The Role And Significance Of PHH3 In Gastrointestinal Neuroendocrine Tumors

Objective:1.To study the correlation between the results of nuclear fission image counting under PHH3 staining and under HE staining in gastrointestinal neuroendocrine tumor.And to determine whether it is consistent about WHO standard and PHH3 staining at the staging of tumors in gastrointestinal neuroendocrine tumor,and to study the difference between these two methods.Further to explored whether there is the possibility of using PHH3 staining to count mitotic images and even assisted grading in gastrointestinal neuroendocrine tumors.2.To verify whether PHH3 staining is more time-saving for counting mitotic images by comparing the time taken for counting the nuclear fission image under HE staining.3.To analyze the relationship between pathological grade and PHH3 expression and various clinicopathological parameters of gastrointestinal neuroendocrine tumors.To explore the clinicopathological features of tumors by studying the relationship between the expression of PHH3 and Ki-67.Further to study the role of PHH3 and it's significance in gastrointestinal neuroendocrine tumor.Methods: 1.Selected 68 patients with gastrointestinal neuroendocrine tumors from January 2014 to September 2018 in the the Department of Pathology of Affiliated Hospital of Qinghai University,these 68 patients including 32 cases of G1,10 cases of G2,and 26 cases of G3.2.Select wax blocks and perform HE staining and PHH3 immunohistochemical staining for all cases.3.Firstly,the 50 HPFs were observed and counted respectively by the two pathologists in the same area of the two sections of PHH3 and HE.Finally,the mitotic image results of the case are expressed in the form of mitotic figures per 10 HPF,and the time required for each doctor to interpret is recorded.4.Collected relevant clinical and pathological indicators of 68 cases.5.Using IBM SPSS Statistics 22.0 software to process the date.Results: 1.The count results of PHH3 and the count results under HE had high correlation in each pathological grade(p<0.001),and the count time of PHH3 was less than that of HE,and the difference was statistically significant(p< 0.001).2.The results of pathological grading with PHH3 had good consistent with WHO grading results(K=0.822).3.The pathological grade of tumor and the high expression of PHH3 were related to the patient's gender,the diameter of the tumor,the location of the tumor,and lymph node metastasis,ect,and the difference was statistically significant(p<0.05).4.The expression of PHH3 had good consistent with Ki-67 in gastrointestinal neuroendocrine tumors(Kappa=0.970,p<0.001).Conclusion: 1.The results of nuclear fission image counting under PHH3 staining have a high correlation with the counting results under HE,which and the nuclear fission image counting under PHH3 was accuration.2.Compared to under HE staining,the PHH3 staining is a faster counting method at the counting nuclear fission images.3.The results of PHH3 grading were highly consistent with those of WHO grading results,and the antibody might be helpful in grading.4.The pathological grading of GI-NETs is related to the patients' age,the diameter of tumors,the location of tumors and lymph node metastasis.The GI-NETs in rectum have lower grading,while the GI-NETs in cardia maybe have the higher grading.5.PHH3 is associated with many clinical indicators of gastrointestinal neuroendocrine tumors and may be a new prognostic predictor of gastrointestinal neuroendocrine tumors.6.The expression of PHH3 and Ki-67 in gastrointestinal neuroendocrine tumors is highly consistent.In gastrointestinal neuroendocrine tumors,PHH3 may have the same role and significance as Ki-67.