肺大细胞神经内分泌癌中耐药蛋白表达的免疫组织化学研究

Immunohistochemical study of the expression of drug-resistant proteins in large cell neuroendocrine carcinoma of the lung.

作者信息

Okada Daisuke, Kawamoto Masashi, Koizumi Kiyoshi, Tanaka Shigeo, Fukuda Yuh

机构信息

Department of Pathology, Nippon Medical School, Tokyo, Japan.

出版信息

Jpn J Thorac Cardiovasc Surg. 2003 Jul;51(7):272-6. doi: 10.1007/BF02719377.

DOI:10.1007/BF02719377

PMID:12892456

Abstract

OBJECTIVES

In 1999, the World Health Organization categorized pulmonary large cell neuroendocrine carcinoma as a variant of large cell carcinoma. However, an optimal treatment for large cell neuroendocrine carcinoma has not been established yet. Recently, multimodality therapy combining both surgery and adjuvant chemotherapy has been reported as a useful treatment for large cell neuroendocrine carcinoma, but the effect of chemotherapy on it has not yet been fully investigated. Thus, we evaluated immunohistochemical data of the expression of drug-resistant proteins in large cell neuroendocrine carcinoma.

METHODS

We identified 10 large cell neuroendocrine carcinomas (1.2%) out of 850 primary lung cancers that had been surgically resected. We examined the immunohistochemical staining of three drug-resistant proteins, namely, P-glycoprotein, metallothionein and glutathione S-transferase-pi to compare large cell neuroendocrine carcinoma with other histological types of lung cancer.

RESULTS

The mean tumor cell positivity rates for P-glycoprotein, metallothionein and glutathione S-transferase-pi in large cell neuroendocrine carcinoma were 0%, 2.4 +/- 3.6% and 35.0 +/- 37.5%, respectively. The positivity rates for P-glycoprotein and glutathione S-transferase-pi were significantly lower than those in adenocarcinoma (P = 0.0003, P = 0.0009). The positivity rate for glutathione S-transferase-pi was also lower than that in squamous cell carcinoma (P = 0.0387). These drug-resistant proteins showed similar expression pattern in both large cell neuroendocrine carcinoma and small cell carcinoma except glutathione S-transferase-pi.

CONCLUSION

Immunohistochemical expression of drug-resistant proteins in large cell neuroendocrine carcinoma was lower than that in adenocarcinoma and squamous cell carcinoma, and differences exist in drug-resistance between large cell neuroendocrine carcinoma and small cell carcinoma.

摘要

目的

1999年，世界卫生组织将肺大细胞神经内分泌癌归类为大细胞癌的一种变体。然而，大细胞神经内分泌癌的最佳治疗方法尚未确立。最近，有报道称手术联合辅助化疗的多模式治疗对大细胞神经内分泌癌是一种有效的治疗方法，但化疗对其的影响尚未得到充分研究。因此，我们评估了大细胞神经内分泌癌中耐药蛋白表达的免疫组化数据。

方法

我们在850例接受手术切除的原发性肺癌中鉴定出10例大细胞神经内分泌癌（1.2%）。我们检测了三种耐药蛋白，即P-糖蛋白、金属硫蛋白和谷胱甘肽S-转移酶π的免疫组化染色，以比较大细胞神经内分泌癌与其他组织学类型的肺癌。

结果

大细胞神经内分泌癌中P-糖蛋白、金属硫蛋白和谷胱甘肽S-转移酶π的平均肿瘤细胞阳性率分别为0%、(2.4±3.6)%和(35.0±37.5)%。P-糖蛋白和谷胱甘肽S-转移酶π的阳性率显著低于腺癌（P = 0.0003，P = 0.0009）。谷胱甘肽S-转移酶π的阳性率也低于鳞状细胞癌（P = 0.0387）。除谷胱甘肽S-转移酶π外，这些耐药蛋白在大细胞神经内分泌癌和小细胞癌中的表达模式相似。