Iyoda Akira, Baba Masayuki, Hiroshima Kenzo, Saitoh Hiroko, Moriya Yasumitsu, Shibuya Kiyoshi, Iizasa Toshihiko, Horiuchi Fumio, Ohwada Hidemi, Fujisawa Takehiko
Department of Thoracic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba 260-8670, Japan.
Oncol Rep. 2004 Feb;11(2):285-8.
The World Health Organization (WHO) categorized large cell neuroendocrine carcinoma (LCNEC) as a variant of large cell carcinoma in 1999. However, cytologic features of these tumors have not yet been adequately characterized. The cytologic features of 24 cases of LCNEC were analyzed and compared to the features of 16 cases of classic large cell carcinoma (CLCC). Giant cells, neutrophils and cytophagocytosis were observed more frequently in CLCC than in LCNEC (p<0.05), whereas the unclear border of tumor cells was seen more frequently in LCNEC (p<0.05). The presence of nuclear atypia, such as anisokaryosis, nuclear budding, irregularity of nuclear margins, and multinucleation (having three or more nuclei), was observed less frequently in LCNEC. Characteristic arrangements of tumor cells, such as rosette formation, and palisading, were observed only in LCNEC cases. In morphometric studies, the nuclear areas, cytoplasmic areas, and nuclear rotundity ratios were significantly higher in CLCC cells than in LCNEC cells (p<0.05). However, N/C ratios were significantly higher in LCNEC than in CLCC. LCNEC cells have less nuclear atypia than CLCC cells, and have the characteristic arrangements of tumor cells, such as palisading and rosette. It is possible to preoperatively differentiate LCNEC from CLCC by careful cytologic characterization.
1999年，世界卫生组织（WHO）将大细胞神经内分泌癌（LCNEC）归类为大细胞癌的一种变体。然而，这些肿瘤的细胞学特征尚未得到充分描述。分析了24例LCNEC的细胞学特征，并与16例经典大细胞癌（CLCC）的特征进行了比较。CLCC中巨细胞、中性粒细胞和细胞吞噬现象的观察频率高于LCNEC（p<0.05），而LCNEC中肿瘤细胞边界不清的情况更为常见（p<0.05）。LCNEC中核异型性的出现频率较低，如核大小不等、核出芽、核边缘不规则和多核（有三个或更多核）。仅在LCNEC病例中观察到肿瘤细胞的特征性排列，如菊形团形成和栅栏状排列。在形态计量学研究中，CLCC细胞的核面积、细胞质面积和核圆形度比率显著高于LCNEC细胞（p<0.05）。然而，LCNEC的N/C比率显著高于CLCC。LCNEC细胞的核异型性比CLCC细胞少，并且具有肿瘤细胞的特征性排列，如栅栏状和菊形团。通过仔细的细胞学特征描述，术前有可能将LCNEC与CLCC区分开来。
