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

Alyne Fonseca de Vilhena, João Carlos das Neves Pereira, Edwin Roger Parra, Marcelo Luiz Balancin, Alexandre Ab´Saber, Vanessa Martins, Cecilia Farhat, Marcelo Militao Abrantes, Jose Ribas Milanez de Campos, Miguel Lia Tedde, Teresa Takagaki, Vera Luiza Capelozzi

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)201-210
Number of pages10
JournalHuman Pathology
Volume81
DOIs
StatePublished - Nov 2018

Keywords

  • CD34
  • Carcinoid tumors
  • D2-40
  • Ki-67 index
  • Morphometry
  • Survival

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Fingerprint Dive into the research topics of 'Histomorphometric evaluation of the Ki-67 proliferation rate and CD34 microvascular and D2-40 lymphovascular densities drives the pulmonary typical carcinoid outcome'. Together they form a unique fingerprint.

  • Cite this

    de Vilhena, A. F., das Neves Pereira, J. C., Parra, E. R., Balancin, M. L., Ab´Saber, A., Martins, V., Farhat, C., Abrantes, M. M., de Campos, J. R. M., Tedde, M. L., Takagaki, T., & Capelozzi, V. L. (2018). Histomorphometric evaluation of the Ki-67 proliferation rate and CD34 microvascular and D2-40 lymphovascular densities drives the pulmonary typical carcinoid outcome. Human Pathology, 81, 201-210. https://doi.org/10.1016/j.humpath.2018.07.007