High MET expression tracked with worse features and survival in pancreatic NETs

Design

Retrospective tissue microarray immunohistochemistry study

Population

112 patients with well-differentiated pancreatic neuroendocrine tumours

Primary outcome

MET H-score and progression-free and overall survival

Effect

H-score ≥200: overall survival mean 3.6 vs 7.7 years (P < 0.05)

This Histopathology study, published on 1 September, stained tissue microarray cores from 112 patients with well-differentiated pancreatic neuroendocrine tumours for MET and scored them by H-score.

MET was expressed in 83.5% of cases. Higher scores went with lymphovascular invasion, distant metastases and higher grade. At an H-score cut-off of 200, high MET was associated with shorter progression-free survival (mean 8.7 vs 13.4 years) and overall survival (mean 3.6 vs 7.7 years).

This is prognostic association in a modest single series using microarray cores, which can under-sample heterogeneous tumours. Its value is in pointing to MET as a candidate for scoring standards if MET-directed drugs reach this tumour.

• MET staining is not a routine prognostic test for pancreatic NETs.
• Keep grading with Ki-67 and mitotic count as the prognostic standard.
• Note that cut-offs differed by outcome (150 vs 200), a sign the scoring is not settled.
• Tissue microarray cores may miss heterogeneity seen on whole sections.

Why it matters

If MET-targeted drugs arrive for these tumours, pathologists will need a scoring standard that does not yet exist.

Don't overread it

The cut-offs were chosen within this dataset and may not reproduce elsewhere.

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