Neuroendocrine differentiation in non-small cell lung cancer and its relation to prognosis and therapy
Neuroendocrine differentiation in non-small cell lung cancer and its relation to prognosis and therapy
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DOI：
10.1111/j.1365-2559.2005.02047.x
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发表时间：
2005-02-01
期刊：
影响因子：
6.4
通讯作者：
Hasleton, PS
中科院分区：
文献类型：
--
作者：
Howe, MC;Chapman, A;Hasleton, PS
目的：组织病理学家报告了非小细胞肺癌（NSCLC）中多达三分之一的病例存在神经内分泌（NE）分化，并经常质疑其临床相关性。以往研究的结论并不一致。本文的目的是提供一个答案，通过检查一个大系列与文献的全面批评。方法与结果：对439例非小细胞肺癌进行免疫组化检测，采用抗嗜铬粒蛋白A （CGA）、突触素（SYN）和CD56/神经细胞粘附分子（NCAM）抗体。其中手术切除341例，化疗41例。结果与临床结果进行比较。36%的病例至少有一种NE标记物染色阳性。CGA阳性率为5.5%，SYN阳性率为16.5%，NCAM阳性率为28%。在手术治疗组和化疗组中，NE标记物的存在与生存没有关联。在后一组中，NE标记物与化疗反应之间也没有关联。结论：非小细胞肺癌中存在免疫组织化学检测的NE分化无预后意义。
Aims: Histopathologists report the presence of neuroendocrine (NE) differentiation in non-small cell lung carcinoma (NSCLC) in up to a third of cases and are often questioned about its clinical relevance. The conclusions of previous studies have been inconsistent. This paper aims to provide an answer by examining a large series together with a comprehensive critique of the literature.Methods and results: Four hundred and thirty-nine cases of NSCLC were examined, immunohistochemically, using antibodies to chromogranin A (CGA), synaptophysin (SYN) and CD56/neural cell adhesion molecule (NCAM). Three hundred and forty-one cases had been treated with surgical resection and the remainder with chemotherapy. The results were compared with clinical outcome. Thity-six percent of cases had positive staining for at least one NE marker. CGA was positive in 5.5% of cases, SYN in 16.5% and NCAM in 28%. There was no association between the presence of NE markers and survival in either the surgically treated group or the chemotherapy-treated group. There was also no association between NE markers and response to chemotherapy in the latter group.Conclusions: The presence of immunohistochemically detected NE differentiation in NSCLC is not of prognostic significance.