According to the number of mitotic figures in the tumor cells and the Ki-67 index, NETs are classified into 3 grades: G1, the number of mitotic figures is <2 and/or the Ki-67 index is <2%; G2, the number of mitotic figures is 2 to 20 and/or the Ki-67 index is 3% to 20%; and G3, the number of mitotic figures is >20 and/or the Ki-67 index is >20%.G1 and G2 tumors are NETs, and G3 tumors are neuroendocrine carcinomas.[10] The preoperative pathology suggested that the tumor was in the G1 phase, so early surgery was required. This evidence concerns the gene MKI67 and neuroendocrine carcinoma.