Available online 28 June 2023, 101795

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Histopathological classifications of neuroendocrine neoplasms (NEN) change regularly and the latest WHO classification published in 2022, which concerns all NEN in the body, attempts to standardize classifications in the different locations. Differentiation and proliferation mainly assessed by Ki-67 index are still the cornerstone of those classifications. However, many markers are now used for diagnostic (to check neuroendocrine differentiation, to identify the site of origin of a metastasis, to help separating high-grade neuroendocrine tumors/NET and neuroendocrine carcinoma/NEC), prognostic or theranostic purposes. NENs are often heterogeneous and this can lead to difficulties in classifications, biomarker and prognostic assessment. These different points are discussed successively in this review, insisting especially on the frequent digestive, gastro-entero-pancreatic (GEP) localizations.

Section snippetsINTRODUCTION

The classifications of digestive neuroendocrine tumors play a major role in the management of patients. They have evolved recently and this sometimes makes it difficult for clinicians to understand them.

Moreover, “classic” histological analysis alone is increasingly associated with the search for tissue biomarkers, whose diagnostic, prognostic and especially theranostic usefulness is very promising. It is still the beginning of the use of these markers, often restricted to a few specialized

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