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Grades of NETs

Your doctor might classify your NET as a grade according to the World Health Organization (WHO) grading system. Grading describes how tumour cells look under a microscope. It shows how abnormal the cells are and can give an idea of how quickly the tumour may develop. The grade is determined by both the mitotic count and Ki-67, which are markers of how fast the tumour cells grow and divide. 

Grade Table NCNZ.png

Identifying the grade of your NET helps you and your doctor create an appropriate treatment plan.

  • Grade 1 (low-grade tumor): These cells divide at a low rate and therefore grow slowly.

  • Grade 2 (intermediate-grade tumor): These cells divide at an intermediate rate.

  • Grade 3 (high-grade tumor): These cells divide at a fast rate and therefore grow quickly.

NETs are also usually divided into three groups:

  • Well differentiated – the cells look like normal cells and are usually slow-growing.

  • Moderately differentiated – the cells look more abnormal.

  • Poorly differentiated – the cells look very abnormal. They are likely to grow more quickly and spread.

How are grades different to stages? 


The grade focuses on how the tumour cells look under a microscope, as well as how they’re dividing and at what rate. 

The stage of a NET describes its size and whether it has spread beyond its original site.

Your NET may fall under one of these stages:

  • Localised: Be contained in a particular area of the body 

  • Regional: Have spread to nearby tissues or lymph nodes

  • Metastatic: Have spread throughout the body

Both grades and stages tell your care team more about your NET cancer and which treatment may be most effective. 

Newly Diagnosed?

Receiving the news that you have NET cancer can be worrying and overwhelming. Often reaching out to others who are going through, or have been through similar situations can be comforting. Neuroendocrine Cancer NZ has a community of Unicorns who are supportive and often happy to connect over a phone call, email or even coffee. Check out the various ways you can engage with others in our NZ NET Cancer community, or contact one of our NET Information Managers if you have a specific enquiry. 

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