肺神经内分泌肿瘤的临床病理特征及其分级与预后的关系  

The clinicopathological features of pulmonary neuroendocrine carcinoma and relationship between its pathologic grading and prognosis

作　　者：曹静[1] 吕志排[1] 曾宪旭[1] 雷冬梅[1] 张威[1] 郝志伟[1] 

机构地区：[1]郑州大学第三附属医院病理科,450052

出　　处：《中华实验外科杂志》2015年第8期1795-1797,共3页Chinese Journal of Experimental Surgery

摘　　要：目的探讨肺神经内分泌癌的临床病理特征及其分级和预后的关系。方法复习166例肺神经内分泌癌的临床病理资料，分析其神经内分泌免疫标记嗜铬素A（CgA）、突触素（Syn）、CD56表达的阳性率。并参照2010年版世界卫生组织（WHO）消化系统胃肠胰神经内分泌肿瘤分级标准对肺神经内分泌癌进行分级，分别比较肿瘤组织分型及新分级与预后的相互关系。结果典型类癌（TC）和不典型类癌（AC）患者标本CsA、Syn、CD56的表达相同（P〉0．05），阳性率分别为90．7％、91．3％、87．5％及63．1％、83．3％、89．4％。而在小细胞癌（SCLC）和大细胞神经内分泌癌（LCNEC）中表达不同（P〈0．05），阳性率分别为38．1％、82．4％、90．5％及33．3％、76．9％、66．7％。肺神经内分泌癌的组织分型及新分级均与预后相关（P〈0．05）。TC预后最好，其余依次为AC、LCNEC、SCLC。NETG1预后最好，其余依次为NETG2、NECG3。结论肺神经内分泌癌依据Ki-67增殖指数进行分级，能较准确的反映预后。Objective To investigate the elinieopathological features of pulmonary neuroendocrine carcinoma and correlation between its pathologic stage and prognosis. Methods The expression of neuro- endocrine immunohistochemical markers such as chromogranin A （CgA）, synaptic element （Syn） and CD56 were analyzed in 166 patients. According to the 2010 World Health Organization （WHO） classifica- tion and staging system of gastroenteropancreatic NENs, pulmonary neuroendocrine carcinoma were classi- fied into different pathologic grading. The relationship between histological classification, pathologic grad- ing and prognosis were compared with respectively. Results The expression of CgA, Syn and CD56 in typical carcinoid （TC） specimen were same with in atypical carcinoid （ AC, P 〉 0. 05 ）, the positive rates were 90. 7% , 91.3% , 87.5% and 63. 1% , 83. 3% , 89.4% respectively, while were different in small cell lung cancer （ SCLC ） and large cell neuroendocrine carcinoma （ LCNEC ） specimen （ P 〈 0. 05 ）, the positive rateswere 38. 1%, 82. 4%, 90. 5% and 33. 3%, 76. 9%, 66. 7% respectively. Histological classification and pathologic grading had relation with prognosis （ P 〈 0. 05 ）. The prognosis of TC is the best, followed by AC, LCNEC, SCLC. Similarly, NET G1 the best prognosis, followed by NET G2, NEC G3. Conclusion On the basis of Ki - 67 proliferation index for pathologic stage was useful for long - term prognostic value.

关 键 词：肺神经内分泌癌 临床病理特征 预后 

分 类 号：R734.2[医药卫生—肿瘤]