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Vol. 57, No. 3, 2013
Issue release date: May – June
Section title: Techniques
Acta Cytologica 2013;57:281-290
(DOI:10.1159/000346394)

Utility of the Quantitative Ki-67 Proliferation Index and CD56 Together in the Cytologic Diagnosis of Small Cell Lung Carcinoma and Other Lung Neuroendocrine Tumors

Zheng G. · Ettinger D.S. · Maleki Z.
Departments of aPathology and bOncology, The Johns Hopkins Hospital, Baltimore, Md., USA

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Article / Publication Details

Received: 7/30/2012 9:45:42 AM
Accepted: 12/6/2012
Published online: 4/25/2013

Number of Print Pages: 10
Number of Figures: 3
Number of Tables: 2

ISSN: 0001-5547 (Print)
eISSN: 1938-2650 (Online)

For additional information: http://www.karger.com/ACY

Abstract

Background: Distinction of small cell lung carcinoma (SCLC) from non-small cell lung carcinoma (NSCLC) is critical because of the differences in prognosis and management. Patients with SCLC usually present with distant metastasis, and clinicians demand an accurate diagnosis in order to initiate appropriate therapy. Limited cytology material, occasionally with crush artifact, is not uncommon. Therefore, robust cytomorphologic features and a small immunostaining panel would be ideal to differentiate SCLC from NSCLC and other neuroendocrine neoplasms. We evaluated CD56 and the quantitative Ki-67 immunohistochemical panel in comparison to synaptophysin and chromogranin, along with cytomorphology to diagnose SCLC. Design: Eighty-eight cases of SCLC were retrieved from the cytology archives of The Johns Hopkins Hospital. Forty neuroendocrine neoplasms were used as control cases. Results: SCLCs included 33 lung cases and 55 metastatic lesions. The specimens were obtained by fine needle aspiration, thoracocentesis, bronchoalveolar lavage and abdominal paracentesis. CD56 was expressed in 98.9% of SCLCs, which is significantly more sensitive than synaptophysin and chromogranin. The Ki-67 labeling index was high (>70%) in all cases, which is a reliable marker to differentiate SCLC from other neuroendocrine neoplasms and NSCLC. Conclusion: CD56 and quantitative Ki-67 along with cytomorphology is a robust immunohistochemical panel to differentiate SCLC from other neuroendocrine neoplasms and NSCLC.


Article / Publication Details

Received: 7/30/2012 9:45:42 AM
Accepted: 12/6/2012
Published online: 4/25/2013

Number of Print Pages: 10
Number of Figures: 3
Number of Tables: 2

ISSN: 0001-5547 (Print)
eISSN: 1938-2650 (Online)

For additional information: http://www.karger.com/ACY


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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