The Unique Importance of Differentiation and Function in Endocrine Neoplasia

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.

Automated summary

The assessment of cell differentiation in endocrine neoplasms involves the identification of cell structure, specific transcription factors, hormones, and enzymes. Differentiation status serves as prognostic and predictive factors for endocrine neoplasms. Hormones can act as biomarkers for clinical surveillance and loss of differentiated hormone production can indicate dedifferentiation and aggressiveness of the tumor. Differentiated endocrine cells express targets for therapy, providing opportunities for targeted treatment.