肺小细胞癌细胞异质性电镜和免疫组织化学观察

ELECTRON MICROSCOPIC AND IMMUNOHISTOCHEMICAL OBSERVATION ON CELLULAR HETEROGENEITY OF LUNG SMALL CELL CARCINOMA

采用电镜及免疫组织化学方法对３２例肺小细胞癌细胞异质性及组织学起源等问题进行了研究。结果提示：肺小细胞癌主要由神经内分泌分化型细胞组成，其中间杂少数鳞状细胞分化型，腺分化型及未分化型细胞，显示多向性分化和细胞异质性。未分化型细胞可能是起源细胞。免疫组织化学染色表明嗜铬蛋白Ａ具有较强特异性，为首选免疫标记，与神经特异性烯醇化酶、角蛋白、癌胚抗原联合使用。

The cellular heterogeneity and histologic origin of 32 cases of lung small cell carcinoma (LSCC) were studied by electron microscopic and immunohistochemical technique. The results indicated that LSCC was largely composed of neuroendocrine-differentiated cells, in which a few of squamo-differentiated cells, adeno-differentiated cells and undifferentiated cells were interspersed, showing the characteristies of multidifferentiation and cellular heterogeneity. LSCC may be originated from undifferentiated cells. Immunohistochemical stain exhibited that chromograin A was a high specific immunohistochemical marker for LSCC, and therefore was an antibody of first choice. The use of chromograin A with NSE, KT and CEA was able to improve the accuracy in diagnosing LSCC.