Overall survival of group PHNENs was significantly shorter than that of group PanNENs.[25] Chen et al[32] found that pathological classification of grade 3, high expression of Ki–67 positive index (PI), abnormal elevation of CA125, abnormalities of ALT and AST, anemia and lack of radical operation indicated a poor prognosis. This evidence concerns the gene MKI67 and anemia (phenotype).