Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Nantong University, 20 Xi-Si Road, Nantong, 226001, Jiangsu, China.
Nantong University, Nantong, Jiangsu, China.
J Cancer Res Clin Oncol. 2023 Mar;149(3):1063-1077. doi: 10.1007/s00432-022-03970-x. Epub 2022 Mar 6.
Pulmonary neuroendocrine tumors (PNETs) consist of small-cell lung cancer (SCLC), large-cell neuroendocrine carcinoma (LCNEC), typical carcinoid (TC), and atypical carcinoid (AC). We aimed to analyze the immunophenotypic, metastatic, and prognostic risk factors for PNETs.
A total of 266 patients with PNETs were enrolled, including 219 patients with SCLC, 18 patients with LCNEC, 11 patients with TC, and 18 patients with AC. Clinicopathological characteristics and immunophenotypes were compared among the subtypes of PNETs. Risk factors for metastasis, progression-free survival (PFS), and overall survival (OS) were analyzed.
Thyroid transcription factor-1 (TTF-1) and the Ki-67 index were significantly different among subtypes of PNETs (all P < 0.05). Smoking (OR, 2.633; P = 0.031), high pretreatment carcinoembryonic antigen (CEA > 5 ng/ml: OR, 3.084; P = 0.014), and poorly differentiated pathotypes (P = 0.001) were independent risk factors for lymph-node metastasis. Smoking (OR, 2.071; P = 0.027) and high pretreatment CEA (OR, 2.260; P = 0.007) were independent risk factors for distant metastasis. Results of the multivariate Cox regression model showed pretreatment CEA (HR, 1.674; P = 0.008) and lymphocyte-monocyte ratio (LMR) (HR = 0.478, P = 0.007) were significantly associated with PFS; BMI (P = 0.031), lymph-node metastasis (HR = 4.534, P = 0.001), poorly differentiated pathotypes (P = 0.015), platelet-lymphocyte ratio (PLR) (HR = 2.305, P = 0.004), and LMR (HR = 0.524, P = 0.045) were significantly associated with OS.
PNETs are a group of highly heterogeneous tumors with different clinical manifestations, pathological features, and prognoses. Knowing clinicopathological characteristics and immunophenotypes of PNETs is significant for diagnosis. Pretreatment PLR, LMR, and CEA have certain value in the prognosis of PNETs.
肺神经内分泌肿瘤（PNETs）包括小细胞肺癌（SCLC）、大细胞神经内分泌癌（LCNEC）、典型类癌（TC）和非典型类癌（AC）。本研究旨在分析 PNETs 的免疫表型、转移和预后危险因素。
共纳入 266 例 PNETs 患者，包括 219 例 SCLC、18 例 LCNEC、11 例 TC 和 18 例 AC。比较不同 PNETs 亚型的临床病理特征和免疫表型。分析转移、无进展生存期（PFS）和总生存期（OS）的危险因素。
甲状腺转录因子-1（TTF-1）和 Ki-67 指数在不同 PNETs 亚型之间存在显著差异（均 P<0.05）。吸烟（OR，2.633；P=0.031）、高术前癌胚抗原（CEA>5ng/ml：OR，3.084；P=0.014）和低分化组织学类型（P=0.001）是淋巴结转移的独立危险因素。吸烟（OR，2.071；P=0.027）和高术前 CEA（OR，2.260；P=0.007）是远处转移的独立危险因素。多因素 Cox 回归模型结果显示，术前 CEA（HR，1.674；P=0.008）和淋巴细胞-单核细胞比值（LMR）（HR=0.478，P=0.007）与 PFS 显著相关；BMI（P=0.031）、淋巴结转移（HR=4.534，P=0.001）、低分化组织学类型（P=0.015）、血小板-淋巴细胞比值（PLR）（HR=2.305，P=0.004）和 LMR（HR=0.524，P=0.045）与 OS 显著相关。
PNETs 是一组具有不同临床表现、病理特征和预后的高度异质性肿瘤。了解 PNETs 的临床病理特征和免疫表型对诊断具有重要意义。术前 PLR、LMR 和 CEA 对 PNETs 的预后具有一定的价值。
