TY - JOUR
T1 - Typical and Atypical Carcinoid Tumors of the Mediastinum
T2 - A Biomarker Analysis of 27 Cases With Clinical Correlation
AU - Zaleski, Michael
AU - Kalhor, Neda
AU - Moran, Cesar A.
N1 - Publisher Copyright:
© The Author(s) 2020.
PY - 2021/6
Y1 - 2021/6
N2 - Thymic typical and atypical carcinoids are rare and appear to be more aggressive than similar tumors in other sites. We retrospectively analyzed a group of biomarkers that hold therapeutic and prognostic utility, in 27 of these tumors. All cases were immunohistochemically stained with PAX5, MET, CRMP5, paxillin, p21, p27, EZH2, PDL-1, and Ki-67, and then H-scored. Clinicopathologic and survival data were statistically analyzed against staining (χ2 test). Five- and 10-year-survival rates were 53% and 18%, respectively. Mitotic counts ≥4 per 2 mm2 and tumor size ≥5 cm, associated with death of disease (DoD; P =.010 and.016). Ki-67 expression ≥1% associated with DoD (P =.003) and death within 5 years (P =.031). Biomarkers stained tumor cases as follows: PDL-1 = 0%, PAX-5 = 0%, MET = 7.4%, paxillin = 41%, CRMP5 = 78%, p21 = 63%, p27 = 63%, EZH2 = 37%, and MASH1 = 59%. Overall ± staining did not associate with survival or grade. Cases with low CRMP5 H-scores (<80) associated with DoD (P =.002), while CRMP5 H-scores >80 associated with 10-year survival (P =.022). Cases with high MASH1 H-score (>100) associated with DoD (P =.021). Accurate grading and staging remain paramount in predicting clinical outcome. Biomarkers may have significance in subsets of patients and the use of these studies likely should be focused on a more personalize type of approach.
AB - Thymic typical and atypical carcinoids are rare and appear to be more aggressive than similar tumors in other sites. We retrospectively analyzed a group of biomarkers that hold therapeutic and prognostic utility, in 27 of these tumors. All cases were immunohistochemically stained with PAX5, MET, CRMP5, paxillin, p21, p27, EZH2, PDL-1, and Ki-67, and then H-scored. Clinicopathologic and survival data were statistically analyzed against staining (χ2 test). Five- and 10-year-survival rates were 53% and 18%, respectively. Mitotic counts ≥4 per 2 mm2 and tumor size ≥5 cm, associated with death of disease (DoD; P =.010 and.016). Ki-67 expression ≥1% associated with DoD (P =.003) and death within 5 years (P =.031). Biomarkers stained tumor cases as follows: PDL-1 = 0%, PAX-5 = 0%, MET = 7.4%, paxillin = 41%, CRMP5 = 78%, p21 = 63%, p27 = 63%, EZH2 = 37%, and MASH1 = 59%. Overall ± staining did not associate with survival or grade. Cases with low CRMP5 H-scores (<80) associated with DoD (P =.002), while CRMP5 H-scores >80 associated with 10-year survival (P =.022). Cases with high MASH1 H-score (>100) associated with DoD (P =.021). Accurate grading and staging remain paramount in predicting clinical outcome. Biomarkers may have significance in subsets of patients and the use of these studies likely should be focused on a more personalize type of approach.
KW - biomarkers
KW - carcinoid
KW - mediastinum
KW - neuroendocrine
KW - thymus
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U2 - 10.1177/1066896920976845
DO - 10.1177/1066896920976845
M3 - Article
C2 - 33243039
AN - SCOPUS:85096852097
SN - 1066-8969
VL - 29
SP - 358
EP - 367
JO - International Journal of Surgical Pathology
JF - International Journal of Surgical Pathology
IS - 4
ER -