Histomorphometric evaluation of the Ki-67 proliferation rate and CD34 microvascular and D2-40 lymphovascular densities drives the pulmonary typical carcinoid outcome

Autor(es):Mostrar menos -

de Vilhena, Alyne Fonseca ^[1] ; das Neves Pereira, Joao Carlos ^[1] ; Parra, Edwin Roger ^[2] ; Balancin, Marcelo Luiz ^[3] ; Ab'Saber, Alexandre ^[3] ; Martins, Vanessa ^[3] ; Farhat, Cecilia ^[3] ; Abrantes, Marcelo Militao ^[1] ; Milanez de Campos, Jose Ribas ^[1] ; Tedde, Miguel Lia ^[1] ; Takagaki, Teresa ^[4] ; Capelozzi, Vera Luiza ^[3]

Afiliação do(s) autor(es)

^[1] Heart Inst Incor, Dept Thorac Surg, BR-05403000 Sao Paulo - Brazil

^[2] Univ Texas MD Anderson Canc Ctr, Dept Translat Mol Pathol, Houston, TX 77030 - USA

^[3] Univ Sao Paulo, Dept Pathol, Lab Genom & Histomorphometry, Sch Med, BR-01246903 Sao Paulo - Brazil

^[4] Univ Sao Paulo, Div Pneumol, Heart Inst Incor, Fac Med, BR-05403000 Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: HUMAN PATHOLOGY; v. 81, p. 201-210, NOV 2018.
• Citações Web of Science: 2

Resumo

Ki-67 has shown promise as a prognostic factor in pulmonary carcinoids. In this study, we sought to validate the importance of Ki-67 and study the relationships between Ki-67 and other stromal biomarkers of vascular density. We examined Ki-67, CD34, and D2-40 in tumor tissues from 128 patients with surgically excised typical carcinoid of the lung. We used immunohistochemistry and morphometry to evaluate the amount of tumor staining for cellular proliferation (Ki-67), microvascular density (CD34-MVD), and D2-40 lymphovascular density. The main outcome was overall survival, considered as life expectancy until death from metastasis. Specimens from patients with central tumors showed high CD34-MVD (P = .01), which was also significantly associated with a compromised surgical margin, lymph node metastasis, and clinical stage Ib. Equally significant was high D2-40 lymphovascular density in central specimens with a compromised surgical margin and lymph node metastasis. A high Ki-67 proliferation rate was significantly associated with tumors from patients with clinical stage IIb, IIIa, and IV disease. Multivariate Cox model analysis demonstrated that tumor location and stage, surgical margin, tumor size, and N stage were significantly related to survival time (P < .05). Quantitative staining of the tumor for Ki-67 and CD34-MVD served as prognostic factors (P < .05), which were more relevant than the surgical and pathological stage. Ki-67 greater than 5% and CD34-MVD greater than 7% staining comprise a subset of patients with higher death hazard; this outcome may harbor evidence for further prospective studies of target therapy after surgical resection. (C) 2018 Elsevier Inc. All rights reserved. (AU)

• Processo FAPESP: 13/14277-4 - Prognóstico e evolução clínica de novos e vigentes biomarcadores genéticos e protéicos em câncer de pulmão
• Beneficiário: Vera Luiza Capelozzi
• Modalidade de apoio: Auxílio à Pesquisa - Regular