Ishida T, Nishino T, Oka T, Yasumoto K, Sugimachi K, Hara N, Ohta M
Second Department of Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
J Surg Oncol. 1989 Mar;40(3):188-93. doi: 10.1002/jso.2930400312.
Thirty-three patients with small cell carcinoma of the lung were treated surgically, and immunohistochemistry of the cell differentiations was examined in detail. The overall 5-year survival rate was 38% and the rates in patients with stage I or stage III were 57% and 11%, respectively (P less than 0.05). Survival rates in patients with the oat cell type and intermediate type were 24% and 44%, respectively, but with no significant difference. This carcinoma seemed to originate from primitive multipotential stem cells, i.e., those of a neuroendocrine or epithelial nature. Histochemically and immunohistochemically, argyrophilic granules and neuron-specific enolase, neuroendocrine markers, were detected more frequently in the oat cell type rather than in the intermediate type. In contrast, keratin, epithelial membrane antigen, and carcinoembryonic antigen, epithelial origin markers, were present more frequently in the intermediate type than in oat cell type. However, the difference was significant only in case of detection of argyrophilic granules and the carcinoembryonic antigen (P less than 0.05). Our current recommendation is that surgical resection should be done in the earlier stage in both subtypes. A more favorable prognosis can be expected when adjuvant chemotherapy is prescribed.
33例肺小细胞癌患者接受了手术治疗，并对细胞分化进行了详细的免疫组织化学检查。总体5年生存率为38%，I期和III期患者的生存率分别为57%和11%（P<0.05）。燕麦细胞型和中间型患者的生存率分别为24%和44%，但无显著差异。这种癌似乎起源于原始多能干细胞，即神经内分泌或上皮性质的干细胞。在组织化学和免疫组织化学方面，嗜银颗粒和神经元特异性烯醇化酶（神经内分泌标志物）在燕麦细胞型中比在中间型中更频繁地被检测到。相反，角蛋白、上皮膜抗原和癌胚抗原（上皮起源标志物）在中间型中比在燕麦细胞型中更频繁地出现。然而，仅在嗜银颗粒和癌胚抗原检测方面差异具有统计学意义（P<0.05）。我们目前的建议是，两种亚型均应在早期进行手术切除。当进行辅助化疗时，可以预期有更良好的预后。
