Genetic Alteration in Carcinoid Tumors of the Lung

Kenji Sugio, MD,1,2 Toshihiro Osaki, MD,1 Tsunehiro Oyama, MD,1 Mitsuhiro Takenoyama, MD,1 Takeshi Hanagiri, MD,1 Masaru Morita, MD,1 Koji Yamazaki, MD,2 Akira Nagashima, MD,3 Hisashi Nakahashi, MD,4 Yoshihiko Maehara MD, 2, and Kosei Yasumoto, MD1

Surgically resected specimens of 13 carcinoid tumors of the lung including nine typical carcinoids and four atypical carcinoids, and eight salivary gland type carcinomas (six mucoepidermoid carcinomas and two adenoid cystic carcinomas) were analyzed regarding p53 expression, loss of heterozygosity (LOH) in chromosome 3p, 9p, and K-ras mutation. The overexpression of p53 was identified in four atypical carcinoid tumors, one mucoepidermoid carcinoma, and one adenoid cystic carcinoma, however, none of typical carcinoids showed p53 immunoreactivity. LOH in 3p14 was demonstrated in three of seven informative cases in all tumors. LOH in 9p was demonstrated in two of five informative cases in all tumors. Two of three cases with LOH at 3p14 had a poor prognosis, one of which also had LOH at 9p. No mutation of the K-ras gene was observed in any of these tumors. These data thus indicate that p53 overexpression might distinguish atypical carcinoid tumors from typical tumors and might therefore be useful as an adjunct modality in the differential diagnosis of pulmonary carcinoid tumors. The presence of LOH at 3p14 or 9p may thus help to identify lung cancer patients with a poor prognosis. (Ann Thorac Cardiovasc Surg 2003; 9: 149-154)

Key words: lung cancer, carcinoid, p53, 3p, 9p

From 1Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, 2Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 3Department of Chest Surgery, Kitakyushu Municipal Medical Center, Kitakyushu, and 4Department of Respiratory Surgery, Matsuyama Red Cross Hospital, Matsuyama, Japan

Received September 5, 2002; accepted for publication December 13, 2002
Address reprint requests to Kenji Sugio, MD: Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan.