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Abstract：
To understand the pathogenesis of high-grade neuroendocrine carcinoma (HGNEC), we examined the histopathology and immunoreactivity against adenocarcinoma (AD), squamous cell carcinoma (SQ), and neuroendocrine markers in 34 cases with combined HGNEC. The 5 year overall survival rates of patients with combined small cell carcinoma (SCC) (n = 9) and combined large cell neuroendocrine carcinoma (LCNEC) (n = 25) were 33% and 75%, respectively (P = 0.011). Most of the patients were male (94%), smokers (94%), and had tumors located in the peripheral (94%) and upper lobe (65%) of the lung. Histopathologically, non-HGNEC components were predominantly ADs (65%) followed by SQs (26%). In combined HGNEC and AD, a lepidic AD component was found in 12 cases (48%). For the HGNEC components of combined HGNEC and AD, the incidence of positivity of thyroid transcription factor-1 (TTF-1) (8G7G3/1) and TTF1 (SPT24) were 64% and 91%, respectively. For HGNEC components of combined HGNEC and SQ, the incidence of positivity of 34βE12 and p63 were 22% and 11%, respectively. In conclusion, 48% of combined HGNEC and AD cases had a lepidic AD component, suggesting that HGNEC can develop in association with pre-existing AD. AD markers, but not SQ markers, were frequently retained through development of the HGNEC component.
摘要：
了解高级别神经内分泌癌（HGNEC）的发病机制，我们检查了腺癌（AD）的组织病理学和免疫反应性，鳞状细胞癌（SQ），34例合并HGNEC的神经内分泌标志物。合并小细胞癌（SCC）（n=9）和合并大细胞神经内分泌癌（LCNEC）（n=25）患者的5年总生存率分别为33％和75％。分别为(P=0.011)。大部分患者为男性（94%），吸烟者（94%）肿瘤位于肺的外周（94％）和上叶（65％）。组织病理学,非HGNEC成分主要是AD（65%），其次是SQs（26%）。结合HGNEC和AD，在12例（48％）中发现了抗体AD成分。对于组合的HGNEC和AD的HGNEC组件，甲状腺转录因子-1(TTF-1)(8G7G3/1)和TTF1(SPT24)阳性率分别为64%和91%,分别。对于组合的HGNEC和SQ的HGNEC组件，34βE12和p63阳性发生率分别为22%和11%，分别。总之,48％的HGNEC和AD合并病例具有瘦素AD成分，表明HGNEC可以与预先存在的AD相关。AD标记,但不是SQ标记，经常通过开发HGNEC组件而保留。
