Immunohistochemical detection of neuroendocrine differentiation in non-small-cell lung cancer and its clinical implications
Immunohistochemical detection of neuroendocrine differentiation in non-small-cell lung cancer and its clinical implications
复制标题
非小细胞肺癌神经内分泌分化的免疫组织化学检测及其临床意义
DOI：
10.1007/s00432-009-0544-1
复制
发表时间：
2009
影响因子：
3.6
通讯作者：
S. Takashima
中科院分区：
文献类型：
--
作者：
Y. Segawa;Saburo Takata;M. Fujii;I. Oze;Y. Fujiwara;Y. Kato;Atsuko Ogino;E. Komori;S. Sawada;M. Yamashita;R. Nishimura;N. Teramoto;S. Takashima
目的前瞻性评价神经内分泌(NE)分化在非小细胞肺癌(NSCLC)肿瘤中的临床意义。支气管镜活检标本接受常规病理检查，如果诊断为肺癌，则进行免疫组织化学研究。用嗜铬粒蛋白A、突触素、神经细胞黏附分子和Leu7来显示NE的分化。在这项研究中，149名受试者可被评估，其中130人被诊断为非小细胞肺癌(55例腺癌，50例鳞癌，24例非小细胞肺癌，1例典型类癌)。本研究未发现大细胞非小细胞肺癌。免疫组织化学显示，除典型类癌外，16%的NSCLC肿瘤有NE分化。根据NSCLC肿瘤的NE分化程度，非手术治疗的73例患者(阳性10例，阴性63例)和手术切除的43例患者(阳性8例，阴性35例)的无进展生存期相似。NE阳性的NSCLC患者非手术治疗和手术切除患者的总体生存率均较高，但差异无统计学意义(P分别为0.11和0.35)。然而，在这项研究中，这一特征的存在对预后的影响尚不能明确确定。
PurposeThe purpose of this study was to prospectively assess the clinical implications of neuroendocrine (NE) differentiation in non-small-cell lung cancer (NSCLC) tumors.MethodsThis study accrued subjects suspected to have lung cancer who underwent diagnostic bronchoscopy. Bronchoscopically-biopsied specimens were subjected to routine pathologic examination, and immunohistochemical studies were then performed if lung cancer was diagnosed. Chromogranin-A, synaptophysin, neural cell adhesion molecule, and Leu7 were used to demonstrate NE differentiation.ResultsA total of 280 subjects were accrued to this study over a period of 2 years. Among them, 149 subjects were assessable for this study, and 130 were diagnosed as having NSCLC tumors (55 adenocarcinomas, 50 squamous cell carcinomas, 24 NSCLCs not otherwise specified, and 1 typical carcinoid). Large cell NE carcinoma was not observed in this study. Immunohistochemically, NE differentiation was detected in 16% of NSCLC tumors excluding typical carcinoid. By status of NE differentiation of NSCLC tumors, progression-free survivals were similar in 73 patients undergoing non-surgical treatment (positive,n= 10; negative,n= 63) and 43 patients undergoing surgical resection (positive,n= 8; negative,n= 35), respectively. Overall survival of patients with NE-positive tumors appeared to be favorable both for those undergoing non-surgical treatment and those undergoing surgical resection, though the differences in survival were not significant (P= 0.11 and 0.35, respectively).ConclusionsNE differentiation was detected in 16% of NSCLC tumors in our study. However, the prognostic implications of the presence of this feature could not be clearly determined in this study.