Evolving therapeutic landscape of duodenal neuroendocrine neoplasms: From endoscopic resection to systemic strategies

doi:10.4240/wjgs.v18.i5.118355

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Surg. May 27, 2026; 18(5): 118355
Published online May 27, 2026. doi: 10.4240/wjgs.v18.i5.118355

Table 1 Concise classification and grading criteria for neuroendocrine neoplasms of the gastrointestinal tract and hepatopancreatobiliary organs

Terminology	Differentiation	Grade	Mitotic rate¹ (mitoses/2 mm²)	Ki-67 index²
NET, G1	Well differentiated	Low	< 2	< 3%
NET, G2		Intermediate	2-20	3%-20%
NET, G3		High	> 20	> 20%
NEC, small-cell type (SCNEC)	Poorly differentiated	High³	> 20	> 20%
NEC, large-cell type (LCNEC)	Poorly differentiated	High³	> 20	> 20%

¹Mitotic rates are to be expressed as the number of mitoses/2 mm² as determined by counting in 50 fields of 0.2 mm² (i.e., in a total area of 10 mm²).

²The Ki-67 proliferation index value is determined by counting at least 500 cells in the regions of highest labelling (hot-spots), which are identified at scanning magnification; the final grade is based on whichever of the two proliferation indexes places the neoplasm in the higher-grade category.

³Poorly differentiated neuroendocrine carcinomas are not formally graded, but are considered high-grade by definition.

LCNEC: Large-cell neuroendocrine carcinoma; NEC: Neuroendocrine carcinoma; NET: Neuroendocrine tumour; SCNEC: Small-cell neuroendocrine carcinoma.

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Citation: Fei S, Wei P, Ming N, Yao HB. Evolving therapeutic landscape of duodenal neuroendocrine neoplasms: From endoscopic resection to systemic strategies. World J Gastrointest Surg 2026; 18(5): 118355
URL: https://www.wjgnet.com/1948-9366/full/v18/i5/118355.htm
DOI: https://dx.doi.org/10.4240/wjgs.v18.i5.118355

Fei S, Wei P, Ming N, Yao HB. Evolving therapeutic landscape of duodenal neuroendocrine neoplasms: From endoscopic resection to systemic strategies. World J Gastrointest Surg 2026; 18(5): 118355 [DOI: 10.4240/wjgs.v18.i5.118355]

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