Bronchopulmonary carcinoids 2012-2022 Manchester University NHS Foundation Trust, United Kingdom

Retrospective analysis of surgically resected lung carcinoids to examine the significance of pathological and radiological variables in preoperative diagnosis. Particular focus was on Antigen Kiel 67 (Ki-67) proliferation index. Exploratory analyses was performed to study pre- and post-operative concordance of carcinoid histology, clinical and pathological staging, and post treatment outcomes of recurrence and survival. We found that high Ki-67 has reasonable accuracy (77.8%) in suggesting the final diagnosis of atypical carcinoid and is significantly associated with disease recurrence. Fluorodeoxyglucose-18 SUV (with cut-off of 5.0) showed modest sensitivity and specificity to distinguish typical and atypical subtype. Typical carcinoid showed better pre and post operative concordance than atypical carcinoids. More research is needed to identify atypical carcinoids more accurately. This study suggests that Ki-67 index should be calculated on all diagnostic samples before treatment of lung carcinoids, and may be incorporated as an essential criterion in lung carcinoid classification.

本研究为针对手术切除肺类癌的回顾性分析，旨在探讨病理学与影像学变量在术前诊断中的价值，重点关注Ki-67增殖指数（Antigen Kiel 67，Ki-67）。本研究开展探索性分析，以明确类癌组织学、临床与病理分期的术前术后一致性，以及治疗后复发与生存结局。研究结果显示，高Ki-67指数对非典型类癌的最终诊断具有中等合理的准确率（77.8%），且与疾病复发显著相关。18F-氟脱氧葡萄糖标准化摄取值（Fluorodeoxyglucose-18 SUV，截断值为5.0）在区分典型与非典型亚型时仅表现出中等灵敏度与特异度。典型类癌的术前术后一致性优于非典型类癌。未来仍需开展更多研究以实现非典型类癌的精准鉴别。本研究提示，在肺类癌患者接受治疗前，应针对所有诊断样本计算Ki-67指数，并可将其纳入肺类癌分类的核心标准。