目的:免疫组织化学(IHC)标志物已在小细胞肺癌(SCLC)的病理诊断中发挥作用,尤其是神经内分泌标志物有助于区分SCLC与其他肿瘤。该研究旨在评估不同IHC标志物在SCLC患者中的临床作用。
方法:将378例SCLC患者纳入研究,并进行回顾性分析。TTF-1,神经内分泌标志物(嗜铬粒蛋白,突触素,和CD56),和角蛋白标记(pancytokeratin,评估CK7和CK5/6)。
结果:CD56的表达最高(92.3%),其次是全细胞角蛋白(82.8%),TTF-1(74.8%),突触素(72.7%),嗜铬粒蛋白(55.6%),CK7(54.8%),和CK5/6(9%)。根据疾病的阶段,在所有标志物的表达中没有观察到差异。与未染色的患者相比,突触素表达的扩展疾病SCLC(ED-SCLC)患者对化疗的反应更高(p=0.01);另一方面,当表达CK7时,这些患者的化疗反应无显著差异(p=0.06).在限制性疾病SCLC(LD-SCLC)(p=0.02)和ED-SCLC(p=0.005)患者中,Pancytokeratin的表达与良好的生存率相关。同样,具有CD56染色的ED-SCLC患者的寿命比没有表达的患者更长(p=0.001)。LD-SCLC患者中突触素表达的缺乏(p=0.06)和ED-SCLC患者中TTF-1表达的缺乏(p=0.06)与更好的生存率相关。
结论:我们得出结论,IHC标记,经常用于SCLC的诊断,也可能用于临床决策,因为它们与疾病的预测和预后因素相关。
OBJECTIVE: Immunohistochemistry (IHC) markers have established a role in the pathological diagnosis of small cell lung cancer (SCLC) and especially neuroendocrine markers help to differentiate SCLC from other tumors. The study aimed to evaluate the clinical role of different IHC markers in SCLC patients.
METHODS: A total of 378 SCLC patients were enrolled in the study and analyzed retrospectively. TTF-1, neuroendocrine markers (chromogranin, synaptophysin, and
CD56), and keratin markers (pancytokeratin, CK7 and CK5/6) were assessed.
RESULTS: CD56 had the highest expression (92.3%) followed by pancytokeratin (82.8%), TTF-1 (74.8%), synaptophysin (72.7%), chromogranin (55.6%), CK7 (54.8%), and CK5/6 (9%). No differences were observed in the expression of all markers according to the stage of the disease. Extended disease SCLC (ED-SCLC) patients with synaptophysin expression had a higher response to chemotherapy compared to those without staining (p = 0.01); on the other hand, the chemotherapy response of these patients was not significantly different when they expressed CK7 (p = 0.06). Pancytokeratin expression was associated with favorable survival in both limited disease SCLC (LD-SCLC) (p = 0.02) and ED-SCLC (p = 0.005) patients. Similarly, ED-SCLC patients with
CD56 staining lived longer than those without expression (p = 0.001). The lack of synaptophysin expression in LD-SCLC patients (p = 0.06) and TTF-1 expression in ED-SCLC patients (p = 0.06) were correlated with better survival rates.
CONCLUSIONS: We conclude that IHC markers, used frequently in the diagnosis of SCLC, might also be used in clinical decision-making, since they are correlated with predictive and prognostic factors for the disease.