Atypical carcinoid (AC) is a rare neuroendocrine neoplasm of the lung, which exhibits a varying malignant potential. In this study, we aimed to identify the prognostic thresholds of the mitotic count and Ki-67 labeling index for recurrence and survival in AC. We retrospectively reviewed 78 patients who had been radically resected for AC and calculated said thresholds using time-dependent receiver operating characteristic curves and the Youden index. We then dichotomized the patients into groups of above or below these thresholds and estimated the cumulative incidences of the groups using the Aalen–Johansen estimator. We compared the groups using univariable and multivariable Fine–Gray subdistribution hazard models. Our findings show that more patients recurred and died from this disease if their mitotic count exceeded three and four mitoses per 2 mm2, respectively, or if their Ki-67 labeling index exceeded 14% and 11%, respectively. Both thresholds independently predicted survival (p< 0.001 andp= 0.015, respectively). These thresholds may serve as a valuable tool for clinicians and researchers in making treatment plans and predicting outcomes for patients with AC.
非典型类癌是一种罕见的肺部神经内分泌肿瘤，其恶性潜能存在差异。本研究旨在确定有丝分裂计数和Ki-67标记指数对非典型类癌复发与生存的预后阈值。我们回顾性分析了78例接受根治性切除术的非典型类癌患者，采用时间依赖性受试者工作特征曲线和约登指数计算上述阈值。随后将患者按阈值进行分组，并运用艾伦-约翰森估计量评估各组的累积发病率。通过单变量与多变量Fine-Gray亚分布风险模型进行组间比较。研究结果显示，当有丝分裂计数分别超过3个/2mm²和4个/2mm²，或Ki-67标记指数分别超过14%和11%时，更多患者出现疾病复发并因此死亡。这两个阈值均能独立预测生存结局（p<0.001和p=0.015）。这些阈值可为临床医生和研究人员制定治疗方案及预测非典型类癌患者预后提供重要参考依据。
肿瘤(癌症)患者之家