Neuroendocrine marker staining pattern categorization of small‐sized pulmonary large cell neuroendocrine carcinoma
Neuroendocrine marker staining pattern categorization of small‐sized pulmonary large cell neuroendocrine carcinoma
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小尺寸肺大细胞神经内分泌癌神经内分泌标志物染色模式分类
DOI：
10.1111/1759-7714.13202
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发表时间：
2019
期刊：
影响因子：
2.9
通讯作者：
Maniwa Yoshimasa
中科院分区：
文献类型：
--
作者：
Minami Kazuhiro;Tanaka Yugo;Ogawa Hiroyuki;Jimbo Naoe;Nishio Wataru;Yoshimura Masahiro;Itoh Tomoo;Maniwa Yoshimasa
本研究的目的是根据神经内分泌标志物的免疫组织化学染色方法，确定肺大细胞神经内分泌癌患者预后良好或不良的亚型，并与小细胞肺癌进行比较。方法2001年1月至2017年12月，在所有接受肺大细胞神经内分泌癌和小细胞肺癌切除的患者中，选择病理肿瘤直径为≤30 mm(定义为小肿瘤)并完全切除加淋巴清扫的患者。根据3种神经内分泌标志物(嗜铬粒素A、突触素和神经细胞黏附分子)的免疫组织化学染色方式，将小型LCNEC(SLCNEC)患者分为两组，并与小型小细胞肺癌(SSCLC)进行比较。48例sLCNEC患者中，21例为三种神经内分泌标志物均阳性的小型三联阳性组(STP)，27例为三种神经内分泌标志物均不阳性的小型非三联阳性组(SNTP)。SNTP组的淋巴结转移率明显低于STP组和sSCLC组。两组总体生存率无显著差异，但无复发生存率(RFS)和肿瘤特异性生存率(TSS)明显低于SNTP组。多因素分析显示，STP和sSCLC是影响RFS和TSS的独立预后因素。结论SNTP组预后较好，STP组预后较差。STP和sSCLC的临床病理特征有一些相似之处。
BackgroundThe aim of this study was to identify subgroups with good or bad prognosis in patients with pulmonary large cell neuroendocrine carcinoma (LCNEC) based on immunostaining patterns with neuroendocrine markers and compare them with small cell lung carcinoma (SCLC).MethodsFrom January 2001 to December 2017, of all patients with resected LCNEC and SCLC, we selected patients whose pathological tumor sizes were ≤30 mm in diameter (defined as small‐sized tumors) and who underwent complete resection with lymphadenectomy. We classified patients with small‐sized LCNEC (sLCNEC) into two subgroups based on immunostaining patterns with three neuroendocrine markers (chromogranin A, synaptophysin, and NCAM) and compared them to small‐sized SCLC (sSCLC).ResultsA total of 48 patients with sLCNEC and 39 patients with sSCLC were enrolled. Of 48 patients with sLCNEC, 21 were categorized as the small‐sized triple‐positive group (sTP), whose patients were positive for the three neuroendocrine markers, and 27 patients were categorized as the small‐sized nontriple‐positive group (sNTP), whose patients were not positive for all three neuroendocrine markers. The percentage of lymph node metastasis was significantly lower in sNTP than in sTP and sSCLC. There was no significant difference in overall survival, but recurrence‐free survival (RFS) and tumor‐specific survival (TSS) were significantly poorer in sTP and sSCLC than in sNTP. Multivariate analysis revealed sTP and sSCLC were independent prognostic factors for poorer RFS and TSS than those of sNTP.ConclusionsThe sNTP subgroup had a good prognosis and the sTP subgroup a poor prognosis. There were some similarities in clinicopathological features between sTP and sSCLC.