Sandria, Krisna Murti

Immunohistochemistry Profile of Neuroendocrine Tumor of Five Years’ Experience at Tertiary Referral Hospital in Palembang

Introduction

Immunohistochemistry profile of neuroendocrine tumor of five years’ experience at tertiary referral hospital in palembang. Immunohistochemistry profiles of neuroendocrine tumors from 5 years at a Palembang hospital. Synaptophysin showed the highest diagnostic rate for NETs; Ki-67 linked to tumor location.

Abstract

Background Neuroendocrine tumors (NET) are a type of uncommon neoplasms originating from the neuroendocrine cell system. Recent decades, the prevalence of NET gradually increases, attributing partially to the utilization of advanced detection procedures using modern methodologies. Objective The aim of this research was to assess the profile of neuroendocrine tumors of 5 years experiences in our hospital. Methods In this retrospective cross-sectional study, a thorough examination was performed on a total of 71 cases obtained from archives of the Department of Anatomic Pathology Mohammad Hoesin Hospital, over the period from 2017 to 2021. The Chi-square test was used for data analysis. Bivariate analysis was performed using binary logistic regression tests to investigate the correlation between the independent variables, including gender and tumor site, and the dependent variables. Result and Discussion Out of the 71 recorded samples, 69 samples were subjected to be analyzed while the remaining samples were excluded due to have incomplete data. Four different antibodies were evaluated to find the association between these antibodies and tumor with location (chromogranin, P=0.792; synaptophysin, P=0.100; Ki-67, P=0.026; CD56, P=0.511) and gender (chromogranin, P=0.627; synaptophysin, P=0.929; Ki-67, P=0.315; CD56, P=0.524). Conclusion: The study showed synaptophysin has the highest positive rate on NET diagnosis. There is no association was found between chromogranin, synaptophysin, and CD56 staining to tumor location, except for Ki-67. Similarly, no association was found between staining performance (chromogranin, synaptophysin, Ki-67, CD56) with gender.

Review

The study presents a retrospective analysis of the immunohistochemistry (IHC) profiles of neuroendocrine tumors (NETs) over a five-year period at a tertiary referral hospital in Palembang. Investigating 71 cases, this research aims to characterize the local experience with NET diagnosis, a topic of growing importance given the increasing prevalence of these uncommon neoplasms. The utilization of a regional tertiary center's archives provides valuable insights into the diagnostic landscape and challenges within that specific healthcare setting, contributing to the understanding of NET epidemiology and diagnostic practices in Indonesia. While the premise of the study is commendable, the abstract raises several methodological and reporting concerns that warrant clarification in the full manuscript. The presentation of results, particularly regarding the statistical associations, is ambiguous. The abstract states associations between "antibodies" and tumor location/gender, but the provided p-values appear to relate to the association of *each antibody's positivity* with these variables, not a collective association. For instance, stating "chromogranin, P=0.792" for association with tumor location implies testing whether chromogranin positivity is associated with tumor location. Furthermore, the conclusion that "synaptophysin has the highest positive rate on NET diagnosis" is stated without presenting the actual positive rates for comparison, which is crucial for substantiating this claim. Only Ki-67 showed a significant association with tumor location (P=0.026), but the nature of this association (e.g., which specific locations, higher/lower Ki-67 expression) is not detailed. The absence of specific positive rates for each marker and clearer interpretation of the p-values diminishes the impact of these findings in the abstract. Despite these limitations in the abstract's presentation, the study offers an important baseline of NET diagnosis using IHC at a regional hospital. For a complete manuscript, it would be crucial to clearly delineate the positive rates for each of the four antibodies (chromogranin, synaptophysin, Ki-67, CD56) across the NET cohort. A more detailed explanation of the statistical methodology and a thorough interpretation of the significant association found for Ki-67 with tumor location would also significantly enhance the paper's scientific rigor. Providing specific details on tumor locations and their corresponding Ki-67 positivity patterns would add substantial value. This dataset, once fully elaborated, has the potential to guide local diagnostic strategies and contribute to broader discussions on NET characteristics in the region.

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