DNA CYTOPHOTOMETRY AND PROGNOSIS IN TYPICAL AND ATYPICAL BRONCHOPULMONARY CARCINOIDS - A CLINICOMORPHOLOGICAL STUDY OF 100 NEUROENDOCRINE LUNG-TUMORS

Surgical material obtained from 100 patients with typical carcinoids ( TC) and atypical carcinoids (AC) of the lung (including 100 primary, f our residual tumors, and four lymph node or distant metastases) was in vestigated by conventional histology and scanning DNA cytophotometry. Of the 60 TC (96%), 58 exhibited euploid DKA histograms compared with only 20 (50%) of the 40 AC. The morphologic findings were related to t he patients' survival (median observation period, 9 years). Statistica l analyses disclosed the histologic type of disease (TC versus AC) and the DNA content of tumors (euploid versus aneuploid) to affect progno sis significantly (p < 0.001). Deaths resulting from tumor were exclus ively observed among patients with atypical (eight of 40) or DNA aneup loid carcinoids (eight of 22). Six patients were alive with persistent tumor manifestations 3 to 20 years after initial diagnosis, four with DNA diploid primary carcinoids. The presence of lymph node metastases alone was not associated with poor prognosis as long as the primary t umor or the related metastases showed a diploid DNA content. DNA cytop hotometry thus might be regarded as an adjunctive prognostic criterion in individual carcinoid cases.