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Review Variable Clinical Classifications and Diagnostic Coding Systems of Colorectal Neuroendocrine Tumor
Byung Chang Kim, Cheol Hee Park1, Tae Il Kim2, Suck-Ho Lee3, Jin-Oh Kim4, Hyun Soo Kim5, Dong-Hoon Yang6, Bora Keum7, Sung Pil Hong2, Seong-Eun Kim8, Hyun Gun Kim4, Jeong Eun Shin9, Jae Myung Cha10, Young Eun Joo11, Dong Il Park12, Hwang Choi13, Kyu Chan Huh14, Seung-Jae Myung6, Dong Kyung Chang12, Seun Ja Park15
[Epub ahead of print]
DOI: https://doi.org/10.5217/ir.2013.11.1.14
Published online: January 31, 2013
1National Cancer Center, Goyang, Department of Internal Medicine, Hallym University College of Medicine
10Kyung Hee University School of Medicine0
11Seoul, Chonnam National University Medical School1
12Gwangju, Sungkyunkwan University School of Medicine2
13The Catholic University of Korea College of Medicine3
14Konyang University College of Medicine4
15Daejeon, Kosin University College of Medicine5, Busan, Korea
2Anyang, Yonsei University College of Medicine
3Seoul, Soonchunhyang University College of Medicine
4Cheonan, Soonchunhyang University College of Medicine
5Seoul, Yonsei University, Wonju College of Medicine
6Wonju, University of Ulsan College of Medicine
7Korea University College of Medicine
8Ewha Womans University School of Medicine
9Dankook University College of Medicine
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The incidence of colorectal carcinoid tumor is recently increasing as screening colonoscopy increased. Traditional carcinoid tumor had been known as low grade, malignant neuroendocrine cell orign tumor. In 2000, World Health Organization (WHO) suggested that carcinoid was called well-differentiated neuroendocrine tumor (NET). It recently updated in 2010 by WHO; according to the differentiation and malignant potential, NET classified with NET Grade 1, Grade 2, and neuroendocrine carcinoma. They suggested that NET had malignant potential in accordance with histopathologic characteristics. Therefore, WHO recommended the behavior code of NET as malignant. However, European Neuroendocrine Tumor Society (ENETS) proposed the behavior of NET to four grades based on the histopathologic features; benign, benign or low grade malignant, low grade malignant, and high grade malignant. Also, American Joint Committee on Cancer (AJCC) suggested that topography codes of NET were defined as malignant. Korean Standard Classification of Diseases (KCD) described the different codings of carcinoid (NET). The discrepancies of behavior code or coding system exist among WHO, ENETS, AJCC and KCD. Also, there were differences in the perception for topographic coding system between clinicians and pathologists. NETs of colorectum were reported with the variable clinical characteristics (especially, metastasis) and long term prognosis from many studies. Especially, risk of metastasis and long term prognosis of small sized NET (<1 cm) had some discrepancies and should be investigated prospectively. Therefore, the consensus about topographic codes of NET should be needed with multidisplinary approach among gastroenterologists, pathologists and surgeons. (Intest Res 2013;11:14-22)


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