ArticleVirchows Archiv : an international journal of pathology2017
Distinctive pathological and clinical features of lung carcinoids with high proliferation index.
Article in Virchows Archiv : an international journal of pathology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 2 of them syntheses that pooled it.
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Who cites it
40 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Utility of KI-67 as a prognostic biomarker in pulmonary neuroendocrine neoplasms: a systematic review and meta-analysis.BMJ open · 2022Pooled it
- The use of Ki-67 labeling index to grade pulmonary well-differentiated neuroendocrine neoplasms: current best evidence.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2018Pooled it
- Noninvasive Method for Predicting the Expression of Ki67 and Prognosis in Non-Small-Cell Lung Cancer Patients: Radiomics.Journal of healthcare engineering · 2022Trial
- Article
- Well-Differentiated Neuroendocrine Tumors of Lung: A Case Series Supporting the IARC/WHO Common Classification of Neuroendocrine Tumor Nomenclature and Grading.Endocrine pathology · 2026Article
- Neuroendocrine neoplasms of the lung: The latest updates.World journal of clinical oncology · 2025Review
- Diagnostic relevance of p53 and Rb status in neuroendocrine tumors G3 from different organs: an immunohistochemical study of 465 high-grade neuroendocrine neoplasms.Virchows Archiv : an international journal of pathology · 2025Article
- Narrative review: this or that?-uncommon challenges in mediastinal pathology.Mediastinum (Hong Kong, China) · 2025Review
- Molecular Classification of Gastrointestinal and Pancreatic Neuroendocrine Neoplasms: Are We Ready for That?Endocrine pathology · 2024Review
- Article
- Prognostic Thresholds of Mitotic Count and Ki-67 Labeling Index for Recurrence and Survival in Lung Atypical Carcinoids.Cancers · 2024Article
- Neuroendocrine neoplasms of the thymus.Frontiers in immunology · 2024Review
- Diagnostic, Prognostic, and Predictive Role of Ki67 Proliferative Index in Neuroendocrine and Endocrine Neoplasms: Past, Present, and Future.Endocrine pathology · 2023Review
- The Complex Histopathological and Immunohistochemical Spectrum of Neuroendocrine Tumors-An Overview of the Latest Classifications.International journal of molecular sciences · 2023Review
- A semi-automated microscopic image analysis method for scoring Ki-67 nuclear immunostaining.Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologica · 2023Review
- Lung carcinoid tumours: histology and Ki-67, the eternal rivalry.Histopathology · 2023Article
- Review
- Article
- Article
- Overview of the 2022 WHO Classification of Neuroendocrine Neoplasms.Endocrine pathology · 2022Review
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9 authors.
Funding
Abstract
Typical (TCs) and atypical carcinoids (ACs) are defined based on morphological criteria, and no grading system is currently accepted to further stratify these entities. The 2015 WHO classification restricts the Ki-67 role to biopsy or cytology samples, rather than for prognostic prediction. We aimed to investigate whether values and patterns of Ki-67 alone would allow for a clinically meaningful stratification of lung carcinoids, regardless of histological typing. Ki-67 proliferation index and pattern (homogeneous versus heterogeneous expression) were assessed in a cohort of 171 TCs and 68 ACs. Cases were subdivided into three Ki-67 ranges (<4/4-9/≥10%). Correlations with clinicopathological data, univariate and multivariate survival analyses were performed. The majority of cases (61.5%) belonged to the <4% Ki-67 range; 25.1 and 13.4% had a proliferation index of 4-9% and ≥10%, respectively. The <4% Ki-67 subgroup was significantly enriched for TCs (83%, p < 0.0001); ACs were more frequent in the subgroup showing Ki-67 ≥ 10% (75%, p < 0.0001). A heterogeneous Ki-67 pattern was preferentially seen in carcinoids with a Ki-67 ≥10% (38%, p < 0.02). Mean Ki-67 values ≥4 and ≥10% identified categories of poor prognosis both in terms of disease-free and overall survival (p = 0.003 and <0.0001). At multivariate analysis, the two thresholds did not retain statistical significance; however, a Ki-67 ≥ 10% identified a subgroup of dismal prognosis even within ACs (p = 0.03) at univariate analysis. Here, we describe a subgroup of lung carcinoids showing brisk proliferation activity within the necrosis and/or mitotic count-based categories. These patients were associated with specific clinicopathological characteristics, to some extent regardless of histological subtyping.
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