Sica Gabriel, Wagner Patrick L, Altorki Nassar, Port Jeffrey, Lee Paul C, Vazquez Madeline F, Saqi Anjali
Department of Pathology, Weill Cornell Medical Center, New York, NY, USA.
Arch Pathol Lab Med. 2008 Dec;132(12):1889-95. doi: 10.5858/132.12.1889.
Lung and breast carcinomas are among the most prevalent cancers. Advances in cancer therapies can provide survival benefit and be potentially curative, even in metastatic disease. Due to the high prevalence of these carcinomas, it is not unusual to encounter lung nodule(s) in a patient with breast carcinoma, and distinguishing between primary and metastatic disease is critical for management/treatment. Occasionally neuroendocrine differentiation is present in breast carcinoma, making its distinction from pulmonary/nonpulmonary neuroendocrine tumors in the lung difficult.
To assess estrogen and progesterone receptor expression in the entire spectrum of pulmonary neuroendocrine tumors.
Seventy-one neuroendocrine neoplasms including typical carcinoids (42), atypical carcinoids (7), small cell carcinomas (14), large cell neuroendocrine carcinomas (2), and combined small cell carcinomas (6) were evaluated for estrogen and progesterone receptors. Mammary and non-small cell lung carcinomas were also stained for comparison.
The entire spectrum of neuroendocrine neoplasms demonstrated focal to diffuse estrogen (typical carcinoid, 23; atypical carcinoid, 6; small cell carcinoma, 8; large cell neuroendocrine carcinoma, 2; combined small cell carcinoma, 4) and progesterone (typical carcinoid, 11; atypical carcinoid, 2; small cell carcinoma, 7; large cell neuroendocrine carcinoma, 0; combined small cell carcinoma, 2) expression. There was no correlation between sex and estrogen/progesterone status. Estrogen and progesterone staining were also noted in endothelial cells. Relative to neuroendocrine carcinomas, mammary carcinomas expressed estrogen and progesterone more frequently. Non-small cell carcinomas had greater and similar immunoreactivity for estrogen and progesterone, respectively.
Although estrogen and progesterone receptor staining is frequently associated with breast and gynecologic primaries, it can also be observed in "nontarget" organs. Therefore, presence of estrogen and/or progesterone expression in neuroendocrine tumors involving the lung should not exclude a primary pulmonary neoplasm.
肺癌和乳腺癌是最常见的癌症。癌症治疗的进展可以带来生存益处，甚至对转移性疾病也可能具有潜在的治愈效果。由于这些癌症的高发病率，乳腺癌患者出现肺结节并不罕见，区分原发性和转移性疾病对于管理/治疗至关重要。偶尔乳腺癌会出现神经内分泌分化，这使得其与肺部的肺/非肺神经内分泌肿瘤难以区分。
评估肺神经内分泌肿瘤全谱系中雌激素和孕激素受体的表达情况。
对71例神经内分泌肿瘤进行评估，包括典型类癌（42例）、非典型类癌（7例）、小细胞癌（14例）、大细胞神经内分泌癌（2例）和混合性小细胞癌（6例），检测其雌激素和孕激素受体。同时对乳腺癌和非小细胞肺癌进行染色以作比较。
神经内分泌肿瘤全谱系均显示出局灶性至弥漫性的雌激素（典型类癌23例、非典型类癌6例、小细胞癌8例、大细胞神经内分泌癌2例、混合性小细胞癌4例）和孕激素（典型类癌11例、非典型类癌2例、小细胞癌7例、大细胞神经内分泌癌0例、混合性小细胞癌2例）表达。性别与雌激素/孕激素状态之间无相关性。在内皮细胞中也观察到雌激素和孕激素染色。相对于神经内分泌癌，乳腺癌更频繁地表达雌激素和孕激素。非小细胞癌对雌激素和孕激素分别具有更强且相似的免疫反应性。
虽然雌激素和孕激素受体染色通常与乳腺和妇科原发性肿瘤相关，但也可在“非靶”器官中观察到。因此，累及肺部的神经内分泌肿瘤中存在雌激素和/或孕激素表达不应排除原发性肺肿瘤。
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