observation, biotherapy or chemotherapy. The large epidemiologcal data from US published by Modlin, Maggard and Yao present the tendency for the increase of the incidence of NET during 5 and 3 decades from 1.09 to 5.25 in 100 000 population per year. They also showed the increase in the rectum and stomach NET and decrease in appendix NET. Epidemiological European data based on a smaller number of cases as compared to US data. Larger data are from Germany, Spain, Norway and Austria. The systems of NET nomenclature are based on the morphology, differentiation and grading of NET. Fundamental in all systems is a sharp division between well differentiated and poorly differentiated tumors. The grade reflects the biologic behavior and agressiveness of the tumor. All classifications and guidelines for diagnosis and therapy regardless of the sources are based on 3 fundamental features, the type of NET according to WHO classification, grading and staging based on ENETS and AJCC/UICC TNM system.
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Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
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