Abstract
OBJECTIVE: To 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. METHODS: A 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. RESULTS: Multivariate 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). CONCLUSIONS: In 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.