支气管肺类癌临床和病理学特点的回顾性研究

BACKGROUND AND OBJECTIVE: Bronchopulmonary carcinoid (BPC) account for less than 2% of all primary lung malignant tumors, but few related studies were reported. The aim of this study is to analyze this rare disease's clinicopathological characteristics. METHODS: The clinical data of 28 patients with BPC in Cancer Center of Sun Yat-sen University, from January 1994 to June 2009, were enrolled into retrospective analysis. First, the corresponding paraffin blocks reexamined, slice up and stained, multiple pathologists re-consulted, and its subsets (typical carcinoid, TC; atypical carcinoid, AC) defined. Second, the clinical characteristics and immunohistochemical markers and its relationship with prognosis were analyzed. RESULTS: First, the 5-year survival for overall and TC, AC was 56% and 70%, 41% respectively in 28 cases. The markers CD99, Bcl-2 and Ki-67 expression correlated significantly with the BPC subsets (P=0.017, P=0.043, and P=0.033 respectively). Further univariate analysis revealed that advanced TNM staging (P=0.037), lymph node metastasis (P=0.001) and Ki-67 nucleolus's positive expression (P=0.009) are poor prognostic factors. Second, the overall, TC, AC 5-year survival rate was 73%, 83%, 57% respectively in 20 cases underwent the radically surgical resection. Further univariate analysis revealed that AC subset (P=0.013), lymph node metastasis (P=0.004) and Ki-67 nucleolus's positive expression (P=0.006), advanced TNM staging (P=0.047) are poor prognostic factors in this 20 cases. Third, as univariate analysis, local recurrence and metastasis (n=4) correlate significantly with Ki-67 nucleolus's and Bcl-2 positive expression (P=0.027, 0.045, respectively). CONCLUSION: The prognosis of BPC was better than other types of primary lung cancer. Ki-67, bcl-2 high expression and advanced TNM staging are the poor recurrence and prognostic factors of BPC. The radical surgery remains the treatment of choice for resectable candidates in BPC as NSCLC.