title: Prognostic value of MIB-1 in neuroendocrine tumours of the lung.
abstract: The spectrum of neuroendocrine lung tumours ranges from highly aggressive small cell carcinomas (SCLC) to carcinoid tumours (CD) of low malignant potential. Between these two extremes, the 'well-differentiated neuroendocrine carcinomas' (WDNEC) form a transitional group with uncertain biological behaviour. This study investigated the prognostic value of the proliferation marker MIB-1 (paraffin Ki-67) in 59 neuroendocrine lung tumours (32 SCLC, 13 WDNEC, 14 CD) by immunostaining of routinely processed paraffin sections. Morphometric evaluation was done by semi-automatic image analysis. The results were compared with survival data (mean follow-up: 42 months). The proliferation rates of the tumours as determined by MIB-1 immunoreactivity (MIB-1-PR) were significantly different between the tumour types (SCLC > WDNEC > CD) and showed a strong inverse correlation with survival time. In CD, the percentage of MIB-1-labelled nuclei never exceeded 1.1 per cent; higher values would therefore favour the diagnosis of WDNEC over that of CD. Among WDNEC, MIB-1 was able to differentiate a subgroup with excellent prognosis (MIB-1-PR: 0.3-3.4 per cent) from another subgroup with a death rate of 50 per cent (MIB-1-PR: 7.3-20.3 per cent). Within each tumour type, all patients without distant metastases at diagnosis survived when MIB-1-PR was < or = 9.4 per cent, suggesting a potential threshold for prognosis. Although the status of metastases are complementary prognostic indicators and are best used in combination to characterize the biological behaviour of neuroendocrine lung tumours.
authors.affiliation: Institute of Pathology, Technical University of Munich, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Böhm
authors.forename: S
authors.initials: S
authors.lastname: Koch
authors.forename: P
authors.initials: P
authors.lastname: Gais
authors.forename: U
authors.initials: U
authors.lastname: Jütting
authors.forename: H W
authors.initials: HW
authors.lastname: Präuer
authors.forename: H
authors.initials: H
authors.lastname: Höfler
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal; D002276:Carcinoid Tumor / Q000473:pathology; D018278:Carcinoma, Neuroendocrine / Q000737:chemistry / Q000473:pathology*; D018288:Carcinoma, Small Cell / Q000473:pathology; D002455:Cell Division; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019394:Ki-67 Antigen; D008175:Lung Neoplasms / Q000737:chemistry / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000032:analysis*; D009687:Nuclear Proteins / Q000032:analysis*; D011379:Prognosis; D015996:Survival Rate
chemical_list: D000911:Antibodies, Monoclonal; D019394:Ki-67 Antigen; D009363:Neoplasm Proteins; D009687:Nuclear Proteins