High-grade in the WHO 2017 grade, Ki-67 labeling index, mitotic count, tumor size, vascular and lymphatic invasion rates and stage (European Neuroendocrine Tumor Society: ENETS) were significantly higher in the synchronous and metachronous metastasis groups (WHO 2017 grade: p = 0.002; Ki-67: p = 0.003; mitotic count: p = 0.017; tumor size: p = 0.001; vascular invasion: p < 0.001; lymphatic invasion p = 0.002; stage: p < 0.001). This evidence concerns the gene MKI67 and neoplasm.