title: Pulmonary neuroendocrine tumors: study of 90 cases focusing on clinicopathological characteristics, immunophenotype, preoperative biopsy, and frozen section diagnoses.
abstract: OBJECTIVE
  Pulmonary neuroendocrine tumors have a prognostic spectrum including typical carcinoid (TC), atypical carcinoid (AC), small cell carcinoma (SCLC), and large cell neuroendocrine carcinoma (LCNEC). We conducted a retrospective study to compare their clinicopathological characteristics, immunophenotype, preoperative biopsy and frozen section diagnoses, and prognosis.
  
  
  METHODS
  Ninety cases of surgically treated pulmonary neuroendocrine tumors were studied. Immunohistochemical studies were performed using antibodies to chromogranin A, synaptophysin, and CD56. The preoperative biopsy and frozen section diagnoses were reviewed.
  
  
  RESULTS
  The 5-year survival rates for TC, AC, SCLC, and LCNEC were 96.6%, 66.7%, 42.4%, and 38.0%, respectively. T stage and pleural status correlated with outcome of SCLC and LCNEC, but N-stage and overall TNM stage did not. In preoperative biopsy, accurate diagnosis was achieved in 5 of 11 TC, 2 of 4 AC, 6 of 15 SCLC, and 0 of 5 LCNEC cases. Using frozen sections, accurate diagnosis was achieved in 8 of 12 TC, 2 of 11 SCLC, and 0 of 11 LCNEC cases.
  
  
  CONCLUSIONS
  LCNEC was the most difficult to diagnose using either preoperative biopsy or frozen sections. T stage and pleural status can predict outcome of SCLC and LCNEC.
authors.affiliation: Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Yi-Chen
authors.initials: YC
authors.lastname: Yeh
authors.forename: Teh-Ying
authors.initials: TY
authors.lastname: Chou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D001706:Biopsy; D019002:CD56 Antigen / Q000032:analysis; D002276:Carcinoid Tumor / Q000473:pathology; D018287:Carcinoma, Large Cell / Q000473:pathology; D018278:Carcinoma, Neuroendocrine / Q000473:pathology; D018288:Carcinoma, Small Cell / Q000473:pathology; D053379:Chromogranin A / Q000032:analysis; D005260:Female; D005629:Frozen Sections; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018358:Neuroendocrine Tumors / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D016708:Synaptophysin / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; D019002:CD56 Antigen; D053379:Chromogranin A; C522918:NCAM1 protein, human; D016708:Synaptophysin
keywords: frozen section; immunohistochemistry; lung; neuroendocrine; prognosis