Ileal neuroendocrine tumors: clinicopathological features and associations with systemic inflammatory and nutritional markers.

BACKGROUND: Ileal neuroendocrine tumors (NETs) are well-differentiated neoplasms with relatively indolent histological features but an often aggressive biological behavior, characterized by early lymphatic and hematogenous dissemination. Increasing evidence suggests that systemic inflammatory and nutritional status may influence tumor progression; however, data regarding these parameters in ileal NETs remain limited. PATIENTS, MATERIALS AND METHODS: A retrospective observational study was conducted on 12 consecutive patients with histologically confirmed ileal NETs who underwent surgical treatment between 2018 and 2024. Clinicopathological, morphological, immunohistochemical, and laboratory data were analyzed. Systemic inflammatory and nutritional indices, including neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index, lymphocyte-to-monocyte ratio, and prognostic nutritional index, were calculated from preoperative blood tests and evaluated in relation to metastatic status. RESULTS: The cohort comprised predominantly well-differentiated NETs classified as NET G1-G2. Most tumors showed deep wall infiltration and a high prevalence of regional lymph node and distant metastases at diagnosis. Patients with metastatic disease were significantly younger and had lower hemoglobin levels. Higher values of inflammatory indices and lower nutritional markers were consistently observed in the metastatic group, although these differences did not reach statistical significance. CONCLUSIONS: Ileal NETs exhibit a distinct biological behavior in which well-differentiated morphology frequently coexists with advanced disease. Systemic inflammatory and nutritional indices may reflect tumor burden and metastatic potential and could complement histopathological evaluation in the clinical assessment of ileal NETs. Larger prospective studies are warranted to clarify their prognostic value.