Wagner Patrick L, Kitabayashi Naoki, Chen Yao-Tseng, Saqi Anjali
Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, NY, USA.
Am J Clin Pathol. 2009 Mar;131(3):376-82. doi: 10.1309/AJCPYNPFL56POZQY.
Combined small cell lung carcinomas (CSCLCs) are small cell lung carcinomas (SCLCs) containing discrete areas of non-small cell morphologic components, found in up to 30% of SCLCs. We assessed immunophenotypic and genotypic similarity between the distinct morphologic constituents in 7 CSCLCs. Each was stained for synaptophysin, CD56, chromogranin, bcl-2, thyroid transcription factor (TTF)-1, cytokeratin 7, and PAX-5. Loss of heterozygosity (LOH) analysis was performed using markers on 3p (2 loci), 17p (3 loci), 17q (1 locus), and 22q (2 loci). The distinct components shared an identical immunophenotype in 6 cases; all were positive for synaptophysin and CD56 in both components. LOH analysis revealed shared loss of least 1 marker in every lesion, including LOH at 22q13 (characteristic of SCLC) in 5 tumors. The individual elements constituting CSCLCs are closely related in most cases despite their distinct morphologic appearances. The prevalent expression of synaptophysin and CD56 and loss of 22q13 suggest that these tumors are biologically closer to SCLC.
复合性小细胞肺癌（CSCLCs）是指包含非小细胞形态学成分离散区域的小细胞肺癌（SCLCs），在高达30%的SCLCs中可发现。我们评估了7例CSCLCs中不同形态学成分之间的免疫表型和基因相似性。每例均进行突触素、CD56、嗜铬粒蛋白、bcl-2、甲状腺转录因子（TTF）-1、细胞角蛋白7和PAX-5染色。使用位于3p（2个位点）、17p（3个位点）、17q（1个位点）和22q（2个位点）的标记进行杂合性缺失（LOH）分析。6例中不同成分具有相同的免疫表型；两个成分中突触素和CD56均呈阳性。LOH分析显示每个病变中至少有1个标记存在共同缺失，包括5例肿瘤中22q13（SCLC的特征性缺失）的LOH。构成CSCLCs的各个成分在大多数情况下尽管形态不同但密切相关。突触素和CD56的普遍表达以及22q13的缺失表明这些肿瘤在生物学上更接近SCLC。
