1. Ki-67 Evaluation for Clinical Decision in Metastatic Lung Carcinoids: A Proof of Concept.
- Author
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Pelosi, Giuseppe, Massa, Federica, Gatti, Gaia, Righi, Luisella, Volante, Marco, Birocco, Nadia, Maisonneuve, Patrick, Sonzogni, Angelica, Harari, Sergio, Albini, Adriana, and Papotti, Mauro
- Subjects
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PLATINUM , *CANCER chemotherapy , *CARCINOID , *LUNG tumors , *METASTASIS , *NECROSIS , *SOMATOSTATIN , *STAINS & staining (Microscopy) , *SURVIVAL , *TUMOR markers , *TUMOR classification , *DECISION making in clinical medicine , *THERAPEUTICS - Abstract
Accrual of metastatic pulmonary carcinoid patients for therapy is usually relied on clinical and histologic characterization, with no role for the proliferation activity as defined by Ki-67 labelling index (LI). A total of 14 carcinoid patients with tumour primaries (TP) and 19 corresponding tumour metastases (TM) were blindly reviewed by 2 different pathologists for necrosis, mitotic count, and Ki-67 LI. Ki-67 LI outperformed histologic subtyping, mitotic count, and necrosis with good to almost excellent (0.40-0.75) inter-observer agreement. About 10% cut-off Ki-67 LI predicted survival better than histology for TP and TM for both observers. The TM patients survived differently according to diverse treatments (somatostatin analogues [SSAs], analogues plus additional treatments except for platinum; platinum-based chemotherapy) in close correlation with <10%, 10% to 20%, and >20% cut-off thresholds of Ki-67 LI, respectively. There was also a trend for an increase in Ki-67 LI in TM as compared with TP. This is the first proof of concept in which a clinical potential is preliminarily suggested for Ki-67 LI to better stratify pulmonary metastatic carcinoid patients for treatment according to a criterion of histology-independent biological aggressiveness. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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