Yamamoto Junya, Ohshima Koichi, Ikeda Seiyou, Iwashita Akinori, Kikuchi Masahiro
Department of Pathology, Fukuoka University School of Medicine, Japan.
Hum Pathol. 2003 Nov;34(11):1108-15. doi: 10.1053/j.humpath.2003.07.010.
Esophageal small cell carcinoma (SmCC) is a rarer, more highly aggressive, and more rapidly growing neoplasm than esophageal squamous cell carcinoma (SqCC). SmCC and SqCC also differ in terms of chemotherapy of choice, response to therapy, and prognosis. Accordingly, it is important to differentiate the 2 carcinomas. We studied the histology and immunohistochemical profiles of 6 cases of esophageal SmCC to elucidate the correct diagnosis of this tumor. We performed immunohistochemical analysis antibodies against cytokeratins (CKAE1/AE3, CKCAM5.2, CK34betaE12, CK7, CK8, CK10/13, and CK19), epithelial membrane antigen (EMA), neural cell adhesion molecule (NCAM; CD56), neuron-specific enolase (NSE), chromogranin-A, S-100 protein, carcinoembryonic antigen (CEA), E-cadherin, thyroid transcription factor-1 (TTF-1), and p53. In 3 of the 6 SmCCs, heterogeneous components of in situ or invasive SqCC were observed. SqCC was found in the mucosa adjacent to the main SmCC, and the boundary between SmCC and SqCC was distinct, with no transitional features. Staining for NCAM, NSE, and chromogranin-A was positive in SmCCs, but negative in SqCCs. Both SmCCs and SqCCs were positive for CKAE1/AE3, CKCAM5.2, CK8, and EMA, but only SqCCs were positive for CK34betaE12 and CK19. Moreover, SmCCs containing SqCC components were positive for CEA and E-cadherin, whereas SmCCs without SqCC were negative. Our study suggests that NCAM and NSE are useful markers in diagnosing esophageal SmCC, and CK34betaE12 and CK19 are useful for differentiating SqCC components from SmCC.
食管小细胞癌（SmCC）是一种比食管鳞状细胞癌（SqCC）更罕见、侵袭性更强且生长更快的肿瘤。SmCC和SqCC在化疗选择、对治疗的反应及预后方面也存在差异。因此，区分这两种癌症很重要。我们研究了6例食管SmCC的组织学和免疫组化特征，以明确该肿瘤的正确诊断。我们使用了针对细胞角蛋白（CKAE1/AE3、CKCAM5.2、CK34βE12、CK7、CK8、CK10/13和CK19）、上皮膜抗原（EMA）、神经细胞黏附分子（NCAM；CD56）、神经元特异性烯醇化酶（NSE）、嗜铬粒蛋白A、S-100蛋白、癌胚抗原（CEA）、E-钙黏蛋白、甲状腺转录因子-1（TTF-1）和p53的抗体进行免疫组化分析。在6例SmCC中的3例中，观察到原位或浸润性SqCC的异质性成分。在主要SmCC相邻的黏膜中发现了SqCC，且SmCC与SqCC之间的边界清晰，无过渡特征。SmCC中NCAM、NSE和嗜铬粒蛋白A染色呈阳性，而SqCC中呈阴性。SmCC和SqCC对CKAE1/AE3、CKCAM5.2、CK8和EMA均呈阳性，但只有SqCC对CK34βE12和CK19呈阳性。此外，含有SqCC成分的SmCC对CEA和E-钙黏蛋白呈阳性，而无SqCC成分的SmCC呈阴性。我们的研究表明，NCAM和NSE是诊断食管SmCC的有用标志物，而CK34βE12和CK19有助于将SqCC成分与SmCC区分开来。
