Abstract：
The reporting of lung neuroendocrine neoplasms (NENs) according to the 2021 World Health Organisation (WHO) is based on mitotic count per 2 mm2, necrosis assessment and a constellation of cytological and immunohistochemical details. Accordingly, typical carcinoid and atypical carcinoid are low- to intermediate-grade neuroendocrine tumours (NETs), while large-cell neuroendocrine carcinoma (NEC) and small-cell lung carcinoma are high-grade NECs. In small-sized diagnostic material (cytology and biopsy), the noncommittal term of carcinoid tumour/NET not otherwise specified (NOS) and metastatic carcinoid NOS have been introduced with regard to primary and metastatic diagnostic settings, respectively. Ki-67 antigen, a well-known marker of cell proliferation, has been included in the WHO classification as a non-essential but desirable criterion, especially to distinguish NETs from high-grade NECs and to delineate the provisional category of carcinoid tumours/NETs with elevated mitotic counts (> 10 mitoses per mm2) and/or Ki-67 proliferation index (≥ 30%). However, a wider use of this marker in the spectrum of lung NENs continues to be highly reported and debated, thus witnessing a never-subsided attention. Therefore, the arguments for and against incorporating Ki-67 in the classification and clinical practice of these neoplasms are discussed herein in detail.
摘要：
根据2021年世界卫生组织（WHO），肺神经内分泌肿瘤（NEN）的报告基于每2mm2的有丝分裂计数，坏死评估以及一系列细胞学和免疫组织化学细节。因此，典型的类癌和非典型类癌是低级到中级神经内分泌肿瘤（NET），而大细胞神经内分泌癌（NEC）和小细胞肺癌是高级别NEC。在小型诊断材料（细胞学和活检）中，关于原发和转移诊断设置，引入了未另作说明的类癌肿瘤/NET（NOS）和转移性类癌NOS的非明确术语，分别。Ki-67抗原,一个众所周知的细胞增殖标志，已被列入世卫组织分类，作为一项非必要但可取的标准，特别是区分NETs和高级NECs,并划分有丝分裂计数升高(>10个有丝分裂/mm2)和/或Ki-67增殖指数(≥30%)的类癌肿瘤/NETs的临时类别。然而,在肺NEN谱中更广泛地使用这种标记继续被高度报道和争论，从而见证了从未平息的注意力。因此,本文详细讨论了支持和反对将Ki-67纳入这些肿瘤的分类和临床实践的论点。
