Abstract:
Objective We aimed to explore the clinical features, computed tomography (CT) findings, treatment, and prognosis of bronchopulmonary carcinoid.
Methods Clinical data of 31 patients with primary carcinoid tumor of the lung were retrospectively reviewed. The prognostic factors were analyzed via Cox univariate and multivariate analyses.
Results Clinical symptoms included coughing or expectoration in 17 of the 31 cases, hemoptysis or blood-stained sputum in 7 cases, and chest pains or shortness of breath in 8 cases. Six cases were asymptomatic. The CT scans showed round or oval nodules with clear boundaries, and enhancement CT scans indicated mild, homogeneous enhancement. Immunohistochemistry results revealed the positive expression rates of synaptophysin (Syn), chromogranin A (CgA), and neuron-specific enolase (NSE) were 90.3% (28/31), 87.1% (27/31), and 90.3% (28/31), respectively. Therapy and prognosis results were as follows: 28 of the total number of patients underwent surgery, among which 3 underwent postoperative adjuvant therapy, 2 received chemotherapy; and only 1 refused treatment. The 1-year overall survival rates were 100% (18/18) and 92.3% (12/13), whereas the 3-year survival rates were 94.4% (17/18) and 69.2% (9/13) in the typical and atypical carcinoid cases, respectively. Cox univariate analysis results revealed that lymphatic metastasis (P=0.02), tissue types (P=0.017), TNM stage (P= 0.005), and therapies (P=0.01) were the prognostic factors. Cox multivariate analysis results showed that lymphatic metastasis (P= 0.032) and tissue types (P=0.002) were the independent prognostic factors.
Conclusions Compared with other lung cancers, the bronchopulmonary lung carcinoid has no special clinical manifestation in clinical and radiographic images. The diagnosis was mainly based on histopathology results. Surgery was the main and effective treatment, whereas chemotherapy and radiotherapy showed unsatisfactory results. The overall prognosis was satisfactory. However, the atypical carcinoid was inferior to the typical carcinoid in terms of prognosis. Pathological typing and lymph node metastasis were significant prognostic factors.