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Y. Xu
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P3.02 - Biology/Pathology (ID 620)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Biology/Pathology
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.02-097d - Pulmonary LCNEC Might Be Aggregated With SCC On the Basis of Different Clinical Features, Overall Survival, and Pathogenesis (ID 8916)
09:30 - 09:30 | Author(s): Y. Xu
- Abstract
Background:
According to the 2015 World Health Organization classification of lung tumors, neuroendocrine tumors can be subdivided into typical carcinoid (TC), atypical carcinoid (ATC), large cell neuroendocrine carcinoma (LCNEC) and small cell carcinoma(SCC). LCNEC was previously categorized into non-small cell lung carcinoma (NSCLC) and received chemotherapy similar to NSCLC in advanced stage. To clarify the clinical and immune profile of the LCNEC, we retrospectively compared the resected carcinoid, LCNEC and SCC.
Method:
125 cases of primary pulmonary neuroendocrine tumors were included and subdivided into TC (10), ATC (15), LCNEC (62) and SCC (38) according to the 2015 World Health Organization guidelines. LCNECs were separated from atypical carcinoids according to modified criteria using the morphology and mitotic count. Clinical information and survival data were obtained, and immunohistochemical studies for p53, SSTR2A, SSTR5 and PTEN were conducted.
Result:
According to clinical features, compared with atypical carcinoid patients, the LCNEC patients were older (mean age, 60.1 vs. 48.5 y, P = 0.005), and more commonly in advanced stage (stages III and IV 32.3% vs. 16.0%, P=0.125). In survival analysis, 78 patients were enrolled and the 5-year survival rates for the carcinoids, LCNECs, and SCCs were 70.0%, 55.5%, and 25.0%, respectively (P=0.016). According to immunohistochemical results, p53 expression was significantly higher in LCNECs than that in carcinoids (p53, 67.7% vs. 32.0%, P = 0.002). Conversely, both SSTR2A, SSTR5 expression scores and PTEN immunoreactivity levels were lower in LCNEC than those in carcinoids (SSTR2A, 37.1% vs. 60.0%, P = 0.051. SSTR5, 8.1% vs. 28.0%, P = 0.034. PTEN, 48.4% vs. 84.0%, P = 0.002.). However, no significant difference was found in the comparison between LCNECs and SCCs (p53, 67.7% vs. 73.7%, P = 0.529. SSTR2A, 37.1% vs. 31.6%, P = 0.574. SSTR5, 8.1% vs. 0%, P = 0.153. PTEN, 48.4% vs. 42.1%, P = 0.541).
Conclusion:
In the aspect of clinical features, survival and immunoprofile, LCNEC showed more similarity with SCC rather than ATC, which indicated that it might be treated according to SCC procedure. The new classification may provide better risk stratification and useful information for proper treatment. The mTOR inhibitors and somatostatin receptors analogues might be potential novel therapy for primary pulmonary neuroendocrine tumors.
