肺癌组织神经内分泌分化的免疫组化研究

Immunohistochemical Study of Neuroendocrine Differentiation in Lung Carcinoma

目的 了解非小细胞肺癌 (NSCLC)的神经内分泌 (NE)分化特征 .方法 采用SP超敏免疫组化法对 12 0例NSCLC和 2 4例SCLC进行了神经烯醇化酶 (NSE)、嗜铬粒素A(CgA)和突触素 (SYN)的检测 .并与各型肺癌的分型及分化程度进行了相关分析 .结果 三种神经内分泌标记物均为胞浆染色 .NSE和SYN的阳性染色部分为弥漫性 ,部分为灶性分布 .而CgA均为小灶性分布 .在NSCLC中CgA和SYN阳性的病例NSE均阳性 ,除 2例外CgA阳性的SYN均阳性 .NSE的阳性染色除分布癌细胞外 ,部分间质亦可见非特异染色 .在 12 0例NSCLC中 ,5 2 .5 %表达NSE ,9.2 %表达CgA ,2 8.3%表达SYN .在SCLC中 10 0 %表达NSE ,33.3%表达CgA ,5 4.2 %表达SYN .三种标记物的阳性率与NSCLC的分型及分化程度、病人的年龄及性别均无明显关系 (p >0 .0 5 ) .结论 NSE敏感性较高 ,特异性较低 ,而CgA和SYN特异性较高 ,敏感性较低 ,故在NSCLC的临床诊断NE分化时 ,须三者结合应用 .

Objective To investigate the immunohistochemical diagnosis of neuroendocrine differentiation in surgically resected NSCLC.Methods Tumors from 120 patients with NSCLC and 24 patients with SCLC were analyzed by SP immunohistochemical method with antibodies to neuron specific enolase (NSE),chromogranin A (CgA) and synaptophysin (SYN). The correlation of their expression with the histological type and tumor differentiation was investigated.Result The expression of three markers was in cytoplasm. Some expression of NSE and SYN were diffused distribution and others were local distribution. All expression of CgA was local distribution. The expression of NSE was detected in all NSCLC patients with CgA and SYN positive staining. The expression of SYN was found in all sections in which CgA was positive except 2 cases. The positive rate of three markers in NSCLC wes respectively: NSE 52.5%; CgA 9.2%; SYN 28.3%. The positive rate of three markers in SCLC was respectively: NSE 100%; CgA 33.3%; SYN 54.2%. The expression of three markers was no significantly related to sex,age of patients,the histological type and differentiation (p>0.05).Conclusions The marker of NSE had higher sensitivity and lower speciality,however,CgA and SYN had higher speciality and lower sensitivity. So the use of three markers of CgA,SYN and NSE together might be recommended to diagnose the neuroendocrine differentiation of NSCLC.