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L. Yan



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    P1.07 - Poster Session with Presenters Present (ID 459)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: SCLC/Neuroendocrine Tumors
    • Presentations: 1
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      P1.07-038 - Typical Morphological Features Revealed Unfavorable Survival Benefits in High-Grade Neuroendocrine Carcinomas (ID 5718)

      14:30 - 14:30  |  Author(s): L. Yan

      • Abstract
      • Slides

      Background:
      The 2015 WHO classification of lung cancer has proposed an revision about high-grade neuroendocrine carcinomas(HGNEC). Neuroendocrine(NE) markers are necessary for differentiations in cases lacing in typically morphological features, but their roles in survival benefits remain unclear.

      Methods:
      A total of 700 consecutive patients diagnosed with pNET were re-diagnosed during 2008 to 2015 and 632 were HGNECs. NE markers, such as Syn(synaptophysin), CgA(chromogranin A) and CD56, were stained by immunohistochemistry(IHC) if morphological features were not enough for diagnoses.

      Results:
      Four were excluded due to clinical identification of transformation from adenocarcinomas to SCLC. Nine HGNECs were previously diagnosed with AC. TTF1 stained 77.4%(459/593) HGNEC patients, of which 50.6% in LCNEC, 80.9% in SCLC and 62.5% in poorly differentiated HGNEC(P<0.001). Syn staining(94.1%, 571/607) were not statistically significant in three groups(89.1% vs. 94.6% vs. 100.0%, respectively; P=0.30). The same situation was in CgA(52.6%, 319/607), with a frequency of positive staining as 46.9%, 53.6% and 25.0%(P=0.26), respectively in three diagnoses. The number of positive NE markers were generally balanced(P=0.62). Cases with zero to three positive NE markers indicated marginal significant differences of overall survival(OS)(P=0.05). Meanwhile, no differences of mOS existed in positive and negative staining of Syn(14.7 vs. 32.53 mons, P=0.14) or CgA(14.6 vs. 15.9 mons, P=0.82); but patients with typical morphological features for diagnose and thus without IHC staining Syn or CgA (mOS, 9.13mons) bore significantly poorest OS benefits than those with positive(Syn, HR=2.71, 95%CI=1.24-5.86, P=0.01; CgA, HR=2.72, 95%CI=1.25-5.92, P=0.01) or negative(Syn, HR=3.44, 95%CI=1.39-8.52, P<0.01; CgA, HR=2.76, 95%CI=1.26-6.05, P=0.01) staining. The same condition occurred especially inⅠto Ⅲa patients(P<0.01). Figure 1



      Conclusion:
      The number of positive NE markers were necessary for precise diagnoses but not significant for survival benefits. Typical morphological features of NE tumor cells were unfavorable factors for OS. Further studies are imperative to identify its crucial role in HGNEC patients.

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