CAJ | 학술논문

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CgA、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.NET G1预后最好,其余依次为NET G2、NEC G3.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.
목적 탐토폐신경내분비암적림상병리특정급기분급화예후적관계.방법 복습166례폐신경내분비암적림상병리자료,분석기신경내분비면역표기기락소A(CgA)、돌촉소(Syn)、CD56표체적양성솔.병삼조2010년판세계위생조직(WHO)소화계통위장이신경내분비종류분급표준대폐신경내분비암진행분급,분별비교종류조직분형급신분급여예후적상호관계.결과 전형유암(TC)화불전형유암(AC)환자표본CgA、Syn、CD56적표체상동(P＞0.05),양성솔분별위90.7％、91.3％、87.5％급63.1％、83.3％、89.4％.이재소세포암(SCLC)화대세포신경내분비암(LCNEC)중표체불동(P＜0.05),양성솔분별위38.1％、82.4％、90.5％급33.3％、76.9％、66.7％.폐신경내분비암적조직분형급신분급균여예후상관(P＜0.05).TC예후최호,기여의차위AC、LCNEC、SCLC.NET G1예후최호,기여의차위NET G2、NEC G3.결론 폐신경내분비암의거Ki-67증식지수진행분급,능교준학적반영예후.
Objective To investigate the clinicopathological features of pulmonary neuroendocrine carcinoma and correlation between its pathologic stage and prognosis.Methods The expression of neuroendocrine 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) classification and staging system of gastroenteropancreatic NENs,pulmonary neuroendocrine carcinoma were classified into different pathologic grading.The relationship between histological classification,pathologic grading 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.