The Unique Importance of Differentiation and Function in Endocrine Neoplasia.

Sylvia L Asa, Silvia Uccella, Arthur Tischler

Journal: Endocrine pathology 2023;34(4):382-392

PMID: 37043101

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.

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Address: Department of Pathology, University Hospitals Cleveland, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44106, USA. [email protected].; Unit of Pathology, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.; Department of Pathology, Humanitas Research Hospital, Rozzano, Milan, Italy.; Department of Pathology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, 02111, USA.

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