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Annals of Oncology Advance Access published online on September 16, 2009
Annals of Oncology, doi:10.1093/annonc/mdp334
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© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Somatostatin receptor tissue distribution in lung neuroendocrine tumours: a clinicopathologic and immunohistochemical study of 218 ‘clinically aggressive’ cases

L. Righi1,*, M. Volante1, V. Tavaglione1, A. Billè2, L. Daniele3, T. Angusti4, F. Inzani5, G. Pelosi6, G. Rindi5 and M. Papotti1

1 Division of Pathology, Department of Clinical & Biological Sciences, University of Turin at San Luigi Hospital, Orbassano, Torino
2 Division of Thoracic Surgery, Department of Clinical & Biological Sciences, University of Turin at San Luigi Hospital, Orbassano, Torino
3 Department of Biomedical Sciences and Human Oncology, University of Turin, Torino
4 Division of Nuclear Medicine, Department of Clinical & Biological Sciences, University of Turin at San Luigi Hospital, Orbassano, Torino
5 Department of Pathology and Laboratory Medicine, Division of Pathology, University of Parma, Parma
6 Diagnostic Histopathology Unit, European Institute of Oncology, University of Milan, Milan, Italy

* Correspondence to: Dr L. Righi, Department of Clinical & Biological Sciences, University of Turin at San Luigi Hospital, Regione Gonzole 10, 10043 Orbassano, Torino, Italy. Tel: +390119026018; Fax: +390119026753; E-mail: luisella.righi{at}unito.it

Background: The management of pulmonary neuroendocrine tumours (NETs), with special reference to clinically aggressive carcinoids and large-cell neuroendocrine carcinomas (LCNECs), is poorly standardised and data about somatostatin receptor (SSTR) expression or therapeutic guidelines for somatostatin analogue administration are still debated.

Materials and methods: A series of 218 lung NETs [24 metastatic typical carcinoids (TCs), 73 atypical carcinoids (ACs), 60 LCNECs and 61 surgically resected small-cell lung carcinomas] were investigated for SSTR types 2A and 3 tissue distribution using immunohistochemistry, in correlation with clinicopathologic parameters, outcome, scintigraphy and treatment.

Results: SSTRs were heterogeneously distributed with a significant progressive decrease from low- to high-grade forms. SSTR type 2A was strikingly overexpressed in metastatic TCs as compared with ACs and clinically benign TCs. SSTR tissue immunolocalization correlated with octreotide scintigraphy in 20 of 28 cases.

Conclusion: The immunohistochemical determination of SSTRs, with special reference to low-grade/intermediate-grade tumours, may assist the clinical approach with somatostatin analogue-based diagnostic and therapeutic procedures in clinically aggressive pulmonary NETs.

carcinoid, immunohistochemistry, lung, neuroendocrine tumours, scintigraphy, somatostatin receptor

Received for publication November 21, 2008. Revision received May 7, 2009. Accepted for publication May 27, 2009.


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