Prognostic markers in patients with typical bronchial carcinoid tumors.
Typical bronchial carcinoids are usually considered fairly benign tumors. Metastases do however occur, and up to 10% of the patients ultimately die from their disease. To identify prognostic markers, we immunostained 43 typical bronchial carcinoids with antibodies against 8 possibly relevant hormones, oncogenes, tumor suppressor genes, adhesion molecules, and proliferation markers. Altogether 12 patients (28%) had metastatic disease, of whom 10 had regional lymph node metastases at diagnosis. Distant metastases have occurred in 5 patients (12%); all of these have died from their disease. Patients with high expression of Ki-67 had shorter survival time (P < 0.01). None of the immunostained hormones correlated to distant metastases or shorter survival time, but gastrin-releasing peptide correlated to metastatic disease (P < 0.05). All patients who died had CD44-negative tumors (P < 0.001). Nuclear nm23 staining correlated to decreased risk for metastatic disease and distant metastases per se (P < 0.01). Bcl-2 and p53 were associated with increased risk for distant metastases (P < 0.05 and P < 0.01, respectively). We conclude that some patients with typical bronchial carcinoids die from their disease and that gastrin-releasing peptide, Bcl-2, and p53 may be of importance for the malignant transformation of the tumor. Moreover, CD44, nm23, and Ki-67 may give valuable prognostic information and help identify the patients at risk of disease-related death.
Granberg
D
D
Department of Medicine, University Hospital, Uppsala, Sweden. dan.granberg@medicin.uu.se
Wilander
E
E
Oberg
K
K
Skogseid
B
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D017209:Apoptosis / Q000502:physiology; D014408:Biomarkers, Tumor; D001984:Bronchial Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology; D002276:Carcinoid Tumor / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology; D005260:Female; D016147:Genes, Tumor Suppressor / Q000235:genetics; D006133:Growth Substances / Q000097:blood; D006728:Hormones / Q000097:blood; D006801:Humans; D018960:Hyaluronan Receptors / Q000097:blood; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009857:Oncogenes / Q000235:genetics; D011379:Prognosis; D016019:Survival Analysis
D014408:Biomarkers, Tumor; D006133:Growth Substances; D006728:Hormones; D018960:Hyaluronan Receptors