Head-to-head: Should Ki67 proliferation index be included in the formal classification of pulmonary neuroendocrine neoplasms? Review
| Authors: | Pelosi, G.; Travis, W. D. |
| Review Title: | Head-to-head: Should Ki67 proliferation index be included in the formal classification of pulmonary neuroendocrine neoplasms? |
| Abstract: | The reporting of lung neuroendocrine neoplasms (NENs) according to the 2021 World Health Organisation (WHO) is based on mitotic count per 2 mm2, necrosis assessment and a constellation of cytological and immunohistochemical details. Accordingly, typical carcinoid and atypical carcinoid are low- to intermediate-grade neuroendocrine tumours (NETs), while large-cell neuroendocrine carcinoma (NEC) and small-cell lung carcinoma are high-grade NECs. In small-sized diagnostic material (cytology and biopsy), the noncommittal term of carcinoid tumour/NET not otherwise specified (NOS) and metastatic carcinoid NOS have been introduced with regard to primary and metastatic diagnostic settings, respectively. Ki-67 antigen, a well-known marker of cell proliferation, has been included in the WHO classification as a non-essential but desirable criterion, especially to distinguish NETs from high-grade NECs and to delineate the provisional category of carcinoid tumours/NETs with elevated mitotic counts (> 10 mitoses per mm2) and/or Ki-67 proliferation index (≥ 30%). However, a wider use of this marker in the spectrum of lung NENs continues to be highly reported and debated, thus witnessing a never-subsided attention. Therefore, the arguments for and against incorporating Ki-67 in the classification and clinical practice of these neoplasms are discussed herein in detail. © 2024 The Authors. Histopathology published by John Wiley & Sons Ltd. |
| Keywords: | cancer surgery; histopathology; review; clinical practice; ki 67 antigen; cell proliferation; mitosis; ki-67 antigen; metabolism; metastasis; classification; tumor volume; lung neoplasms; tumor differentiation; tumor biopsy; pathology; tumor marker; neuroendocrine tumor; lung tumor; ki-67; diagnosis; lung; cell count; carcinoid; world health organization; cancer tissue; lung biopsy; tumor classification; carcinoid tumor; tumor diagnosis; predictive value; oncogenesis and malignant transformation; genetic heterogeneity; neuroendocrine tumors; neuroendocrine carcinoma; small cell lung cancer; large cell neuroendocrine carcinoma; meta analysis (topic); tumor necrosis; mitosis index; mitotic index; neuroendocrine tumour; grading; mitotic count; cancer prognosis; proliferation index; historical research; mitoses; limit of quantitation; intratumor heterogeneity; humans; prognosis; human; cell cycle parameters; biomarkers, tumor; pulmonary carcinoid |
| Journal Title: | Histopathology |
| Volume: | 85 |
| Issue: | 4 |
| ISSN: | 0309-0167 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2024-10-01 |
| Start Page: | 535 |
| End Page: | 548 |
| Language: | English |
| DOI: | 10.1111/his.15206 |
| PUBMED: | 38728050 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF -- Source: Scopus |
