Cancer Res Treat. 2003 Jun;35(3):245-53. doi: 10.4143/crt.2003.35.3.245.
This study was performed to investigate the clinical features of large cell neuroendocrine carcinomas (LCNEC).
We retrospectively reviewed the histopathology and clinical information of 37 patients with LCNEC, diagnosed between June 1992 and May 2002 at the Severance Hospital, and performed immunohistochemical (IHC) staining.
The prevalence of LCNEC among primary lung cancers was 0.3%, 37 out of 13, 012 cases over a 10 year period. The mean age was 61+/-12 years old, with 34 (92%) males and 3 (8%) females. 30 patients smoked, with an average of 42 packs per year. A cough was the most frequent symptom. The tumor was located at the periphery of the lung in 24 cases (65%). Among the 30 cases that underwent surgery, 4 were diagnosed pathological stage IA, 11 IB, 1 IIB, 13 IIIA and 1 IIIB. The 7 clinically non-operable cases were IIIB in 3, and IV in 4. The positive rates of CD56, thyroid transcription factor-1 (TTF-1), chromogranin A, synaptophysin and 34betaE12 for tumor cells were 88.9, 55.6, 42.1, 31.6 and 21.1%, respectively, from the IHC staining. The median survival time and 5 year-survival rate were 24 months and 27%, respectively. The group that underwent surgery had a better prognosis than those that did not.
The positive rates for the tumor markers varied, but those of the CD56 and TFT-1 were the highest. The possibility of LCNEC needs to be evaluated for the following situations: small cell carcinomas located at the periphery and not responding chemotherapy, small cell carcinomas diagnosed by percutaneous needle aspiration, poorly differentiated non-mall cell carcinomas, with uncertain histologic type, and unclassified neuroendocrine tumor, etc.
本研究旨在探讨大细胞神经内分泌癌（LCNEC）的临床特征。
我们回顾性分析了 1992 年 6 月至 2002 年 5 月在 Severance 医院诊断的 37 例 LCNEC 患者的组织病理学和临床资料，并进行了免疫组织化学（IHC）染色。
LCNEC 在原发性肺癌中的患病率为 0.3%，13012 例中 37 例，10 年间患病率。平均年龄为 61+/-12 岁，其中 34 例（92%）为男性，3 例（8%）为女性。30 例患者吸烟，平均每年 42 包。咳嗽是最常见的症状。肿瘤位于肺外周 24 例（65%）。在 30 例接受手术的患者中，4 例病理分期为 IA，11 例 IB，1 例 IIB，13 例 IIIA，1 例 IIIB。7 例临床不可手术患者中，3 例为 IIIB，4 例为 IV 期。肿瘤细胞 CD56、甲状腺转录因子-1（TTF-1）、嗜铬粒蛋白 A、突触素和 34βE12 的阳性率分别为 88.9%、55.6%、42.1%、31.6%和 21.1%，免疫组织化学染色结果。中位生存时间和 5 年生存率分别为 24 个月和 27%。手术组预后优于未手术组。
肿瘤标志物的阳性率各不相同，但 CD56 和 TTF-1 的阳性率最高。对于以下情况需要评估是否存在 LCNEC：位于外周且对化疗无反应的小细胞癌、经皮针吸诊断的小细胞癌、分化差的非小细胞癌、组织学类型不确定的、未分类的神经内分泌肿瘤等。
