Correlation between insulin receptor expression and tumor cell proliferation, recurrence and metastasis in well-differentiated pancreatic neuroendocrine neoplasms.

ObjectiveTo investigate the correlation between insulin receptor (IR) expression and patients' preoperative blood glucose level, and to analyze the correlation between IR expression level (IR percentage) and well-differentiated pancreatic neuroendocrine neoplasms (pNENs) cell proliferation and recurrence, and to explore whether it can be used as a potential biomarker for predicting tumor recurrence and metastasis.MethodsA retrospective evaluation of the clinical data of 81 patients with well-differentiated pNENs who underwent surgical treatment at five different centers between January 2015 and September 2024 was performed. A subset of patients' pathological sections was collected for analysis.ResultsMultivariate linear regression analysis revealed that blood glucose (P = 0.024) was the only risk factor for increased Ki-67 expression. Preoperative blood glucose was significantly associated with IR percentage (P = 0.001). There was a significant positive correlation between Ki-67 and IR percentage in patients with G1-2 pNENs (P = 0.003). Cox regression analysis showed that IR percentage >12.5% was a good predictor of tumor recurrence (HR = 9.12, P = 0.004).ConclusionsIn patients with G1-2 pNENs, IR percentage could effectively predict tumor recurrence and metastasis, indicating that it can be used as a potential biomarker to predict pNEN recurrence and metastasis.