ACTH-producing tumorlets and carcinoids of the lung: clinico-pathologic study of 63 cases and review of the literature.

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Serval ID
serval:BIB_73364EEDBA89
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
ACTH-producing tumorlets and carcinoids of the lung: clinico-pathologic study of 63 cases and review of the literature.
Journal
Virchows Archiv
Author(s)
La Rosa S., Volante M., Uccella S., Maragliano R., Rapa I., Rotolo N., Inzani F., Siciliani A., Granone P., Rindi G., Dominioni L., Capella C., Papotti M., Sessa F., Imperatori A.
ISSN
1432-2307 (Electronic)
ISSN-L
0945-6317
Publication state
Published
Issued date
11/2019
Peer-reviewed
Oui
Volume
475
Number
5
Pages
587-597
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
Adrenocorticotropic hormone (ACTH)-secreting lung carcinoids represent the principal cause of ectopic Cushing syndrome, but the prevalence of ACTH expression and the association between ACTH production and Cushing syndrome in lung carcinoids have scarcely been investigated. In addition, available information on the prognostic meaning of ACTH production is controversial. The aims of this multicentric retrospective study, also including a review of the literature, were to describe the clinico-pathologic features of ACTH-producing lung carcinoids, to assess recurrence and specific survival rates, and to evaluate potential prognostic factors. To identify ACTH production in 254 unselected and radically resected lung carcinoids, we used a double approach including RT-PCR (mRNA encoding for pro-opiomelanocortin) and immunohistochemistry (antibodies against ACTH and β-endorphin). Sixty-three (24.8%) tumors produced ACTH and 11 of them (17.4%), representing 4.3% of the whole series, were associated with Cushing syndrome. The median follow-up time was 71 months. The 10-year overall and specific survival rates were 88.5% and 98.2%, respectively, with difference neither between functioning and nonfunctioning tumors nor between ACTH-positive and ACTH-negative carcinoids. At univariate analysis, histological type (typical or atypical) and Ki67 index significantly correlated with tumor recurrence. The literature review identified 172 previously reported patients with functioning ACTH-secreting lung carcinoids, and the meta-analysis of survival showed that 92% of them were alive after a mean follow-up time of 50 months. Our results demonstrate that ACTH-producing lung carcinoids are not rare, are not always associated with Cushing syndrome, and do not represent an aggressive variant of lung carcinoid.
Keywords
Adrenocorticotropic Hormone/metabolism, Adult, Aged, Carcinoid Tumor/metabolism, Carcinoid Tumor/pathology, Cushing Syndrome/metabolism, Cushing Syndrome/pathology, Female, Humans, Lung/metabolism, Lung/pathology, Lung Neoplasms/metabolism, Lung Neoplasms/pathology, Male, Middle Aged, Neoplasm Recurrence, Local, Prognosis, Retrospective Studies, Survival Rate, ACTH, Adrenocorticotropic hormone-producing lung carcinoid, Cushing syndrome, Ki67 index, Prognostic factors
Pubmed
Web of science
Create date
18/07/2019 16:17
Last modification date
05/01/2020 6:18
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