Miremadi A, Pinder S E, Lee A H S, Bell J A, Paish E C, Wencyk P, Elston C W, Nicholson R I, Blamey R W, Robertson J F, Ellis I O
Department of Histopathology, Nottingham City Hospital, Nottingham, UK.
Histopathology. 2002 Mar;40(3):215-22. doi: 10.1046/j.1365-2559.2002.01336.x.
Neuroendocrine differentiation has been detected, and its prognostic value studied, in a number of common human carcinomas. To date there are few detailed studies examining its relevance in breast carcinoma. In this study we evaluate the frequency and prognostic importance of neuroendocrine differentiation in breast adenocarcinoma.
The presence of neuroendocrine differentiation, defined as positive reactivity for three markers, neuron-specific enolase (NSE), chromogranin A and/or synaptophysin, has been evaluated in 99 patients with primary operable breast cancer using standard immunocytochemical techniques. A consecutive cohort of patients were selected from the Nottingham/Tenovus series. Comprehensive patient and tumour records have been maintained, and patients were followed up according to a defined protocol. Eighteen cases were positive for NSE, 10 for chromogranin A and 13 for synaptophysin. Eleven percent were positive with more than one neuroendocrine marker. No significant association was found between neuroendocrine differentiation and tumour size, grade, stage or the prevalence of vascular invasion. There was no significant difference in either overall or disease-free survival between patients with or without neuroendocrine differentiation.
In this study we confirm that neuroendocrine differentiation can be identified in a subset (10-18%) of human breast carcinomas. This phenomenon appears to have no relationship to established prognostic factors or patient outcome.
在多种常见人类癌症中已检测到神经内分泌分化，并对其预后价值进行了研究。迄今为止，很少有详细研究探讨其在乳腺癌中的相关性。在本研究中，我们评估了乳腺腺癌中神经内分泌分化的频率及其预后重要性。
采用标准免疫细胞化学技术，对99例原发性可手术乳腺癌患者的神经内分泌分化情况进行了评估，神经内分泌分化定义为对三种标志物神经元特异性烯醇化酶（NSE）、嗜铬粒蛋白A和/或突触素呈阳性反应。连续选取诺丁汉/特诺福斯系列中的患者。保存了完整的患者和肿瘤记录，并按照既定方案对患者进行随访。18例NSE呈阳性，10例嗜铬粒蛋白A呈阳性，13例突触素呈阳性。11%的患者有一种以上神经内分泌标志物呈阳性。未发现神经内分泌分化与肿瘤大小、分级、分期或血管侵犯发生率之间存在显著关联。有或无神经内分泌分化的患者在总生存期或无病生存期方面均无显著差异。
在本研究中，我们证实神经内分泌分化可在一部分（10 - 18%）人类乳腺癌中被识别。这种现象似乎与既定的预后因素或患者预后无关。
