Center for Pulmonary Disease, Clinical Center, Kragujevac, Serbia.
Biomarkers. 2011 Jun;16(4):311-20. doi: 10.3109/1354750X.2011.560281.
Nonsmall cell lung cancers with neuroendocrine differentiation (NSCLC-ND) may demonstrate biologic behavior intermediate between NSCLC and small cell lung cancer (SCLC) with impact on prognosis.
We analyzed 116 consecutive patients with Stage III and IV NSCLC who were diagnosed and treated between 2001 and 2006. Using immuno-histochemical staining for neuron-specific enolase (NSE), chromogranin A (ChrA), and synaptophysin (Syn), 29 (25%) NSCLC-ND were identified.
Expression of NSE was present in 22.4%, ChrA in 15.5% and Syn in 14.8% of patients with NSCLC. Therapeutic response was significantly better in the NSCLC-ND group and specimens with > 30% neuroendocrine (NE)-differentiated tumor cells showed favourable therapeutic response (P < 0.05). Multivariate binary logistic regression showed that percentage of NE positive tumor cells was a significant independent prognostic factor associated with a favourable outcome. Receiver operating characteristic (ROC) curves and areas under ROC curves confirmed that percentage of NE-differentiated tumor cells could be useful prediction factor of therapeutic response. Moreover, according to percentage of NE-differentiated tumor cells, optimal cutoffs and related sensitivities and specificities were determined for each markers.
Advanced-stage NSCLC with NE tumor cells are clinically less aggressive tumors. Percentage of NE-differentiated tumor cells identifies patients with favourable therapy response to paclitaxel-cisplatin.
具有神经内分泌分化的非小细胞肺癌（NSCLC-ND）的生物学行为介于非小细胞肺癌和小细胞肺癌（SCLC）之间，对预后有影响。
我们分析了 2001 年至 2006 年间诊断和治疗的 116 例 III 期和 IV 期 NSCLC 连续患者。使用神经元特异性烯醇化酶（NSE）、嗜铬粒蛋白 A（ChrA）和突触素（Syn）的免疫组织化学染色，鉴定出 29 例（25%） NSCLC-ND。
在 NSCLC 患者中，NSE 的表达率为 22.4%，ChrA 为 15.5%，Syn 为 14.8%。NSCLC-ND 组的治疗反应明显更好，神经内分泌（NE）分化肿瘤细胞>30%的标本治疗反应良好（P<0.05）。多变量二元逻辑回归显示，NE 阳性肿瘤细胞的百分比是与良好预后相关的独立预后因素。接受者操作特征（ROC）曲线和 ROC 曲线下面积证实，NE 分化肿瘤细胞的百分比是治疗反应的有用预测因子。此外，根据 NE 分化肿瘤细胞的百分比，确定了每个标志物的最佳截断值及其相关的敏感性和特异性。
晚期 NSCLC 中具有 NE 肿瘤细胞的肿瘤在临床上侵袭性较小。NE 分化肿瘤细胞的百分比可识别对紫杉醇-顺铂治疗反应良好的患者。
