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The Unique Importance of Differentiation and Function in Endocrine Neoplasia

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Abstract

The assessment of cell differentiation in endocrine neoplasms involves not only the identification of a cell’s structure and expression of specific transcription factors which regulate that cell, but also the identification of hormones and/or enzymes involved in hormone synthesis. The importance of this functional characterization is emphasized by the fact that the hormones serve as biomarkers for clinical surveillance to identify persistence, recurrence, or progression of disease. Sometimes, unusual patterns of hormone expression lead to unexpected clinical signs and symptoms. Loss of differentiated hormone production can be a sign of dedifferentiation as a tumor becomes more aggressive. In addition to prognostic information, cell differentiation can be predictive, since differentiated endocrine cells express targets for therapy, such as the sodium iodide symporter in thyroid cancers and somatostatin receptors in neuroendocrine tumors. The salient features of differentiation in the three main types of endocrine cells can be used to determine prognosis and to tailor management of patients with endocrine neoplasms.

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Authors and Affiliations

  1. Department of Pathology, University Hospitals Cleveland, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44106, USA

    Sylvia L. Asa

  2. Unit of Pathology, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy

    Silvia Uccella

  3. Department of Pathology, Humanitas Research Hospital, Rozzano, Milan, Italy

    Silvia Uccella

  4. Department of Pathology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, 02111, USA

    Arthur Tischler

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Conception and design: SLA, SU, and AT; data collection and analysis: SLA, SU, and AT; manuscript preparation and editing: SLA, SU, and AT; approval of final manuscript: SLA, SU, and AT.

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Asa, S.L., Uccella, S. & Tischler, A. The Unique Importance of Differentiation and Function in Endocrine Neoplasia. Endocr Pathol 34, 382–392 (2023). https://doi.org/10.1007/s12022-023-09762-4

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